Placebo Journal - Medical Humor With A Purpose

I enjoyed a recent piece by Kevin O’Reilly in the American Medical News about medical errors and the emotional toll it takes on physicians. I recommend you read it if you can, but the basic premise is how a small physician support group got started in Boston to help other doctors when bad things happen on their jobs. Very few people realize the heartache physicians feel when they do make a mistake. In the politically correct world we live in, doctors are not supposed to have a “God” syndrome, yet we are also not allowed to be human and make any errors either; a standard that no one can live up to. Personally, I believe too many physicians deal with these issues by themselves and it is a major cause of early retirement, burnout and suicide in our profession.

Dr. Shapiro, in the article, stated, “In our (medical) culture, it’s not seen as normal to be emotionally affected by your work”. She’s right. As the title of the last Placebo Journal stated, “Disease is my business…..and it ain’t pretty!” We see bad things everyday. I see patients that I have known for years die regularly. Add to this mix some of the things going on in medicine today (lawsuits, pay cuts, physician profiling) and you have a recipe for disaster.

In the article, the support group mentioned seemed more to me like a decompression team that met right after each bad event (mostly surgical). All members of the team including any and all the medical staff were invited. In fact, the crux of the piece made it seem like that dealing with the emotional aftermath after an acute and bad event was all they really did. This sounds great but I want more. There needs places where doctors feel safe to laugh and joke about their job. They need a place to decompress about everything and not just the bad event that happened in the OR. The loss of doctors’ lounges over the years has hurt us. There needs to be more.

I have toyed with the idea of starting something like this for years. I have written ideas and plans but have put them away and kept it on hold. Because of time, I just can’t do it yet. Writing the Placebo Journal, the Placebo Gazette, and practicing full time medicine are only some of the things I do. As I have admitted in the past, I have gone through some major burnout in my life and these activities I just mentioned above were not the cause. They, in fact, saved me and gave me an outlet for my emotions. Your feedback has always been my peer support and helped me as well. In the future, I think what we have as a group of Placebians is what the whole profession needs: the ability to speak openly and the freedom to be as”disruptive” as we want to be. And no matter what happens we can still laugh our asses off because we haven’t lost our sense of humor. That, my friends, is movement that we should try to spread.

“Christopher Thompson, MD, says he signed up because he believes MinuteClinic can improve access to care and lower health care costs in his Nashville, Tenn., community”.

That was caption under Dr. Thompson’s picture. I don’t know the guy. He may be a great person. He may be a great doctor. But don’t try to convince me with the whole “I want to help the world” line. The article was in the AMNews by Tyler Chin. Hey Tyler, do a little more investigative work before you write a flowery piece on a very controversial topic. I am not going to rehash all my thoughts on this retail clinic phenomenon, but we all know this doctor is in it for the money. There is no way he is just trying to help the world. He can join Doctors Without Borders to do that. Even if I am wrong, Tyler, you didn’t even ask the doctor the question! Only at the end of the piece do you write, “No company will say exactly how much physicians get paid for supervising in-store clinics”. Damn straight. Never did Dr. Thompson admit that money has anything to do with his decision. In fact, he talks about how these clinics are allowing docs to have a better quality of life. Come on, now. Maybe you’ll be getting a better quality of life….from the money you receive for SELLING OUT. Don’t get me wrong, if that is what you want to do, then it is your prerogative. But don’t lie or forget to mention the main reason – cash. There is an old rule, whenever they say it isn’t about the money it means it is ALWAYS about the money. Be honest with yourself, Dr. Thompson and us. And for Tyler Chin, do a little digging next time instead of writing this kind of fluff. You should have known that even the topic of your article is a hot spot for us docs right now.

3. Placebo Journal Update

We are starting our sixth year and our fall themed issue comes out this October. Don’t miss this one. We have Drug Rep Piñatas, Pappy Grief Peeping Tours, and awesome X-Ray Files! For those who don’t know, the Placebo Journal is the only medical journal that makes you laugh on purpose. It is not just for physicians. Some of our best feedback comes from non-medical folk. It is in print, 40 pages long and with NO ADVERTISING! Our bimonthly issue is a great gift for young docs, medical students or residents. If you want to subscribe and support our mission of laughter, click below:

4. Don’t Mess With Nurses

Did anyone see where that nurse strangled some intruder with her bare hands? It happened in Oregon earlier this month. Susan Kuhnhausen, 51, came home from work to find Edward Dalton Haffey, 59, with a hammer. That is all we know right now except that in self-defense she strangled the dude! It wasn’t a fair fight though and that is why she needs to get sued. Edward, a convicted felon, was only 180 pounds where she weighed over a deuce and a half. Anyway, this is what her neighbor said about her afterwards, “You didn't need to calm her. She's an emergency room nurse. She's used to dealing with crisis." I love it. I bet you the docs in her ER won’t be bossing her around anytime soon.

Thomas Brotman was a thin 66-year-old retired electrician. Smoke from his
cigarettes had taken their toll, although Tom preferred to think that it was the
smoke from his wood stove, the effects of his exposure to dust from the dirt road
he lived on and the second hand smoke from his fellow workers. At any rate he
was chronically trying to catch enough air to keep his body functioning.
Bronchodilators had little effect on his breathing and medications failed to provide
any significant relief. There had to be an answer. On a trip to Arizona he found a
nutritionist who guaranteed results. Examination of only one small hair provided a
template for treatment. On his return to California he came to the office to show his package of pills. Actually it was a rather large box. He had obviously gotten his money’s worth. For $3500.00, he had obtained a large box of a large assortment of pills, one month’s worth. There were at least 30 different varieties of diverse vitamins and food supplements. His deficiencies must have been very serious. I tried to be supportive especially since I had nothing that was particularly effective. We helped him carry the box back to his car so he wouldn’t run out of air. The cost of reassurance was a little high, but his exuberance was refreshing. Unfortunately it didn’t last too long, in fact he finished less than half of his first month’s supply before he departed on his final journey, undoubtedly completely free of his lack of air at last.

6. False Advertising

N.C. Project Aims To Shorten Wait Times. That is what the title said in a recent American Medical News. It went on. “The unique collaboration among physicians, academic medical centers and Medicaid to provide more timely pediatric subspecialist care could serve as a model for other states.” Wow! This sounded great because some kids have to wait months to see some of these subspecialists. I was excited to find how they were going to do this. Then I got to the end. It was like eating cotton candy. What looked so good at first just dissolved into very little substance. It turned out to be another bogus Administralian project which is only meant to look good on paper. The telltale signs of Administralian, if you don’t know, are in the words and phrases. Obviously the writer, Amy Snow Landa, didn’t pick up on it and took the bait they gave her by just repeating some of what they said. Here are some great Administralian terms or phrases Amy wrote: “unique approach”, “collaboration”, “efficient use”, “improving communication and coordination” (she actually wrote this phrase twice), “provide better information and support”, “health outcomes”, “reduce unnecessary referrals”, “focus”, “launched” (used twice), “pilot program” (used multiple times), “guidelines and protocols”, “use as a tool”, and “serve as a model”.

Very little of you know that I am fully fluent in Administralian. I have listened to the CD program “Learn To Speak Administralian” and now understand what this article actually means. It turns out it means very little. Here is the translation of the basic premise of this program: The whole project is a way to screen out unnecessary referrals because they believe a lot of primary care docs are idiots and need case managers or physician extenders to filter out the appropriate cases. They may even throw some cash to the subspecialist if he gets on the phone with a referring doctor. There you go in a two-sentence nutshell.

As I mentioned in the last Placebo Gazette, due to personal time constraints, I can only lecture about a half dozen times a year. So, now I am toying with starting some type of PJ Dynamic Medical Speaker’s Bureau. Many of you have written back with interest as being speakers. I have not gotten back to you all, but I will. Sorry for the delay.

I find that there is a lack of speakers’ bureaus that specialize in dynamic medical topics that are not disease specific or bought out by the pharmaceutical industry. Topics in the areas below really need to be promoted to physicians more:

Once again, if you think you can be one of these speakers (and have experience), email me at doug@placebojournal.com. I will probably ask for a tape, references, etc. so that I can prove to event planners that you can do what you say you can do.

I want to formally introduce you to a new band called Bad Prescription. This is not a joke nor is it a parody. And no, I am not in it. Bad Prescription actually sings medically related songs. They are weird but very talented. To listen to their first song “Disruptive Physician”, please here and you will see the radio player at the bottom. Their first CD is forthcoming with other songs like “Old Man’s Friend”, “Call Sucks!”, and “Doctor, Can You Spare A Signature”. They are available to play at bigger gigs for entertainment. See contact information on the web page. Enjoy!

9. Fireworks in Michigan

This is a great one. There is a Michigan bill coming down the pike that would require girls entering the sixth grade next year to be vaccinated against cervical cancer. Now here is the beauty of this. This law was backed by a bipartisan group of female lawmakers and it may be the first of its kind to make people get a vaccine. Well, kind of. Schools demand vaccinations on kids but parents can get around it by signing a waiver in many states. So now we have some women lawmakers showing solidarity and demanding that girls prevent the infections caused by the sexually transmitted human papilloma virus. Though I can see a lot of good to this, I don’t think it will go through without a fight. Because there is some association of sex to this disease , this means that the super-right winged conservatives have to get their ire up. Here is what they are arguing, “requiring the vaccine would infringe on parents' rights and send a message that underage sex is OK.” What makes this so ironic is that I have seen the earthy crunchy left wingers get their panties in a bind about the rights of parents to choose that their kids not getting the regular vaccines because of the bogus conspiracies. So, by convenience, both groups are easily able to switch sides on the same issue in order to keep fighting and make our political and healthcare systems suffer.

I would like to offer my services to provide lethal injection to some of these death row inmates. How come they get a painless death? And how come the AMA are such freaking wimps saying doctors cannot ethically participate in executions?

The last dude in California stabbed a high school girl in the chest multiple times, showing no mercy. He is still alive, because no anesthesiologist has the guts to be there and monitor the execution. They say they can't guarantee his death will be painless. How come most people who aren't felons get painful deaths? It stinks, but I have seen very few painless deaths, sadly, in my career and life. Am I out in right field here? Hell, I'd volunteer, but as generalist, I could only beat him to death with a reflex hammer.

If this is published, I will never be permitted to serve on a jury anywhere and perhaps that is part of the problem. We need to outsource our legal system to a country with some common sense. Sadly, I think ours has completely atrophied, as has my brain. I'll take my foot out of my mouth now, and I apologize if I have offended anyone. Maybe this is a good career choice for burned out physicians? Hey, are you are already fried? Why not pass it on?

11. Some Final Thoughts

A recent Archives in Internal Medicine study just came stating that men with lower testosterone die at an earlier age but the researchers couldn’t give a reason why. For once I wish that someone would just write in the discussion session of the research article what we are all thinking. It would be great to see the following: “It is our opinion that men with lower testosterone, who tend to have less desire for sex, die earlier because….well…who really wants to live longer if you can’t get laid anymore?”

Ben Roethlisberger played last night for the Pittsburgh Steelers about a week after having an appendectomy. He had a 104 fever and got pounded by 300 + pound lineman. Talk about having a bad HMO.

11. Feedback About The Placebo Gazette

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