Thoughts

Healthcare in Romania

 

There are two options for the person requiring care: the public healthcare system, financed by the government, where one is supposed to be cared for without cost if they hold medical insurance, and the private healthcare system, which is not really a system but is made up of different, unrelated private clinics or hospitals, where one must pay all expenses out of pocket. Let’s look at each system in more detail.

Public healthcare

I believe there are three main problems plaguing public healthcare in Romania:

  1. Widespread corruption at all levels of care. Bribes must be paid to hospital directors, managers, doctors and nurses, and sometimes even to hospital guards, if you are to get any competent care other than a daily temperature and blood pressure check until you check out or expire, whichever comes first.
  2. Incompetent personnel, due to:
    1. An inefficient medical education system, staffed with teachers and professors who care more about furthering their own careers, brown-nosing and getting bribes than teaching students how to be proper nurses and doctors.
    2. An unwillingness on the part of most students and medical personnel to put in the effort to acquire the knowledge they need to do their jobs right.
  3. Old facilities and equipment. Hospitals and clinics lack the funds to maintain the infrastructure properly, so all of them are run-down, cold in winter, hot in the summers, with drafty rooms and hallways where you’re likely to catch pneumonia, with bathrooms that have leaky faucets and leaky toilets, mostly left uncleaned, smelly, wet and old, with metal beds that date way back from the 1st or 2nd world war (I’m not kidding about this), and with mattresses that have seen more than their fair share of human bodies and bodily fluids. When it comes to equipment, it’s mostly non-existent, other than basic X-ray machines.

Sure, there are exceptions. There are some doctors and nurses who don’t ask for bribes. And there are some medical personnel who are competent at their jobs — they know how to do them and take the time and effort to put their knowledge to good use. But if you think the two groups contain the same people, you are probably mistaken. It’s usually the doctors who are the most competent that demand the bigger bribes, though it could be that a really good doctor or nurse may also be the one who doesn’t ask for or accept bribes. There’s no way to tell, really. It’s like taking a potshot in the dark. You’ll go to get some care and may end up with a butcher or a blundering fool who only makes things worse, and you may also end up paying him or her plenty of money for the shoddy treatment.

On some level, I understand why the corruption exists. Salaries for government-paid doctors and nurses are very low — janitors at profitable private businesses usually make more money than doctors in government hospitals — but that’s still no excuse for the endemic corruption. While salaries are low, medical personnel have also gotten used to asking for money from each and every patient, to the point where they expect it for the littlest thing and won’t help you if you don’t pay. There’s a ridiculous, infuriating sense of entitlement among most, if not all of them. Somehow they’ve gotten to think you owe them money simply for looking at you. That’s not right.

If only they’d take the time to study more, to get better at their craft, I, along with the millions of Romanians who visit hospitals, would feel better about paying extra to get care, but most are ignorant of any new developments in their fields. They only know enough to get by on routine matters. As soon as there are complications, they’ll take your money for a consultation, then tell you to go see this other doctor, who’ll ask for his share, then send you along to another, and so on and so forth until you’ve seen seven, eight, nine, ten doctors, have spent a month’s or two months’ salary on bribes, and you’re still no closer to getting treated right or cured. They’ll all nod their head, promise to help, take your money, run their tests, then scratch their heads and say they’re not sure what’s going on, that you’ll need to come see them again in a little while, etc., while happily fleecing you.

When it comes to government nurses, they won’t administer the injections or infusions or obey the doctors’ orders if you don’t slip them a bill, or some coffee, or chocolate, or whatever. It has to be something a little more expensive than just some candy or a trinket, and let me tell, when you’re being seen by four or five nurses and you need to make sure each of them gets something, it gets expensive. It’s so sad to visit hospitals and see all the old people on small pensions walk about with sad looks on their faces, mostly ignored by the nurses who are supposed to care for them, simply because they can’t afford to bribe them.

Private healthcare

There is hope when it comes to Romanian healthcare, and as is usual in a free enterprise system, it’s found in the private arena, where there are financial incentives for those willing to take some risks and make some investments in buildings, medical equipment and qualified personnel.

There are private clinics and hospitals, completely separate and unrelated to the government, where you can get competent care if you have the money to pay for it. Truth be told, it may end up costing you less than government healthcare if you add up all the extra costs involved with bribing government personnel.

Only the best doctors and nurses get hired in the private clinics and hospitals, are paid good salaries, are forbidden from taking bribes, and these facilities are equipped with the latest devices needed for proper patient care. There are entire hospitals and sanatoriums placed in beautiful locations in the mountains, where you can go to spend a few weeks to relax and get allopathic or natural, holistic treatments. There’s an entire gamut of options available to those willing to pay out of pocket.

For example, let’s say you need to run a whole battery of tests to see how your body is doing. You can go to the local government hospital, see and bribe a doctor to get some tests, then go to five or six different labs inside the hospital to run those tests, bribe your way through each place, then come back to the doctor in a few days to give him or her more money to look at the test results and tell you what’s going on. Or you can check into a private clinic, where for a fixed cost, you will spend a few days in a clean, private room with proper heating and cooling, pick your food from a menu, have your meals served to you, be able to take showers in a clean bathroom, be seen by caring, competent doctors and nurses, and get accurate test results interpreted properly. That’s the difference.

I should mention that private doctors’ offices aren’t the same thing as privately-run clinics and hospitals. Many government doctors also keep private offices, and will actually force people who come to see them in hospitals to go to their private offices and pay out of pocket to get the same care they could get for free in hospitals, but the care patients get there is just as bad as inside hospitals, and the facilities are usually just as unhygienic and inefficient. No, you must seek out professional private clinics and hospitals if you want to get the serious care I mentioned above.

Possible solutions

I think you know by now which option I would pick if I were to get sick in Romania, and for good reason. That’s not to say public healthcare can’t be fixed. In recent years, there’s been a serious push against corruption in Romania, at all levels of government, not just in healthcare, driven by the EU, but they haven’t made much headway other than talking about it and putting up posters in government agencies. Much more needs to be done, and it needs to start first with better salaries for medical personnel, probably double or triple what they are now.

Corruption in Romania is a very serious problem, one that requires an organization with teeth, one that can and does take immediate action against infractors, and where the identity of the person reporting incidents of corruption is kept top secret. Sadly, the system is still stacked against those willing to report it. Think for a moment what happens to someone who wishes to report a doctor who asks for money. First, they won’t get the treatment they need, and they may have an urgent medical problem, and then, if their identity is leaked, word about them spreads like wildfire, and no medical personnel at that hospital will want to treat them — and it may be the only government hospital or clinic in town. So people usually shut up and pay up, because they want to get on with their lives, not cause problems for themselves and for others.

Until the problems of corruption and salaries and public healthcare infrastructure get resolved, I would encourage people to use private healthcare options, if they can afford it. The more people use private healthcare, the more affordable and accessible it will get over time, and the more incentive there will be for the government to fix public healthcare.

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Places

Peruvian vampire bats carry silent strain of rabies

Courtesy of the Greenhall's Trust - WI

Courtesy of the Greenhall's Trust - WI

In Peru, vampire bats are increasingly biting people, and death is often the result of their normally innocuous bites. Researchers are exploring the possibility that the bats are carrying a strain of rabies known as paralytic or dumb rabies, which causes disorientation, muscle weakness, then death.

The vampire bats normally stick to biting wildlife or livestock, but as more people infringe on their habitat, through deforestation and agriculture, the growing bat population turns to them as another food source.

Research is focusing on how the disease persists in the bat population, and also on where it is located, so that health authorities may know where people will need to be vaccinated against this particular strain of rabies.

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Thoughts

Don’t play with Tussionex

Late last night, I kept coughing due to a passing cold. After taking several doses of other cough syrups during the evening, which had obviously not done their job, I decided to take some Tussionex — my ultimate weapon against coughing. I try to use it only when I absolutely need it, because it’s fairly expensive and it’s also hard to get (it can only be prescribed by a doctor). But after three days of coughing through the night and keeping my wife and myself awake, I figured the time had come. I took a teaspoon, waited a half hour, and nothing happened. I took another, waited another half hour, and still the coughing continued. I began to worry: had the syrup expired? Was my coughing so bad that I needed to take more? I took another teaspoon. Bad idea!

Tussionex

Soon after that, I started to feel the effects. Tussionex contains a codeine derivative, which means that, along with stopping my cough, it usually gives me a warm and fuzzy feeling that wears off in a couple of hours or so. This time, because I’d unwittingly (and stupidly) overdosed, the effect was very pronounced, and it was mixed with a sensation of nausea. I found it hard to sit up or stand up and went to bed, where I fell asleep immediately.

Here’s the full list of side effects for Tussionex, from the PDR (Physician’s Desk Reference):

“Anxiety, constipation, decreased mental and physical performance, difficulty breathing, difficulty urinating, dizziness, drowsiness, dry throat, emotional dependence, exaggerated feeling of depression, extreme calm (sedation), exaggerated sense of well-being, fear, itching, mental clouding, mood changes, nausea, rash, restlessness, sluggishness, tightness in chest, vomiting.”

I guess I should be thankful the only side effect I’d experienced before this was the “exaggerated sense of well-being”, along with a slight headache which occurred a few hours after taking the medication. Things were going to be very different now.

I woke up early in the morning, around 6 am, feeling rested and alert. I figured the effects of the overdose had worn off. They hadn’t. I got up to go about my business, and shortly after that, a general, overpowering feeling of nausea swept over me. I could not stand up. I couldn’t keep my balance at all. I felt sick, wasn’t seeing straight, I couldn’t control my movements and had trouble putting words together. It didn’t take long after that for me to experience a fuller spectrum of the side effects: decreased mental and physical performance, dizziness, drowsiness, mental clouding, nausea and finally, vomiting. That’s right, I did it again… I vomited more often in these past few months than in the past several years, and I don’t like it.

I’m still in bed as I write this. The moment I stand or sit upright, the nausea comes back, my face turns white, etc. I’ll be in bed for a while, hopefully not the whole day. All this fun gave me a chance to think about the situation. It’s clear that this wouldn’t have occurred if I hadn’t overdosed. The recommended dosage is one teaspoon every 12 hours. The PDR says: “The usual dose is 1 teaspoonful (5 milliliters) every 12 hours. Do not take more than 2 teaspoonfuls in 24 hours.”

I took three teaspoons within 1 ½ hours. That was incredibly stupid and irresponsible of me, and truthfully, I should be thankful I’m still alive. Here’s what one should expect from a Tussionex overdose:

“Blue skin color due to lack of oxygen, cardiac arrest, cold and clammy skin, decreased or difficult breathing, extreme sleepiness leading to stupor or coma, low blood pressure, muscle flabbiness, slow heartbeat, temporary cessation of breathing”

There it is, in black and white: cardiac arrest, stupor or coma. Instead of getting up from my bed last night and doing a quick search for this info last night, I overdosed like a dummy. My wife could have woken up next to my corpse. Thank God that didn’t happen!

I found out this morning that the FDA, since 2008, is also cautioning healthcare providers, pharmacists and patients, to guard against Tussionex overdose. After my own accidental brush with death, I agree with them.

Recommended Site: Many have become so addicted to certain cough medicine brands that prescription drug abuse treatment has become necessary for them. 

Still, I’m not sorry I took Tussionex. I’m definitely sorry I overdosed though. I’ve used many cough syrups over the years, and none stops my coughing like Tussionex. Here’s a sample of the stuff I tried in only the past few months:

Ketof

Coughend Sirop

Stodal

Ketof is the only other cough syrup that helps me marginally. The rest are garbage, particularly that Coughend Sirop. I also used a syrup called Prospan (not pictured here) in the last few days, which I found did a good job at clearing my throat. It tastes great, but still, it doesn’t stop my coughing. And of course I tried plenty of American cough syrups over the years, none of which helped.

Don’t think I cough all the time, either. But I’m stubborn like a mule, and will often go outside when it’s cold and I’m not dressed adequately. So naturally, I catch colds, and when I do, I cough a lot.

This experience also got me thinking about drugs and their effects on the body. Our bodies, you see, are endowed with the capability to heal themselves. That capability works better or worse in people, depending on how well they take care of themselves (diet, exercise, regular sleep, etc.) Drugs will usually only mask the symptoms of a disease, not cure it. Even though I’m not coughing now, that doesn’t mean Tussionex cured my cough and sore throat. It only stopped my coughing. Here’s what the PDR says about it:

“Tussionex Extended-Release Suspension is a cough-suppressant/antihistamine combination used to relieve coughs and the upper respiratory symptoms of colds and allergies. Hydrocodone, a mild narcotic similar to codeine, is believed to work directly on the cough center. Chlorpheniramine, an antihistamine, reduces itching and swelling and dries up secretions from the eyes, nose, and throat.”

You see, it’s used to “relieve” coughs and other symptoms, not “cure” them. They’re not even sure how it works. They “believe” the codeine derivative in it works directly on the cough center. The human body’s internal chemistry is so complex that I don’t know if we’ll ever figure it out properly. Right now, we’re still just stabbing in the dark when it comes to medicating people. We give them a drug and then, oops, we realize the effect isn’t the desired one, or that it interacts with other drugs and causes undesirable side effects. The PDR says about Tussionex that its “side effects cannot be anticipated”. And there’s also a section dedicated to its possible food and drug interactions. Here’s what that says:

“Tussionex may increase the effects of alcohol. Do not drink alcohol while taking this medication. If Tussionex is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Tussionex with the following:

  • Antispasmodic medications such as Bentyl and Cogentin
  • Major tranquilizers such as Thorazine and Compazine
  • MAO inhibitor drugs (antidepressant drugs such as Nardil and Parnate)
  • Medications for anxiety such as Xanax and Valium
  • Medications for depression such as Elavil and Prozac
  • Other antihistamines such as Benadryl
  • Other narcotics such as Percocet and Demerol”

You see, this is what medicine has become these days: the chemistry of drug interactions. Every physician that works in a field where they prescribe lots of medications has to know drug interactions perfectly, or they will put their patients’ lives at risk. Sadly, most do not know all they need to know, because the interactions are so complex.

My dad is a psychiatrist. He made it a point to know all the psychiatric drug interactions and those of common drugs administered by other doctors, such as primary care providers or internal medicine specialists. He studies them all the time and keeps up to date with all the latest medications. He meets plenty of other doctors who aren’t as well prepared as he is, and he’s told me often how shocked he is to find these people are prescribing drugs that readily conflict with others, creating undesired and potentially lethal side effects. The sad part is that when he tries to let them know about it, they usually brush him off. And then we wonder why so many patients do poorly in hospitals… Isn’t it to be expected when most doctors are ill-prepared to prescribe medications for their patients?

I think the takeaway lesson from all this is that prescription drugs can be very dangerous. They are not to be treated lightly, like I treated Tussionex — even though its nature is supposedly benign — it is, after all, “only” a cough syrup, right? A drug’s side effects and its interactions with other drugs need to be known not only by the doctor but also by the patient, so that each of us is aware of what we are putting inside our bodies. The consequences — if we don’t do this — can be fatal at times. I may not realize it fully right now, but I might not have been around today, and it was all because I self-medicated carelessly.

Updated 1/11/10: I’ve gotten a number of rude comments since I wrote this article, none of which were published, where dorm room heroes and couch potato experts called me all sorts of names, all because the dosage that I took was too low by their standards. They’d have been satisfied if I drank a whole bottle of Tussionex and woken up a month later out of a coma, or if I hadn’t woken up at all. What can I say, other than your mileage may vary. People react differently to different dosages. I suppose if my body had been addled by years of alcohol and prescription drug abuse, my tolerance level for the drug would have been higher, and three teaspoons wouldn’t have done much for me. However, when you lead a clean life and are in full possession of your senses, you tend to be much more sensitive to these situations. So please stop criticizing the article. I wrote it not to draw attention to myself, but to put up a warning sign about prescription drug abuse.

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Reviews

One way to get food poisoning

I held off writing about this because I couldn’t even look at photos of the stuff that gave me food poisoning and kept me in bed and feeling miserable for two days, but the embargo is finally lifted. Here’s the culprit behind a nasty bout of food poisoning back in January: 7 Days Bake Rolls.

7 Days Bake Rolls - Pizza Flavor

The company that makes these things stuffs them full of chemicals and preservatives and flavors to make the taste hard to resist. I ate about three quarters of a bag one evening, as we were watching a movie. Then, during the night and early morning, the “fun” began. A general feeling of malaise grew until I hugged the porcelain throne and went through several private and painful “confessions” that purged the “sins” out of me. I was weak, could barely get out of bed, and if I ate anything I only hurled more. Even though I could move around and eat smaller portions for the rest of the week, I was still sick and couldn’t do what I needed.

I don’t know what in the world they put in those things, whether it was a bad batch, or whether I’d have the same reaction if I ate any more, but I do know one thing. I never want to see or touch them or smell them again. It’ll turn my stomach inside out. It’s one bad product, which exemplifies what I wrote recently about packaged foods versus fresh foods. The next time I want some toasted bread, I’ll make it myself, without preservatives and other artificial crap.

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Thoughts

Pork's dirty secret: It's one of America's worst polluters

Pork’s Dirty Secret: The nation’s top hog producer is also one of America’s worst polluters : Rolling Stone.

I’m shocked beyond belief by what I read in Rolling Stone magazine today, in the article pointed about above. Let me quote a few excerpts to draw your attention to the crimes that have gone unpunished for the last couple of decades, done right here in the US, under our eyes and noses, and with the approval of smarmy politicians all too happy to oblige deep-pocketed campaign contributors.

This is how pig farms function:

“Taken together, the immobility, poisonous air and terror of confinement badly damage the pigs’ immune systems. They become susceptible to infection, and in such dense quarters microbes or parasites or fungi, once established in one pig, will rush spritelike through the whole population. Accordingly, factory pigs are infused with a huge range of antibiotics and vaccines, and are doused with insecticides. Without these compounds — oxytetracycline, draxxin, ceftiofur, tiamulin — diseases would likely kill them. Thus factory-farm pigs remain in a state of dying until they’re slaughtered. When a pig nearly ready to be slaughtered grows ill, workers sometimes shoot it up with as many drugs as necessary to get it to the slaughterhouse under its own power. As long as the pig remains ambulatory, it can be legally killed and sold as meat.

The drugs Smithfield administers to its pigs, of course, exit its hog houses in pig shit. Industrial pig waste also contains a host of other toxic substances: ammonia, methane, hydrogen sulfide, carbon monoxide, cyanide, phosphorous, nitrates and heavy metals. In addition, the waste nurses more than 100 microbial pathogens that can cause illness in humans, including salmonella, cryptosporidium, streptocolli and girardia. Each gram of hog shit can contain as much as 100 million fecal coliform bacteria.

Smithfield’s holding ponds — the company calls them lagoons — cover as much as 120,000 square feet. The area around a single slaughterhouse can contain hundreds of lagoons, some of which run thirty feet deep. The liquid in them is not brown. The interactions between the bacteria and blood and afterbirths and stillborn piglets and urine and excrement and chemicals and drugs turn the lagoons pink.”

This is the man in charge of the largest pig producer in the US:

“The chairman of Smithfield Foods, Joseph Luter III, is a funny, jowly, canny, barbarous guy who lives in a multimillion-dollar condo on Park Avenue in Manhattan and conveys himself about the planet in a corporate jet and a private yacht. At sixty-seven, he is unrepentant in the face of criticism. He describes himself as a “tough man in a tough business” and his factories as wholly legitimate products of the American free market. He can be sardonic; he likes to mock his critics and rivals.”

This is how the journalist describes his encounter with the smell from one of the pig shit lagoons:

“Concentrated manure is my first thought, but I am fighting an impulse to vomit even as I am thinking it. I’ve probably smelled stronger odors in my life, but nothing so insidiously and instantaneously nauseating. It takes my mind a second or two to get through the odor’s first coat. The smell at its core has a frightening, uniquely enriched putridity, both deep-sweet and high-sour. I back away from it and walk back to the car but I remain sick — it’s a shivery, retchy kind of nausea — for a good five minutes. That’s apparently characteristic of industrial pig shit: It keeps making you sick for a good while after you’ve stopped smelling it. It’s an unduly invasive, adhesive smell. Your whole body reacts to it. It’s as if something has physically entered your stomach. A little later I am driving and I catch a crosswind stench — it must have been from a stirred-up lagoon — and from the moment it hit me a timer in my body started ticking: You can only function for so long in that smell. The memory of it makes you gag.”

And this is what happens to the people who live near the pig shit lagoons:

“Epidemiological studies show that those who live near hog lagoons suffer from abnormally high levels of depression, tension, anger, fatigue and confusion. “We are used to farm odors,” says one local farmer. “These are not farm odors.” Sometimes the stink literally knocks people down: They walk out of the house to get something in the yard and become so nauseous they collapse. When they retain consciousness, they crawl back into the house.”

And this is what happens when the lagoons spill their vile contents into the environment, which happens all too often:

“The biggest spill in the history of corporate hog farming happened in 1995. The dike of a 120,000-square-foot lagoon owned by a Smithfield competitor ruptured, releasing 25.8 million gallons of effluvium into the headwaters of the New River in North Carolina. It was the biggest environmental spill in United States history, more than twice as big as the Exxon Valdez oil spill six years earlier. The sludge was so toxic it burned your skin if you touched it, and so dense it took almost two months to make its way sixteen miles downstream to the ocean. From the headwaters to the sea, every creature living in the river was killed. Fish died by the millions.”

As if those sorts of unmitigated environmental disasters aren’t enough, it gets worse:

“… Corporate hog farming contributes to another form of environmental havoc: Pfiesteria piscicida, a microbe that, in its toxic form, has killed a billion fish and injured dozens of people. Nutrient-rich waste like pig shit creates the ideal environment for Pfiesteria to bloom: The microbe eats fish attracted to algae nourished by the waste. Pfiesteria is invisible and odorless — you know it by the trail of dead. The microbe degrades a fish’s skin, laying bare tissue and blood cells; it then eats its way into the fish’s body. After the 1995 spill, millions of fish developed large bleeding sores on their sides and quickly died. Fishermen found that at least one of Pfiesteria’s toxins could take flight: Breathing the air above the bloom caused severe respiratory difficulty, headaches, blurry vision and logical impairment. Some fishermen forgot how to get home; laboratory workers exposed to Pfiesteria lost the ability to solve simple math problems and dial phones; they forgot their own names. It could take weeks or months for the brain and lungs to recover.”

And now the bastard that runs Smithfield, Joseph Luter, wants to expand into Europe, particularly into Poland and Romania:

“When Joseph Luter entered Poland, he announced that he planned to turn the country into the “Iowa of Europe.” Iowa has always been America’s biggest hog producer and remains the nation’s chief icon of hog farming. Having subdued Poland, Luter announced this summer that all of Eastern Europe — “particularly Romania” — should become the “Iowa of Europe.” Seventy-five percent of Romania’s hogs currently come from household farms. Over the next five years, Smithfield plans to spend $800 million in Romania to change that.”

You want to see a real terrorist? One that’s irreversibly damaged the environment, killed millions of fish and other aquatic life, and ruined the lives of tens of thousands of people? Look no farther than Joseph Luter. The evidence is overwhelming. And yet he’s not in prison. No, he’s out, enjoying his life while ruining the lives of others. I say we put him not in jail, but in a prison which contains one of his very own pig shit lagoons, where he’s to spend the remainder of his criminal life.

Luter has made pig farming profitable, but at what expense? The environmental disasters he’s directly responsible for equal the ones perpetrated on mankind by the industrial revolution — only we outgrew those abuses, and didn’t expect to find such flagrantly illegal and morally corrupt behavior in the businesses of today.

Don’t think Luter is the only one. You look at cows, at sheep, at chicken and other farm animals, and you’ll find incredible, criminal abuses of animal life and the environment in all those industries. Seemingly everywhere, our food supply has been hijacked by companies hell-bent on making profits at the expense of health, safety, the environment and even life.

Quotes used courtesy of Rolling Stone magazine. If the magazine feels that the quotes are too extensive, please contact me and I will abbreviate them.

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Happy Birthday Tataie

It’s my grandfather’s birthday today. He died just a couple of weeks ago after a painful struggle with mesothelioma, a form of cancer caused by asbestos exposure.

He’d been coughing for a few years. It was a persistent cough, but it wasn’t a severe cough. He coughed here and there, and especially after he came into a cooler room after working outside, in his beloved garden. Then things got worse. He kept getting cold-like symptoms and coughing more. When doctors in Romania examined him, they discovered water in one of his lungs. They started drawing it out with syringes regularly, liters at a time. A lesion of sorts developed at the site where they kept inserting the needle. A biopsy of the lesion revealed nothing. Things didn’t improve.

My parents hoped that the Florida weather would do him good, so they brought him to the States. He loved the weather, but didn’t get better. They thought US medical care would be better than Romanian medical care, so they put him in a hospital here. Doctors literally paraded by his bedside by the tens, specialist after specialist, all of them clueless. Oh, let’s try this, let’s try that, blah, blah, blah — that’s how the story usually goes. X-rays and CT scans and urine and lab tests every day, and still they couldn’t figure things out.

Finally they decided to open him up and see what was going on. That’s when they discovered he had mesothelioma, with a few “localized” tumors in his right lung. But they still couldn’t figure out what to do about the water accumulation, so they proposed to insert talcum powder between the lung walls, in the hope of sealing that chamber and stopping the leaks (that’s apparently a standard procedure for this sort of thing).

So they opened him up again and inserted the powder. Water still accumulated, this time more slowly, but it still happened. Then he developed difficulty swallowing. They stuck tubes with cameras down his throat. More CT scans, more X-rays, and still no idea why. Well, let’s enlarge his esophagus and cardiac sphincter (the opening from the esophagus to the stomach.) That might help… Well, it didn’t. He still had trouble swallowing.

They didn’t know what else to do for him, so they released him from the hospital. The bill came to well over $100,000, and my grandfather was no better than before. He was worse, and now he had to contend with pain from the surgery and the other procedures done on him while in the hospital.

My mother had to blend everything into a soupy puree before feeding him, and still he had trouble swallowing. He withered and dried out and lost tens of pounds. He was hardly recognizable, but his spirit was still well, and he hoped he’d get better. That was the hardest part, to see him trying to eat and unable to swallow, then leave the table with a horribly sad look on his face.

We knew he wouldn’t last long like that, so we convinced him to return to Romania, where at least he could die in his own home, if it were to come to that. Once he got there, my aunt, who took care of him, put him on IV fluids. He got a little better. We decided to try seeing some specialists there in Romania, so she took him to the hospitals in Sibiu and Timisoara.

If you don’t know how the healthcare system works in Romania, I’ll tell you. It’s based on heavy bribes. If you don’t bribe the doctors and nurses, no one cares about you. No one even looks at you, and you’re treated like scum. If you have the money to give them, you actually get somewhat decent service, depending on how much you give. You can’t lay the blame entirely on the medical personnel for this practice though. Doctors’ salaries are horribly tiny, smaller than the salaries of some janitors at well-to-do companies. So they need cash infusions from the patients in order to be able to live properly. But the way they go about it is disgusting to me. And there’s no telling when they’ll make up stuff about your condition just so they can get more money out of you. They’ll even do extra procedures (if they’re unethical people) so you’ll pay them more.

Once in the hospital, they slipped a feeding tube through his nose and into his stomach. In Sibiu, they opened him up again and discovered some lesions on his esophagus, and some on his stomach. They said he needed his esophagus replaced, but that they couldn’t do the procedure, and that he needed to be sent to Timisoara. We believe the doctor who operated on him at Sibiu twisted his stomach or intestines around and caused a severe blockage in his GI tract, because his digestion and regularity were never the same after that.

In Timisoara, the specialist who was to replace his esophagus with a silicone stent bragged to high heaven that he was the only one doing the procedure in Romania and in the entire Western Europe. If that sounds phony to you, don’t worry, you’re right. He just wanted to make sure he got enough money for the job. He ended up operating on my grandfather, but replaced less of the esophagus that he’d originally said. We’re not sure why. Things went completely downhill from there.

My grandfather never recovered from that operation. His situation got worse and worse every day. Now he couldn’t digest his food at all, even the soups he was fed through his tube. He coughed up blood and fluids of various colors. He got thinner and more dehydrated every day. My aunt put him back on IV fluids, but they didn’t help. He was in horrible pain, throughout the day and night. He moaned in agony. He couldn’t sleep. When he did manage to sleep, he would writhe and cry out in anguish. He was dying.

Four days before he died, he asked my aunt to make the preparations for his burial. He knew it and he was ready. He asked her to let him go, to stop trying to keep him alive. She couldn’t stop caring for him, but she knew it was going to end anyway. He looked forward to joining my grandmother in the grave next to hers.

And then he died in the evening. I got the call from my mother. She was crying. I couldn’t cry. I knew what he’d been through, and wanted him to get the rest and peace he so badly needed. I was angry with everything that had happened to him, and still am. Why did he have to die in such pain? Why did he have to encounter the utmost morons in his quest for decent medical care? Why did he have to suffer so much?

We don’t know when he got exposed to asbestos. It wasn’t uncommon in communist Romania to get exposed to dangerous conditions or materials. He worked at the same factory all his life, and got promoted to chief technical engineer from a humble line worker. He came up with various inventions and improvements during his career, and was even decorated by Romania’s dictator, Nicolae Ceausescu, for his contributions. I’m not saying this because I care about Ceausescu, who was a horrible man, but I care about my grandfather and about his life’s work, and was glad to see him get recognized.

For me, my grandfather’s suffering serves to underline how little medical science really knows about the human body, and how horribly few things they can do to cure people. In spite of all our technology and advances and drugs, when it comes to treating disease, our options are very limited, and very primitive. We can:

  • Mask the symptoms by treating them with drugs
  • Cut into people and butcher them with plain knives or sear them with electric knives, then sew them up with string
  • Poison them with radiation therapy and chemotherapy

I remember my frustration with this while in medical school, and perhaps it had something to do, subconsciously, with my leaving it to return to IT work. At least in IT you can find out what’s really wrong and can fix it either through code or hardware replacements.

What my grandfather’s death also showed (amply) is how many idiots there are in the healthcare system. My God, we have so many doctors out there that can’t diagnose their way out of a paper bag, and they run test after test and try this and that and still can’t figure out what’s wrong. I’m fortunate enough to know there are good doctors (although they’re few and far between) who know how to diagnose with much less information at their fingertips, because I’ve met some of them.

If all these retards can graduate medical school and can pass the boards, then clearly medical education isn’t doing its part in weeding them out. I had plenty of them in my class in med school, too. They were the ones who got by very nicely by rote memorization. Worked great, until you asked them to analyze something — then they looked at you like a hen looks at a newspaper.

Another one of my beliefs was reinforced: that the overwhelming majority of nurses are lazy asses that don’t care at all about their patients. I’m sorry if that offends you, but that’s the truth. I know this because I saw they way they treated my grandfather, and I saw the way they treated other patients over the years.

All nurses seem to want is more money and more benefits for as little work as humanly possible. Oh sure, they put in a lot of “hours”, but most of those hours are spent socializing at the nursing station, not by the patient’s bedside. What’s unfortunate is that the market is tilted so much in their favor right now (and will continue to be for the next several years) that nothing significant can be done about it. There’s a nursing shortage, and that means we’re going to have mediocre, good-for-nothing nurses in all of our hospitals until supply meets demand, and hospitals can start to weed out the non-performers.

I tell you, the nursing profession will not emerge unscathed from this. The stink caused by these bad nurses will taint the good ones, too. The good ones are out there, I’ve met some of them, and when I say they’re good, I honestly mean it. They’re great, and they care, and they know a lot, but they’re few and far between, and they’re mostly in academia.

Coming back to my grandfather, I think of my grandmother’s death two years ago, also in June. A week or so after her burial, it was my grandfather’s birthday, and I remember him celebrating it with us, his family, but without his beloved wife. The sorrow was evident on his face, even through his smiles, and there was nothing any of us could do for him but to try and cheer him up.

Now, he’s resting in the grave, and it’s his own birthday. There’s no birthday celebration now. Just pain and a feeling of irreplaceable loss.

Rest in peace, tataie. You taught me how to build and fix things and work in the garden, and how to use tools and paint and be the man I am today. You were the first man I looked up to, the first one that made me want to learn how to shave. I saw you do your best, every day, to care for and protect your family. You never spoke much, but you did much. You were loved, and are loved. Rest in peace.

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Reviews

Awakenings (1990)

Awakenings (1990)

We watched Awakenings (1990) tonight, and I was left with a newly found appreciation for life. This movie drives home the following point very well: you don’t know what you have till you’ve lost it.

Imagine watching your life, as you know it, become unavailable to you, which is what happens to people who suffer from neurological diseases. Imagine sitting there, trying to fight it, but knowing there really isn’t anything that can be done, while you slowly lose your coordination, balance, speech, senses, and become a catatonic mass, a vegetable, a ghost of what you once were. Through it all (and this point is debatable) you are aware of what happens around you, of what others are trying to communicate to you, but you cannot respond in any way. As one character in the movie puts it, it is “unthinkable”.

As I sat there, taking it all in, a photo of Ligia and I stood by the screen, and my eyes kept jumping to it. What we have is so precious. Much more precious than anything else out there. We not only have life, but we have love. We have so much. So much more than many others. And even if I didn’t have her, I’d still have my life and my health. These are both amazingly precious, and I always fail to realize it until either of them is in danger. Only then do I begin to see all of the things I take for granted.

I can’t put this into words properly. Every once in a while, I get a glimpse of my life from an outside perspective, and then it hits me: I’m a fortunate person. I should stop worrying about the little things. I should be happy. All the time. I have so much. The other things: gadgets, technology, computers, income — these are all insignificant without love, life and health.

Let’s face it, computers may have made our lives a little better, but they’ve also made them more miserable, busier, and more complicated. Gadgets are cool, but we don’t really need them. Technology is nice, but without human interaction and common sense, it only makes things worse. Income is nothing more than an enabler, something that lets you have a place to live and buy food and other things. When you start seeing it as something else, you’ve got problems.

What really matters is life — experiencing it to the fullest, gaining the realization of the gift that it is and being thankful for being alive. It’s so easy to get caught in the busy-ness of life that we lose our self-consciousness, that child-like sense of wonder at the things around us. I know I do that, and I shouldn’t. Every time I get caught up in pointless things, I waste precious time, which adds up. Life is so short… too short.

There was a scene in the movie which was telling for me. It was at the end. Dr. Sayer was typing an article, and the nurse, Eleanor, got ready to head home for the night, but lingered, hoping he might ask her out. He continued working, so she left, quietly. As soon as she closed the door to his office, he fidgeted nervously, knowing what he should have done. Then he jumped up, opened the window, called out to her, and ran out to invite her for coffee. But this wasn’t what struck me. After all, this was what we, as an audience, expected him to do. No, what I found interesting was the way he saved his work. He simply stopped typing, got up and left…

Think about that for a moment.

More information

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Lists

Condensed knowledge for 2007-05-14

Today’s calorie-free serving:

  • Clive Thompson from the NYT has a detailed write-up of what’s involved if small bands want to get their name out there these days. The almost-requisite MySpace page is a given… But while the web makes it easy for them to get their names out there, keeping up with the fans becomes a full-time computer job — just what they were trying to avoid when they became musicians. And at some point, the relationship reaches a plateau. A single human being can only keep up with a limited number of fans before they are overwhelmed. But the fans don’t care, they each want personal interaction. Sounds like a very non-fun experience for the musician.
  • Mandy Sellars in England suffers from a very rare condition called Proteus Syndrome. She will likely lose her legs. The article talks about her desire to experience life, and daily struggles.
  • This is good reading for us IT geeks: Top 7 things system administrators forget to do.
  • The NYT has a great profile of Walt Mossberg. The article not only talks about his career, but also about where things are going in terms of journalism when you factor in this “new media” we keep hearing about…
  • Mental_floss talks about the world’s most wanted (and expensive) poo. It’s ambergris. Yuck.
  • Look At This has posted a full-length movie called “When the Wind Blows“. It’s about an elderly couple who build a bomb shelter. When nuclear war breaks out, they survive, but unfortunately succumb to the fallout radiation while waiting for the government to help them. Here’s a direct link to the video.
  • According to this article, Bill O’Reilly uses old propaganda techniques to bias his listeners toward those he doesn’t agree with. Interesting stuff.
  • A pair of falcons has made their nest in the building of the San Jose City Hall, and they’ve installed a falcon cam for us web visitors. Neat!
  • Some charlatan who claims he’s Jesus Christ incarnate is fooling plenty of people down in Orlando. Don’t these people bother to read the Bible?
  • A brave little terrier saved 5 New Zealand kids from being torn up by violent pit bulls. Unfortunately it ended up so injured they needed to put him to sleep, but the children weren’t hurt.
  • Apparently ceiling height can affect how people think and act. A taller ceiling can make you more creative and artistic. Very interesting stuff!
  • Weirdomatic has a post with examples of old, creepy ads. I don’t know, Max Factor’s beauty micrometer seems reasonable enough, given the need to look fairly perfect on screen. Have a look and decide for yourselves.
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Lists

Condensed knowledge for 2007-05-08

Here’s the good stuff:

  • XKCD put together a hilarious map of the online communities. 🙂
  • Steve Jobs published an open letter to Apple users outlining the progress Apple is making toward being a completely “green” company. From the looks of it, Apple is ahead of most other folks in the technology field. Then again, it could also seem this way because of his reality distortion field.
  • A man traveling on a plane from Vietnam to Australia vomited a small bag containing something that looked like drugs. The plane promptly turned back, and meanwhile, the man vomited up two more bags. Apparently, this is quite common, and these people are called “drug mules”. Doctors found 30 more bags containing drugs in his stomach.
  • A flavoring agent used in microwave popcorn, by the name diacetyl, is blamed for bronchiolitis obliterans, an obstructive lung disease that affects popcorn workers. It’s also called “popcorn workers’ lung”, and there is no cure. A transplant is the only solution. Something to think about the next time you eat popcorn…
  • Want to see living conditions for coal miners back in 1938?
  • A remote-controlled robot uses thermal imaging to locate and destroy termites.
  • ProBlogger’s put together a post called “9 attitudes of highly creative people“.
  • Packet Garden is a really cool application that constructs 3D maps of your internet traffic.
  • Mental Floss is running a feature called “8 smooches that shook the world“.
  • Who holds the record for being arrested the most times? It turns out to be a man named Henry Earl.
  • Back in 1946, Mike the Headless Chicken roamed the countryside. Looks like Mike was going to be dinner, but the farmer cut too high, and left just enough brain stem for the chicken to still be a chicken. Although it couldn’t feed, it could walk and “socialize” with the other chickens just fine, and even managed to earn the farmer the equivalent of current-day $50K/week.
  • A Japanese firm has developed special packaging that contains an exothermic agent. Pre-cooked rice placed inside can be warmed up simply by pouring cold water inside the packaging. The reaction with the agent creates steam that warms the rice and gets it ready to eat in about 15 minutes.
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Thoughts

Michael J. Fox campaigns for stem cell research

Michael J. Fox appeared in some TV ads recently, to support stem cell research for Parkinson’s disease. The ads showed him moving uncontrollably, due to Parkinson’s. They were candid, and truthful. I’ve always liked Michael as an actor, and I thought he’s been a real gentleman throughout his ordeal with Parkinson’s. I agree with him, and with the ads. Stem cell research should be allowed, because it holds the potential for so many cures. So I was shocked to hear that Rush Limbaugh — although it shouldn’t be a surprise that he’s callous and inconsiderate — accused Michael of faking it in the ads. I love Michael’s response, which shows, again, how much of a gentleman he is:

“The notion that you could calculate for effect … People out there with Parkinson’s are going, would that we could.”

If I had been in his place, I wouldn’t have minced my words — and perhaps, that’s why I’m not in his place. Bravo to you, Michael! Keep up the fantastic work you’re doing, and I do hope they find a cure for Parkinson’s soon!

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