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The Main Page
Wednesday, November 29, 2006
Not A Post
Just in case you were wondering why we don't blog anymore. This is what we're up to around here:

And it sure is fun!

Saturday, November 04, 2006
100th Post
There. I was just flippin' through, for old time's sake and found out that this blog had 99 posts before it went on indefinite hiatus.

So there. Now there's one hundred.

Does anyone come here anymore?
Wednesday, June 21, 2006
Blogging is Hard
My friend Doctor Bean introduced me to Blogger about a year and a half ago. It began with an email he sent me with the subject "bloggy goodness" and included a link to his group blog Kerckhoff Coffeehouse. I have to admit that his email was opened, quickly read, and then allowed to languish in the never-ending queue know as "The Inbox."

For some reason, a few months later, I came across his initial email, and finally clicked over to Kerckhoff and read a few posts. I liked what I saw, and thought, hey, what a great idea, I'll just set up a blog, send out an email to a few friends I regularly correspond with anyway inviting them to join, and put our rantings and ravings on the 'Net for all to see and partake in. What could be easier?

No dice. Of the half dozen friends I emailed to join, not one responded. Now mind you, these are people I email and talk to regularly anyway, but on the topic of starting a blog, the response was no response. A second round of cajoling resulted in my Manhattanite friend goldstone jumping on the bandwagon, and he even posted a few times in the early days. My darling wife of course did what she could being eight or nine months pregnant and then nursing and doing most of the raising of Baby Wanderer. She supported me as I tried to get this blog off the ground.

Being the perfectionist that I am, I must admit that I have been disappointed with the results. Sure I've had a few ok posts and so on. I've also acquired a handful of regulars who stop by and shoot the breeze with me, and I am indebted to them - I don't think I would have lasted this long without them. I am continuously in awe (and jealousy) of the real blogs out there. You know, the ones who get like more than 20 comments per post, nearly daily and actually have something interesting to say, nearly daily. I am particularly in awe of the solo bloggers, who despite having "day jobs" still manage to churn out good stuff on a regular basis, without the benefit of co-bloggers to take up the slack on those apathetic days, and its the good stuff that really keeps 'em coming. Their quality humbles me, and makes me feel like I'm doing something wrong here.

People have asked me what the name of the blog means. In truth, the title comes from an old demented patient of mine during my training days in the Bronx. He would lie in bed all day long saying "Why You Treat Me Like A Dog? Why You Treat Me Like A Dog? Why You Treat Me Like A Dog?" Many medical professionals develop a cynical sense of humor that this type of patient and his mantra can feed. His chant had an almost hypnotic cadence to it, and it belied on many levels how terrible his life really was. In any case, it stuck with me, and goldstone, who trained with me, knew about it, so I thought it could work as a title for the blog. Since most blogs in the J-Blogosphere tend to have a conservative slant to them, I thought that there might be room for a more Blue State take on things, and anticipated some flack, maybe even being treated like a dog sometimes. Bella, our family beagle, just seemed like a natural mascot...

I didn't set out on writing this post like it were an obituary for this blog, but am beginning to feel that it reads like one. Perhaps the fact that it hasn't taken off is emblematic of the political shift that has been occurring in the American Jewish community over the last two decades. I know I am assigning myself more importance than I deserve, particularly given the overall lack of political material here. The truth probably lies somewhere else - relating more to the overall quality of writing and perhaps the subject matter (or lack thereof). Just another voice in the wilderness.

In any case, I think I'll be taking a break from posting for a while. Perhaps I'll be back, perhaps I won't. Maybe I need to create a new blog that'll be my own, and designed that way. I don't know, but I like being called wanderer, so if you see my name somewhere, just click on it, you'll either be brought here, or directed somewhere new. In the meantime, I'll just keep reading everybody else's blogs, because that's just what I've enjoyed most about blogging. Thanks for stopping by.
Tuesday, June 06, 2006
Every Once in a While, There's A Patient
Miguel was born with a hole in his heart. He grew up in a small town in Mexico, with his poor, penniless parents always hoping that the hole would close on its own (as they often do). But every doctor who would listen to his young heart would invariably look up at his mother and shake his or her head, no.
By the time they crossed the border and moved to the L.A. area, Miguel was a teenager. He grew appropriately, meeting all his milestones and despite his "asthma" he was able to play soccer with his friends. His parents, illegal aliens, could not afford medical care for him and certainly didn't have medical insurance.
They brought him to the pediatric cardiology clinic at County Hospital, where again, the doctor would look up and say, "no, the hole is still there." Repair of the hole would require a pediatric heart surgeon, and the County didn't have one. His parents couldn't afford to pay for the surgery, and for some odd reason, no one ever helped them find other ways to get surgery for Miguel. He was lost to follow-up for a few years. Why bother, he and his parents thought.
I met Miguel in my first months as a training cardiologist at County Hospital. It was in the adult cardiology clinic, he was now 24 years old. He continued to play soccer, as long as his "asthma" wasn't too bad. He was married, had one son and had a part time job as, of all things, a luggage handler at LAX.
His was an exciting case for a training cardiologist. Putting a stethoscope on his chest was like listening to a veritable concerto of heart sounds, murmurs and gallops. We reviewed his records from the pediatric clinic and together with one of my mentors, I set out to work him up - completely.
An echocardiogram was arranged - the ultrasound images showed us the gaping hole between his two ventricles. One of his heart valves had been sucked into the hole with every beat for the last 24 years, and was beginning to collapse. He needed surgery.
His part time job did not provide him with insurance, though luckily by now he had obtained legal documentation and had a green card. Social workers were contacted and we began the process of obtaining adequate insurance coverage for what was now a very complex and unusual surgical procedure.
Two years passed – I continued to see him in clinic on a regular basis. In the mean time I was able to arrange for the necessary preliminary procedures to be done at County Hospital, and actually performed most of them myself. The social workers continued to work on arranging for surgery at Major University Medical Center.
Then one day in the fall of my last year of training, his insurance came through! By now his wife was seven months pregnant with their third child. The first two had been screened for heart disease and were spared; the third one’s fetal ultrasound was also encouraging. We arranged for Miguel’s surgery.
The heart surgeons at Major University Medical Center operated on Miguel and he did great! I visited him on the second day post-op. He had just finished vomiting his first meal. He had been given spaghetti and meatballs when all he should have had was jello and clear liquids… But he did fine.
I continued to see him in the clinic for the remainder of my training. He knew that I would soon be leaving County Hospital to enter private practice. On my last clinic visit with him, he asked me where I was going. I told him the name of the practice, and where it was. He said to me, “Doc, you have done so much for me and saved my life. I am going to get insurance, and I am going to come see you in your private office.”
Yesterday morning, five years almost to the day from that last visit, Miguel was waiting for me with a huge smile on his face in an exam room in my office. He had been promoted to a full time dispatcher, qualified for insurance and tracked me down. He now has two healthy sons and a healthy daughter. He still plays soccer, and even coaches his eldest son’s soccer team. His “asthma” is gone.
Tuesday, May 30, 2006
Hi, I'm Digger, the dermatophyte.
Hi! "Remember me? Hello, I'm Digger, the dermatophyte, your naaaaiiiil infection." That's how the ad for Lamisil, a drug to treat a fungal infection of the toes begins. As a physician, I must say that I find most direct to consumer drug ads entertaining at best, possibly informative but generally useless. Worldwide, only the United States and New Zealand allow drug companies to advertise directly. The ads are more or less effective, otherwise the drug companies wouldn't spend the billions they cost. Most patients can now name at least two cholesterol medications, whether they have high cholesterol or not. I've had patients come in asking me for "the purple pill," when a little Tums or Mylanta would do the trick. Ah, Allegra! Live Claritin clear! No one has ever asked me for Valtrex to suppress their genital herpes, yet. Many, many patients have asked for Viagra, Cialis or Levitra for their E.D. (erectile dysfunction), which by the way is the medical term favored by Pfizer to make it easier for men with impotence to ask for Viagra. Either that's an effective ad technique or patients with heart disease have a lot of problems with impotence (they actually do) and that's why so many of them ask for the E.D. drugs. By the way, no one has ever complained about "erections lasting longer than four hours, a rare and serious side effect."

Lately, there's been a new line of ads for Mucinex, a cough medicine, where Mr. and Mrs. Mucus set up house in your airways:


Yuck. I don't like mucus (Mister or Missus). Then of course there are the old Raid ads where they show the bugs croaking.


But then I can't really complain about the drug companies when it has to do with Raid, and this post is about direct to consumer drug ads, so please forgive the digression.

What a punim!

To make a long story short, and all seriousness aside, I think Digger is the coolest. I love the way he flips up the nail like he's popping the hood on a car (that would kill!) and jumps into the nailbed where he and his friends scratch around like a kitty in a litterbox. Lamisil comes around, and, then they die! Not just "pass on," or even "buy the farm." They keel over, look really kind of ill, turn greener and then croak! Poof they disappear! And remember, Lamisil isn't for people with liver and kidney problems. No duh, its for people with nail infections!!! Ask your doctor!

By the way, stay tuned for full-length cartoons coming this summer!
Sunday, May 28, 2006
Baby wanderer (BW) is nearing the 10 month old mark. It seems like in the last few weeks someone pressed fast forward, and he has just started hitting milestone after milestone in rapid succession:

1) He's crawling - in the forward direction. It seemed like for the longest time he would just lay there having "tummy time," or perhaps crawl backwards a few inches. But now he actually books across the room, follows Bella around everywhere and would probably follow her out into the yard if we didn't catch him.

2) He's consistently saying his first word - as would be expected, his first word was...Bella! Except it sounds more like Deda. Nonetheless he is consistent.

3) He waves and says hi - so effin' cute!

4) He claps. BW watched the American Idol finale with us last week (he just wouldn't go to bed, and we couldn't risk missing it). Everytime the audience applauded so did BW. He voted for Taylor.

5) He made his first phone call. Well, sort of. He must have pressed redial or something, but ended up calling my aunt in Seattle. Luckily, it was in front of us, so we were able to hear her saying "hello, hello" before the minutes started adding up...

6) He can pull himself up to a standing position. Very problematic. It used to be we would lay him down in his crib after rocking him to sleep. He might cry for a few seconds, but then would just fall asleep. Now he actually pulls himself up and stands there crying, which brings me to the milestone he has not yet reached:

He doesn't know how to sit down.

Yup. Not only does he not know how to sit down, he is so afraid to try (because of previous bad experiences), that he will just stand there and cry until we come and help him down. And then what does he do? He stands right back up and the cycle starts again. Oy.

I guess we'll just to wait until he hits that sitting down milestone... In the meantime, there isn't much sleep going on around here. Again. (Note that the yawning hippo is back!)
Saturday, May 20, 2006
What Are Your Favorite Song Lyrics?
Jack's Shack and Sweettooth both have posts about their favorite song lyrics. Coincidentally, I had been working on just such a post last week, but through the magic of me screwing up, it somehow got deleted before I could post it. Anyway, in no particular order, here's another go at some of my favorites:

Before you slip into unconsciousness
I'd like to have another kiss
Another flashing chance at bliss
Another kiss, another kiss
- The Doors, The Crystal Ship

This song to me just kind of epitomizes the Doors and Jim Morrison. Sex, drugs and rock and roll! During my teenage, psychedelic phase, this just seemed so cool.

But I remember us riding in my brother's car
Her body tan and wet down at the reservoir
At night on them banks I'd lie awake
And pull her close just to feel each breath she'd take
Now those memories come back to haunt me
they haunt me like a curse
Is a dream a lie if it don't come true
Or is it something worse
- Bruce Springsteen, The River

The Boss just has so many awesome lyrics that he's written. To me this one captures so beautifully the restlessness and desperation of the love story described in the song.

We stop for a while, she gives me a smile,
And snuggles her head on my chest.
We started to pet, and thats when I get
Her talcum all over my vest.
-Nat King Cole, Walkin' My Baby Back Home

A sweet, sweet song that I've always loved. My wife and I chose it to end our wedding video and it works so well!

I am the son and the heir
Of a shyness that is criminally vulgar
I am the son and heir of nothing in particular
You shut your mouth

How can you say I go about things the wrong way ?
I am Human and I need to be loved
Just like everybody else does
-The Smiths, How Soon is Now?

High school. My awkward stage. Enough said.

The monkeys stand for honesty,
Giraffes are insincere,
And the elephants are kindly but they're dumb.
Orangutans are skeptical
Of changes in their cages,
And the zookeeper is very fond of rum.
- Simon & Garfunkel, At The Zoo

I could write post after post of my favorite Simon & Garfunkel lyrics. I love them all. It always cracks me up how Paul Simon assigned random human qualities to the animals at the zoo, and it just works! I've been enjoying singing this song to my son lately.

We're just two lost souls swimming in a fish bowl, year after year,
Running over the same old ground.
What have we found?
The same old fears.
Wish you were here.
-Pink Floyd, Wish You Were Here

This song brings back many memories. Discussing its meaning in eighth grade English class, singing along at camp, hearing it at a bar in Jerusalem. Who cares what it means?

I can make it through the rain
I can stand up once again on my own
And I know that I'm strong enough to mend
And everytime I feel afraid I hold tighter to my faith
And I live one more day and I make it through the rain
- Mariah Carey, Make It Through The Rain

This song was released by Mariah after she had a bout with severe depression. Some people might consider it (and her) cheesy, but its helped me get through some tough times myself.

I'm fixing a hole
where the rain gets in
and stops my mind from wondering
- The Beatles, Fixing a Hole

Like Simon & Garfunkel, I could write post after post about Beatles lyrics. This one has always appealed to me, because I never understood how the rain gets in and stops his mind from wondering. But somehow it still makes sense that it did...

"There must be some way out of here," said the joker to the thief,
"There's too much confusion, I can't get no relief.
Businessmen, they drink my wine, plowmen dig my earth,
None of them along the line know what any of it is worth."
- Bob Dylan, All Along the Watchtower

No collection of lyrics could leave off the master poet, Bob Dylan. This song was probably made more popular by Jimi Hendrix, but Dylan's version tells it like it is.

And you can tell everybody this is your song
It may be quite simple but now that it's done
I hope you don't mind I hope you don't mind
that I put down in words
How wonderful life is while you're in the world
- Elton John, Your Song

Like most classic Elton John songs, the lyrics were written by Bernie Taupin. I could well quote the whole song, it really holds together so well, and Elton does such a great job singing it.

So there you have it, ten of my favorites, and there's many many more. Music is just one of the things that makes life so great, no?

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