Feet First

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Sunday, August 31, 2008
    It's Finally Over

    Today marks the last strip of Lynn Johnson's For Better or For Worse. It ended more or less as predicted, with the wedding of Elizabeth Patterson and Anthony Caine (or, as us FOOB-haters prefer to call him, "Blandthony") and spadefuls of hokey dialogue, not to mention bad puns. Over at the Comics Curmudgeon site the commenters have been weighing in like mad, mainly to indicate their disgust with the feeble ending and to state that they're glad the strip has come to an end.

    Only it hasn't.

    Johnson is restarting it; that is to say, she's going back to the beginning of the strip and redrawing it. Yes, she's telling the whole damn saga all over again. You can imagine how the FOOB-haters feel about that: Apparently, our venom has been significant enough to garner national notice, as witness this article. I'm so proud of my fellow snarkers.

    I myself find this an odd decision. Johnson announced her decision to retire over a year ago, at which time she made the decision to end the strip. Sadly, her marriage ended right after that. I can understand her changing her mind, but in that case why not continue with an ongoing story? Putting yourself into your work is supposed to be therapeutic, but merely redrawing strips without new storylines doesn't sound very satisfying to me.

    My favorite comment on all this was the following, from the CC site:

    "My strip is gone"

    cried Lynn the hack.

    "But look - surprise!

    It's coming back!"

    Burma Shave


    Friday, August 22, 2008
    Paris in the Rain

    This is the second of my two days in Paris: I got in late Wednesday night and will be leaving for home tomorrow. Right now I'm sitting in an Internet cafe watching the rain pour down outside, trying to decide whether to continue with my plans to tour around or just go back to my hotel and sack out. The sack-out option is looking pretty good (it's a very comfortable room), but I think I'll soldier on for a little longer before going back.

    I've been to Paris before so I don't feel the need to run to the Louvre or Notre-Dame; I've really just been wandering around the city, doing some shopping and so forth. I've found the city quite pleasant and have scraped together the remnants of my high-school French, though I occasionally find myself substituting Spanish by mistake (it's embarrassing to be saying "gracias" instead of "merci"). I also had a delicious choucroute garni for lunch yesterday, which is sauerkraut cooked with ham, sausage and various other meats; reason enough to come to Paris if you like sauerkraut.

    My Internet time is about to run out so I'll sign off here. Next week it'll be back to the patients and paperwork, but I will be armed with a slightly better attitude thanks to the break. And Labor Day is coming up, so I still have a three-day weekend to look forward to.


    Tuesday, August 19, 2008
    Now This is a Reality Show!

    In a sense my vacation has been misspent. I have watched more television in the past week than I have in the past several months. But, I tell myself, I am gaining a valuable insight into the British psyche by doing so. I have learned the following:
    • British soaps are telecast in the evening, not early afternoon. The storylines are real-life and revolve around the working classes; not a scrap of glamour is to be seen.
    • Britcoms continue to be the best by far.
    • Britons love their reality shows, oh yes they do. Both "Big Brother" and "X Factor" (the inspiration for "American Idol") are on right now and garnering big ratings.

    Last week here saw the premiere of a new reality show called "Maestro," in which nine celebrities learn to conduct an orchestra. Each week they are assigned a piece of music and take turns conducting the BBC Orchestra, with one or two competitors getting knocked out each week. The winner gets the chance to conduct a real performance of the orchestra. As far as I'm concerned this is a brilliant idea: who hasn't conducted along with the radio and fantasized about directing an orchestra? I've been gripped by the show, enjoying the music and watching the efforts of the competitors to learn an entire piece within a week. Most pleasant of all, they aren't jostling for money or fame. They're doing it for love of music.

    I hope this show is successful. It would be nice to see more reality shows with a higher tone about something besides scrabbling for cash.

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    Monday, August 18, 2008
    Checking In

    Vacation has been great fun, considering I was stupid enough to check my work email a few days ago only to be greeted by the news that one of my partners is quitting. Which means the fall will be a slow ongoing disaster. Never mind.

    Brighton, where I am staying, is a beach town and very fun: Lots of pubs, lots of shops, the Prince Regent's summer palace to tour and so forth. The palace was built in the late eighteenth century, is known as the Pavilion and is right in the middle of town. It's a pile of Indian-styled domes and peaks and looks as if an architect had designed it while under the influence of a dysenteric fever dream. Today I walked down to the beach with Jess and watched the waves crashing - the surf is very high for August, so she tells me - and we wound up having a full English breakfast for lunch. So I guess it was brunch.

    The classic full English breakfast is a cardiologist's nightmare: bacon, sausage, toast, two fried eggs, baked beans and a grilled tomato (to balance all the meat). But it's very delicious. I requested my eggs scrambled but apparently this is unheard of: they arrived sunny side up with scary quivery yolks. Solved that dilemma by just eating the crispy whites.

    I'm off to Paris in a day or so and hope to post more then.

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    Saturday, August 02, 2008
    Stock Up on Those Pens

    I first heard the news a couple of weeks ago as I was leaving a restaurant. I had been a guest at a dinner sponsored by a pharmaceutical company (a.k.a. "drug dinner") with an informational speaker. As we headed toward the door, the representative ("rep") who had invited me mentioned that in the future pharmaceutical companies would be instituting new restrictions on promotional events like dinners, and then added, "And they won't even let us give you guys pens any more, either!"

    "What?" I responded.

    "As of 2009, no more pens."

    "You can have my drug pen when you pry it from my cold, dead fingers!" I responded dramatically.

    Then I came across this article confirming the sad news. No more baseball caps or coffee mugs. No more Post-It pads shaped like lungs or kidneys. No more (sob) pens.

    The cold hard truth is that American drug companies spend quite a lot of money on product promotion. They used to spend even more; I recall in the past going to Staples Center once or twice to see the Lakers, courtesy of a friendly drug rep (they can't do stuff like that any more). Are drug companies doing this to influence doctors' prescribing choices? Of course they are. They start early, with medical students getting a free stethoscope and "sponsored" lunches, and escalate their marketing efforts from there.

    My view of drug marketing has always been pretty pragmatic, in case you haven't figured it out by now, but I have to admit I've heard of freespending promotions in the past that gave me pause. I got this attitude from my dad the retired M.D., who never met a drug rep he didn't like. Mostly I feel that the drug companies write all this off as a business expense. As long as they're throwing the dinners, I might as well go. I usually learn something at these functions, as they feature excellent speakers. Whether it's hypertension, cervical cancer or asthma, these docs know what they're talking about and their speeches are quite a bit more than nonstop shilling. (Full disclosure: doctors these days are under a lot of pressure to prescribe generic drugs as well. This pressure comes from insurance companies and - if you are a member of a large practice like The Firm - from the administration. Generic drugs make perfect sense in many, if not most, cases, and I have been assured during my performance reviews that my prescribing habits are not out of line. So doctors are getting pressure from both directions, not just one.)

    Do all doctors agree with me? Definitely not. I've heard of projects such as the pen exchange where docs bring their drug pens to trade for ordinary unlabeled pens. I know some docs who resolutely refuse to talk to drug reps or accept any of their offerings. And that's fine; if you aren't comfortable accepting these things, then don't.

    But I have to admit I'll be sorry to see the tchotchkes go. My all-time favorite was the Levitra pen which slowly unfolded to its full length when the user pushed a release on the side. In case you don't know, Levitra (vardenafil) is used to treat erectile dysfunction. I've heard rumors that these pens were sold on Ebay. I gave mine all away to friends - wonder if I can nab one or two more before the big crackdown?


    Weekend Links

    If you're looking for an excuse to web surf, the Blogspot home page can be a fruitful source of links to interesting blogs. (You do have to have an account.) Here are a few:
    • It's Lovely! I'll Take It! - a listing of hideous photos of real estate. Extremely funny.
    • Ikea Hacker - this blog is a cornucopia of inventive ideas for Ikea products: Cool storage ideas, inexpensive ways to personalize the stuff you buy so it doesn't look so assembly-line and so on. It's a fun read.
    • Junk - two guys go all Kon-Tiki, build a raft from plastic bottles and a Cessna engine and sail from California to Hawaii. Really.