{"id":4612,"date":"2011-01-12T11:11:22","date_gmt":"2011-01-12T16:11:22","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=4612"},"modified":"2011-01-12T11:46:19","modified_gmt":"2011-01-12T16:46:19","slug":"not-melodrama","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2011\/01\/12\/not-melodrama\/","title":{"rendered":"not melodrama…"},"content":{"rendered":"\n

I spent several years as a kid with an illness that now doesn’t exist, chronic tonsillitis that kept me from eating. It was in the 1940s before antibiotics, and there was a terror about tonsillectomy. It predisposed kids to polio. So I spent a couple of winters in bed sick, being fed on cokes and soft-boiled eggs, waiting to be old enough for a safe operation. In the interim, the treatment was frequent "painting" of my tonsils with Mercurochrome. And while I dreaded those treatments, the doctors that attended me as a child were indelibly imprinted on my mind. Whatever I saw in them must’ve been pretty important, because years later when it dawned on me that I was going to have to be an adult, I decided to go to medical school "out of the blue." At the time, I had no idea where that decision came from, but I now know it was driven by something I saw in those doctors as a young child. I was also left with an aversion to undercooked eggs.<\/p>\n

I don’t know if painting tonsils, or postponing curative surgery, or the later restrictions to prevent polio even mattered medically. The coming of antibiotics and polio immunizations made those questions irrelevant – ideas long forgotten. But I do know now [as I knew then] that my caretakers believed those things were important, and their motives were only to take good care of me. I’m absolutely sure that my doctors had no stock in a Mercurochrome company. Whatever you call those motives, that’s the thing that ultimately attracted me to medicine. I call it Integrity<\/font><\/strong><\/em>. <\/p>\n\n\n
\n
in·teg·ri·ty<\/font><\/strong>
noun<\/em> \\in-\u00cb\u02c6te-gr\u00c9\u2122-t\u00c4\u201c<\/font><\/strong>\\<\/div>\n
    \n
  1. \n
  2. \n
  3. \n
    the quality or state of being complete or undivided : completeness<\/a><\/div>\n<\/li>\n<\/ol>\n<\/td>\n<\/tr>\n<\/table>\n

    Mercurochrome was toxic to germs and<\/u> people, so the "painting" was a compromise in one direction. Postponing surgery was a compromise in the other direction – restraint. And keeping me from swimming in public pools or the wonderful nearby lake was a social compromise that weighed heavily on a six year old. They didn’t get those recommendations from their own experience. They were told those things by other doctors – the 1940s version of Key Opinion Leaders<\/font><\/strong><\/em> [who also didn’t have stock in Mercurochrome, connections with Operating Room revenues, or anything to do with the local swimming pool economy].<\/p>\n

    That’s how medical practice works. It’s an applied science. The questions are bottom-up<\/em><\/strong> – they come from sick people. The answers are top-down<\/strong><\/em> – they come from academic medicine, research, or specialists who limit themselves to a particular condition. Practicing clinicians are in the middle, where personal experience is heavily informed by the recommendations from above – thus the requirement for Continuing Medical Education<\/font><\/em><\/strong> whether by formal or individual routes. In medicine, almost everything is a compromise, and this flow of information is the way of finding right compromises [known as best practices<\/font><\/strong><\/em>].<\/p>\n

    It’s number 3. above that comes closest to the root meaning of Integrity<\/font><\/strong><\/em> – wholeness or completeness – like the word Integer<\/font><\/strong><\/em> [a whole number]. The Integrity<\/font><\/strong> of Medicine includes the integrity [as in wholeness] of the system, not just the personal integrity of individual physicians. The things that I’ve been writing about – the Pharmaceutical Industry’s invasion of Academic Medicine, the ghostwritten journal articles, the corruption of Continuing Medical Education, and the commercialization of KOLs – destroys the Integrity<\/font><\/strong> of System Medicine at every level. To use a worn movie metaphor, it’s a disturbance in the force<\/font><\/strong> that pushes us over to the dark side<\/font><\/strong>. But it is not melodrama to say that these things threaten the whole enterprise.<\/p>\n

    It’s just the truth…<\/div>\n","protected":false},"excerpt":{"rendered":"

    I spent several years as a kid with an illness that now doesn’t exist, chronic tonsillitis that kept me from eating. It was in the 1940s before antibiotics, and there was a terror about tonsillectomy. It predisposed kids to polio. So I spent a couple of winters in bed sick, being fed on cokes and […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-4612","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/4612","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=4612"}],"version-history":[{"count":0,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/4612\/revisions"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=4612"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=4612"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=4612"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}