Saturday, November 11, 2017

Traveling At The Edge Of Life Expectancy

Allow me to deviate a bit from the worlds of Imaging and PACS...I'm straying way out of my wheelhouse on this one.

This starts off with a happy occasion, a Mediterranean cruise. Mrs. Dalai and I recently joined some friends for a two-week trip through various European cities and towns. We had a great time and enjoyed some beautiful sights and wonderful food. I won't bore you with every little detail, but suffice it to say the ship was very comfortable, and the destinations were spectacular.

Mrs. Dalai and I have travelled extensively over the years, often by sea. Until recently, we were generally the youngest people on the ship, and even when we went to Antarctica, we were in the lowest quartile or quintile age-wise. On this last trip, we were perhaps in the lower third. Still respectable.

Modern medicine is a wonderful thing. We cure diseases that were once fatal, and we perpetuate life way beyond the limits our grandparents, or even our parents, thought possible. And that is certainly a good thing. But it can be somewhat of a mixed blessing. With the reasonable expectation of living well into our 70's, 80's, and not uncommonly, our 90's, we may feel less pressure to accomplish the things we should be doing at a younger age. I'm surrounded by this mentality. Many colleagues and acquaintances are working themselves to death, hoping that they really aren't, trying to make hay while the sun shines. If you believe you will be alive and kicking after retirement, and assume you will be as healthy as the day you turned 40, that makes some sense. But my observations on this particular journey demonstrate some fallacy in that approach.

True, modern medicine has delivered us many spry individuals in the 70's and 80's, although I can't honestly say if they represent the majority of their age-group. Some of our fellow travelers certainly fit that category. Sadly, many, at least a significant plurality, did not. There were any number of folks who could not walk up a flight of stairs (but tried anyway), who could not walk more than a few hundred feet on a tour clearly labeled "NOT FOR THOSE WITH PHYSICAL LIMITATIONS" (but tried anyway), and who really weren't quite sure what time-zone, what port, what country, or even what planet they were visiting (but didn't care anyway). These pour souls rather clearly didn't enjoy the experience, and presented an impediment and even some danger to the rest of the gang. I'm speculating a bit, of course, but I think it likely that these folks delayed their gratification to the point of no return. They saved and saved and saved for the trip of a lifetime, working hard, sacrificing, scrimping, and generally putting things off until just short of too late.

Please don't think I'm a callous jerk. I love old people. I hope to be one someday. According to AARP, I'm one already. So stop throwing dentures at me. I don't blame the old folks for trying to enjoy life, even if their insistence on doing so impacts me. That isn't really what this is about.

The message I want to deliver is directed at those my age and younger. It is simple but profound: Life is to be enjoyed, treasured, and cherished. It is not meant to be a rat-race wherein we try to accumulate the most cash and the most stuff before we croak.

He who dies with the most toys is still dead.

While it's rude to tell people how to spend their money, and how much to work or not to work, I'm hoping I can inspire some of you to strike a balance. Find what you love, and indulge yourself while you can still enjoy it. Obviously, don't break the bank, but don't deprive yourself until you have no self to deprive. Find a way to enjoy yourself without killing yourself, losing sight of who you are and what incredible things you already have. Like a spouse, kids, dogs, cats, etc.

I wish I had the complete answer, but I don't. You can't take a round-the-world cruise in the Owner's Suite of the Queen Mary II, or drive a $300,000 Bentley SUV at age 35 unless you were born rich, hit the lottery, or came up with that Killer App. But perhaps you can do a shorter trip on a slightly less luxurious vessel, and drive a very nice Toyota. Or a trip to the beach. Or even camping in the backyard. Enjoy what you have while you have it. There is always something desirable just out of reach, no matter what level you've achieved. If you let the pursuit of such define you, you'll never, ever be content.

For most of us, it's all about compromise, and the realization that very, very few can have it all right bloody now. But putting everything off until you're 95% deceased because you had to collect just one more paycheck is a shame, a tragedy. Compound that with the sad truth, which I see daily, that sometimes life does not go on. All the more reason to celebrate and enjoy.

In the Talmud, the collective work of Jewish wisdom, is found this passage:
Rabbi Eliezer said: “Repent one day before your death.” So his disciples asked him: “Does a person know which day he will die?” Rabbi Eliezer responded: “Certainly, then, a person should repent today, for perhaps tomorrow he will die—so that all his days he is repenting.” (Talmud, Shabbat 153a)
I'm more into reflecting than repenting, although I do my share of that, too. I might alter the Rabbi's response to read, "Certainly, then, a person should live today..." I'm not suggesting indulging in a daily bacchanalia, but rather to simply enjoy life and all the gifts thereof. Live within your means, invest for the future, but LIVE today. It really is that simple.

You may now resume throwing your dentures.

Wednesday, November 08, 2017

Interventional SPAM

I've been out of the country for several weeks, which is the usual explanation for by lack of posting. I was on a pleasure trip, or I would have posted from off. There will be an article about that later.

Blogs are easy targets for spammers, if you didn't know. That "Comment" field is a magnet to the unscrupulous who somehow think that bloggers will gleefully allow advertisements to appear on their site. Wrong, buffalo-breath. All but the least experienced bloggers maintain control over their comments and never, ever, EVER allow this trash to reach their readers. 

Most of this seems to come from a concept called "affiliate marketing" wherein someone gets paid for pushing someone else's product or website. Great idea? Not to me. When coupled with the power and reach of the Internet, it prompts the greedy to bombard the rest of us with garbage emails, blog-comments, and other bogus instruments designed to make us click into some site for which the spammer gets a penny or two. Or some fraction thereof. When you send out millions of these things, those fractions add up. These are mostly generated by 'bots, as an aside, a complete misuse of limited AI technology. But some might be human-borne...

Normally, I delete each and every SPAM comment, after reporting the sender and the advertised company to the appropriate places. Once in a great while, I shut one of them down. Today, however, I'm going to make an exception, and publish the SPAM comment as its very own blog-post. And the advertiser is NOT going to like it. 

Early this morning, I received this comment from "Ruben Fogg" on my RAD-AID article:

Ruben Fogg has left a new comment on your post "Giving Back: RAD-AID":

RAD-AID has literally hundreds of opportunities for everyone in imaging from physicians to medical students and residents, as well as interventional radiology chicago technologists, sonographers, nurses, physicians assistants, health physicists, as well as specialists in health information technologies and public health. If you have a radiologic skill, there’s a place where you are needed. Trust me on that. 

This miscreant inserted his advertising link into a paragraph quoted from the article itself. I find it rather sad that he chose this particular post, but spammers tend not to have much of a conscience. 

Against the usual standing advice, I clicked the "interventional radiology chicago" link...and it leads me to the advertiser, VIR Chicago:

Find an Interventional Radiologist at VIR Chicago

VIR is comprised of eight IR specialists whose experience in interventional radiology in the Chicago area extends over 25 years. We are clinic-based, but practice at and cover the Adventist Midwest Health hospitals in the western suburbs of Chicago:

Adventist Bolingbrook Hospital
Adventist GlenOaks Hospital
Adventist Hinsdale Hospital
Adventist La Grange Hospital
Advocate Sherman Hospital

Please contact us to schedule a consultation with one of our Chicago-based interventional radiologist team members.

Each interventional radiologist at VIR has been a leader in bringing this modern specialty to Illinois. All of our physicians have the highest level of certification from the American Board of Medical Specialties: the Certificate of Added Qualifications in Vascular and Interventional Radiology. At VIR, our interventional radiologist team participates in ongoing research and clinical trials and has authored many scientific papers and presentations in the field of interventional radiology. We have had several “firsts” including the first uterine fibroid embolization (UFE) in Illinois, the first placement of a flexible metal stent in a human in Illinois, and recently, the first fibroid embolization ever performed in a gorilla (see photo).

The VIR interventional radiologist team has three other condition-specific websites that we invite you to visit:

Uterine Fibroids
Aortic Stents

Seems like an upstanding practice; at least they came up with a good website. But someone thought it necessary to hire affiliate marketer to SPAM on behalf of their site. And that is a very, very bad idea.

I'm old enough to remember when doctors (and drug companies) didn't advertise. At all. It was consider gauche, low-class, greedy, nasty, whatever. That has changed, obviously. Our local news broadcasts are all sponsored by various hospitals, orthopedic groups, and chiropractors. The national network shows feature ads for various biologicals and chemo drugs that can only be delivered by prescription.

Clearly, the implication is that Health Care is just another product like cars or floor wax, to be sold with Madison Avenue aplomb. How do you feel about that? I'll tell you how I feel...I feel sickened. This is not how the profession should function. Clearly, the pursuit of revenue has taken precedence over everything else. Some will argue that patients need to be empowered and educated, and that's true to an extent. However, as with the issue of patients reading their own reports, their ability to assimilate the information thrown at them is variable at best. I personally see all of this, advertising and all, as attempts to decrease the influence and importance of physicians. And to boost revenue by directly targeting patients as customers. Is this why I went to medical school?

I guess I'm getting old and crotchety.

I'm not going to apologize for "outing" VIRChicago. They hired the spammer, I mean marketing affiliate. They wanted publicity. I'm happy to oblige.

If you’re interested, here is some information about the spammer...note nation of origin...