So a nice bonus about the Obama win is that I have an easy ice-breaker for patients at our clinic. I was talking to one mother about the celebration in the street; apparently, in her neighborhood (East New York), people were firing guns into the air. I'm sure Obama would be proud.
Finally, here's a choice bit from the Fed that they snuck in underneath all of the election news:
New York—Michael Alix has been named a senior vice president in the Bank Supervision Group of the Federal Reserve Bank of New York. He will serve as a senior advisor to William L. Rutledge, executive vice president, Bank Supervision Group. Mr. Alix’s appointment was made by the Bank’s board of directors and is effective, November 3, 2008.
Most recently, Mr. Alix worked for the Bear Stearns Companies, Inc., where he served as chief risk officer from 2006-2008 and global head of credit risk management from 1996-2006.
I mean, it wasn't enough that they got a former Bear Sterns exec... it had to be the RISK OFFICER.
So I ended up voting Obama/Biden. Partially, it was a gut thing; I thought about how disappointing it'd be the next day if McCain were president. But my rationale justification was that the Republican party is where the Democratic party was 4-6 years ago: in its death-throes. No central ideas or solid plans, no sense of real direction, just maintain the status quo. And like the Dems over the past year, the only real opposition is driven by anger and zealotry, not rationality or proof. And Obama has shown that, in practice, he's more pragmatic than ideological (and hopefully Rubin and Volcker can convince him that "fairness" has limited use in economic policy). So I'm okay with seeing what the Democratic party does; just gotta hope don't they screw up like the last two times they were in power (fortunately, a lot of their seats are up for grabs in 2012).
One thought is that even as America goes Democrat, EU has already begun going more to the right (I'm thinking Sarkozy or Merkel, to a lesser extent, Brown). Politics on continents have shifted due to economic pressure. Since a European conservative is essentially a moderate American liberal, it seems like we're nearing a Western political consensus.
Last night itself was pretty insane in Brooklyn. People started gathering on the major street corner, encouraged by car honking. In fact, the chorus of cheers elicited could be graded by the size of the honking vehicle. Small sedan, big SUV, van, bus, and finally GARBAGE TRUCK each drew progressively larger crowds. So, basically, imagine a rally of grown 2-year old boys. Eventually people figured out, hey, they can dance in the MIDDLE of the street, which was slightly more exciting than dancing on that boring sidewalk. So a bunch of nerdy white professionals started dancing in the street, while the police just sort of laughed and thanked the higher power that they were assigned to a neighborhood that they singlehandedly kick the shit out of. I tried to capture some video on camera phone, but it didn't really do the scene justice, so here's something from the Columbia Blue and White website. It was taken up on Broadway and 115th.
Basically, same idea as Park Slope, except slightly younger white nerds.
Wow, what a good friggin' episode of South Park. Given all the opportunity for cynicism and satire right now, its interesting that they went for an inspiration plot. Normally, their preachy episodes aren't as funny, but this one was able to keep it light all the way up to the signature South Park concluding lecture.
So the election season is looking like its pretty much over. Unless Obama plans on rebutting McCain in the final debate solely by projecting his voice to his butt, he's got this thing wrapped up. And its looking like its going to be a landslide.
So I should be thrilled, right? I mean, I'm a 20-something year-old male from the East Coast whose major occupation over the past decade has been studying trivial bullshit that I might be able to use at cocktail parties. Fuck, I'm even starting to use the term cocktail party. You can almost see my Obama/MLK XXXL "Dream" t-shirt if you stare closely enough through the screen.
But I'm really just disappointed. At the beginning of February, I figured this would be the first election in my lifetime that wouldn't be between a giant douche and a turd sandwich. Two guys that were supposedly above partisan politics, who actually thoughtfully deliberated on issues, instead of reading off the memo from their respective party's think tank. Now I realize that these guy's are so beholden to the biggest bunch of bozos this side of the Atlantic that its really just a matter of picking my poison. I realize a lot of my thinking is "guilt by association," but at a certain point, you expect these semi-intelligent men to stand back and realize, wow, I am totally surrounded by a bunch of douche nozzles.
Choice 1: You have a guy who gave almost a MILLION dollars to a group that for the past 4 presidential elections has distinguished itself for its complete disregard for electoral procedures. What was this money for? To help voter registration. He then was so desperate to get in good with unions that he started spouting stupid isolationist diatribes against globalism. Then, when he realized he was actually saying this stuff on national TV when people with half a brain cell could listen, he all of sudden backtracked on everything he said. Hey, its just words! But those are just the constituents he's trying to appease. WITHIN his circle of advisers he chose Jim Johnson. A man who made a good chunk of money figuring out ways to get health insurance executives MORE money (of course, this was after he held positions at Lehman Brother and Fannie Mae, and took loans from Countrywide). Home run.
That brings us to Choice 2: The guy who pretty much hammered the final nail in the coffin of whatever iota of intellect that was left in the GOP by picking Vice President Rambo. I didn't think it was possible to get a generation of Jewish grandma's to vote against McCain, but the maverick figured it out: find a woman who epitomizes shiksa, who named her child after an 8th grade math class. Her greatest accomplishment so far has been NOT to act like a TOTAL ding-dong on at least one televised event. This is the guy whose decided his main constituents are going to be named after a means of packaging beer. Between you and me, I think Joe Six-Pack has become a little bit smug with all the media attention; its time we start representing Steve Thirty-Rack or Kenny Keg-Stand. The idea is we find someone so inebriated and stupid that when you unveil your plan to save the economy, he won't realize it was already packaged into legislation that's been on the news non-stop for the past 72 hours.
So the first week is almost over, and its a little hard to get a sense of the semester ahead. Right now, I'm spending about an 1-2 hours reviewed material just lectured upon and 1-2 hours previewing the next week. Those numbers are probably going to double in a few weeks when things pick up. You start feeling entrapped by the curriculum: you can tell your life the next few years will be dictated by the school work. Your activities won't be dictated by what you WANT to do as much as what you CAN do. I'm not complaining; the information itself is pretty empowering.
We've also been introduced to ECM, or Essentials to Clinical Medicine. The course is supposed to teach us how to become counselors and partners of patients, a departure from the paternalism of the past. Instead of dictating orders to repair a disorder, we learn about working with the patient to understand their values and needs and to tailor their treatment to those ends. I agree with it in theory, but there's a lot of bullshit you have to wade through once you get past the basic principles. For example, one chapter in our required reading discusses different words to express emotions (use "infuriate" for intense anger, "irritate" for minor anger, and "anger" for moderate anger).
One term that gets thrown around a lot in our reading is "value." While I like that they're being brought up, I'm interested to see how they address values. How do you address the values of your patient if they're a child? Do you use the parents' values as surrogate? What if you patient is mentally invalid or masochistic? What if they're inherently wrong (maybe a man feels like its his right to have unprotected sex with non-consenting women)?
Right now, I feel like "values-based medicine" is a term academics throw around to make themselves feel better or more sensitive towards the patient. The bottom-line is you can't be an insensitive jerk, with each case being unique. There's no one paradigm for patient care. I don't know if that can be taught in a class, but I guess they're going to try. We'll see how it goes.
