Running Mates and Other Mates: Fighting Trump, Fighting Cancer

Girl, I heard you’re getting married,

Heard your getting married,

This time you’re really sure.

Brooklyn Bridge-1969

Ted Cruz keeps looking for a partner. First we have the sort of/maybe/not really deal with John Kasich, trying to not cut each others throats in the remaining primaries. Quickly followed by yesterday’s announcement of Carly Fiorina as his Vice Presidential running mate, and vocal coach as well. All of this, of course, in an effort to stymie Donald Trump in his march to the Republican Presidential nomination. It appears that Cruz’s philosophy is that if you can’t win on your own, grab your partner or partners and do-si-do.

I don’t know how well the pairing technique is going to work in politics, but a new study reported in the journal Cancer and summarized in the Chicago Tribune suggests that married patients do better in their fight against cancer than comparable single people. The advantage is greater for men than women, and is not associated with socio-economic status. It seems that hand holding, cooking, chaffeuring and all around loving can help survival. No surprises there, right? But it brings to mind a former colleague of mine, one of the most talented men that I have had the pleasure to have known and work with. Let’s call him John, and his wife Mary About 18 months ago John was given the diagnosis of advanced lung cancer. He has undergone surgery, traditional chemotherapy, and novel treatments as a patient in advanced clinical trials. During all this John has maintained his active lifestyle and achieved new professional goals and accomplishments. He has documented his battle in a wonderful blog (the blog is not public, I cannot share a link) that both faces the difficult realities and celebrates all the wonderful triumphs. And as he freely admits, it is the love, care and support of the magnificent Mary, now aptly nicknamed Chemo-sa-babe, that makes it all possible. I know that as I experience John’s life on his blog, Mary is there holding his hand for every battle won and for every set-back. And as the study in Cancer suggests, that hand holding may be the reason the wins so greatly outnumber the backslides.

Cancer has also visited our family; fortunately it did not stay. I hope I did enough to support Barb four years ago, though I think it may have been the prospect of Michael and Becca’s wedding that hastened her recovery. I hope neither one of us becomes the supporter or the supportee in the future.

And as for Ted Cruz, does it matter how many partners he takes? He will continue to be Ted Cruz, and that doesn’t seem to be the man the rest of America wants to marry!

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Doctor, Doctor, Give Me the News

Affordable Care Act or Obamacare, no matter which one you call it, it has probably had some effect on you or your family. As a “bleeding heart liberal,” I applaud the expansion of some sort of insurance coverage to millions of Americans. As a physician, employer and provider of health care insurance for the two of us, I have my reservations about the cost-benefit ratio. I have been hit by higher premiums, higher deductibles, changing provider networks and complex pharmacy rules. I understand that even without the ACA, health insurance premiums would rise pretty steadily every year, but some of the other perturbations in the health care system seem to be a direct result of the Act. And don’t ask Barb about the phone calls she gets from our insurance carrier offering to make her primary care appointments for her, probably as a result of the carrier trying to meet some new quality regulation. As she points out to the caller regularly, she is quite able to make an appointment, and money spent on calling her is money wasted.

When I look for data about the effectiveness of the Act, I can find statistics about the number of new insurance enrollees and Medicaid enrollees, but nothing much telling me if the health of the nation has improved and if people are satisfied with their coverage. So I am taking an informal poll. Its just a few questions, and won’t be scientifically significant, but if you have a few moments, click on the link below. If we have enough results, I will publish them at a later time. To that end, please feel free to pass this post around!

Click here to take the poll.
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When Cancer is no Longer Cancer

Things change. A recently published study discusses re-evaluation of a certain type of thyroid lesion–Encapsulated Follicular Variant of Papillary Carcinoma of the Thyroid (EFVPTC). Follow up on over 100 patients who had the lesion surgically removed showed no evidence of spread or recurrence. The findings imply that EFPVTC is benign, with no need for further treatment, and tumors with this particular microscopic appearance will henceforth be given a rather lengthy name, shortened to NIFTP . Don’t call it cancer! The appearance of the tumor hasn’t changed, just our understanding of its behavior*. This is big and important news for patients with a lump in their throat. Similar re-evaluations have arisen or may arise in dealing with lesions in the bladder, prostate and breast.

I learned about the study in an article in the New York Times. The article is interesting reading, but what I spent more of my time examining was the Reader Comments section of the Times. I am amazed at the varying opinions, observations and hostility that this article provoked. A major thread is that Cancer-Industrial Complex (CIC) of physicians, hospitals, and Big Pharma are in the business of over-diagnosing and over-treating cancer in the interest of increasing revenue. These readers are amazed that the CIC would ever allow a study to be published that would decrease the number of cancer patients. After all, fewer cancer patients equals fewer dollars in the hands of greedy docs, hospital administrators and pharma execs. Then there are the readers who believe a study such as this one must be supported by the government and insurance industry. Medicare, Blue Cross, Humana and others stand to save millions of dollars if there are fewer thyroid cancer patients making claims.

My view? Designations change. One way is through the use of long term follow up studies such as the one on EFVPTC. Molecular studies on the genes in tumor cells may soon do an even better job at differentiating benign tumors from malignant ones. In the meantime, I report what I see under my microscope, the “names” I use based on our current knowledge and agreed upon terminology. My goal is neither to enrich our “industry” or save the insurance company some bucks. The people whose biopsies I look at may not know my name or where my office is, but they are still my patients, and I want only the best for them.

*A reinforcement. The findings in the published article refer to only one very specific type of thyroid cancer.

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Kitten Power Can Get Things Done

And I’ll be takin’ care of business, every day…

…takin’ care of business, every way.

Bachman-Turner Overdrive-1973

The mighty Colorado River carved the Grand Canyon over millions of years. The immense pressure of the earth’s mantle creates the environment for the creation of diamonds. Small aquatic plants and animals crushed under the weight of sea beds leads to petroleum. So eons and eons and tons and tons can lead to massive changes. But what can the weight of a seven pound cat accomplish in the span of just a few years?

We have talked about our kitten and my problems with her before. The two of us are on improved terms these days, though her objections to visiting the veterinarian did lead to several scratches, puncture wounds and a cancelled appointment. She remains tiny, even more apparent now that she has lost her warm winter coat. But this skinny, demure creature has made an indelible impression on our house (for sale! for sale!) , or at least on our furniture.

Note chair “A”. See the nice straight line of the back cushion. That’s what our bedroom chairs looked like before Princess Kitten came along. Now lets take a look at Chair “B”, the cat’s favorite perch. On this chair, that back cushion is a deep “v”, a permanent, unreversable groove. I don’t have to tell you which chair has been the kitty’s favorite sunning spot for the last four years, do I?

So it doesn’t take a lot of weight, or even a lot of time, to make a dent in things. Look what this welterweight has done in just four years, the length of one Presidential term, or the length of time it might take to build our house. Is there a lesson to be learned? I guess you don’t have to have the power of the Colorado, or the weight of the earth’s crust to make a difference. Sometimes a little steady, gentle, pressure can get the job done. Sort of fits with my preferred management style. Of course, unlike our kitten, I try not to shed my fur as I go!

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What’s in Your Wallet? There’s a Little Aluminum Foil Package In Mine.

You can’t always get what you want

but if you try sometime you find

you get what you need.

The Rolling Stones-1969

I don’t leave it to chance anymore. There is always one in my wallet, sealed in its aluminum pouch. It was Barb’s idea. “You’re out and about and wish you had one, and then you get irritated when you try to buy one and can’t get the type you like.” After almost forty years of marriage, I have learned to listen to my wife on matters of such importance.

It wasn’t always a necessity. I used to be able to get them with ease. Every store had one of my favorites. Barb could buy them for me anywhere. We could share one, or I could grab one even if Barb wasn’t around.

It is a lot tougher to find what I want now. Last month we were headed for what promised to be an interesting evening at the home of friends. From past experience, I knew our hosts wouldn’t have any and it would be prudent to bring my own. Maybe I was distracted when we left our house, but I forgot to grab one or two from my stash. Realizing my slip-up, we stopped at a convenience store and I searched the shelves. I found plenty of exotic varieties. But where were my favorites? I unearthed a pile of them in the back of the store, unwrapped, unappealing, and not for sale. But I convinced the clerk I absolutely had to have one, and we negotiated a price. We closed the deal and the night was saved…I had my Lipton Tea Bag.

Yes, when it comes to my tea, I am a demanding purist. Give it to me black, without bergamot or orange rind. Load it with caffeine and make the water hot enough for a full, rich brew. No fancy blend is needed. Plain old English Breakfast will do nicely. But the supermarkets are crowded with frou-frou flavors, and restaurants are even worse. When I ask for tea at the trendy neighborhood trattoria, the waitress will flip open the polished rosewood box and tell me they “have Herbal Raspberry Zapper and Decaffeinated Green and of course Chamomile with Rose Hips.” Or the snooty waiter at the four star joint will tell turn up his nose and say “we have first blush, the finest tea in the world,” for a mere $25.00 a cup. I beg for Lipton. And if my favorites cannot be found? I whip the aluminum pouch from my wallet, rip it open, and ask for a pot of boiling water. Let them charge me a corkage fee, I am brewing my own! I was never a Boy Scout, but now I know. When it comes to my favorite drink, just like everything else in life, it pays to be prepared.

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It’s a Puzzlement–Putting the Pieces Together When Building a House

Oh the games people play now…

…every night and every day now.

Joe South, 1968

Got your Rubik’s Cube handy? You know, that multicolored puzzle cube from the 1970’s made of smaller blocks that twist and turn, billions of possibilities but only one correct solution. It was designed by Hungarian Erno Rubik, and has been called the best selling puzzle of all time. It is easy to solve if you take apart the pieces and reassemble them in the correct way. Build your blue face, your yellow, your green, red, white and orange. It takes a minute or two and you get the right answer. But that is not what the cube is all about. It is about all that twisting and turning. Each cube influences the one next to it and the one after that and after that. Everything is interrelated. Or as Jonathan Safran Foer said in the title of his first novel, get it right and everything is illuminated.

Why talk about an old toy now? Because that maxim, that “everything is related” thing, is what is making it so difficult to design, build, and decorate the house. How can you choose a countertop until you know what the flooring will be. And how do you pick a flooring without deciding what color the cabinets will be. Plumbing fixtures? That depends on the whether the tub is built in or free standing, and that depends on what tile is attractive, affordable and available. Roof color? Well that depends on the exterior stone color, which is hard to pick when the samples don’t always accurately portray the actual product. All separate choices, but they all need to come together.

Those are the puzzles that swirl in our brains and keep us awake at night. I know it is not solving world hunger, but it is the immediacy of our life and (chosen) project. Actually, I lie when I say it is keeping us up at night. It is only Barb who is charged with making all this work. Her hands are the ones turning the inter-linked cubes over and over, lining up all the colors in their proper location. With the toy Rubik’s Cube there are some savants who can come up with the solution in seconds. I wish I could magically grant that power to Barb for the house. But that is not likely to happen.

Barb has undertaken this challenge before, redesigning various parts of our current home. And the spectacular results should make the house very marketable. But in comparison, those projects were like solving a 2 x 2 cube, not the full 3 x 3 version. This is the real enchilada, or in honor of Mr. Rubik, the authentic goulash. I help where I can, but I lack Barb’s sense of style and her vision. My best role is as a documentarian and as a sounding board, and I apologize for even getting impatient with that.

So Barb, this one’s for you. We will find the tile, find the fixtures, sell our house and make our move. And oh yeah, plan a wedding too!
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An Icon Abandoned, and It’s No April Fool Prank!

Oh this is the night…

…it’s a beautiful night.

Lady and the Tramp–1955

Who reads the “Legal Notices” in the back pages of their daily paper? Sandwiched between obituaries and want ads, the notices provide legally mandated information that is hidden away where no one will read it. As a Stevenson High School Board of Education member years ago I remember that’s where we stuck the notices notifying the public about bond sales. I’m sure the notices are the precursors and inspiration for all those annoying fast talking announcements at the end of television car ads. You know, the part where you learn what your “no money down” car is really going to cost you. But the other day in the lunch room I had finished scanning the obits without finding anyone I knew, and my eyes continued to the next column. And in the “Legal Notices” section I found this, and I shuddered:

ABANDONMENT OF TRADEMARK “NOODLE RONI”

The Golden Grain Company…has determined that the Noodle Roni trademark is no longer of use to the company…it will forever relinquish and abandon…all right, title and interest.

It is part of my childhood that is being abandoned! OK, I admit that my family never bought Noodle Roni. My mom was a Rice-a-Roni (The San Francisco Treat) chef. Rice, vermicelli (never knew what that was) and packaged flavoring. A great compliment to Kraft Macaroni and Cheese in the blue box — we ate a lot of starch in those days. Noodle Roni seemed like the little orphan step-child of the Golden Grain family. It never got quite the respect, and it really didn’t have as good of a jingle as big brother Rice-a-Roni. But how can you kick your baby sister out the door? Had the world really forgotten Noodle Roni Fettuccine Style?

Well, the truth is actually not quite that depressing. A little research revealed that Noodle Roni was renamed Pasta Roni many years ago. It comes boxed in a few different flavors, and single serving bowls — just zap and enjoy!– are out there too. I guess in this sophisticated, modern world, “pasta” is a far more impressive word than “noodle.” But Noodle Roni was etched into my youth and I will miss it. So if any of you have a case of Noodle Roni squirreled away in your 1950’s era bomb shelter, send me a box. I am sure it had enough to preservatives to survive, even if it’s name will not.

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