Rice-Baylor College of Medicine?

For those not up on their Texas Medical Center gossip, some relatively big stuff has been going down at Baylor lately. The Houston Chronicle had an article a few days ago reporting that President Traber will likely be asked by the board of trustees to step down this Wednesday. My understanding of the situation is limited, but I have heard that it stems from the decisions he made shortly after becoming president in 2003.

He wanted Baylor to have its own hospital, and he pushed plans to build it next to the VA hospital just next to the medical center. Baylor had long had good relationships with the hospitals in the med center; it partnered with Texas Childrens hospital, Ben Taab, the VA, and the Methodist hospital very closesly for a long time. However, the new hospital would compete directly with the Methodist hospital, and the plans put so much strain on the relationship that Baylor stopped working with Methodist completely as a result.

The new Baylor hospital has turned out to be more expensive than expected, and the worsening economic crisis has only made things worse. This has resulted with close talks with Rice University about a merger that may get approved in the coming months. A former Baylor president, Dr. Butler, is expected to take over, and it will be interesting to see how he handles the merger possibility.

Personally, I have no clue why Baylor would want to build another hospital in the med center, which already has something like 12 hospitals in one spot. I do understand the desire for autonomy, and most elite medical schools do have their own teaching hospital. However, Bayor is unique in its location in the medical center, and another hospital was simply not something it needed. I hope my tuition doesn't go up...

Sick Around The World

For my health policy class, we were assigned to watch part of a Frontline documentary called Sick Around The World. The documentary feels kind of like Sicko when Michael Moore is examining the heath care systems of other countries, except I think that T.R. Reid gives the issue a more even-handed treatment. If you want to watch some of the documentary, it is available online and is broken up into segments by country.

12 Days

This past Friday Baylor had its traditional "12 Days" celebration. This is a yearly event which honors the mere 12 days of class the second years have before they take exams and finish their pre-clinical courses (of course they have THREE straight weeks of exams... yikes!) The event is a conglomeration of short skits that these days were all done as videos and put together in a large movie. One second year was actually a film major in college, and the editing was quite good.

Interestingly, there is an article on slate.com about exactly these types of shows. Our skits contained some of the things that the article talked about, but nothing that I would say was too shocking or offensive. Most of the videos were just parodies of TV shows and songs, as well as some poking fun of the many professors we have at Baylor. I really enjoyed the video, but I agree with the author that these are probably best left for a closed medical school audience. Besides, who would want to sit through two hours of inside jokes that they don't understand? Lisa made the right choice and stayed home.

Gone Forever

My green mountain bike was stolen last week. I kept it locked up on the first floor of our parking garage. A few days ago Lisa and I parked right in front of where it should have been, and all we found was the clipped lock. I received the bike as a birthday present almost nine years ago, so maybe it was time to move on. Luckily, I have kept my nice road bike inside the apartment, and now I think it will stay that way year round. Oh the bitterness of big city crime!

An unexpected result

I'm taking a little break from studying to write this post. We have our Block II exam this coming Monday and Tuesday, and I have still have a lot to learn about renal, respiratory, and cardiology before then! But I have decided to pause and tell a little story.

First I have to tell everyone that I like to make pizza. I make the dough with my stand mixer and then bake it in the oven using a pizza stone and pizza peel. When I first opened the stone right after the wedding, I read the instructions printed on the cardboard packaging. They instructed me to "season" the stone by rubbing vegetable shortening into the top and baking it in the oven at 350 for 1 hour. I did this, and it smelled like burning fat for a while. Since then, whenever I used the stone for pizza, it always filled the apartment with the awful stench of burning fat. Sometimes it even gave off thin gray smoke that stung my eyes a little bit. Lisa hated it and just wanted to get a new stone...

However, I found a message board online where several people claimed that their stones also had burning fat problems, and the consensus was that if you put the stone in the oven and ran the self clean cycle, all the fat would get burned out and the stone would be good again. I waited until Lisa was not home and gave it a shot.

Things went well at first. The oven heated up way past the 500 degrees that it is capped at for normal cooking and I started to smell some burning fat. I was sitting at the dining room table keeping an eye on it, when all of a sudden a ball of fire erupted from inside the oven with a loud whoosh sound. I jumped up and shut the oven off, but as soon as I did, that thin gray smoke started pouring out of the vent and began to hurt my eyes/lungs. I ran and opened all the windows and doors in the apartment, even though it was an 85 degree day in Houston.

The fats that were absorbed into the stone had become volatile and mixed with the air in the oven, the same way gasoline vapors would at normal temperatures. Either the fats got hot enough to reach their autoignition point (which could be possible since the oven reaches 800 degrees during a self clean), or the calrod in the oven gave off a spark (I don't actually know if that could happen, but somehow there was fire). The pizza stone had tuned a darker color, and lots of crispy junk had formed across the surface.

Now the good news:
- The oven received no damage and works fine.
- After a day or so the apartment no longer smelled like burnt vegetable shortening.
- After cleaning the stone very well, I used it to make pizza and there was NO smell! Internet wisdom prevailed!
- Dinner tomorrow is pizza, the dough is in the fridge.

Alright, now I have to learn about the marvelous kidneys.

Things a respectable Democrat should never say

There is a funny article on slate.com that ends with a list of "liberal utterances" that might become "acceptable" under a presidency and congress controlled by the Democrats. Some made me laugh, some made me cringe, while others made me nod in agreement...

Is health care a right, a privilege, or a responsibility?

I was thrilled when Tom Brokaw asked this question, because it probes at the ideology behind each candidate's plan. I think this is important because we know that no matter who gets elected, the next president will not pass the same plan that they have proposed.

I have been able to listen to two different doctors talk about the candidate's health plans in the last couple days. The first doctor was invited to speak by Baylor's student pediatric society and gave a fairly non-partisan review of each plan. The second lecture was part of a new health policies elective that I am taking, and it clearly took sides on this issue, although it was deliberate in ignoring other political issues.

What is pretty easy to figure out is that neither plan clearly solves the biggest issues facing health care today. Fundamentally, the problem is that we continue to use more and more complex, technologically intensive therapies that cost lots of money. In addition, we continue to use more and more prescription drugs, have an aging population of baby boomers, and simply more people in this country to cover.

I personally agree with Obama's response that health care is a right. If it is a responsibility as John McCain says, then Americans have been pretty irresponsible people. As a future doctor, I don't ever want to work a hospital that has to deny care in order to turn a profit, yet that is how the system is currently set up. I don't really care how it is administered, but we are wealthy enough in this country to offer a realistic health care solution for every single person.

The hard question, which no one is really asking and the candidates would never answer anyway, is where should we draw the line on health coverage in order to make health care affordable for more people. When has western medicine done all that it can within reasonable limits to prolong a person's life? Even now, those of us with good health insurance wouldn't be covered for last ditch, experimental procedures to treat a malignant gliobastoma. How much sacrifice would the insured have to make in coming up with a plan for all people? Are there enough low yield, high cost procedures that can be cut, or would we have to accept significant reductions in our current quality of care?

At least if our president is operating under the notion that health care should be a right for all individuals, we might make some steps towards a real health care revolution.