Been providing excellent anesthesia care for over 30 years. That's over 60,000 hours. Malcolm Gladwell would call me an expert. It was pretty much one patient at a time. Some for many hours undergoing the most dangerous and serious procedures. I have patients lives in my hands. Unconscious, paralyzed, cut open and bleeding. I breathe life into them. I monitor and control there vital signs. Sometimes we stop the heart and bring it back to life hours later. Very dangerous business for them.
Who are they? The are people like you and I who have been dealt a poor genetic profile or, more frequently, never really felt that looking after themselves. We are not totally to blame. The food industry does studies to see what we crave and it is three items; salt, sugar, and fat. They found the "bliss point"; that point with right combination that drives us wild. Areas of the brain that light up in a scan after ingesting sugar is the same pleasure sensors that light up for cocaine. Almost all my patients have hypertension, arthritis, many with diabetes and coronary artery disease. Hypertension and diabetes contribute to kidney disease further worsening hypertension. I take care of patients with ongoing strokes helping to rip out clot from cerebral arteries.
Thirty years and it just doesn't seem to be letting up. The costs are staggering: $2.8 Trillion in expenses in 2012, 18% of our GDP. Most other developed countries only spend about 9 - 11% of their GDP. Most of our cost go to maintaining chronic disease that are preventable and reversible. We have 10,000 people turning 65 every day. People are living longer. The fastest growing sector of our population is those over 85. That sounds great. But these people are not that well though well enough to continue on upwards of 19 or so medications. Some interacting with each other as there is very little communication among prescribers. I see the biggest culprit resulting in emergency surgery in the form of the anticoagulants for prior stroke or atrial fibrillation (an irregular beating of the heart conducive of blood clot formation and stroke). Now we have anticoagulants that cannot be reversed very easily. These patients bump their heads, bleed into their heads, and require emergency neurosurgery to evacuate the blood. Since we can't easily reverse these new anticoagulants that can hemorrhage during surgery. Ask your doctor about that when they want to prescribe Pradaxa. About 150,000 people die each year of proper medical therapy. Proper is a still open for judgement. Sometimes we just don't know what proper is. As much as 100,000 due of medical mistakes as reported in the 1999 report To Err Is Human by the Institute of Medicine. Medicine is a very dangerous industry. We a growing aging population the demands on already stressed unaffordable system will only escalate. Big Pharma wants it to stay that way. Medical device companies want it to stay that way. Hospitals, doctors, nurses want it to stay that way. Most if the doctors I talk to are convinced not much can be done. I disagree. We have a dysfunctional industry. Though I have done my best and many of us physicians have, the system is dysfunctional. How we delivery care needs to be reworked. However, there is something we all can do to increase our chances of not only survival but to prosper and live long healthy productive enjoyable lives. Chronic disease is not inevitable. It is a product of our own growth, a product of modern times. We know what we need to do. Yes, eat better with the correct fuel and in the right amount. We have become addicted to sugar. We need detoxification just like any other drug. Let's get started
I am a turning point in my career. I always wanted to be a physician. I became a critical care expert, an anesthesiologist. I take care of all patients with all sorts of diseases that are affected their survival everyday. We are not in the business of healthcare. It is better described as "sick care". We will never survive as a happy prosperous competitive nation by waiting for disease to manifest itself. Most of these diseases are already in progress. Atherosclerosis has been found in children. Type 2 diabetes is also called adult-onset diabetes. But not any more.
We are starting to wake up. Sugar taxes on sugary is on the ballot in November in San Francisco. I am not advocating for any one method but we need to reduce sugar in our children's diets. It is addictive. We are wired for sugar. Manufacturers have figured it out. They also have made it much cheaper with the government's assistance to the corn industry in the form of the worst culprit of them all, high fructose corn syrup. Liquid fructose, like heroin but a much slower debilitating death.
So, I plan to apply to UC Berkeley School of Public Health. I just love working so much I thought I would add another 20 hours or so to my week. At a cost as well. But I think it is that important. The medical profession needs to be provided the incentives to really encourage healthy habits. Society needs to support this. Our workforce is getting sicker and heavier. The armed forces can't find enough recruits at a healthy weight. Our security will be threatened. Corporations are spending more and more on healthcare for a sick nonproductive workforce. They will sent labor overseas. Without our health, nothing else matters.
