Wednesday, April 7, 2010

Small Ruminations While Cutting Grass

Jackson Browne--"Doctor, My Eyes" (mp3)

Out here in the semi-suburbs, when I mow my lawn, I can't help but butt up against neighbor's yards and lives. Ever since I cleared out a lot of weeds and crap earlier this spring, we can step out of our front door and see between the trees to a couple of houses that we used to could not see. One of them right next door.

You other homeowners know what it's like to step behind a lawnmower, as I do right now, its carcinogenic fumes and whining racket envelope you in a private world, one that allows you to ponder the meaning of your semi-suburban existence. It's actually quite cathartic, the closest I get to a meditative state in an average week. My mind is free to drift.

So I glance at the house next door, where our new neighbors reside, and I notice several things--the overgrown lawn, the red wheelbarrow in the exact location where it has been sitting since last fall, the ambitious yard and tree projects that had stalled.

Their arrival last spring was huge and dramatic--the gutting of most everything inside the house, painting, trimming, Porsche and Lexus in the driveway, the clearing out of their backyard, the letting it be known to us through other neighbors that they wished we would take care of some things on our side of the line as well, talk of trees coming down, the rebuilding patio, and finally, the huge outdoor party last summer when all of their old friends and neighbors came to see their new home!

And now, they are getting divorced. You see, the husband is a doctor, the wife is one of those small women possessed with a kind of demonic energy. They are workout fanatics. The wife is a runner. The husband, I don't know, because I've never seen him. He leaves the house every morning about 4AM to go work out, then puts in his long medical hours. And, he harbored a terrible secret which came out before Thanksgiving--he wanted a divorce, he wanted to leave, he has been angry with his wife for the past 10 years. That's all I know. Except that the guy was never home, never around for his kids, completely into himself.

The doctor, unfortunately, has become almost the stereotype of the modern physician. Caught up in conspicuous consumption. Buying whatever he wants without hesitation--expensive car, nice house, health club membership. Too busy for his children. Ready to move on to a (likely) younger, (likely) better-looking wife.

And, unfairly, I know, that's where some of the anti-health care reform arguments break down for me. Some people are so worried about what it will do to the doctors. The doctors won't be able to make as much money. The doctors will have to continue to worry about "frivilous" lawsuits if we don't have tort reform. Well, guess what, a doctor nearly killed my wife with a misdiagnosis, and we couldn't even bring a "frivilous" lawsuit against him because 1) we couldn't afford to front $20,000 to hire expert witnesses and 2) our chances weren't deemed that good because she did not die.

If you don't think that today's doctors are even offering prescriptions to us that we don't need simply because of mutually-beneficial relationships with drug reps, you are not paying attention.

When did a career in medicine have to become a path to excessive wealth? When did it start attracting people who had monetary interests which so powerfully overrode their concern for the welfare of others? When did it create practitioners who refuse Medicare patients because they aren't worth it? When did it lead to the creation of a culture of people who supposedly live to save lives but who live shallow lives with excessive personal spending, tax shelters, and values that can only be characterized as "new money?" I know these are naive questions. I don't care. I think they're still valid, and I don't hear anyone else asking them.

Do you really think that if a doctor's potential income were cut in half that people wouldn't pursue that line of work? I don't. I think if that changed, it would attract a different kind of people. Better? Who knows. As motivated? Well, maybe not by the money. For all the talk of the burgeoning costs of being a doctor, I certainly don't see it impacting the lifestyles of the doctors I know. What, will they have to buy used BMWs?

Here's my solution: I'd like to see us find ways to subsidize the cost of med school, so that a doctor didn't come out of there with such tremendous debt. Maybe a young, graduated doctor could do public service health work for two years, in exchange for that debt, and maybe that work would help to re-sensitize him or her to the original values of the profession. Perhaps then a doctor wouldn't require such a substantial salary and could return to being a respected member of the community instead of sitting on a lofty perch above us.

I know I'm generalizing. I know there are doctors that care about more than money. But I also can see the sad, empty house next door where a man has put his personal needs related to being a doctor above his wife and children. It's a life out of balance in a way that I think many doctors are out of balance.

But what do I know? The grass is cut. I going to take the lawnmower out back and put it away and sit on my deck and drink a beer.


goofytakemyhand said...

So much depended on that red wheelbarrow, glazed with rainwater, beside Bob's lawn.

Billy said...

One medical specialist's salary would cover, what?, the main teaching faculty of a small middle school (6 x ~ $40k)?

I hear many connected to the health profession saying things like, "They sacrificed almost a decade of their lives to become doctors, and they deserve everything they can get and then some."

Meanwhile, teachers? They just do it because they must love it. It must be a "calling." Screw the money, and screw "deserve." They get summers off; end of debate.

The medical profession won't die out if income levels drop. Nor will it suffer from a paucity of enthusiasm. The best doctors I know really don't care so much about the money but do constantly complain that there's no way to be a great and dedicated doctor without sacrificing too much of their family time.

There's already a gross shortage of family practice and general practice doctors, because the money in it sucks compared to specialties. And that has nothing to do with Obamacare. It has to do, yet again, with serious flaws in the system that won't die.

troutking said...

Great segment in Michael Moore's movie about health care about doctors in France. They make a "good living", work reasonable hours and enjoy their jobs and its contributions to society. They aren't rich by American standards, but their lives seem to be.

troutking said...

Great segment in Michael Moore's movie about health care about doctors in France. They make a "good living", work reasonable hours and enjoy their jobs and its contributions to society. They aren't rich by American standards, but their lives seem to be.