Editorial comment by me 5/14/2020

What I’m seeing here in Pittsburgh is similar to what’s happening elsewhere in the mid-west, lots of people believing that rituals will save them from doom and gloom. That wiping down things with alcohol, wearing essentially ineffective surgical masks and bandanas that demonstrate they’re “doing something” and playing out the opera as dictated by expertsContinue reading “Editorial comment by me 5/14/2020”

Some history that might affect us in 2020

Some history that might affect us in 2020 David Crippen The great famine in Ireland, 1845 -1849.  During the worst of it, 1847, one million Irish died and another one million were put on ships bound for America. A microorganism, the “potato blight” was actually found first in Philadelphia and New York City. Winds spreadContinue reading “Some history that might affect us in 2020”

A treatise on aging and dementia

I read with great interest Mike Darwin’s essay on aging and potential dementia. I decided to add some to that, including a perspective of my own experience- how it applies to me as I age. (76 years of age this month). The issue of dementia has become more prevalent for a very interesting reason. InContinue reading “A treatise on aging and dementia”

A political/medical care observation for the New Year

It is after all Sunday and this is a bit more of a time for a “Village Green” observation by your FL, for what it might be worth. What I’m about to say involves an obligatory observation on National politics because it impacts what’s happening in medicine today and in the near future. My observationsContinue reading “A political/medical care observation for the New Year”

Some comments on where critical care medicine is headed in the next ten years

Recall several months ago I wrote some editorial opinions on where I thought critical care was headed, some of them not too kind. I foresaw a critical care world full of Physicians Assistants (PA) and Nurse Practitioners (CRNP) doing patient care and critical care physicians as their handlers in executive roles. The actual experience andContinue reading “Some comments on where critical care medicine is headed in the next ten years”

Some acerbic notes on the new generation of physicians

“My impression is that the older ones found work-life integration while the younger ones are focused on work-life balance. There’s not a lot of balance when up at 3 am with a sick patient or 5. And the a common refrain is “I don’t want to work weekends “ Crippen: When I was a medicalContinue reading “Some acerbic notes on the new generation of physicians”

A few notes on State of Pennsylvania health care politics

This missive is an abstract of two letters to a friend asking me to sign a petition urging current Pennsylvania Governor to “do the right thing” and expand Medicaid benefits in our State. Sadly, I think the fate of that issue is not amenable to public or provider opinion, for the reasons outlined below. ———————————————Continue reading “A few notes on State of Pennsylvania health care politics”

Stress, physicians and age

Physician “burnout” is defined as loss of enthusiasm for work, feelings of cynicism, low sense of personal accomplishment. I think the factors involved are infinitely complex. I will also hazard a guess that the issue of burnout builds on two fronts:  Stress and Age, and the nomenclature for each is radically different. Front 1– TheContinue reading “Stress, physicians and age”

The “new brain death” in 2014

<http://usnews.nbcnews.com/_news/2013/12/30/22114290-brain-dead-teen-to-remain-on-life-support-pending-appeal-by-family#comments&gt; We now have a completely different complexion on the brain death = death issue. Back in antiquity (1968) brain death was defined objectively as death so we could get dead people off ventilators. Organ issues came later.  But 1968 was a different world of “life support” than it is now and many of theContinue reading “The “new brain death” in 2014″

Some thoughts on mandatory influenza prophylaxis

This month marks a year since I got a demyelinating spinal cord disorder a week after getting the same flu shot I had received every year for at least 20 years. This one happened to be the one that liked me spinal cord better than the virus. It is very slowly improving but definitely stillContinue reading “Some thoughts on mandatory influenza prophylaxis”