Drinking and Thinking
April 13, 2013
LoveLife IS Love™©,
Whimsical Words With A Serious Meaning
On a Spring Morning in Maine
Are you thinking,
an alcoholic beverage. No.
I am drinking ...
Hot coffee, it is, as is usual for me this time of day,
for me to drink and think and,
to tell what my sense and senses say,
as I sit in my cozy seat and sip this warm, delicious mix.
It is a fix,
for me to watch through kitchen window,
this, another day grow out of darkness,
a joyful pleasure and good way to spend some leisure,
giving my two cents
and say,
This morning Snow, White, I tweet these words
"Today, white. Yesterday's snow, clouds +ice -new blanket spread around on trees & ground, &crystals bending branches. Still now, Love." U?M
and think, "this is too short. And, besides, on Twitter, everyone talks and nobody listens. So, what is the point of words on twitter? Then again, there are a few I know ... have come to know through Twitter ... who are real people and solid friends ..."
So, my reasons unfold,
"These words resonate with some. Few, but enough hearty souls and courageous, as they speak out as well. It is good to know and to share words from the heart, to know you are on this earth, myy kindred spirits."
and as I sit and think about it all,
clumps of snow begin to fall,
and drip from trees.
A brighter sky now warming,
the ice begins to sparkle in sunbeams,
this crystal splendor soon to be ... gone
as it is, time passing and thoughts so fast and words so slow,
"and writing such a distraction from being ...the page is not real ... here and now ... words, there are never enough of them to tell the story, but it is just another form of expression, as is life ... and every step taken ... expression of self"
Sunbeams, within each droplet an infinite rainbow sparkles
"Life IS Love and precious ... not to be wasted ... on the greedy. Reciprocity is the rule, Love and tough love. Am I trying to convince myself? There are others I know who live by this simple rule. The only reason we are here on this earth is to Love and be Loved in Return."
Shadows in the sunlight,
and, you know,
warming, melting, dripping,
dropping water from the trees
turning brown and green before my eyes.
Drooping leaves and branches,
bouncing up from under the melting snow and ice.
There is no breeze.
"It is nice"
A bird, birds, birdsong.
"How is it that they can find the feeder after it has been gone so long. Within a day they found it."
They flutter by the steel gray sky,
and yet, they sing
to each other?
"Is this Love?"
I wonder what this day has in store for me?
Have a great day!
StepWisely®™©, Take the Best Care™© of Yourself and those in your charge. Have fun and be careful.
Dr. Mike
Showing posts with label Life is Love™©. Show all posts
Showing posts with label Life is Love™©. Show all posts
Saturday, April 13, 2013
Saturday, June 30, 2012
PGY 39, Day # 366
PGY 39, Day # 366
Back in the SICU again
This is my transitional week; my last week of ICU duty for PGY 39, and the start of my first week of duty for PGY 40. That means we have the short timers now and newbies to start on July 1 ... house staff that is. In other words, the more experienced interns and residents will move up a notch, while the interns move in. This transition is always exciting
A few observations/thoughts/teaching points from rounds ... these reflect my collective experience ... not just this week's events.
1. Monster Healthcare Organizations (as well as other corporations and governments) generate momentum and inertia that is dependent upon size and responsiveness. Like Giant Ships (eg. Titanic) they have a tendency to "stay the course" for many reasons, not the least of which is the failure to have accurate "sensors" in and on the front lines and they lack facility to change direction. In other words, they loose their sensitivity to the people they are serving and the servers (providers), get preoccupied with and distracted by things that are essentially phobias, impose top down "solutions" to non problems, increase burdens on front line providers, interfere with quality front line care and, basically, miss the mark on many opportunities to improve care quality and outcome. Basically, they lack the ability to move smart and fast. Electronic Medical Records are a perfect example of new technology that was imposed top down without proof of effectiveness and safety. This technology consumes between 25% and 50% of front line provider time, and that takes away from patient care time. Scribes can eliminate the time wasted on computers, but the safety and effectiveness of first generation EMRs is yet to be determined. My bet is that drastic changes in form and function will be mandated in the near future.
2. Benchmark Quality "Standards", lower the quality of care, by justifying mainstream levels of performance. In other words, mainstream performance becomes a standard by default. This is dangerous in healthcare, where optimal performance and outcome is always the goal and mainstream performance may well be substandard. Disinguishing comparative benchmarks from true quailty measures is a serious problem that can only be addressed through solid scientific research. This research should take the form of Continuous Quality and Performance Improvement measures that review 100% of care provided and examine the impact (outcome) of changes in practice, new techniques and technology. The goal is to optimize patient care constantly and to raise the bar continuously. That is the only way to provide the best possible patient care at all times.
3. Causes of vascular injury in trauma
4. Need for and Implementation of Continuous Quality and Performance Improvement Process to Measure Outcome: Provider Role
5. Need for Advanced Directives to prevent unnecessary and inappropriate care
6. Comparison of Morphine and Hydromorphone, cost, effectiveness, dose, side effects
7. Arterial and Venous Gas Embolism
8. Brain and Spinal Cord Protection Strategies
9. Nosocomial Pneumonia, Colonization, Transmission and other assorted issues related to Ventilator Associated Pneumonias and Hospital Acquired Pneumonias
10. Targeted Strategies for Patient Care and Organ Preservation in the ICU
As I was about to leave the hospital tonight, during a conversation after evening rounds with my night coverage resident ... one of the more experienced and competent residents on service ... about patient care and teaching, and the fact that this is "a labor of Love", and stating, "It is a good thing I love what I do." We both laughed about the difficulties encountered in teaching and providing services, and I think he got the point that I reiterate on a regular basis. Specifically, "there is not enought money in the world to make this right."
I have to give it up now, and try to get some sleep. On call, but the coverage tonight is solid, and tomorrow will be a Long Day!
PGY 40, Day 1 meets PGY 1, Day 1! LOL ... we will see how that goes.
Love to all!
"Love is the Power, Care is the Mission, Safety and Optimal Care are the Goals and The Hippocratic Oath is our Guide."
You can quote me on that.
Dr. Mike
Back in the SICU again
This is my transitional week; my last week of ICU duty for PGY 39, and the start of my first week of duty for PGY 40. That means we have the short timers now and newbies to start on July 1 ... house staff that is. In other words, the more experienced interns and residents will move up a notch, while the interns move in. This transition is always exciting
A few observations/thoughts/teaching points from rounds ... these reflect my collective experience ... not just this week's events.
1. Monster Healthcare Organizations (as well as other corporations and governments) generate momentum and inertia that is dependent upon size and responsiveness. Like Giant Ships (eg. Titanic) they have a tendency to "stay the course" for many reasons, not the least of which is the failure to have accurate "sensors" in and on the front lines and they lack facility to change direction. In other words, they loose their sensitivity to the people they are serving and the servers (providers), get preoccupied with and distracted by things that are essentially phobias, impose top down "solutions" to non problems, increase burdens on front line providers, interfere with quality front line care and, basically, miss the mark on many opportunities to improve care quality and outcome. Basically, they lack the ability to move smart and fast. Electronic Medical Records are a perfect example of new technology that was imposed top down without proof of effectiveness and safety. This technology consumes between 25% and 50% of front line provider time, and that takes away from patient care time. Scribes can eliminate the time wasted on computers, but the safety and effectiveness of first generation EMRs is yet to be determined. My bet is that drastic changes in form and function will be mandated in the near future.
2. Benchmark Quality "Standards", lower the quality of care, by justifying mainstream levels of performance. In other words, mainstream performance becomes a standard by default. This is dangerous in healthcare, where optimal performance and outcome is always the goal and mainstream performance may well be substandard. Disinguishing comparative benchmarks from true quailty measures is a serious problem that can only be addressed through solid scientific research. This research should take the form of Continuous Quality and Performance Improvement measures that review 100% of care provided and examine the impact (outcome) of changes in practice, new techniques and technology. The goal is to optimize patient care constantly and to raise the bar continuously. That is the only way to provide the best possible patient care at all times.
3. Causes of vascular injury in trauma
4. Need for and Implementation of Continuous Quality and Performance Improvement Process to Measure Outcome: Provider Role
5. Need for Advanced Directives to prevent unnecessary and inappropriate care
6. Comparison of Morphine and Hydromorphone, cost, effectiveness, dose, side effects
7. Arterial and Venous Gas Embolism
8. Brain and Spinal Cord Protection Strategies
9. Nosocomial Pneumonia, Colonization, Transmission and other assorted issues related to Ventilator Associated Pneumonias and Hospital Acquired Pneumonias
10. Targeted Strategies for Patient Care and Organ Preservation in the ICU
As I was about to leave the hospital tonight, during a conversation after evening rounds with my night coverage resident ... one of the more experienced and competent residents on service ... about patient care and teaching, and the fact that this is "a labor of Love", and stating, "It is a good thing I love what I do." We both laughed about the difficulties encountered in teaching and providing services, and I think he got the point that I reiterate on a regular basis. Specifically, "there is not enought money in the world to make this right."
I have to give it up now, and try to get some sleep. On call, but the coverage tonight is solid, and tomorrow will be a Long Day!
PGY 40, Day 1 meets PGY 1, Day 1! LOL ... we will see how that goes.
Love to all!
"Love is the Power, Care is the Mission, Safety and Optimal Care are the Goals and The Hippocratic Oath is our Guide."
You can quote me on that.
Dr. Mike
Life is Love™©
StepWisely®™©
Thursday, June 14, 2012
Medical Killing is Just Plain Wrong
MEDICAL KILLING IS WRONG!
Medical Killing is a clear violation of the Hippocratic Oath, it undermines the Doctor-Patient Relationship and it is just plain wrong. Don't let the Business of Medicine and the Politicians enable medical killing!
Below you will find two emails: the first is my respnse to the Care Not Killing administrator, Robert Colquhoun, and the second is the email that prompted my response. It appears that the movement to enable medical killing is growing, and this is a very dangerous policy for many reasons. Read the emails below to get a better understanding, and let me know if you have any comments, or questions.
Dr. Mike
dr.mike@ihealsolutions.com
From: "Michael F. Mascia MD, MPH" <masciam@aol.com>
Date: June 14, 2012 12:30:33 EDT
To: CNK Administrator <administrator@carenotkilling.org.uk>
Subject: Re: Vote NO on poll, respond to articles
Hello!
This is the complete title/author info on the MUST READ book to see how we are allowing the mainstream to slip into the Nazi mode ... AGAIN!
It is a compelling and nauseating read.
The Nazi Doctors: Medical Killing and the Psychology of Genocide
Robert Jay Lifton
Thanks for your help.
I will try to tweet/blog on this soon.
Interesting that I just put out a Tweet #quote yesterday about Killing ... as there is never any justification for intentional killing. With rare exceptions ... perhaps someone like Hitler being the exception ... oddly enough. Now ... with greedy and selfish people pushing the mainstream for profit over people ... we see this surge again with all sorts of excuses for the bad behavior.
Doctors should NEVER participate in KILLING for ANY REASON.
That said, there are some triage situations, and some allowing people to die in dignity ... which is clearly distinguishable from, and not to be confused with active killing. Abortion to save the mother of an unborn baby perhaps being the most extreme example. But, many can't make the distinction, as their minds are clouded with all sorts of nonsense.
That's why the Hippocratic Oath has stood the test of time ... despite the fact that many have messed with it over time including Hitler's people ... it always come back to the original, wise document +/- that serves as a foundation for our work.
It is time for Doctors to restore the Doctor Patient Relationship and this must go against the grain of the Business of Medicine ... which is clearly on a very bad path ... bad for Patients and Doctors.
Let me know if you need any other contact information.
Ciao for now,
Dr. Mike
Michael F. Mascia, MD, MPH
President
Infinity Health Solutions
dr_mike_ihs @ twitter
MFM@IHS ip
On Jun 14, 2012, at 6:55, CNK Administrator <administrator@carenotkilling.org.uk> wrote:
Dear All,
The next few weeks are shaping up to be extremely busy on the euthanasia front as pro-euthanasia activists are gearing up for a new assault on the media, the courts, the medical profession and Parliament.
The pro-euthanasia lobby has begun its campaign in earnest with three articles in the British Medical Journal which aim at neutralising medical opposition to euthanasia.
Please respond and comment on the articles below on the BMJ website:
Raymond Tallis, chairman of Healthcare Professionals for Assisted Dying, argues that medical institutions should take a position of studied neutrality on assisted suicide: http://bit.ly/M6rUBX
Tess McPherson, tells the story of her mother who died from cancer last year: http://bit.ly/LG9VmX
The journal’s editorial by Fiona Godlee, ‘supports’ call for assisted suicide: http://bit.ly/OGdjz7 Vote NO on the opinion poll on this page (scroll down on the right).
Iona Heath, President of the RCGP, argues that assisted suicide would marginalize the most vulnerable: http://bit.ly/K4scan
Many thanks,
Robert Colquhoun
Administrator
Please come to our symposium in Scotland:
http://www.carenotkilling.org.uk/forms/first-european-symposium/
--
Robert Colquhoun, Administrator
Website: http://www.carenotkilling.org.uk/
E-mail: info@carenotkilling.org.uk
Address: 6 Marshalsea Road, London, SE1 IHL
Phone: 020 7234 9680; Skype: carenotkilling
Registered as a Limited Company in England and Wales, Company No. 06360578
Newsletter
Get Involved here
Donate
Follow on facebook or twitter
Medical Killing is a clear violation of the Hippocratic Oath, it undermines the Doctor-Patient Relationship and it is just plain wrong. Don't let the Business of Medicine and the Politicians enable medical killing!
Below you will find two emails: the first is my respnse to the Care Not Killing administrator, Robert Colquhoun, and the second is the email that prompted my response. It appears that the movement to enable medical killing is growing, and this is a very dangerous policy for many reasons. Read the emails below to get a better understanding, and let me know if you have any comments, or questions.
Dr. Mike
dr.mike@ihealsolutions.com
From: "Michael F. Mascia MD, MPH" <masciam@aol.com>
Date: June 14, 2012 12:30:33 EDT
To: CNK Administrator <administrator@carenotkilling.org.uk>
Subject: Re: Vote NO on poll, respond to articles
Hello!
This is the complete title/author info on the MUST READ book to see how we are allowing the mainstream to slip into the Nazi mode ... AGAIN!
It is a compelling and nauseating read.
The Nazi Doctors: Medical Killing and the Psychology of Genocide
Robert Jay Lifton
Thanks for your help.
I will try to tweet/blog on this soon.
Interesting that I just put out a Tweet #quote yesterday about Killing ... as there is never any justification for intentional killing. With rare exceptions ... perhaps someone like Hitler being the exception ... oddly enough. Now ... with greedy and selfish people pushing the mainstream for profit over people ... we see this surge again with all sorts of excuses for the bad behavior.
Doctors should NEVER participate in KILLING for ANY REASON.
That said, there are some triage situations, and some allowing people to die in dignity ... which is clearly distinguishable from, and not to be confused with active killing. Abortion to save the mother of an unborn baby perhaps being the most extreme example. But, many can't make the distinction, as their minds are clouded with all sorts of nonsense.
That's why the Hippocratic Oath has stood the test of time ... despite the fact that many have messed with it over time including Hitler's people ... it always come back to the original, wise document +/- that serves as a foundation for our work.
It is time for Doctors to restore the Doctor Patient Relationship and this must go against the grain of the Business of Medicine ... which is clearly on a very bad path ... bad for Patients and Doctors.
Let me know if you need any other contact information.
Ciao for now,
Dr. Mike
Michael F. Mascia, MD, MPH
President
Infinity Health Solutions
dr_mike_ihs @ twitter
MFM@IHS ip
On Jun 14, 2012, at 6:55, CNK Administrator <administrator@carenotkilling.org.uk> wrote:
Dear All,
The next few weeks are shaping up to be extremely busy on the euthanasia front as pro-euthanasia activists are gearing up for a new assault on the media, the courts, the medical profession and Parliament.
The pro-euthanasia lobby has begun its campaign in earnest with three articles in the British Medical Journal which aim at neutralising medical opposition to euthanasia.
Please respond and comment on the articles below on the BMJ website:
Raymond Tallis, chairman of Healthcare Professionals for Assisted Dying, argues that medical institutions should take a position of studied neutrality on assisted suicide: http://bit.ly/M6rUBX
Tess McPherson, tells the story of her mother who died from cancer last year: http://bit.ly/LG9VmX
The journal’s editorial by Fiona Godlee, ‘supports’ call for assisted suicide: http://bit.ly/OGdjz7 Vote NO on the opinion poll on this page (scroll down on the right).
Iona Heath, President of the RCGP, argues that assisted suicide would marginalize the most vulnerable: http://bit.ly/K4scan
Many thanks,
Robert Colquhoun
Administrator
Please come to our symposium in Scotland:
http://www.carenotkilling.org.uk/forms/first-european-symposium/
--
Robert Colquhoun, Administrator
Website: http://www.carenotkilling.org.uk/
E-mail: info@carenotkilling.org.uk
Address: 6 Marshalsea Road, London, SE1 IHL
Phone: 020 7234 9680; Skype: carenotkilling
Registered as a Limited Company in England and Wales, Company No. 06360578
Newsletter
Get Involved here
Donate
Follow on facebook or twitter
Saturday, June 9, 2012
One more Bit on Love
There is only one reason why we are here on this earth ...
To Love and Be Loved in return.
Get it?
Do it!
Never underestimate the Power of Love
The question is this: How do we put this Power to Work for All?
Toward that end, I have been working with a few set this up.
My goal? By the end of this year ... to set up a Non Profit that will enable and put this fundamental concept to work for the health and benefit of ALL who choose to participate.
I need a few folks, Doctors, Nurses and Patients to contribute and help get this going. Not looking for money. We don't need money ... we need People. This is a Cooperative ... Of the People, By the People and For the People. You can particpate from anywhere in the world. You give and you get in return.
Looking for ...
Founding members
Board members
Participants
Ordinary folks
to help us.
Let me know ... by email, or by responding to this blog.
Dr.Mike@ihealsolutions.com
Ciao for now, and LOVE to all.
Dr. Mike
To Love and Be Loved in return.
Get it?
Do it!
Life is Love™© so StepWisely®™©
Never underestimate the Power of Love
The question is this: How do we put this Power to Work for All?
Toward that end, I have been working with a few set this up.
My goal? By the end of this year ... to set up a Non Profit that will enable and put this fundamental concept to work for the health and benefit of ALL who choose to participate.
I need a few folks, Doctors, Nurses and Patients to contribute and help get this going. Not looking for money. We don't need money ... we need People. This is a Cooperative ... Of the People, By the People and For the People. You can particpate from anywhere in the world. You give and you get in return.
Looking for ...
Founding members
Board members
Participants
Ordinary folks
to help us.
Let me know ... by email, or by responding to this blog.
Dr.Mike@ihealsolutions.com
Ciao for now, and LOVE to all.
Dr. Mike
Thursday, June 7, 2012
Love Tid Bit
Love, An Eternal Moment
I close my eyes ...
you appear ...
Sweet images of you ...
wondering ... why ...
You are the Fire ...
that burns ...
in my ...
Heart.
Never underestimate the power of Love.
Love to all.
Dr. Mike
I close my eyes ...
you appear ...
Sweet images of you ...
wondering ... why ...
You are the Fire ...
that burns ...
in my ...
Heart.
Never underestimate the power of Love.
Love to all.
Dr. Mike
Friday, May 25, 2012
More On Love
Heavenly Love
But Ahhh ...
the crumbs that fall from the table of the gods ...
so delicious ...
a taste ...
wants more.
That ...
craving ...
desire ...
power ...
charge ...
heart and soul.
And ...
mutual ...
when mutual ...
a heavently crescendo ...
lifting toward their feast.
But ...
we never reach the table ...
rather ...
drifting up ...
and
down ...
with the Power.
When one fails ...
a sudden fall ...
and painful ...
crash.
Veritas est!
Enjoy!
Dr. Mike
But Ahhh ...
the crumbs that fall from the table of the gods ...
so delicious ...
a taste ...
wants more.
That ...
craving ...
desire ...
power ...
charge ...
heart and soul.
And ...
mutual ...
when mutual ...
a heavently crescendo ...
lifting toward their feast.
But ...
we never reach the table ...
rather ...
drifting up ...
and
down ...
with the Power.
When one fails ...
a sudden fall ...
and painful ...
crash.
Veritas est!
Enjoy!
Dr. Mike
Saturday, April 14, 2012
The Power of Love
On a Spring Morning in April
Hushhhh ... north winds speak ...
gently blowing through naked trees,
sweet cool air
wraps me ... face first,
mingling birdsong, brilliant eternal blue skies ...
hot sun penetrates my back.
Flowers ... few ... yellow ... forsythia ... popped open ...
rare bright spots ... mostly gray, brown and evergreen ...
many more soon to be.
Silent ... thinking ... last night ... the skies ...
bright with stars ... close ... reaching out in darkness.
Countless ... infinite, but so close ... and, how is it?
How can it be ... how can people ...
divided by countelss barriers,
feel so close?
Is it, like reaching for the stars?
No ... that is the power of love.
You are not alone.
Have a great day!
Life is Good and Life is Short, so make it as sweet as it can be, and don't hurt anybody.
Life is Love™© & StepWisely®™©
Dr. Mike
Michael F. Mascia, MD, MPH
Hushhhh ... north winds speak ...
gently blowing through naked trees,
sweet cool air
wraps me ... face first,
mingling birdsong, brilliant eternal blue skies ...
hot sun penetrates my back.
Flowers ... few ... yellow ... forsythia ... popped open ...
rare bright spots ... mostly gray, brown and evergreen ...
many more soon to be.
Silent ... thinking ... last night ... the skies ...
bright with stars ... close ... reaching out in darkness.
Countless ... infinite, but so close ... and, how is it?
How can it be ... how can people ...
divided by countelss barriers,
feel so close?
Is it, like reaching for the stars?
No ... that is the power of love.
You are not alone.
Have a great day!
Life is Good and Life is Short, so make it as sweet as it can be, and don't hurt anybody.
Life is Love™© & StepWisely®™©
Dr. Mike
Michael F. Mascia, MD, MPH
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