A Facebook Debate with a Good Outcome?

Facebook has gone nuclear. It is always blowing up about something but in the last few weeks it has gone nuclear. Everyone is at someone’s throat about someone’s political post. Immigration and deportations, Travel bans and Circuit court rulings, protests and counter protests have all served as fodder for raging political fires.

Reading the posts and the comments (I know, I know, NEVER read the comments) one thing is overwhelmingly clear. No one is listening. Lot’ s of people are talking, but no one is listening. I have yet to read a single comment saying, “Why do you feel that way?” or “Tell me more, I would like to understand where you are coming from?”

I decided to counteract this trend a few weeks ago. A Facebook friend I have not seen since high school made a liberally leaning comment on another friend’s post and I decided to respond. Instead of posting a comment, I sent him a message-

You are on the left and I am on the right. We are both writers. I am wondering if you would be interested in a genuine dialogue on some of the issues. I would love to engage with someone who disagrees with me without either side attacking the other.”

Over the course of the next several days, we dialogued. We exchanged emails on taxes, health care and media bias. We found a few areas of agreement and many more where we saw the world from completely different perspectives. Neither of us changed our minds.

The most important thing we agree on is that both of us love our country and want what is best for it and that neither of us wants to destroy it. Beyond that, we are still friends.

Something to think about the next time you are tempted to type out an angry comment. If you’re not willing to dialogue in private, you probably shouldn’t say anything.

- Bart

thanks for reading and sharing. Comments and questions are welcomed, and personal messages are especially welcome!

A Different Road to Success

Everyone wants to make a lot of money. Most people think the path to success runs through college and is paved with textbooks, term papers and scantron forms. This belief has led countless young people to invest their parent's life savings, and much of their future earnings, in financing a college education. All who do this get a piece of paper with their name on it, trailed by a couple of very expensive letters (the most appropriate of which are B.S.)

Many are soon surprised to learn that those letters are not worth the paper they are printed on. Their dreamed of earnings don’t materialize. Their dream degree in their chosen field either turns out not to be the degree employers want or a degree that is wanted by only a few. In either case the opportunities available to them often provide only a living wage. They have a lifetime of debt in front of them and wasted years behind them.

I have received applications from a number of these people. When I post an ad for a position in my office I without fail receive several resumes from desperate college grads searching for a job. There is a degree of sadness when I delete their emails. They may have a college degree but they lack the skills and experience needed to work as a receptionist in a medical office. Over-qualified, mis-qualified and unemployed.

A few weeks back I met a young man who took a different path yet embodies the success for which so many young people strive. He is 29, single, self-employed and financially secure. His job pays well, enough for him to buy a home in Huntington Beach in a zip code with a median home price of $762,000. By most measures of financial success he is doing well, very well for his age.

He is successful, yet he had never attended college. Not one class, seminar or night course will be found on his resume. He has no formal business training, yet he makes over $100,000 a year.

He is a pool man.

He has been cleaning swimming pools for 13 years, since he was 16 years old. His father is a pool man and he learned the trade from him, how to monitor chlorine levels, remove algae and repair heaters and filters. After a few years working with his father he struck out on his own, acquiring customers and building his business.  Before long he was making a good living. Young and debt free, he was able to put a large portion of his earnings into savings, eventually enough for a down payment. He is a success.

He is a reminder that the road to success does not always go through college. Something for students and their parents to remember!

- Bart

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Learning to Prescribe Kindness

“You’re different than you used to be.” The comment came at the end of the visit with a patient I have known for over 20 years. “I’m not sure how to describe it, but you are different.”

“I’m nicer,” was my reply.

“That’s it! You are nicer.” It was as if she was afraid to say it for fear of insulting me. She didn't need to apologize. She wasn't the first person to notice. What she did not know was how the change occurred. I shared with her that one day over 15 years ago that I had stopped to perform a self-assessment, asking myself what people would likely say about me if I were to die. As I listed my dominant personality traits- passion, integrity, honesty, commitment to doing the right thing, I realized that there was something missing. I doubted that anyone would say I was kind. It was a sobering realization.

I told her that became my prayer, that God would make me kind. It proved to be a costly prayer, as within a few years a virus attacked my spine, bringing severe and debilitating pain. The pain faded, but the weakness and numbness never left. A few years later came panic attacks and anxiety disorder. These conditions brought me to my knees and opened my eyes to the struggles of others. They softened me and made me kinder.

She shared with me that she knew that I was someone keen on becoming a better person. She told me she was an avid reader of this blog (Hello Ms. D!) and that she had concluded that I was someone who was working on myself, someone who was trying to improve. I thought this was an incredible compliment, for to me, this should be one of the defining characteristics of a Christian.

We are all sinners, we are all broken and selfish. One of my greatest areas of brokenness over the years has been the tendency to use being “right” as a justification for not being kind or compassionate. God has been working on this part of my life for years now. I still have a long way to go, but if I am becoming a kinder person, if I can be described as someone who is less broken and less selfish with each passing day, then I am comforted knowing that God is doing his work in me. Which is... nice!

-          Bart

Thanks for reading and a special thanks to those who take the time to click one of the share buttons below. I am honored to have many who subscribe to the blog and have posts delivered to their email automatically. You can join these ranks by clicking the button on the page that says "sign up to receive my blog posts via email." I can also be followed on twitter @bartbarrettmd.

The Doctor at Your Fingertips

The future has arrived. This week we did over 10 visits electronically, visits that would require an office visit in almost any other office.

We had several patients with high blood pressure send us electronic messages with their home blood pressure readings. Most were normal and we refilled their medications for 6 months. One, who is newly diagnosed, needed an increase in his dose. None required a visit.

One patient had a bald patch on his scalp. We made the diagnosis of alopecia immediately upon receiving the photo he sent to our office iphone. The treatment will require a visit, but the diagnosis didn’t.

Another patient send in a photo of a new mole, which looks like a benign seborrheic keratosis. While you probably have no idea what that is, it is nothing to worry about and a visit was avoided.

This morning a patient called me with an asthma exacerbation. As she has had the condition for years she was able to describe her symptoms accurately. Instead of sending her to urgent care I was able to treat her over the phone, saving her time and money.

Two other patients who were seen in the office scheduled their next visits via Facetime, grateful that they would not have to take time off of work to follow up on their conditions.

The overlooked benefit of all of these visits is that they took much less time than an office visit would have. The result was more room in the schedule for those who did need to come in and more time when they did.

It’s a whole new world!

-          Bart

Adding My Name to a List of Uncaring Doctors

She has been in constant severe pain for over 15 years. The pain in her upper back defied explanation, identification or treatment. It continued its relentless course undeterred by needles, pills, scalpels and physical therapy. Family physicians, internists, orthopedic surgeons and pain specialists all failed in their attempts to provide relief or answers. The universal response was an increase in pain medications, with the end result being a daily dose of morphine 5 times the recommended limit yet no discernible change in her pain.

She came to me hoping against hope for an answer. At a previous visit I had promised to set aside time to review whatever records she could provide. She scheduled a lengthy visit and came with a CD of her medical records. I opened the electronic copy of her chart and reviewed with her the 240 pages of data it contained. It contained volumes of data but no answers. All of her tests, MRIs, blood tests and CT scans, were normal. Like so many chronic pain patients multiple explanations had been eliminated but no cause had been found.

The only treatment not yet tried was a frightening one. Research has shown that there are many patients whose pain is actually worsened by high doses of pain medication. “Opioid induced hyperalgesia” is the big-worded label for the condition, a fancy way of saying that not only has the patient become tolerant to pain medications, the pain medications have actually caused the pain to increase. The only treatment is to stop the medication, all of it. For the immediate term, pain is certain to increase. What isn’t certain is that the pain will be better in the long term. As bleak as this choice is it was her only hope.

My heart broke for her as I entered into the computer a referral to the addiction specialist who could guide her though her detoxification. Her tears and fears were overwhelming. The recommendation was so easy for me to make yet the road would be so difficult. I felt a sense of sadness and anger at the failure of the medical profession to help her and my inability to provide her with an answer. Her unhappiness and disappointment were palpable.

A few days later I received a sad and angry email message. In great detail she shared her feeling that I had failed her, that my name was being added to the list of doctors who had dismissed her concerns and failed to listen. She had hoped for more tests, more specialists, more… something. My inadequate reply was that I did not see any other options and my opinion was that stopping the pain medications was the best option.

I have thought about her ever since. I have reviewed her chart over and over again in my mind, wondering if there was any diagnosis that I might have missed. Sadly, the location and nature of her pain had been thoroughly and extensively investigated. There is nothing more that I can do. Her hope in me was misplaced.

My name has been added to her list of uncaring doctors. Her name has been added to my list of patients to pray for. 

- Bart

Thanks for reading and sharing, and for praying for this patient.