I watch SNL on my DVR Sunday mornings, which permits me the luxury of not suffering through interminable bad sketches. Wiig’s characters are so often terrible that my Television Scheduler and I coined a term for fast-forwarding through a bad sketch: “wiiging” — as in, “Crap, we wiiged through half the episode.”

Two of her stock sketches in particular — Gilly and Secret Word — are instant wiigings, except that last night’s Secret Word was actually reasonably funny for Mick Jagger’s character. Target Lady usually gets wiiged, Shanna usually gets wiiged, the woman who can’t handle surprises usually gets wiiged. There’s a reason it’s called wiiging — they’re all her characters. Add in crap musical acts, Fred Armisen, and repeat commercial parodies: some mornings, SNL is just a 30-minute show punctuated by extended blurs of fast forward.

One might hope that Wiig would leave quietly, but last night’s episode was constructed as a farewell, including some of her stock characters. The ‘cold open’ featured Wiig in a spoof Lawrence Welk Show.  Wiig’s character is called Doonese, which Wiig plays with a prosthetic forehead and plastic baby arms. Get it? She has congenital defects, so she’s gross, thus hilarious!

I have always particularly disliked the Doonese character. She is insulting, demeaning, and tediously unfunny. Last night’s was the only remotely enjoyable iteration of that sketch, and for two reasons: Jon f-ing Hamm and the peeing statue. Otherwise, the whole premise of the sketch is that people with birth defects are repulsive and we can laugh at them. Setting the sketch in the 1950s or whenever doesn’t make it funny, either. This is 2012 — we’re better than this.

I have long wondered what power Wiig holds over the producers and writers of the show. The problem may be that she is acting for the studio, not the screen — which means her gestures are over-exaggerated and clownish. Part of what makes her good in the movies is her deadpan and subtlety, which is entirely absent in SNL. What might play well to the back row of studio 8H looks corny and clumsy on HDTV. It even occurs to me that the writers are producing deliberately weak characters for her, so that she has to flail and twist to try to make them funny. Whatever the problem, be it of her or through her, it is now blissfully gone.

The only possible downside from Wiig leaving is that we might not be able to wiig through significant portions of the show. Now we have to budget an hour or more for watching it. From our point of view, that might be a bad thing: we could put the extra time to good use. For the producers, it should be a good thing. They should have dumped her years ago.

I mean, it seemed like we had a good thing going, and I guess I thought we were going to live there forever. I had really gotten used to it; it felt really comfortable, like an old pile of leaves that you’ve worn forever and broken in so they’re nice and soft. So I miss that. I’m grieving for that loss.

I hear you saying you feel overly criticized about the whole deal, and I don’t want to sound like I’m dumping. I know you’re  into personal growth and new horizons and exploration, and that’s a big part of what I love about you, and I want to support you in that.

It’s just… I feel like the fruit was maybe taking ‘personal growth’ too far. I mean, I was really okay without the knowledge of good and evil — I was trucking along fine without that in my life. I know you want us to share experiences, to ‘live our adventure together’, but maybe I didn’t also have to eat the fruit.

No — darling, I am not criticizing you for eating the fruit. That was fine. You needed that for you, and I support your decision to eat the fruit. I am just saying, maybe I didn’t have to eat the fruit. I never really wanted it, and I didn’t even like the way it tasted. Like sour pine nuts, or something.

And, well, maybe we wouldn’t have had to leave if just one of us had eaten the fruit? Maybe we could have worked something out? I don’t know — maybe there was a fruit of the ignorance of good and evil, that we didn’t know about? I just feel like things would have been better if I hadn’t eaten the fruit.

Of course I would have gone with you if you had been kicked out — yes, even if I had not eaten the fruit. You don’t know what it was like here without you, before you came. You and I were meant for each other. I would follow you anywhere. I’m here, right? I mean, it’s been a while, and we’re still together. So where else would I go?

No, it’s not about him. You’re right; I never liked him. He skeeved me out, but you know — you were new to the area, and lonely — you didn’t have any family or anything, except me, and that was intense. It was a new relationship, and I know you needed a friend, a safety valve. I just — I mean, the serpent? Of all the creatures in Eden? No, no — I’m not jealous. He just rubbed me the wrong way. But that’s not a judgment of you. That doesn’t diminish my respect for you one bit.

I guess I do blame him a bit for the whole fruit thing. I mean, I don’t think you would have done it if he hadn’t suggested it to you. I feel like if I had asked you to eat the fruit, you probably would not have eaten the fruit. You never try the stuff I think you’ll like. Remember guavas? Or chard? Point being, I just think he was a bad influence in the whole fruit thing.

Darling, I’m sorry. I know you’re suffering, too. I don’t mean to keep rubbing your nose in it. Yes, I am responsible for my own decision to eat the fruit. I own that mistake. I am not blaming you for my own failures.

You’re right — we should keep looking forward. I know what will cheer us up: let’s find some sticks to rub together. It’s getting chilly. I have a feeling rubbing sticks together will help somehow.

I love you. I wouldn’t want to be anywhere but here with you.

For some reason, the equipment and medications associated with my condition make me suspicious by TSA rules. This time it was the scissors — short, blunt-tipped — that I have to carry for my appliance. I had no idea the scissors were even suspicious, so they were buried in my bag inside my appliance kit. The TSA agent of course had to take all of this apart to find them, which meant going through my medical stuff there on the exam table. Sometimes it’s the powdered medicine. I also am not at all comfortable in the milliwave scanners, so I end up just getting a pat-down. It’s always something, it’s always unpleasant, and it’s always a little bit humiliating. Once they took a jar of peanut butter from me, on the grounds it was a “gel”.

My one joy in life at these times is my pocket knife — one of those tiny keychain knives, which I take everywhere I go. I broke the blade off so I can take it on airplanes, since what I really need are the tweezers and scissors. But everytime TSA finds it, the agent pulls it out of my bags with a glint in his eye like he has stopped a Serious National Threat. And I have to disappoint him, that no, you won’t be getting Patriot Points for this one — the blade is broken off and it’s not an inch-long murder machine.

Thing is, I remember when this country wasn’t afraid of inch-long pocket knives. I remember when we weren’t paralyzed by scissors and powder. I remember when didn’t think a bottle of water was possibly a lethal explosive.

And we were a better country then, too. We were better people. Not cowards terrified of 3 and a half ounces of gel or liquid, and not bullies who hassle disabled people just because they’re different in ways that make us afraid. At the very least, we can’t claim to be “the Home of the Free, Land of the Brave” while the TSA is taking naked pictures of us, rifling through our luggage, and stealing our hand sanitizer. Brave people by any definition aren’t afraid of 12 ounces of peanut butter.

I am still not afraid of liquids or tiny knives of peanut butter. I am not even afraid of being blown up or crashing in an airplane, because that would actually be a much better way to die than my disease promises to be. I would rather that than die from Crohn’s — which is infinitely more likely to happen. The federal government isn’t doing a hell of a lot to prevent the latter, and the TSA is meanwhile making my illness even more difficult to manage by pretending to protect me from imaginary threats.

Someday Al Qaeda or whoever is going to put explosives into a colostomy bag, and then I’m done. I’ll never be able to fly again. In the meantime, TSA has become a painful reminder of the liberties we surrendered — that we have given up willingly — in order to feel more secure. To make healthy people feel more secure, that is — because those of who are sick have real problems and don’t need the TSA inventing new ones.

Famous Waikkiki: wander the sun-drenched beaches of Waikkiki, where world-class shopping and surfing are only a few steps away. You’ll rub shoulders with the winners of dozens of famous daytime basic cable game shows, such as Let’s Make Copies, The Deal is Right, What’s My Color?, and Count to Ten! Spend several leisurely hours listening these lucky winners argue over whether Hawaii a U.S. state or a foreign country.

Waimea Canyon: hike cliffside tropical trails to hidden waterfalls behind a German couple who are obviously more fit than you. You’ll feign delight as they explain Germans get eight weeks of vacation each year, plus a stipend for travel. That’s more than twice the amount of time you will spend on your once-in-a-lifetime trip, which your boss only approved because you promised to keep your Blackberry on your person at all times. Still getting service out there?

Keilekekua Reef: You’ll thrill to the many tropical fish in this subaquatic paradise, and discover that Claire is not getting out the boat, no, Daddy, no, she does not want to, and it does not matter how many thousand miles they flew so that Claire could snorkel with Nemo and his friends, no no no no no no no no, she does not want to get out of the boat. Isn’t it so much more peaceful under the water? Look at all the fish!

Wailua River: Kayak the beautiful Waihua canyon, while you enjoy lush scenery, take in gorgeous views, and try to hide your dismay that all the other people in your kayak tour, who are all wearing matching neon yellow T-shirts that say “Wooltwaddle Family Reunion – Hawaii!” are in fact in Hawaii for the Wooltwaddle family reunion. Spend an invigorating day evading questions like, when are you going to start a family? how many children will you have? Have you started saving for their college yet? Later that evening, you and your spouse can relax by the pool, and reflect on the fact that you dated for three years without ever discussing baby names.

Hawaii Volcanoes National Park: come visit the only active flowing lava in the 50 States, as it bubbles and steams its way to ocean, where it cools into brand new land. During the day, hike the crater trail through an alien landscape of jagged rocks. After dark, dodge Park Rangers as you try to get close enough to the hot lava to actually see it. You’ll marvel at how some parents actually let their kids get right up to the lava to poke it with a long stick. And when you mutter, “Hey, watch where you wave that lava-coated stick”, said parent will amaze you by yelling that you are not his parents, don’t you dare tell my child what to do, who the hell do you think you are? Awake the next morning refreshed, to find little burn holes in your clothes where the kid with the stick spattered lava.

Whatever you choose, you can’t go wrong in Hawaii, where everyone exudes the “Aloha” spirit. “Aloha” is a native Hawaiian word which means “the conceit of instant familiarity”, and by the end of your honeymoon you will appreciate why the original Hawaiians set out bravely in fragile canoes on perilous journeys to find these charmed islands: to get away from these people.

A couple stories that caught my eye:

Dr. Jordan Grumet at Kevin, MD says that being a physician is like trying to parent 2,000 teenagers. Do they train physicians in paternalistic condescension at medical school? Or is medical school simply attractive to people already disposed in that direction? I would have no problem if Dr. Grumet’s post were titled, “Sometimes Patients Behave Like Teenagers”, or “Some Patients Behave Like Teenagers” — but instead all 2,000 patients end up being teenagers. The fact that adults sometimes disagree with one another is hardly reason to denigrate a whole class of people, if even the person being disagreed with is a supposed expert. If Dr. Grumet talks to patients with the same tone as the post, I would walk right the hell out of that exam room. But I guess that’s just me, behaving like a teenager. [Edit 5-15:  See Dr. Grumet's comments below, and my reply.]

This post at The New Health Dialogue is about Facebook’s organ donation thing, which I have not paid attention to. I am an organ donor myself, but I don’t think I would ever want a donated organ installed in my body. This is something I’d like to learn more about — my understanding is that receiving a donated organ is a pretty grueling, pretty risky process, and in the best case you end up taking loads of meds for the rest of your life. Am I wrong? Are there good blogs by organ recipients?

I am headed to my hometown for a few days this weekend, to see my grandmother. She has been in and out of the hospital for the last few years, but more in than out the last several weeks. A couple weeks ago, she made the decision to turn off her defibrillator, which apparently involves a procedure of some sort. If I ever need a defibrillator, I will probably decline it, or at least insist that it have a switch I can turn off at my discretion. If I get the latter, I’ll use the switch for all sorts of stuff, like to win arguments and avoid jury duty and whatnot. “Oh, honey — sorry. Can’t take out the trash. My defibrillator is turned off. I might die.” Otherwise it just seems like a way to keep people longer than they want to live.

My breakout role was playing a baby found in the Christmas episode of “Law and Order:SVU” — one of those goofy things where they imply the kid is another Christ child. That was me: Messiah of the show about sex crimes. After that I got steady work — some commercials, some movies, lots of TV.

I was a small baby and that helped me get a lot of roles for birthing scenes. Mom helped me keep the weight off with juice fasts and lite formula. I was in an R-rated movie called “Away in the Night”, where my character was squeezed out of Sharon Stone’s uterus. I nailed my part, but it went to direct to video. I was still doing newborn scenes at four months.

When I was closer to six months, I started doing more commercials — for baby food, diapers, stuff like that. Most of the roles for baby actors are for newborns. When you start crawling or just being too heavy for a 90 lb. actress to pick up two dozen times at five minutes a take, the casting agent goes looking for the next young thing. Wynona Ryder only works with premies under four pounds, from what I hear. You can try to keep the weight off, but a baby will grow unless you just quit feeding it.

About that time, I started teething and things went off the rails. Before the teeth, I was placid and cheery on every take — bright blues eyes, beatific smile, little halo of golden curls. You could put me in front a camera and I would smile and stare and maybe babble a little bit, adorable as anything you ever saw. The teeth made me cranky. Mom tried to fix it by giving me a little cough syrup with codeine that she bought in Mexico, but that put the dimmer to those baby blue eyes of mine. I was once kicked off the set of a mashed peas commercial for sleeping through the whole thing.

By the time I was eighteen months, I was an addict. I learned to ask for the syrup by brand name — not my first word, but certainly one of. I mostly quit eating; I let my mom think it was because my teeth hurt too much, but really I just wanted the syrup. Man, I can almost taste it still, that bitter grape-y flavor. I lost a lot of weight, which we thought was good for my career, until I won a role as a baby that dies in a concentration camp during the Holocaust. Makeup said I only needed some eye shadow to play the part, which is when the other baby actor parents staged an intervention.

The good news is that baby rehab is pretty easy: just stopping giving baby the stuff. The bad news is that it makes baby a son of a bitch. I got super cranky — way off the normal temper-tantrum spectrum. At one point I stole my brother’s Power Wheels and just took off. The police pulled me over going flat out on the 101, like maybe 4 miles an hour in a 55 zone. The cop had to administer the field sobriety test like it was a game of “Simon Says”. The video is classic: the cop keeps trying to get cuffs on my tiny wrists, cuffs keep slipping off. My sponsor says I have to make amends to my brother as part of the 9th step, or whatever. Mom bought him that car with my money in the first place.

Eventually I got through withdrawal, my teeth stopped growing in, and I got more or less back to normal. I had to quit the acting business because Mom stopped taking me to auditions. But I am four years sober, I spent a lot of time coming to terms with my addiction and my ego, and I can speak in complete sentences now — so I want to ask her to start looking for a new agent. Not a lot of people get a second chance in life, but this might be mine. I hope I don’t waste it.

1. Dr. Rob at  More Musings (of a Distractible Kind) posts Ten Bad Assumptions Patients Can Make. This is a helpful post, but I have to say that many of his points are not strictly assumptions. An assumption is made without evidence or indication of its truth; in many cases patients are told or taught to believe these things, as if there were evidence of their truth. And I think Dr. Rob knows this at some level. In #9, “The Doctor Will Think I Am Stupid”, he writes that “I know there are doctors out there who treat patients like bad kids or like they are morons, but those doctors are out of step with reality.” If patients come to Dr. Rob believing doctors think they are stupid because they have been treated as stupid by doctors, then it’s not an assumption on the patients’ part but something they have learned. To say that the patient “makes an assumption” is to blame the patient for something unavoidable. The patient didn’t make or do anything they weren’t taught to by a health care provider. So this really boils down to a definitional quibble about assumptions, and the title of Dr. Rob’s posts, which I think should read more like “10 Bad Ideas Patients Get Because HealthCare Providers Can Sometimes Be Jerks” — or something like that. But it is still a must-read post, under any title.

2. Barbara Bronson Gray at MedPage Today’s Kevin, MD blogs about long patient waits, why they happen, and what you can do. She has some great advice for dealing with this problem, to which I would just add the following point: after 20 or 30 minutes in the waiting room, you can approach the reception staff and ask them to reschedule the appointment. Tell them something like, “I’m sorry the doctor won’t be able to see me today; when can I come back?” Granted, you may prefer to sit and wait, or your situation may be urgent, but sometimes this approach galvanizes the staff into getting you seen sooner. I recently spent an hour in a physician’s office without seeing the physician; I at least had my vitals taken and was shown to a room. But I had somewhere to be and couldn’t afford to wait forever, so I let the nurse know I was leaving. The doctor got in touch later and was very apologetic — there had been an emergency that threw off his entire schedule — and his staff rescheduled me for a few days later.

3. The Weekly Standard has an article by Eli Lehrer, A Health Insurance System That Works , in which Lehrer describes how great the free market is for puppies and kitties whose owners want to buy them health insurance. Lehrer is stone-face serious in describing pet insurance as a model for human insurance, but there are some numbers he avoids carefully. According to the ASPCA, “About 78.2 million dogs and about 86.4 million cats are owned in the United States.” What percent of those have health insurance? According to USA Today, only 2 million dogs and 900,000 cats — for about 3% and 1% respectively. Let’s consider for a moment what our healthcare system would look like if only 3% of Americans had health insurance. Close your eyes and picture that for as long as you can bear the horror and the agony and the suffering you should be imagining. Also, there are 70 million stray pets we’re not even counting here, so keep that in mind.

And it gets worse. Lehrer concedes admits laments mentions, oh, hey, by the way, “widely held values make it praiseworthy to euthanize animals facing reduced future ‘quality of life’ but rule out doing the same to humans, even though the inability to cut costs by speeding death almost certainly requires that human health insurance have a benefit limit much higher than that of most pet plans and, thus, higher front-end premiums.” Darn those ‘widely held values’. Actually, we don’t only euthanize sick animals, but some 3 to 4 million pets just because nobody wants them — from that same ASPCA link. Now close your eyes and imagine that for people. Or, just rent the DVD.

There’s an economist-styled mindset that says, let’s look at the institutional features of the various markets and compare them. That’s the pretense Lehrer adopts here — ‘we’re just looking at the nuts and bolts’. But the background, the context of the market, matters a whole lot more. The “widely held values” Lehrer mentions in passing are in fact so crucial to the distinction between pets and humans that the whole comparison disintegrates into farce. There is no comparison at all. There is, rather, a debate over what values should be ‘widely held’ — should we build a system that insures the whole population, or an efficient market that insures 1% of us. Lehrer knows he’s on the wrong side of that debate.

Amazing European foam technology mattress pad gets firmer each consecutive night of use – perfect for unwelcome guests! After two nights, they will awake with aching backs. After three nights, they sleep fitfully, if at all. After four nights, the mattress hardens into a cementitious plank. After five nights, guests have gone ahead and checked themselves into the skeezy Days Inn next to the interstate.

Bladerunner ™ IceBalls $35, set of six

Surprise your friends by popping these amazingly life-like eyeballs into their next mojito. Each eyeball is molded from medical-grade silicone using the original molds for the frosty lab scene in the film, Blade Runner. The silicone shells are filled with high-density gel that freezes quickly and keeps drinks cold a long, long time. So amazingly realistic – they’re ‘more human than human’!

iPaw automatic pet sitter $575

This innovative robot feeds, waters, cuddles, grooms, and plays with your pet while you are away. Water reservoir holds eight gallons. Kibble bin holds up to 15 pounds of food. Laser beam attachment entertains pets for hours. Available with litter module for cats, or scooper module for dogs. Can be programmed with your voice, specific commands. Not for use with pet snakes.

WhaleBox Voice Modulator $60

Digital technology translates everything you say into ‘Whalespeak’ – haunting whistles and hums that carry for miles underwater. Be the first to recite the Gettysburg Address entirely in ‘whale’. Blow away the karaoke competition with a fin-slapping version of “Whales Just Want to Have Fun”. Use it for your vows in a white whale of wedding. Not to be used for profanity or threats directed at whales.

HomeMall SkyMall Kiosk $2000 + subscription

Do you love Sky Mall’s great products, but miss shopping for them when you’re not on the plane? With the SkyMall HomeMall Home shopping kiosk, you can shop for dozens of Sky Mall products in the comfort of your home. Amaze friends and family with the great selection of innovative gadgets and thoughtful gifts available from the HomeMall kiosk. Best of all, our HomeMall comes with a subscription plan that ensures you always have new products to choose from.

When I took down my blog last year, I went back and read through most of the posts. The posts I regret — the posts I deleted first — were attacks on specific people or bloggers, very SIWOTI kinds of arguments that don’t really matter to anybody. And I decided I would never do that kind of blogging again.

So this is not that kind of post, but I just can’t let Dr. Salwitz skate past without a few remarks. I mean, really: “At the hospital, we will …  Make new syringes into trash…. Dull scalpels.  Plan vacations….  Give out beds to homeless.” I hope to Hippocrates I don’t need to go to the hospital the day after the day they cured cancer. “We’re sorry, Mr. Cross: you can’t get any needle drugs because we threw away all our syringes, you can’t have surgery until we sharpen all the scalpels we decided to make dull, you can’t see a doctor until they all get back from vacation, and we don’t have a bed for you because we gave all of our Hill-Rom electronic adjustable memory-foam hospital beds that cost $5,000 (used) out to homeless people who are now pushing them around town unplugged and defunct. But you see, this all a good thing: we just cured cancer. You’re f—-ed, but cancer is cured.” Cancer is of course the only disease that matters to anyone, anywhere, ever. The day cancer is cured, the rest of us sick people had better be out there throwing confetti or lighting fireworks or whatever.

And if you currently have or have ever had cancer, guess who Dr. Salwitz considers the ‘soldiers’ in that fight? Not you, my friend. Instead, “the lab tester, blood drawer, x-ray taker, pharmacy mixer, front desker, researcher, bill sender, educator, social worker, floor cleaner, food cooker, CT scanner, doctors and every disease task doer”. So congrats — in the war on cancer, those of you with the disease are just the battlefield, not part of the army. The ‘bill sender’ that sends you the bill you can’t pay because you lost your insurance when you got fired because you were too sick to work: he’s a soldier, but you’re… a survivor? victim? refugee?

Don’t get me wrong: it will be a good day when we cure cancer. I don’t think cancer is a good thing. But I’m also aware that it’s not at all the only bad thing out there. So maybe Dr. Salwitz could just nod in that direction, instead of writing as if a cure for cancer will bring the end of history. And I know this is selfish of me, but the thing I am most looking forward to from the cure for cancer is an airtight excuse not to give money to the cancer walk-a-thonners. That will be a great day, though I have the sneaking suspicion that the very next year I’ll get a ton of emails asking me to contribute money to a walk-a-thon commemorating the victory against cancer, or some such malarkey. That Komen lady will never give up — of that, I am certain.

There, now. I have done my sniping, and it’s time to get serious and meaningful and important. You don’t have to take any of the above too seriously, but the rest is stone-cold reality.

Dr. Salwitz writes that, “I will see life on the day we cure cancer.” I get what he means, but here’s the thing: there will be life to see every second of every day between now and the day we cure cancer. Cancer — disease in general — does not make our lives invisible. Dr. Salwitz does not need to wait for a cure to open his eyes to those lives — the amazing, insistent, exhilarating, exhausting lives being lived by the people all around him, especially his patients. It is there, it is there right now, and it cannot wait for a cure.

The cancer people — the ‘soldiers’, not the patients — have this idea that all we really need to make things right is a cure. A cure will make cancer disappear forever. And it’s a fantasy. It’s not going to happen, and if it does, there would still be millions of people suffering the effects of having had cancer. If my illness were cured tomorrow, I would still be messed up and fragile and difficult. I would still be haunted by death. But even if my illness is never cured, I will still be every bit as alive as I was before I got sick. And I want physicians who see that, who are willing to help me fight to live that life now. I can’t wait for a cure. I won’t suspend my life waiting for a cure that might never come.

Ultimately, I don’t care whether I am cured or not, whether I live or die, so long as the life I have right now is meaningful. I don’t think Dr. Salwitz gets that, and I worry this is a widespread attitude among the medical community. Patients — whether or not they have cancer — do not need a cure to start living. What they do need is physicians with open eyes and hearts and minds, who are ready to help them fight to live as best they can today.

A few interesting posts out there this week:

1. You should definitely watch, if you can, Dr. Otis Brawley’s damning speech about what’s wrong with the American health care system. It’s particularly notable in that Brawley, himself a physician, puts a lot of blame on health care providers. Unfortunately, since Monday (when I watched the speech in full) the video has been made “private” on YouTube. Brawley is the chief medical officer of the American Cancer Society, and was making the speech to a conference of the Association of Health Care Journalists; presumably the AHCJ decided to hide the speech.

From my viewing of the speech, the most telling detail was his description of AstraZeneca’s switch from Prilosec to Nexium: when Prilosec went generic, Astra Zeneca was looking for their next blockbuster. A chemist realized that they could take the active ingredient in Prilosec, cut out an inactive ingredient, and patent the new compound as Nexium. Even though the resulting medicine has exactly the same effect, Astra Zeneca is able to charge $6 a dose for Nexium, compared to $0.35 for generic Prilosec.  Physicians went right along with this, writing prescriptions that earned AstraZeneca $14 billion in profits between 2001 and 2005. You can read about a similar scam involving Abbot Labs’ various versions of Tocor. The result is that we pay a lot more for care, but don’t get any more value. If this stuff is important to you, and you’re reading this blog so it probably is, you should read Dr. Brawley’s book, How We Do Harm, too. I plan to, and will review it when I do.

If you want to see the speech, the best you can do for now is to email Dr. Brawley: otis.brawley@cancer.org and ask him to ensure it is publicly available again. Meanwhile, the best article I have found summarizing the speech is on MinnPost.

2. From Gooznews, a post titled Anatomy of a Walletectomy, reviewing a study of the different rates charged for appendectomies at various hospitals — and even within the same hospitals. An excerpt:

The prices not only varied between hospitals, they varied within hospitals. The largest spread occurred at one hospital, which Hsia wouldn’t reveal, where the cheapest appendectomy went for $7,504 while the most expensive charged was $171,696. There were numerous hospitals where the spread was $100,000 or more.

…

The patients also were charged different rates based on their insurance coverage. Medicaid pays the least while people with either no insurance or in individual plans that don’t negotiate rates paid the most.

One of the reasons health care reform is a moral imperative in this country is that the current system is the total opposite of justice — people without or with lousy insurance pay more than people with good insurance. Of course, the best insurance goes to those with the best jobs, and folks with serious health conditions have difficulty finding significant employment (I speak from long and painful experience), so the sickest people who can least afford it often pay far more for the exact same care as an otherwise healthy person receives. And Medicaid is no cinch to get on, at least in most states.

3. On Kevin, MD, a physician sues an attorney over $600 in unpaid bills and reports on lessons learned. Dr. Baum, the physician, ultimately extracts a settlement for the original amount, plus courts costs and attorney’s fees, and decides that it wasn’t worth the hassle. In a bizarre twist, he donates the  money to charity, explaining that “I certainly didn’t want to enjoy or profit from this ill-gotten award.”

So the justice system works more or less as advertised, Dr. Baum finally gets paid for work he did, and he feels like the money is ‘ill-gotten’? Does that reflect on the medical community’s prejudice against the justice system, the hostility between attorneys and physicians, or simply one physician’s own neuroses? Have fun puzzling that out.

Meanwhile, note that Dr. Baum is surprised how much of a fight $600 ends up being. Now consider the fight his attorney (or his insurers’ many, many attorneys) would put up for a potentially multi-million dollar suit for, say, a medical error that ended up in an amputation, or loss of sexual function, or an early death. It would be pretty fierce — it would make Dr. Baum’s case look like a third-grade’s play about the first Thanksgiving.

So one additional conclusion we can draw from this story is that our justice system is not biased in favor of plaintiffs; it is not the case that injured patients just show up at the courthouse and the bailiffs force doctors to write checks for however much money the patients want. That’s not to say our system is perfect, or even adequate for the hundreds of thousands of injured patients who don’t get a remedy, but it does belie the insistence from some corners of the medical community and right-wing politics that the courts be even further limited against injured patients.