One year!!!

One year ago, this weekend, what started as some simple commentary on a bike race, or a ride, has morphed into opinion statements on many different aspects of what life presents to me.

Since what I know the most about is electrophysiology, writing on matters of the heart seemed logical.

Even after nearly two decades, I still find heart rhythm issues incredibly interesting.   Primarily this is so because hiccups of the heart’s rhythm span the gamut from incredibly benign to acutely life-threatening, from horribly symptomatic to completely unfelt, and from the young to the very old.   In the office, I may see a 95 year-old followed by a 16 year-old. Or perhaps, a cycling android devoid of body fat and common sense followed by an overweight couch potato with a PhD—both with the same problem, usually AF.

That’s not it though.

Work-life as an installer of medical devices, and burner (ablator) of the heart would surely provide ample topics for a blog, but life as a bike racer provides yet even more contrastable life experience.

Take as an example that part of life as a bike racer which includes being as small as possible. Such is simple physics, like those of the horse jockeys. Becoming, and staying little, by making intelligent food decisions, has opened my mind to the struggles of the many patients who battle expanding belt-lines. The magnetic draw of potato chips, ice-cream, pastries and the like does not discriminate. As such, topics on the importance of lifestyle decisions in matters health provides much low-hanging fruit for unsolicited observations.

As a twenty year veteran of endurance sports, a former cross-country coach and a father of a teenage cyclist, I find it easy to write on training topics. Once a coach, always a coach. And coaching is a lot like doctoring. Like a successful medical treatment plan, a successful plan in sport involves dedication, perseverance, and a mastery of the obvious. However, in present-day society’s rush to overachieve, such obviousness is often so close, but yet so far.

Life isn’t always like a strawberry-topped belgian waffle. All jobs have their painful boils. For doctors, of late, we have as our annoyingly painful boil, modern-day health care delivery. For the present, despite the nagging pain, the organism as a whole is functioning well. Our doctoring joys and triumphs outweigh the pain. Things like seeing the steady stream of previously incapacitated AF patients tell of their new found vigor after extensive ablation in the left atrium. Yes, this joy keeps the pain of the boil at bay. But like any early infection left untreated, the body’s immune system can either control the infection, or if not, the once well localized infection can disseminate and overcome its host.  I truly hope that healthcare delivery woes do not disseminate any further than they already have.

Nearly every work day, the farcical nature of recent healthcare changes provide much to comment on. However, there is danger on writing on such real world issues. That is, primarily the danger of becoming overly cynical. This would be bad.

It gets too depressing to log in each day about the endless ways that third-party intrusions undermine the doctoring experience. Things like electronic medical records transforming a simple, couple paragraph story of a patient’s problem into a 3-4 page list of mindless bullet points which serve primarily as a billing invoice to prove we are not overcharging someone for our evaluation. Or perhaps the story of doctors-in-cubicles in far-away cities who are tasked with making it harder for the treating physician to care for the patient. Or, stories about nurses who have become overwhelmed with the necessity of typing in spreadsheets, so much so that it undermines their ability to be at the patient’s bedside, as one human to another.  Or, the notion that a catheter ablation of a cardiac rhythm–a multi-hour procedure performed by a doctor who trained for 15 years–is compensated less than a root canal, and even more outrageous is that doctors have to employ an army of business staff to code the service, bill the service and then appeal the denial of service.   So, if you let it, this boil could overwhelm any medical blog.

There is a saying posted on our home’s bulletin board, cut out from some magazine, somewhere, sometime, that says, “all unsolicited advice is self-serving.” Of course this is true, like a given in a mathematical proof.  I know this. All advice givers should know this, like a disclaimer of sorts.

The internet and the social media revolution has allowed such advice free to give and free to hear.  Hopefully, the saying “you get would you pay for,” isn’t true here, @drjohnm.

Yes, I have learned much this past year, on the blog-o-sphere, and there is much more to learn, and this is a good thing indeed.

JMM