ABC World News Now looks to wrong audience on question about ACA signup problems

I was just checking Facebook before calling it a night and I came across a World News Now post in my feed that hit me as surprisingly out of place. The post asks Facebook users to let them know if you're someone who has used the Obamacare web site to sign up for health insurance. I find this odd, considering that people who don't have or can't afford health insurance probably don't use Facebook.

Let's think about that. If you are a struggling American, are you awake at 2am on a Sunday reading Facebook? Do you even have a Facebook account?

This makes me wonder if ABC is looking to get the answer they want by asking the question in a place where they know responses will be largely made by people who don't need to sign up.

I mean, if you want to make it look like rednecks are ignorant, wouldn't you go to a Toby Keith concert and ask them questions about classical music? You'd get the result you wanted, but it wouldn't be a valid sample.

• Thought of the day: It's easy...

It's easy to call someone lazy from the comfort of an armchair.

It's easy for someone who had opportunities to call someone else lazy who works two jobs, has a couple of kids, and struggles to make ends meet when they cry out for help and health care coverage. It's easy to call someone lazy and demand someone gets off their butt to work when you, a small business owner, has not hired anyone lately. It's easy to call someone lazy, when you, a white person, 30 years ago, were able to go to a decent school and receive a quality education while they, a minority, experienced the exact opposite. It's easy to call someone lazy when you're not the one being screwed over. It's easy to call someone lazy when the company refuses to provide health insurance, so you accuse this person of asking for a government handout instead of placing the blame on the company in question.

It's easy to call someone lazy from the comfort of an armchair.

What These Poll Results Really Represent

Three polls being tossed around in the news have been twisted to fit more partisan views without anyone even considering the views that are realistically represented by those polls.

The first two are Obama's approval rating and the "Obamacare" approval rating. At face value, these numbers show Obama might be struggling a little bit. Republicans are rolling in it painting the American public as being against Obama's policies.

That's not quite right. Let's take a look at why people might disapprove of Obama's policies, specifically with regard to the health care debate.

It should be painfully obvious that anyone on the Right opposes Obama's policies and the Health Care reform going through Congress because it's Obama. They think it's all socialism. Yes? Good. We have that chunk of people accounted for.

But surely pollsters asked more than just right wingers? Of course they did!

Let's move our way left across the spectrum.

Why would people in the middle be iffy on Obama? They're just uneasy, caught up between the fear mongering and the economic crisis. Some believe the "socialism" hype. Others are simply fiscally concerned about debt.

Why would people on the left be iffy on Obama?

Progressives want Obama to be more to the left than he really is. Despite what the Right is trying to say, Obama is not some far left politician. If he were, his numbers would be better from those on the far left. Let's face it. Progressives wanted Single Payer, not the Public Option. They aren't happy with that idea. They also aren't happy that Obama isn't fighting more to get the legislation through Congress by strong arming Dems who are being problematic.

That settles the first two polls. What about the second?

Congress does not have a good approval rating either. The House and Senate have not had a good reputation for a long time though. Americans are increasingly frustrated with our elected officials. They can't get anything done because they cannot agree on anything.

In the current situation, it would appear that the group who can't agree on anything is on the Republican side of the fence. In addition, "conservative" Democrats are becoming obstructionists as well. Nothing gets done when so many members of Congress vote "No."

But the numbers are being twisted to make it look as though Democrats will have a major loss in 2010 elections. That implies Republicans will be filling those slots, doesn't it? Republican leaders want to play this out to work in their favor. Somehow because the Democrats have the slim majority, Republicans want all the blame to fall on that watch and not their own...as if they had nothing to do with legislation failing.

Electing more Republicans will just result in less compromise and fewer opportunities for Obama's administration to get anything done. Of course, in the minds of Republicans, that's a good thing. After all, doing something would equate to big government. God forbid they actually do their jobs. We're going to end up with the same problem we had under Clinton. We won't be able to get anything done because the system of checks and balances will simply end up at the whim of stingy old white men from southern states. Don't re-elect Blue Dog Democrats either because they aren't really Democrats to begin with.

The approval rating for Congress is a reflection of this inability to overcome partisan bickering. The Democrats are showing they want to work. The Republicans are showing they can only vote "No." Doing nothing is not an option. Vote with this in mind or expect to get elected officials who are a mirror image of our own stagnant hatred for one another. Want them to get something done? Send people who want to work to get something passed.

David Gergen Gets It Oh So Very Wrong

Anderson Cooper is hosting a special on CNN with a panel of familiar CNN faces. At one point, Dr. Sanjay Gupta began discussing tort reform and defensive medicine. Then David Gergen followed up with his own example of what an ENT he talked to calls defensive medicine.

Here's the problem. The example is an absurd one. Unfortunately, Dr. Gupta didn't speak up to point out how asinine the example was. Like an episode of House, the example had that far fetched medical practice sound to it. I'm sure physicians everywhere groaned in disbelief, just as they do when watching House.

I don't know what ENT David Gergen spoke to about defensive medicine, but physicians I work with don't order tests just because the patient asks for them to be done. I certainly don't bend over backwards to appease a patient asking for a test just for the sole purpose of getting the test done.

Let's use the example Gergen gave us.

Patient X comes in and asks for an MRI. Doctor gives the patient the MRI, afraid that the patient will sue him or her for not providing the investigation the patient asked for.

That's not evidence based medicine. If your doctor gives in to that sort of thing, he or she is not a good doctor and cannot seem to muster up the sense to explain to the patient why they do not need the MRI. The patient did not go to medical school. The patient, no matter how informed, cannot just snap their fingers and order any test they'd like.

Here's how the situation should have been handled. Communication! The ENT should have asked the patient why they wanted the MRI. Then, after listening to the patient's own reasoning, the physician should have explained what an MRI would tell them and whether or not the reason is really justified.

An MRI is a peculiar example to use because the patient is not exposed to radiation. Let's twist the story a bit and show you how doctors really behave when it comes to patients who demand tests that could do a little more harm.

Instead of an MRI, let's say the patient is asking for a CT or a chest x-ray. If there is no justification for the test, the doctor is going to expose the patient to an unnecessary dose of radiation. That's malpractice. That's bad medicine. That is something they could be sued for, not denying the patient the CT.

Let's go a little further because the next example is a more common form of defensive medicine. A mother brings her child in to the pediatrician. The child has a cold and the mother says she wants antibiotics. The physician has determined the infection is viral. Antibiotics would not treat the viral infection.

Here are the choices the physician has at this point.

1. Deny the patient antibiotics because it's not evidence based medicine. Tell the mother to treat symptoms, have the child rest, and drink plenty of fluids. No lawsuit.

2. Give the child antibiotics to make the mother happy because they know unhappy mothers tend to complain and want the magic pill to make the infection go away. To avoid confrontation, the physician practices some defensive medicine. It's a bad practice and paves the way for superbugs resistant to antibiotics. Lawsuit.

There are other options if the physician feels the mother is confrontational. Those other options are not relevant to this discussion, although again, an open line of communication would have been the best course of action.

In clinics across America, physicians have regular conversations about the overuse of antibiotics and the rise of bacterial resistance to those antibiotics. Superbugs are the last troublesome obstacle we want to face. Just because a patient demands antibiotics is no reason for a physician to throw those concerns out the window.

Let's give an example of defensive medicine that is also evidence based. For the sake of clarity and understanding, let me skip some of the jargon and clinical details and just go for the basics.

Let's say a patient presents with a set of symptoms. The physician recognizes these symptoms and orders the tests to confirm the diagnosis he or she already suspects. However, these symptoms could also be a sign of a malignancy, something that if missed, could result in a much worse situation for the patient. If missed and the malignancy were to progress to the point where outcomes vary tremendously (surgery, removal, and recovery vs metastatic disease and palliative care for example), you've got a lawsuit on your hands. The physician orders the initial tests for the most likely diagnosis and will probably order the other investigation soon to make sure cancer is not the underlying cause.

In that case, the physician is covering his or her ass, but at the same time, understands that cancer is in the list of differential diagnoses. At some point prior to ordering these tests, the physician would have sat down with the patient and discussed his or her concerns and possible diagnoses which warranted the investigations.

KSLA reveals its ignorance

KSLA News 12 out of Shreveport revealed its ignorance on the health care debate this Friday by posting a poll question on its web site which did not represent the reality that is health care reform at this point in time in Washington DC.

Let me explain by showing you the poll.

Here is the poll question and the possible list of answer choices.
Should the president's health care overhaul plan be passed?
1. Yes, as it is
2. No
3. Yes, but it shouldn't be rushed
4. Not as it stands now

Alternatively, here is the screen shot I took.


The thing is, there is no presidential bill yet to overhaul health care. The House and Senate are each working on various aspects of health care reform with their own bills. There is no single plan on the table.

Will someone explain answer choices 1 and 4 to me then? Which bill are we leaving as is? Since no single bill currently exists, "Not as it stands now" is certainly not possible.

Did somebody forget how the legislative and executive branches of government work?

Have the folks at KSLA discovered time travel and jumped ahead into the future?

It seems quite a few people are uninformed. Talk about a sad day for journalism. Thing is, it slipped right by the person typing it on the teleprompter as well as the anchor who read it out loud.

KSLA sucks. KTAL sucks. KTBS sucks. We don't have one decent news station in this area. It's times like these when I'm glad I can at least listen to NPR during the day instead of these chuckleheads. It's bad enough we have a ton of misinformation out there. Now even our news outlets need fixing. Yes, KSLA has been notified by phone regarding this poll and its inaccuracies.

Maher's Obama Audacity Rant

By now, I'm sure you've seen it on tv somewhere. Who says the media doesn't offer up negative Obama coverage? Maher went off on him and the major networks picked it up and played the fat kid/cake routine. In cased you missed it, on the 6/12/2009 airing of Real Time with Bill Maher, the flagrant host ended his New Rules segment with a blurb about Obama. First, he went on and on about how much Obama is on tv these days. Then he went on to discuss how Obama basically needs to become a hardliner with a Bush-esque swagger.

Folks on the Right are actually agreeing with Bill without even wondering where his motivation is coming from. Because it's Obama criticism, they love it. Proof that folks on the Right are sheep. They won't agree once they understand who Maher is. They definitely won't be as pleased with his rant when they discover the ass Maher wants Obama to ram his foot into is a Republican one.

The media has actually covered this next point. Let me enlighten you. Obama obviously faces criticism from the Right. With some policy decisions, even the Left is taking swings at the President now. That's where Maher is coming from. He's an upset leftist in many aspects. By having his little tirade spinning Obama as a pansy spending more time on tv and less time actually doing presidential things, he appeals to a certain crowd. Look deeper. This tirade is a response to his need for Obama to push more liberal policies.

What policies?

Let's stick with health care for the purpose of my post. I'm fairly certain Maher is a strong defender of a single payer system. If you've been watching the news lately, you'll know that's not what the Obama plan is proposing. In fact, even during the campaign season, Obama did not advocate a single payer plan. If you look at Maher's history, he has it in for the drug and insurance companies to the point where you wonder if he might need to be on prescription medication himself. It's no surprise that when Obama tries to find balance with the insurance companies, Maher throws a hissy fit.

But that's the thing about Obama. He understands compromise and middle ground is the stuff Americans are craving right now. It's why he got elected. It's why the Dems are essentially in control on the Hill. The AMA is all over Obama's back. Insurance companies obviously have more than a few politicians in their pocket. It's not like Obama has a slam dunk opportunity to push health care reform through. Middle ground is mandatory, not optional.

But...

With the Dems largely in control, he does have an opportunity to get things done. That's where Maher has a point. We saw this with Clinton. What happened once the Republicans had Congress? Nothing got done and they turned all the focus on the blowjob. We don't need another run of do-nothing politicians and we don't need to shove a boot up anyone's ass. There is no time like the present.

Other issues I'm sure Maher is upset about include legalization of marijuana and the environment. The first isn't happening. Not a priority. The second is sticky, but doable under this administration. With the economy in the shitter, green is the environmental policy and the economic policy all wrapped into one. That's the plan Obama preached during his campaign.

What do we need?

Folks on the Left need to stop throwing punches at Obama and go along willingly with his plans. He sure isn't going to get any support from the "No" Republicans in office now. Wait until later to pick your battles. Save your fighting words for when mid-term elections come.

As Mr. Pink (Steve Buscemi) said, "No man. Fuck sides! What we need is a little solidarity!"

What about Obama's celebrity status?

I think the motivation behind all the tv appearances has to do with morale. When Americans see their President out and about doing normal things, it gives them a warm fuzzy feeling which feeds into the love affair we've had with almost every guy that's taken office, almost (You know who). With the economy still in turmoil, I think Obama is trying to show the country that life is still enjoyable. Go out and do things. It's not like his job isn't stressful. Bush had his ranch. Previous presidents had Camp David. Leisure time is nothing new, even in times of war.

That being said, I do agree that he's spending too much time with things he shouldn't and not enough time getting in front of the camera telling the rest of us we need to sacrifice. I don't think we've learned our lesson yet. People still plan on living outside of their means. Greed isn't gone. We aren't cutting back on fuel consumption. We aren't taking global warming seriously. People still bitch about taxes, yet want government funded programs. Obama has to look these folks in the eye and just say what needs to be said. Sacrifice.

National Health Coverage, The AMA, AMSA, etc

The American Medical Association, aka the AMA, said it would cooperate with the Obama administration in an effort to make health coverage a reality. Now they say they do not approve of a nationalized system. Profit appears to be their primary concern. I thought patient care was behind the oath physicians take.

First, let's get something straight. The proposed plan is not a full nationalized system. Those who are happy with what they have can keep it. Those who are not covered because they cannot afford insurance costs can be covered under the government system. It should create competition with the private insurers and bring costs down for all of us. Think of it as capitalism with a government edge. Competition is, after all, healthy and beneficial to the consumer.

The American Medical Student Association, AMSA, has long been a proponent of a single payer system as reflected in their publication, New Physician. It seems that the young up and coming future doctors in this country are at odds with the current AMA bunch. It must be pointed out, however, that not all physicians are at odds with AMSA. It's the AMA which has decided to make the conflicting statement. In other words, the AMA does not speak for every physician, unfortunately.

Let's look at pay under the British NHS, something I know a little bit about after doing my clinicals there. The starting salary for the first year resident equivalent, the house officer, can range from £25,000 to £35,000. Pay increases in successive years. In American dollars, using a rough exchange rate, that comes out to $50,000 to $70,000 a year for someone just starting out. Do our first year residents make that kind of money? No. The cost of living is also higher in England, but residents still do quite well over there. Residents in the US still struggle.

Do No Harm
There is an interesting debate when public health care is framed under the physician's motto, "Do no harm."

In one aspect, covering the uninsured and focusing on preventative care would improve health among our citizens. Depriving our citizens of health care would do harm. It would be in our philosophical interest to make some attempt at serving the community by offering coverage. Doctors will still get paid.

On the other hand, some doctors argue that if we nationalize the health system, they will be forced to treat more patients with less pay. They argue that patient care in hospitals, for example, would suffer as a result of overwhelming workloads. Less attention would be given to each individual patient. While that might be somewhat true under a completely nationalized system, ie: single payer, again, that's not the system being proposed by the Obama administration. This argument against government coverage needs to be modified to reflect the reality of the policy.

When doctors appear like their only concern is what's in their wallets, it makes us out to be those stereotypical money hungry arrogant jerks who care very little about patient care. On one side, medical students are being hit with medical ethics, the importance of a good history and physical, establishing rapport, and learning to be empathetic. On the other side, they are beat over the head that money dictates care.

What would remedy the workload concerns? Let me make a suggestion. There is already a shortage of physicians in the US, yet the USMLE (United States Medical Licensing Exam) passing score requirements have gone up over the last few years making it more difficult to move on from the 2nd year of medical school to the 3rd. Upon graduating, medical graduates must participate in the residency match program, a centralized system where hospitals match up their choices with potential candidates. The NRMP is somewhat flawed in that hospitals only take so many new residents a year. Thousands of potential physicians go unmatched every year. Yes, thousands. Get those folks into the workforce to take some of the load off.

Let's face it guys. Doctors and patients get screwed by the insurance companies. Insurance companies end up dictating how much a physician will make. The 10 minute consultation is a direct result of the demands insurance companies place on physicians. In order for a family practitioner to cover the costs of his office, he has to see more patients per hour in order to get paid by each insurer. It's really a nightmare trying to appease everyone. Patient care suffers as a result. Doctors who spend more time with patients end up providing better care to each individual patient.

Thoughts on Legalizing Pot

Although I'm a big fan of Bill Maher, there is one issue I am in opposition with him on. That issue is the legalization of marijuana. Whenever he starts discussing anything medical, well, let's just say Bill gets a little ranty and extreme. In light of the present economic downturn, many have been suggesting we should legalize marijuana as a source of monetary gain. Let's explore that idea, shall we?

In my view, there are two schools of thought in favor of legalizing this substance. The first, and more legitimate proposal in my opinion, involves using marijuana for medicinal purposes. The second and more troubling proposal is legalizing marijuana for recreational use. Unfortunately, one group uses the other to advance their cause. I think you know which one.

Although marijuana when thought of as a pharmaceutical product has shown benefits in medical practice, smoking the drug does not come without its pitfalls. Some of the unwanted effects include short-term memory loss, impaired lung function comparable to that of cigarette smokers, cancer, decreased sperm count and motility, interference with ovulation and prenatal development, altered immune response, and may cause detrimental effects on heart function. The well known amotivational syndrome has become the source of humor and represents the common image of the run of the mill stoner. This syndrome is a rather serious consequence of substance abuse and is not entirely desirable, nor funny. Let's not forget the association this drug has with schizophrenia.

So given that background information, smoking this particular product does not appear to be the ideal method of administration. These effects alone are enough to convince physicians that its use as a recreational drug is simply not a good idea. In the world of medicine, physicians will be geared towards getting you to quit whether the drug is legal or not.

Let's look at marijuana as a cash crop at this point in time. It is grown in foreign countries and smuggled across borders. Anyone with seeds can start up their own crop. The number of varieties out there resemble coffee and tea selections.

Now let's legalize it and examine the market as a recreational drug.

What are the proposed benefits?
Monetary gain
Stimulation of the economy
Decriminalization and reduced strain on the judicial system
Reduced border security issues
Reduced funding of criminals abroad

Let's look at the problems from a business perspective.

It will have to become centralized through a company here in the US. Why? A better infrastructure for growing and handling this crop is already in place in other countries. Smuggling will turn into importing and that money will go abroad, not stay at home. Remind me again where the "good stuff" comes from. Why wouldn't a centralized company work? Anyone can grow the stuff. A licensing system will have to be put into place. Consider it similar to having a liquor license. What company would want to grow a crop easily grown by regular people?
There's just no money in it once you legalize the stuff, unless of course, you're the government taxing it.

Ah taxes. That is your proposal, isn't it? The current proposal for economic growth does stem from government taxation. Proponents preach how pot will help reduce the national debt, etc, etc. Yep. Let's tax the substance. You already know how well taxes have gone with tobacco smokers. How much are you paying for a carton these days because of taxes? Do you really want to start paying more for your pot? I didn't think so. Dealers won't like the idea either. They'll have to start paying the IRS for the money they make. Keep it illegal, and all that money stays under the table.

The proposal to legalize marijuana as a recreational drug is nothing more than a notion that if major drug companies are allowed to push their substances, we ought to be able to have our pot too. The problem is, it's not a viable business proposal.

You think it will result in decriminalization? If you do anything under the influence, you will still be treated as a criminal. Possessing it will not be criminal, but daily activities performed under the influence most certainly will. I doubt you'll be able to have the stuff out in the open in your car. Underage possession will still be criminal as well. Places of employment are still going to piss test you. They still don't have to hire you if you test positive. Could be a bigger bureaucratic nightmare than it already is.

So if you want to legalize marijuana for recreational use, show me a business model that works. If anyone can grow it, I'm not sure how profitable marijuana will be as a crop. I just don't see it guys.

"The Doctors" Becoming Novelty Show

The Doctors is a new television show featuring a handful of physicians spending an hour answering questions. People send in email questions and audience members ask questions of their own. The docs on the show have pop quiz segments before commercial breaks. Initially, I thought the show had promise. It looked like their goal was to inform.

Sadly, the show seems to be covering more novelty topics. Did they really discuss whether or not penis size matters? Can you have sex during a woman's period? These are the new topics? I know what is going on. The execs want ratings. You don't get ratings talking about boring problems.

Obesity is a huge problem in our country. There have been some shows discussing this epidemic. It doesn't do anyone any good to get sidetracked from the important health issues facing our nation.

Doctors...

You want to help your colleagues out? Get some repetition in there. Cover obesity every single day. Repeat key phrases to motivate people towards eating healthy and exercising.

Do you want to make it interesting? Discuss current news topics. I can think of two stories Americans recently saw on the news. The first has to do with the possible HIV cure via a bone marrow transplant. The second has to do with a cancer medication being a possible cure for Type 1 Diabetes. Explain the neat science behind those stories. Feed our patients some knowledge.

Don't be a novelty show! I feel like at any given moment, the kid from the movie Jerry Maguire is going to come out and say "Did you know the human head weighs 8 pounds?"

"Fibromyalgia is real" commercial

Yeah. I know it's real. Who told you it isn't? What the hell is the point of your commercial? The medical community accepts fibromyalgia as a diagnosis. Anyone who tells you it isn't real obviously doesn't have a degree in medicine. Here's the kicker though. Fibromyalgia is a diagnosis of exclusion. That means we've exhausted all other investigations looking for another diagnosis, including any kind of somatization disorder. It really could be all in your head. Yes. That is an actual diagnosis too. Yeah it's unfortunate that you're in so much pain. There is no easy set of guidelines for the diagnosis and treatment of fibromyalgia.

If you want to diagnose yourself, skip the trip to the doctor and deal with it on your own. If you want to know what's going on with you, docs are probably going to be able to figure it out. Sure there are some piss poor physicians out there who don't know their ass from a hole in the ground. Most of the time, however, they are on the level. Don't fight them tooth and nail when they tell you a professional opinion. Fibromyalgia is not an easy diagnosis to make.

What is wrong with this country???

Yes I have met patients with this diagnosis. I've listened to them and even know a few things that have worked to help relieve some of their pain.

A Useful Link
Diagnosing and Treating Fibromyalgia in a Patient With Rheumatoid Arthritis.

• CBS Blood Clot BS Story

I was just up watching CBS news around 4am and they were saying doctors aren't giving clot prophylaxis as often as they should. To put things in perspective, studies at individual hospitals, including a major hospital in Indianapolis, have found heparin prophylaxis for blood clots was not warranted for every patient and have adjusted their ER practices accordingly. Many hospitals automatically start patients on heparin for clot prophylaxis and a PPI for GI prophylaxis. Go in and look at a medication list in a chart. Everybody is on a heparin injection and pantoprazole.

Then they interviewed a woman who when in the hospital for knee surgery said she was not informed that she was at risk for a blood clot. Immobility after surgery means stasis after surgery. Surgeons know this. I guarantee that the forms she signed giving consent for the procedure listed blood clots as a risk somewhere. She just wasn't paying attention to the crap she was signing. Saying that nobody pays attention when they sign papers is a pretty piss poor excuse. I say bullshit to her. Hospitals these days are very anal about informed consent.

• Eli Stone On Shaky Ground

The first episode of the show Eli Stone featured a story about a woman taking a vaccine company to court over a mercury/autism claim. There isn't a proven assocation between the preservatives and autism, but the episode portrayed it as such ending in the company cutting a deal with the mother. At the end of the episode, they put up a black screen with white text with a disclaimer that the story was fictional, that the association has not been proven, and information is available at the CDC web site. What? You can have a completely fictional yet controversial and incorrect story line and get away with airing it as long as you cover your ass with a silly disclaimer? I guess you can only expect underhanded goings-on from people who try to revive George Michael. This show stinks of hidden messages. Faith?

Let's talk about the mercury/thimerosal autism association crazies. Look, scientists have studied it and can't find a statistically significant connection. Science showed that the Earth wasn't flat. The world accepted it. The people jumping all over vaccines causing autism are just as hell bent with their cause as the people who don't believe in evolution. The science says otherwise. I could go through all of the data, but the one thing you need to consider is that the preservative was taken out and no impact was seen in autism cases. Oh, that's right. There's a huge cover up behind the science. If you don't get the answer you want, bitch, moan, and groan about it being a conspiracy until somebody kisses your ass. Americans have become the poster children for conspiracy theories. There are people that say there is a connection and I say those people probably can't sit down with you and have an in depth discussion on live attenuated vaccines, inactivated vaccines, toxoid vaccines, or component vaccines, let alone discuss the immunology involved. I challenge any one of you skeptics to do just that, and yes, I want it in essay format, not internet rant format. I want to know you are able to organize the information and understand it. Doctors can. Shouldn't I expect you to if I want to take you seriously?

How about you use those noggins and start thinking of other causes? You know, all the crap we eat, all the pollution in air and water, and let's not leave out genetics. We're surrounded by things that can harm us. Think about how people, including yourself, dispose of batteries, televisions, and computer parts. If you were as passionate about finding a cause as I think you'd want to be, you would be turning over every rock in search of a reason and trying to remedy the easy stuff first. If you can't find something in one place, you probably need to go looking somewhere else. As a medical professional, that's what I will be telling my patients in a much calmer and more charming tone. Who taught you how to look for things? What in the hell happens to these people when they lose their keys? Let's be a little systematic in our search. There's being reasonably skeptical about corporations and then there's having your head completely up your arse. The idea that we all believe our own truths is the real problem. We all get it in our heads that we believe something and we are uncompromising in nature, so these people will never get it into their heads that any other answer is even remotely possible. The quest to be right no matter what is sickening.

Stop hunting zebras when similar four legged creatures in your area don't have stripes.

Don't have a background in statistics or health care? Don't know what a p value is? People in this country don't seem to have enough education to process information anymore. The medical community is going to be the only group that will be able to find out what's going on with autism. When you allow people like McCain to say there is strong evidence supporting a link with vaccines and autism, you're effectually tearing down the one institution that is willing to find the cause.

• Edwards & Giuliani Both Out

Yep. Edwards is out. I'm disappointed because even though he wasn't getting ahead in the primaries, his ideas and commitment to the working class are things we need in a leader after the last 8 years of screw ups. He's the only one up there with a single payer health care system. So much for that idea. I wonder who AMSA (American Medical Student Association) is going to support now. 

Why is everyone saying Edwards would endorse Obama? I don't get it. All the media types are saying it. The blog I just read thinks it. I watched the same debates they did. Edwards has more in common with Clinton on the issues than he does with Obama. Why in the world would he endorse Obama? They just seemed more at odds with each other than Edwards did with Clinton. He obviously wasn't digging either one of them, so my recommendation to him is to just keep his mouth shut and stay away from any endorsements that may haunt him in the future. This idea that he's going to endorse Obama doesn't add up. Let's hear someone explain why they think what they do. I haven't come across anyone who sits down and explains their rationale as I just did with this situation. On one hand, pundits and political bloggers say his withdrawal from the race will benefit Hillary more. Then on the other, somehow they say he will end up endorsing Obama. Why would his supporters be more likely to jump on the Clinton bus, but then end up with Edwards siding with Obama? See how things don't add up. There is a difference between what you think will happen and what you hope will happen. 

I'm glad Giuliani is out of the race. Why he jumped at the chance to support McCain all of a sudden is certainly an interesting twist. We all saw his withdrawal from the race coming a mile away. Personally, I feel that anyone who says "Thank God George Bush is President" when we were attacked on 9/11 doesn't deserve to be our leader. The thing that bugged me most about Giuliani supporters as I followed the debates was that they seemed to conjure up some half true outstanding record and pass him off as someone who had excellent rapport with New Yorkers. He cleaned up crime because he was a hard ass and after a while people learned that they didn't really like someone who was too much of a hard ass and power hungry to boot. The firefighters don't like him. Minorities don't like him. I mean just go down the list. He's not a likable kind of guy. He's far from a great American. Don't believe me. Read this blog post from 2004. Anyone who tries to sell him to you as a hero needs a good kick from a different kind of hard ass to remind them where they left their sanity.