Sunday, June 29, 2008

CERN and the LHC

The European Center for Nuclear Research has been around a year longer than I have, it was founded in 1954 as one of Europe's first joint ventures, and has, over the years, contributed some of the most important fundamental scientific observations of the last half-century. They've had access to the most advanced scientific instruments available at any given time. But what's coming next is of an order of magnitude more complex than anything we have seen before. We are approaching power-on for the Large Hadron Collider. Because I have a background in physics the subject has been brought up in conversations several times in recent days, usually along the lines of, "Do you think when they turn on that big collider on, over there in Europe, it's going to be the end of the world?" My answer is a not very reassuring, "Who knows?"

We live in a whole big world of scary stuff; floods, wars, nuclear bombs, and reality TV just to name a few. In a solar system full of scary stuff, like asteroids, comets, and other stuff that might fly out of the sky and squish us. In a universe full of scary stuff, I don't even want to think of what a supernova or black hole would do. We've done a lot of injury and damage in the name of science in the past. Can the world really be any more over than it is for the amazing number of native populations decimated by smallpox, syphilis, and TB, all in the name of expanding our universe.

I can hear you saying, "We're not like that anymore." Heck boys and girls, we weren't completely sure when we set off the first fusion based "H-bomb" that it couldn't set off a chain reaction that would light up all of the hydrogen floating around our little planetary home. We didn't think it would and it didn't but, "Who knew?"

The chances of the accelerated protons or lead ions we send racing around the new thirteen-mile nuclear racetrack they've built three-hundred feet below the ground over on the Franco-Swiss border, forming a black-hole that doesn't dissipate, or an uncontrolled annihilation reaction due to anti-matter generation is less than one in fifty-million.

The good news, if you believe in string theory, is that even if it happens, we may end up in one of the other ten, twenty, or hundred other dimensions we aren't able to see, but that have to be there for the universe to work right.

How will it turn out? Only God knows, and he isn't telling, but he does give us a few hints, while the LHC may be the most powerful collider on earth it doesn't come close to reaching the energies that particles accelerated through the universe possess when they slam into our atmosphere. If they haven't blown us up yet, why should we be afraid of man's puny attempt to mimic nature's great collider?

Thursday, June 26, 2008

Blogs as Practice

If you want to learn to write, how do you do it? If you believe conventional wisdom you seek instruction, buy a book, read a magazine, or enroll in a course. Everybody has an answer, and is ready to help you learn to write dialog that pops off of the page, stories to rivet your readers, and screenplays that will have studios throwing money at you. Pretty much it's all designed to enrich those offering the instruction, and do relatively little to help the aspiring writer.

What you don't do is ask someone else to write your story, or screenplay, or poem for you. I've had several people ask me to write their stories for them. Unless its one of my partners and they're ready to start a new project, I never have. That doesn't count kids. My kids and I paint, write, or make-up and sing songs all of the time. Sometimes the kids will put on whole stage shows complete with choreographed dance numbers for a paying audience of six or seven (that depends on if we let them bring the goldfish.) Anything that allows them uninhibited creativity is a plus and should be encouraged, so that when they're adults, they aren't sitting around wondering if they need to take a course or read a book to create something worthwhile.

So what do you do? You write. You write all kinds of stuff. You write as if someone is out there to read what you're creating, whether there is or not. That's where blogs come in. Offer an opinion, create a story, do anything; to quote Nike, "Just do it." When you're done writing, read it, then tear it to pieces, and rewrite it. Whoever said writing is rewriting was only ninety-five percent correct. When you feel like it is the best you can write, post it and get some friends to read it and offer criticism, and if a stranger slams it, save the righteous indignation and try to see if what they are saying has any validity. I'm lucky enough to have a lot of what I write reviewed by professional editors, and I still have a little difficulty keeping that righteous indignation at bay.

Will this really work? Can writing regularly in a blog that no one reads improve your writing skills? Who knows? I'll get back to you in a few years, but in the meantime, I'll keep blogging, just for practice.

Wednesday, June 25, 2008


Okay who knows what all that stuff is? I do, but, its only because I've been stuck talking about it year after year with very little hope of any realistic improvement. All of these initials have to do with the current Medicare system (especially the last one). SGR stands for Sustainable Growth Rate and it's how our federal lawmakers have tried to limit the growth of Medicare costs. They tied the total amount of money that can be expended to the United State's GDP or Gross Domestic Product. That means the value of all goods and services produced in the US during the preceding year.

Because our economy is, to say the least, less robust than it was a few years ago, coupled with, the increasing number of folks entering the "Medicare years" due to baby-boomers pouring in like a damn busted, the formula stopped working several years ago. Everybody knows it doesn't work; the lawmakers, the doctors, the hospitals, even the HHS folks who administer Medicare know. Guess who doesn't know? For the most part patients have no idea about the costly, intricate dance that goes on every year, with doctors and hospitals spending millions of dollars to convince the lawmakers to do what they know they are going to have to do anyway. And each time they patch it the formula gets farther and farther away from anything approaching reality. We are now so far behind that a 20-22% cut in current reimbursement rates would be needed to set things straight. That, or the jobs we've allowed to be outsourced overseas will have to start spilling back into the US, the dollar will have to drop so low that its cheaper to make things here than it is in China. Think that's gonna happen soon?

The closest thing I can think of as an example, is that if you needed a new car, and you set the amount of money you could spend on that car a year as a set portion of your income. Now, some hard times come. You make less money. Gas goes up to four dollars a gallon. Could you go to the bank and say, “I’m going to have to cut what I’m paying you on this loan.” Or go in to the gas station owner and tell him, “Sorry buddy, but all I can give you is two dollars a gallon.” You’d be a no car, no gas, walking the road son-of-a-gun. And, if you don’t believe me, just try it.

So what do we Americans do if we want the system to function and doctors to treat us when we become geezers, ( I stand on the very verge of geezerhood myself). The answer is simple we need to SCRAP the CRAP. The SGR can't be fixed so start over. The House has just passed another bill to put another bandage on it for 2008-2009, the Senate has yet to act, but if it doesn't the first 10.8% cut is already programmed into the HHS computers for July 1, with another catch up cut of 10.2% set for January 1st. We have to have the bandage, but before this issue becomes a crisis again we need a serious discussion about a meaningful and realistic fix. We have two new contenders for that big white house on Pennsylvania Avenue, and we need to ask them what they think about it, and what they plan to do to fix it. If we don't, its like the old gospel song says, "Ain't nobody's fault but mine..."

Monday, June 23, 2008

“There’s a threat on the horizon. In terms of lives lost this threat will dwarf 9/11 and the war in Iraq combined. It’s a threat that could potentially result in millions of lives lost prematurely. When it becomes a crisis, your doctor won’t save you from it. He can’t, not without your help now. If you as an American don’t begin to help shape the future of health care delivery in our country, there won’t be anything left to deliver. The politicians put forth fatally flawed proposals that they know won’t work, but they’re committed to them for political rather than scientific reasons. The left has no more of a working plan than the right. The AMA has suggestions, but they’re constrained by what’s politically achievable. Finding the solution won’t be easy, and it won’t be ideal, but unless we as a country begin a discussion, we will surely see a collapse of our country’s health care system. It has, in fact, already started and as evidence there are forty-five million uninsured patients in America right now. Forty-five million Americans are currently unable to access preventive care, putting them at increased risk for costly health problems in the future...Forty-five million with nothing but the spirit of charity in the hearts of health care providers to save them, if something catastrophic happens.”

Let me let you in on one of the basic facts of life, and no, you don’t have to be a doctor to know this one, everybody wants more- more money, more fulfillment from their lives, more love. If you need proof, look in the self-improvement section of any bookstore, or just turn on your television during the day and flip through the channels.

Why do we need more? Well, we need more money so we can get more stuff. Our society and our economy are based on a simple principle…consume, consume, consume. I hate to admit it, but I’m no different from anybody else, I need the newest two terabyte MP3 player, my crummy eighty gig is way too small, it only holds a thousand or so CDs. Who can put up with that? Unfortunately, as much as I delude myself to believe it is, my need isn’t a real need, I don’t have time to download a hundred CDs, much less a thousand. I have about thirty-seven CDs on my player, and yet I believe I need a newer, more technically sophisticated model. With the rapidity of technological evolution in the modern world, this cycle of need and fulfillment is never ending, as soon as I buy the new “two-T”, within weeks of the purchase of this technical marvel, they’ll begin to advertise a newer model, one that comes with a cell phone in it, and as soon as I get that, there’ll be an even newer model with both a cell phone and a miniature computer in it, and so it goes ad infinitum.

In a lot of ways medicine is the same way, but instead of ego and vanity being the only driving forces, it may truly be that our lives are at stake. We want more and we want better, the heck with better, we want the best. Who doesn’t feel that they deserve the best health care? America is nothing, if not an egalitarian society, in this regard, everybody deserves the best health care, right? I don’t know. Let me pose a hypothetical question, what if there were a drug that was ninety-nine percent effective in preventing osteoporosis in post-menopausal women, and had no identifiable side effects, shouldn’t we give it to everyone that could benefit from it? Sure, that seems like a “no brainer”… but, what if it cost twenty thousand dollars a dose? Ok, well, that does seem a bit steep, but it really would make so many lives better, I guess we still should. The problem is, at that cost, for that many women, most of which will be sixty-five years old, or older, the cost of the drug will bankrupt Medicare in a single year. Now, should we make this wonder drug available to our Medicare beneficiaries? By the way, I hate the term beneficiaries, almost as much as I hate the term, health care provider. These are patients, sweet little grandmothers and mamas, wonderful women, and I am their doctor with this wonder drug that will make their lives so much better. No longer will they have to face the chronic back pain and the debility of nerve root compressions that are associated with the pathologic fractures of osteoporosis. Can I give it to them?

This isn’t a medical decision, medically, the answer is obvious. From a risk-benefit standpoint the drug is amazingly effective, so it’s all benefit with no risk. The only risk is to the solvency of the largest health care provider in the United States. So, this decision becomes not a medical decision but a social decision, a governmental decision, a legal decision, even a moral decision, and the consequences of the way a decision like this is made, and the nature of the system put in place to make such decisions, will reverberate through the years, to effect, not just ourselves, but what type of a system our children have to look forward to. Will the egalitarian system we take as given, grant access to all to every technical step forward, or equally restrict access by all. Will equal access become a quaint naiveté` and give way to a two-tiered, or multi-tiered system of health care delivery, with the latest and best going to those who can afford it, and whatever’s left going to those who can’t? We would never stand for that, as a country, would we? We already do. There are forty-five million Americans without health insurance, the uninsured are now a sub-class, they don’t have access to the same preventative care and routine checks that the insured enjoy. As a matter of fact, even if they can afford health care, they may be afraid to seek it. There’s the big punch-a-roo, if they get diagnosed with a pre-existing condition, they may never get access to health care they can afford.

Do you know which segment of the population is the fastest growing pool of the uninsured? Poor people, right? Perhaps, the unemployed? Nope, on either count. That distinction goes to working males over fifty, that make over seventy-five thousand dollars a year. That can’t be right. That’s what I thought, until it happened to me. When a misrouted bill went unpaid, my insurance was cancelled without notification until sixty days after the action. And once you find out your policy has been cancelled, if you’ve gone more than thirty days without a bridge policy, you have to jump through hoops and throw around a good deal of loot to get any type of coverage. After several rounds of denials, and a total inability to get a private policy to cover either myself or my wife (every company was happy to cover our perfectly healthy children, for the same price we had been paying as a family). Thankfully, I have a good income and the cost of establishing a group policy and hiring my wife wasn’t an undue hardship, but it cost twice what I had been paying. Most families can’t absorb this.

In my opinion, any, health care reform has to deal with both of the issues we’ve dealt with. Until there’s some type of controls on drug pricing and insurance reform that actually reforms the practices of private insurers, any health-care policy we undertake is a mere band-aid.

title confusion

I guess when I chose this name I didn't realize that the rap song Boy Looka Here by Rich Boy was going to dominate all search engines for the first forty screens or so. To be perfectly clear this site has nothing to do with that particular song or rap music per se, it may address music (as in our film Teary Sockets) , but it will address a lot of other things as well, health care, writing, social issues, southern issues, political issues, filmmaking, art, who knows? Why should you read it then? You have to figure that out for yourself.

Looka' here

The title of this blog is a term that can be used two ways here in the south. It can be used as a term of emphasis, to say, "Pay particular attention to what I'm about to say." Eg. "Looka' here son, that horse is about to stomp all over you." Another frequently way to use it is to shout it to your friends just before you do something particularly daring and foolish. "Eg. "Looka' here, I'm gonna ride Ol' Tornado bareback." Used in this manner it could probably be the epitath for many a young man who died too young, and broke his momma's heart. Hopefully we will be using in in the former sense rather than the latter.