- Del Meyer, MD - https://delmeyer.net -

The Grimmer Side of Medicine

Atrocities against women continue. Egypt has done another reversal on female circumcision. After CNN aired footage of an amateur cutting away the clitoris of a screaming 10-year-old girl in September 1994, the government again allowed hospitals to do the “procedure” stating that the ban implemented in 1959 had not changed practice. This practice was continued by midwives and surgical barbers at home with dull knives, without anesthetics. However as of December 1995, this mutilating procedure has again been banned from hospitals for fear of losing US Aid… Since these “amateur surgical barbers” know little about female anatomy, the more accurate term is “female genital mutilation.” The AMA Council on Scientific Affairs recommend that we join forces with WHO & WMA and other major health care organizations in opposing all forms of medically unnecessary surgical modification of the female genitalia. (JAMA 1995; 274: 1714-16)

In Uganda, doctors are paid about $3 per day or $1000 per year. When pay becomes poor, ethics frequently are abandoned. So doctors sometimes don’t show up for work because they can make a day’s wages in 10 minutes doing illegal abortions, sell drugs on the open market (by skimming a portion of each patients medications), squeezing bribes out of the sick, selling plastic syringes… Uganda has one medical school, graduating 60 doctors a year, but a quarter leave for better pay elsewhere. There are fewer than 800 doctors for 17 million people. This provides about one doctor for all services to over 20,000 people. The number of bodies in the hospital’s morgue each morning is dependent upon the number of medical personnel who didn’t show up for work or were on strike the previous day. This is the ultimate on capitation.

Although National Public Radio, on “All Things Considered,” aired an apology for the remarks of Andrei Codrescu on the Christian Coalition (“The evaporation of the 4 million who believe in this crap would leave the world a better place.”), the Coalition will intensify lobbying for Congress to discontinue funding public radio. NPR also airs disparaging remarks about physicians and organized medicine. Should we join the Coalition’s effort to eliminate the $200 million NPR receives from us taxpayers?

Doctors and other professionals are joining the ranks of secretaries and nurses as “temp” employees. An outplacement firm in Chicago estimates that 250,000 professionals lost their jobs in 1995. Some doctors who are completing their residencies are also doing “temporary” work until they are able to see what’s going to be happening in health care and whether it’s worthwhile to start a practice. “Temping” has clearly climbed from the secretarial pool to the executive suite, according to the New York Times.

RN at the nursing station after spending several minutes on the phone trying to obtain a physician in one of these new groups with elaborate phone systems: “For a minute I thought that if I punched another key or two, the electronic voice would proceed to answer all my questions and I would not even need to talk to a doctor.”

MDs Woolhandler & Himmelstein have a short article, “Extreme Risk–the New Corporate Proposition for Physicians,” in the NEJM (Dec 21, 1995) cautioning us not to end up like tobacco company executives who, repenting their sins, find that their contracts forbid confessing them.

Scientist at Cornell University have shown that very low calorie diets have extended the outer limit of life span and slowed the aging process in a large number of species from single-cell protozoans to worms, fruit flies, fish, and mammals. Basic research in the cellular mechanisms is going on in a number of laboratories and the research is being extended to primates, the final step before full study in humans. Richard Weindruch, PhD, reporting in Scientific American, states that even if caloric austerity turns out to be a fountain of youth for humans, it might never catch on due to our poor record of adhering to severe diets… A New York marketing research firm estimates that 75 percent of men and 60 percent of women in America are overweight, but only 20 percent are even trying to lose weight.