Comments on: Ask

By: Richard Cundy

Richard Cundy — Wed, 18 Nov 2009 22:03:24 +0000

Brain Storm, p. 324: I may have missed it, but I’ve gone over related pages 2 times, and I can’t find the real words used by Mary for the transcription “vinegar common anthony.” What did she say?
Of course, I enjoyed the book.
Aloha, Richard

By: Richard Dooling

Richard Dooling — Sat, 03 Oct 2009 18:58:22 +0000

Omar,

What about Booktopia?

http://www.booktopia.com.au/rapture-for-the-geeks/prod9780307405258.html

I just searched Google using: Australia and “Rapture For The Geeks”

I know I’ve had several comments from Australian readers, so write back if you have any more trouble.

Thanks.

By: Omar Dabbagh

Omar Dabbagh — Sat, 03 Oct 2009 06:45:01 +0000

Hi Richard, I would like to obtain a copy of your book ‘Rapture for the Geeks’. I attempted to get a copy through Amazon.com, only to be told that Amazon merchants can’t ship the book to Sydney, Australia which is where I live. Would you be able to point me in the right direction to obain a copy of this book please?

By: linda dons

linda dons — Sun, 23 Aug 2009 14:50:00 +0000

RE your article appearing in the Dallas Morning News, Sun Aug 23 09. You pose the question ” I’m just wondering why the nation continues incurring enormous debt to pay for bypass surgery and titanium knee replacements for octogenarians and nonagenarians, when for just a small fraction of those costs we could provide children with preventitive health care and nutrition.” I have an answer for you. When my Mother was 87 yrs. old, she had to have a stint. Soon afterward she was back to having lunch with her children and grandchildren and participating in all kinds of events. At age 90, she was hospitalized for an unknown illness which was latter diagnosed as a urinary infection. She spent a week in the hospital and another 10 days recuperating at home. She is now back to her usual routine – enjoying her family. Medicare paid for everything, including care givers and physical therapy. Did I mention that she is bent over, almost in half from osteoporosis? Here’s another thing – My Mother calls regularly to check on 2 of her, as she puts it ,”elderly friends”. Ms. B who just celebrated her 101st B-Day and Ms. K who just turned 100. Physically, both of my Mother’s “elderly friends” are in better shape than my Mother. These are just 3 reasons why the nation continues to pay for octogenarins. What a blessing! Would you have preferred that My Mother not have received the stint, or was left to die from a urinary infection? I don’t know you but my guess is that you, especially if you knew my Mother, would be at my side to fight for her right to receive whatever medical care she needed to continue her good life.

By: Richard Dooling

Richard Dooling — Fri, 21 Aug 2009 16:49:25 +0000

@ Steve J

Re Medicare coverage of ED drugs. Steve, it’s true that as of 2007-08 Medicare plans are no longer REQUIRED to cover ED drugs, but they MAY cover ED drugs as an added benefit. See, for example, the publications available at medicare.gov, especially this one at page 20:

http://www.medicare.gov/Publications/Pubs/pdf/11109.pdf

By: Steve J

Steve J — Tue, 18 Aug 2009 16:48:12 +0000

Richard,
on your 8/17/09 NYT Op-Ed piece.
In general I agree that too much money is spent on end of life care.
Unfortunately in some cases there is no alternative to dying in a Hospital.
Both my parents died there. My father at age 57 in 1977 after surgery to remove a cancerous tumor bled internally and he went into a coma and died 3 weeks later.
My mother died of complications of Alzheimer’s which caused her colon to shut down .

As a senior on Medicare (Wikpedia says you are 54-55) I can tell you that we pay full bore prices for ED drugs like Viagra, Levitra and Cialis.
See: http://seniorjournal.com/NEWS/MedicareDrugCards/6-10-18-ErectileDysfunctionDrugs.htm
or Google “ed drugs removed from medicare”

I am surprised that the NYT editors didn’t catch your error.
PS: reply directly to my e-mail, TIA

By: Emily Dye

Emily Dye — Tue, 18 Aug 2009 16:33:32 +0000

Mr. Dooling, Thank you for going public in discussing health care. You are addressing a complex and misunderstood topic: Excessive, misdirected, wasteful health care, particularly for the terminally ill, disabled and elderly. My mother was a victim of excessive orthopedic care. A painful external fixator was used to repair a broken ankle when we knew that neuropathy, arthritis, brain deterioration and spinal damage were going to prevent her from ever being ambulatory again anyway. She was also the victim of a “death panel” (a neurologist decided to tell us that her brain lesions were harmless and her condition was a combination of vascular dementia and alzheimer’s. My siblings and I could not see the correlation between the signs and symptoms of those conditions and Mom’s. Eventually, a concerned radiology oncologist alerted us to the aggressiveness of one of the “harmless lesions” but his information was too late. As a result of the 4-year delay in the truth, her palliative care was poorly targeted. If her caregivers and PCP’s had known she was suffering from a ventricle brain tumor, not dementia, they would have dealt with her pains and symptoms differently — and with better results. There are many other ways in which our Mom’s medical care was poor in the last four years of her life — even and maybe because she had very good insurance. Finally, 6 wks before she died, I managed to score a geriatric specialist, after trying to get one involved for four years, but by this time, all he could do was explain the dying process to us, provide her with a kind beside manner, and stand up for us against other physicians who wanted to continue painfully treating her when it was obviously pointless. My brother and sister and I have a great deal of rue and hurt as a result of the inconvenient, poorly directed, painful and harmful medical care Mom received. However, I must clarify that she experienced that alongside good quality, well-chosen, help and healing care. We saw both the best and the worst of the American Health Care System and are well-educated voters and advocates, as a result. Physician honesty and patient education are essential, as is hospice education and intervention, because we need to have the knowledge to know when the truth is being withheld, when mistakes might be being made, when to make inquiries, who to go to, what questions to ask and how to maneuver through an extremely complex and intimidating system. The best patient advocate is the educated patient, loved one or caregiver.

By: Lynn Mary

Lynn Mary — Tue, 18 Aug 2009 04:26:16 +0000

Really appreciated your thought-provoking Op-Ed in the NY Times today, a far overdue discussion of how the healthcare system has turned what is inevitable into a disease to be somehow “cured”. You and your readers might want to check out a new novel, The Leisure Seeker, by Michael Zadoorian, which deals with some of the issues you raise. In this instance, the octogenarian married couple opts out of the relentless end-of-life medical treatments (she has terminal cancer), and instead take a road trip along the remnants of the Route 66, sharing their last days together on an adventure, rather than hooked up to a chemo machine. Were it not for the layers of guilt that doctors (and family members) are apt to apply in great doses (see The Bucket List) most of us would really prefer to end our last days with some semblance of freedom to rest in peace.

By: Richard Dooling

Richard Dooling — Mon, 17 Aug 2009 19:27:46 +0000

Other comments on NYTimes Op-Ed to be found at:

http://www.richarddooling.com/index.php/2009/08/16/critical-care-revisited/#comments

By: Mary D

Mary D — Mon, 17 Aug 2009 18:21:12 +0000

Just read the NY Times Op/Ed/ 8/17/09
In many ways you are so correct. I agree w/ you on many levels…especially where an individual is in the CCU w/o any hope of recovery. Such happend in our well-educated, progressive family in 1992 when my father fell and was in a coma after brain surgery. Mother and Dad simply never discussed this possibility. It was a horrible 30 days b/t Thanksgiving and Christmas, the day Mom let Dad go. Being one of four adult siblings, I, the priest and Mom’s best friend, a CCU nurse had counseled Mom that Dad would not recover, and that she should let him die in peace. Mom was dealing with this until the other three siblings flew in and advised Mom that Dad could get better if only they prayed harder. [ No matter if an advanced directive is in place...it is still hard for a loved one to let another go] Well, for a few days, I was the evil child ……but then the others flew home and it was just mom and me. I sat by his bed with her for 5 days as his body contracted sepis/ pumps in and out of every place pumps could go/ on Christmas Eve, his fever spiked to 105, and Mom let him go on Christmes morning. LESSON LEARNED: Mom got her attorney on the phone/ got her advanced directive/ will/ power of atty, etc. Mom made the decision last year at 88 not to have the aortic replacement that Mrs. Bush had. She decided that she has a good life living w/ me/ has lived a full life/and refuses to ever be in a CCU hooked to pumps and plugs, etc. She discussed w/ her doctor who was in full accord with her. I do disagree w/ you on some level…..if a man is cabable of sexual activity at 80/ he should get his Viagra…ok…b/c if the commercials are correct 35 yr old men are in need as well. As for scooters etc. if such equipment keeps a senior indpendent….why not? The point is…..no person should ever languish in a bed either at the rest home or in a CCU. Funny how my mother chose to spend her remaining yrs w/ me rather than any of her other children! Death is comming for us all. Think about how you believe you would want your life to end…be honest, and if you are, you, any of us will do the best for a loved one. p.s. This fear of elder abuse is BS. Elder abuse is permitting an elder loved one to languish in some filthy rest home/ or keeping a loved one alive w/ pumps and plugs.