When Your Kids Move Out

I have been doing college physical exams for the last several months. It is really exciting to see these young, eager kids (until they are 18!) starting their new lives. I have seen dozens of aspiring engineers, psychologists, teachers, and health care professionals getting ready for university life. Moving out to attend college is very empowering.

Their parents are proud, but they are also very anxious. For many, this is the first time they will be on their own (sort of). Some of the kids are ready. They are already independent, self-disciplined, and mature. For others, college is going to be a time to seriously par-tee! Parents worry about drugs, sex, binge drinking, and other college hazards.  Recently I had a heart-to-heart discussion with a young man about tobacco use. For some unknown reason, this young man, at the height of his physical well-being, decided it was a good idea to start chewing tobacco. Bad decision. He was given my famous anti-tobacco lecture and seemed to listen. I asked him if he used seatbelts.

"Always," he said.

"If you are going to take a chance at developing mouth or throat cancer from using tobacco, you might as well not wear seatbelts either." I think I made my point.

Privately, he also admitted to occasional marijuana use, drinking, and every parent's worst nightmare - having sex. He does not use condoms because his girlfriend is on the pill.

"Ever seen her swallow one?" I asked.

"Girls who want to become pregnant will get pregnant. You may be interested in the pleasure of sex, but secretly, she may have selected you as the future father of her baby; obviously without your expressed consent." If you must have sex, use condoms; even if she is on the pill.

My old college roommate left for the Navy at the end of our first year when his girlfriend became pregnant. They married, had a beautiful little girl. He returned to finish his medical training five years later after completing his Navy obligation. Because he had one year of medical training, the Navy decided he would be a good dental hygienist. After five years of cleaning teeth, he was ready to pick up his life where he had left off.

Becoming a responsible adult does not automatically happen on your 18th birthday. It is a gradual process of trial and error; good decisions and bad decisions. It can be an endless series of mistakes before finally achieving measurable success. Success, of course, is the progressive realization of your OWN predetermined goals and objectives.

Some parents are absolutely elated that their child is moving out. I got a kick out of the television commercial where a couple is saying their goodbyes to a son, standing beside his loaded car. As he drove off to college, they high-fived each other and headed for his old bedroom, measuring it for a pool table and spa.

I vividly remember my first day at college. I was so glad to be out of my parent's house and on my own that I could have shouted aloud. I attended school on an academic and work scholarship, so I didn't need to ask anyone else for a dime. My kids, of course, asked for that dime; lots and lots of dimes. At one time, we had four in college at the same time. Now, we have one in college with two more years to go.

My daughter has been on her own for the last ten years or so; getting financial help from time to time when she needs it. This week, she informed me that she was heading for the University of Washington. Unlike the parents who are high-fiving their kid's departure, I am sad. I will miss her dearly. E-mails and phone calls are not the same as our weekly get-togethers. I love Seattle, so I guess I will be doing some traveling.

In three more years, our oldest granddaughter will be heading off to college. I know her younger brothers will be happy about that; but we will be missing her, too.

Kids grow up. Kids leave home. Some kids come back; some only visit. Such is the life of a parent.

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Tonsils and Adenoids

In years past, tonsils were removed routinely, at the discretion of the doctor. All it took was one infection, and out they came. A tonsillectomy and adenoidectomy were once one of the most common surgical procedures in the U.S. Not any more. Unless children (and adults) meet certain surgical criteria, most insurance companies will not approve their removal.

The tonsils and adenoids are lymphoid tissue; the same as the lymph nodes they you often feel in your neck during infections. Even though tonsil and adenoids are grouped together as one entity, they are distinct, unique structures. They are an integral part of our immune system that protects the upper respiratory tract, fighting off infection in a never-ending battle. As we age and our overall immune system improves, tonsils and adenoids are less problematic.

The tonsils are located on each side of the back of the throat and are easy to see with a good flashlight. Children tend to have relatively large (hypertrophic) tonsils. Some children even have "kissing tonsils" - tonsils that are so large that they touch (kiss) each other. Their appearance alone often concerns parents. Tonsils are filled with little craters or crypts that can trap food or other debris, giving a false impression of being infected.

Of course, large tonsils do not necessarily mean you have tonsillitis (an infection in the tonsils). Normal tonsils are pink; similar to the color of the lining of your mouth. When infected, tonsils appear bright red and inflamed, are painful, and can result in difficulty swallowing. A sore throat (pharyngitis) is different than tonsillitis, although it is common to have both.

The adenoids cannot be seen by looking in the throat, since they are located higher up in the nasopharynx (the area between the back of the nose and the throat). They can only be seen with an endoscope (a flexible, fiberoptic scope that is introduced through the nose), or a laryngeal mirror. A special x-ray of the neck is also used to estimate adenoidal size. The adenoids are located near where the eustachian tubes enter the throat from the middle ear space. Enlarged or diseased adenoids may compromise the normal ventilation and drainage function of the eustachian tubes. Children with enlarged adenoids may have a nasal quality to their voice, mouth-breathe, and can even develop an adenoidal facies - a characteristic facial appearance and dental malocclusion due to chronic airway obstruction. Middle ear fluid (effusion), otitis media, and sinusitis can also develop from enlarged and/or infected adenoids. It is quite common to have the adenoids removed when tubes (Pressure Equalization Tubes) are inserted.

Tonsils and adenoids frequently become infected. The vast majority (90%) of these infections are viral; the other 10% are bacterial, such as Streptococcus (Strep). Mononucleosis (Mono) will also cause tonsillar enlargement. Tonsils that are frequently infected, several times per year, may need to be surgically removed. Rarely, tonsils will develop an abscess on one side (peritonsillar abscess), resulting in severe throat pain (often referred to the ear), difficulty swallowing, and fever. Peritonsillar abscesses often cause the uvula (the little hanging tissue at the back of the throat) to deviate to one side. Peritonsillar abscess may need to be surgical drained; and tonsils may need to be surgically removed for recurrent abscesses. Frequent Strep infections or people that are Strep carriers may also be surgical candidates.

Tonsils and adenoids that are chronically enlarged my compromise the airway, resulting in disturbed sleep, frequent sleep arousals, snoring, and even true apnea (the temporary cessation of breathing). Children who do not sleep well are frequently tired and cranky during the day and can have problems concentrating in school. Obstructive sleep apnea should be considered if your child has an apnea spell lasting ten seconds, loud storing, or daytime sleepiness. Sleep studies, as well as a full cardiac examination should be performed in anyone with sleep apnea.

A frequently-asked question on the WebMD Ear, Nose & Throat message board is about tonsillitis, or tonsillar stones. Food and other debris can build-up in the crypts and craters of the tonsils, and harden to a stone-like consistency. When these tonsillar stones dislodge, they result in a terrible taste in the mouth and halitosis. The only definitive cure for tonsilliths is the surgical removal of the tonsils. As an interim solution, gargling with warm salt water after every meal may help prevent the build-up of this hard debris.

In the adult population, especially in people who smoke, one-sided tonsillar enlargement could indicate a tumor. Lymphomas and HIV infections can also cause tonsillar enlargement, so it is very important to have a thorough medical evaluation.

Related Topics:

• WebMD Video: Child Behavior Issues Could Be Linked to Their Tonsils
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Halloween Hazards

All week, my wife has been feverishly sewing two Anakin Skywalker outfits for two of the grandchildren. She has these huge, fleece capes with hoods that scare the crap out of the dogs when she tries them on. The boys are coming for their final fitting today, so that they can use this costume for a few hours on Halloween.

Halloween costumes were much simpler when I was Trick or Treating. We usually were bums, wearing some old clothes. Of course, being a bum is not politically-correct now, since it reflects adversely on the unfortunate homeless.

When our own five kids were young, Alex was usually a bum. He just wore his school clothes. Ben was an Indian (every year!), another now-politically-incorrect reflection of stereotypical Native Americans. Ryan was a Ninja, perhaps insulting our Japanese friends. Kristin was a punk-rocker (we really didn't care if punk-rockers were miffed), and the eldest child, Josh, just wore a cardboard box. Not just any cardboard box; it was one with a drawer that slid out with a sign that said, "Put candy in drawer". It also had a sign that popped up that said, "Thank you." The box was very popular and resulted in lots of candy.

Kids say, "Trick or Treat", but they really don't do the trick part any more. As kids, we preferred to do the tricks, like soaping windows, throwing dried corn kernels against the windows, or pushing over an occasional outhouse. Of course, there was the bag of burning dog poop that the terrified homeowner, who would then stomp on. We only did it a few times. No one really wanted to search for and/or put the poop in the bag. We would grease a few outside doorknobs so that people could not go back in the house. This rarely worked because there was always someone else inside to let 'em back in.

As kids, we loved the candy. Rumors would quickly spread about certain houses that gave out the BIG candy bars, not those one-bite little ones. We would always try to go back several times until they noticed and chased us away. There was always some health nut handing out fruit, especially old apples. Apples! Hell, everyone had an apple tree. What good was an apple, especially one that will get all bruised-up in your paper sack? We used them to throw at each other. When the rumors came out that someone was hiding razor blades in apples, we were happy. No more apples.

My Aunt Norine was always frugal. She made popcorn balls (a lot of work), wrapped them up, and gave them to the kids. They were hard to eat and got caught in our teeth. Knowing she did not hand out anything else, we avoided her house. She ended up being stuck with a lot of popcorn ball that she tried to get us to eat until way after Christmas.

We always had to watch out for the older kids who would steal our candy. They would hide behind bushes or on porches, grab your bag, and run away - hours of hard work shot to Hell. We would try to get them by following the trail of discarded wrappings, and hopefully, throw an apple at them, but in most cases, the crime went unpunished.

Dogs do not like Halloween. They tend to freak out when kids come to the door. If we decided to "trick" one of the houses (like the one's that handed out apples!), there was always the risk of a dog bite. Homeowners would sic their mongrel dogs on us, eventually biting the slowest of my friends.

I grew up in a highly-religious Pennsylvania community of Bible-thumpers. They did not have any problems with Halloween being the "witch's holiday" or related to Satanic worship. The minister at our church would happily give a Milky Way to a devil or witch without fear of eternal damnation. None of us became pagans or devil-worshipers as the result of our Halloween costumes. California 2008 is a different story.

In California, and perhaps other areas, political-correctness is more important than allowing kids to have fun. There are several misguided medical assistants in our pediatric office who are trying to ban Halloween decorations, if you can believe it.

Kids love to dress up in costumes and I am really sorry that it only happens once per year. And, I am really sorry that it offends some people. Get over it. There is nothing wrong with little girls being princesses or fairies for a day, or little boys being Spiderman or Darth Vader. Granted, I don't like seeing kids walking around with fake knives in their eyes. If I wanted to see that, I would work in the ER.

A local church has a "Trunk and Treat" in the parking lot. This is cool. The kids do dress "down" a bit, foregoing the ax murderer and mutilated corpse, but that's okay. This is good, clean, and harmless fun. We really need more of these holidays just for kids. As parents, you have the right to monitor what kind of costumes your kids wear. If you don't want Charles Manson going door-to-door, don't let 'em.

At a medical meeting held on Halloween several years ago, I went as a tube of KY Jelly. I doesn't fit anymore. I don't have to dress up in my office this year, since Halloween falls on my day-off. The older that I have become, the less interested I am in getting into a costume to work a 12-hour clinic shift. I will sometimes wear a pair of devil horns to tick-off a few of the medical assistants, but that is about it. Dr. G can wear his six foot rabbit suit again, but I would find it difficult to be taken seriously dressed as a bunny. Since I have a white beard, I can always go as Santa, but that is sort of jumping holidays in my opinion. I could go as Moses, but that may insult two different religions.

Maybe I will get my wife to let out the old KY suit so it will be easier to slip into...

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"I Do Not Have Health Insurance"

Several times per week, I have a posting on the Ear, Nose, and Throat message board that mentions that the person posting does not have insurance, or does not have the financial resources to pay for a medical visit. With the economic crisis we are all facing at this time in history, I suspect we will see more and more uninsured Americans. One physician in our office stated just today that three of his patients lost their jobs, along with their insurance, and would not be returning for on-going care. This is just the tip of the financial iceberg.

For the most part, medical care in the United States is embarrassingly expensive. Since I am on the inside, I am often in a position to justify many of those charges to my patients. Insurance is equally as expensive and not all people have insurance benefits with their jobs. In most states, automobile insurance is required - it is the law. Health insurance is optional. I find that inconsistent with common sense since a liver transplant is considerably more expensive than fixing your bent bumper. Unless you have unlimited resources, going without health insurance will devastate your family in the event of a medical crisis. The government will end up paying the costs for the uninsured only after your resources have been depleted. The U.S. does not have universal health insurance, so those people without insurance must pay for their medical care.

When I was a child back in the 1950's, we had one general practitioner in our town. I don't believe my parents had any insurance. An office visit was $3.00 (this included medications in most cases), and a house call was $5.00. Even at those prices, adjusted for the 1950's, this was still a pretty good deal. We were a lower income family; so fortunately, I did not have to utilize medical care very often. At age 18, I had appendicitis, but my mother must have had health insurance by that time, otherwise she would have told me how much it cost.

The cost of a routine office visit in my practice is $141.00, or at least this is what is billed to the insurance companies. Insurance companies typically negotiate these fees and will reimburse considerably less. A cash-paying patient will pay about $98. There are some quick-clinics at the local pharmacy that charges about $65. An urgent care clinic will charge about $75. People who have insurance will typically pay a co-payment of $10 - $30 for their entire out-of-pocket expenses.

Like medical care itself, insurance premiums are astronomical. I have many infants and children in my practice, some who were born with special needs. A parent of a 2-year-old child last week told me that her medical bills are over three million dollars (so far). It only takes a few of those for insurance companies to raise their rates on healthy people to make up for it. In Ancient China, doctors were paid a fee to keep people well. If you became sick, the doctor had to pay you!

I have always been very sensitive about charges, but in my current practice, I have no control over fees that are charged by the medical foundation. I am on salary. If I were in private practice, I would have been bankrupt from giving away free or discounted care. The cost of routine medical care has skyrocketed to the point of embarrassment. The cost of using liquid nitrogen to freeze off ONE common wart is about a $150, and one treatment may not do the job.

When I see a patient or perform a procedure, I put down a billing code that represents what I have done, the complexity of the visit, and the time spent. This code is translated into a bill, either sent to the patient or the insurance carrier. I am basically out of the loop.

Medical providers can "down-code". In other words, they can put down a lesser billing code than what was done. Providers can also not charge for certain "simple and quick" procedures, like removing ear wax. The cost of removing earwax in my office is well over a hundred dollars for the procedure alone. If it only takes me a minute or so to clear out that ear canal so that I can properly see the eardrum, then I do not charge extra. However, if I spend a half hour digging out an impacted amount of earwax from some obsessive Q-tip user, I am going to charge extra - about the cost of 30 boxes of Q-tips.

When I know that a patient is private-pay (paying with cash or credit card), I tend to down-code or cut them a break if I can. If I have samples, I tend to give it to them. There is nothing like paying for an expensive office visit, only to be dinged again at the pharmacy. Medication costs have skyrocketed, too.

When the antibiotic Augmentin first came out, it was expensive compared to plain 'ol amoxicillin. A full-course to treat a middle ear infection in a child could be $65 to $80 or more; amoxicillin was only about $10 or $15. My wife and I were traveling in New Zealand years ago, so I compared some of those prices with a Kiwi pharmacist (chemist). Augmentin in New Zealand only cost about $8.00 and was from the same pharmaceutical company. Why? According to the chemist, the entire country of New Zealand negotiated a lower price - and the cost is not increased to the consumer. In the U.S., we pay top dollar for the same medication. Of course, Augmentin is generic now, and the price has dropped (sort of).

The Veterans Administration and some large HMOs do negotiate for cheaper medications for their patients. When I worked for the VA years ago, it would drive me crazy. I would get someone controlled on one blood pressure medication, only to discover that it was now not available. I would have to change it to another one. Six months later, I would be told that that medication is not available, and I would have to go back to the original one that is now suddenly available again, now at a cheaper cost the government, of course.

The cost of medications has driven many Americans across the border to Canada or Mexico looking for deals. This practice is highly discouraged by our government, and is really illegal in some respects. People on fixed incomes who are paying more than half of their monthly income for medications for cholesterol, blood pressure, or diabetes are desperately looking for ways to reduce their costs. Smuggling medications across the border happens every day. I have personally witnessed people being hassled over a bottle of blood pressure medications they bought in Mexico, while tons of cocaine and marijuana seem to make it across okay.

Our government sites safety as their primary concern. Fake medications made in China are showing up everywhere, even in the U.S. Look-alike medications are being sold by the ton in Mexico to tourists. When someone shells out some cold hard cash for a bottle of Viagra before the cruise ship leaves, there is little recourse when those little blue pills fail to work. Maybe you get the real Viagra, but maybe your little blue pill is just that - a little blue placebo from China. Personally, I would not have any problem buying medication in Canada, but I would be a bit leery of some of those Mexican pharmacies along the border.

When it comes to buying food or buying gasoline, someone without health insurance tends to set priorities. Food comes first, followed by rent or mortgage. Then comes automobile costs. The lowest on the list tends to be routine medical and preventative health care. Emergency medical care tends to get attention, even in the worst of economies. When you have an arrow sticking out of your head, you don't typically wait a few days to see if it goes away on its own. A guy in a neighboring community was shooting arrows into the air. Not understanding gravity, he inadvertently hit himself in the head with one of those falling arrows. He hesitated going to the ER because he did not have insurance. I am surprised that the arrow didn't go all the way through since there appeared to be nothing inside his skull.

If you don't have auto insurance, you are screwed if you wreck your car. If you blow your engine because you can't afford routine maintenance and oil changes, you are screwed because auto insurance does not pay for repairs. If you do not have health insurance, and choose to ignore your crushing chest pain, you may not need health insurance anymore - you so need life insurance for your family. If you do not go to the doctor because you have a cold, you will probably be fine. Colds are self-limiting and you don't really need a doctor to tell you that again and again. Of course, if your cold seems to be turning into pneumonia, you are going to have to make a big decision. Should I take the chance of dying, or use my credit card or hard-earned cash to get some medical care? Get the care. Borrow some money or worry about paying the credit card later.

My auto mechanic charges $90 per hour (even if he fixes my car in five minutes). He is a high school graduate and makes more than my own hourly rate in my clinic. Is it fair? Probably; he can fix my car - I cannot. Of course, when he cuts open his head when he slips on some grease, I am not going to reduce his cost by down-coding him. I am going to get even.

Related Topics:

• 45.7 Million in U.S. Lack Health Insurance
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Poverty is Relative (And Not Just My Relatives)

Poverty is relative. If you don't know that you are poor, and everyone else around you is at the same socioeconomic level, is it really poverty?

When we were children, our family had very little money, but kids seemed happy. Of course, our parents were not as happy living in an impoverished area. Tucked away in a little Appalachian valley, mostly on reclaimed strip mining land is my hometown of Fairchance, Pennsylvania, population around 1,200 - mostly relatives from two hundred years of living in the same place. When the coal played out and the steel mills of Pittsburgh converted to natural gas furnaces, there was no need for the coke that we made (coke?). After the glass factory blew up, the only industry in Fairchance was the coke ovens - a process where coal is converted into a charcoal-like, hot-burning cinder used for melting steel. When the coke ovens closed, there were few jobs.

Oh, how I miss the sulfur-smelling, rotten-egg air, or my mother complaining about black soot getting on her freshly-laundered clothes hanging on the line. At times, the air was so thick and polluted that my family seemed to have trouble lighting their cigarettes. My father died of lung cancer at age 39; followed by two of my uncles and grandfather of the same. No one seemed to know why. My widowed mother, a waitress, did the best that she could for my brother and me. We basically lived on her tips until she remarried. Even our cigar-smoking step-father died a few years later, too. For some reason, poor people always seemed to find money for cigarettes or booze.

I had no idea we were considered poor by national standards. Everyone had a garden, so we had plenty of food. We had lots of government cheese. We always had clothes, shoes, and we had a little house. Sure, I lived in the unfinished, uninsulated attic, but I had my own room, not unlike my mother who shared a tiny, three bedroom house with 13 of her siblings.

We had a swimming pool (of sorts), which was really a sewage-contaminated, damned-up creek (crick) to be accurate. We had dogs - lots of dogs; very few cats. We walked to school; not the proverbial two miles through driving snow, but damn close. We had rocks to throw, sticks to build cabins in the woods, and soda bottles to collect for the deposit money.

During the hot summer months, we would explore for miles, often ending up, dirty and tired, at a local Dairy Queen, requesting a glass of water. One day, a waitress gave all of us ice cream cones for free. That one day, we were not only rich - we were lucky.

Forward thirty or so years: I am not poor; nor am I particularly rich by local standards. Wealth, like poverty is relative as well. We live in a nice home with a beautiful view. We have 8 year old cars in good shape. We have dogs and a three (soon to be four) healthy grandchildren. We eat well; too well in fact. We basically have everything we need and then some.

This year, my wife and I collected thousands of children;s clothes to take to an impoverished area of Baja, Mexico. Smuggling them across the border (Mexico has a particular ban on bringing in used clothing); we were able to distribute them at a place called Miramar - the town dump outside the city of Loreto. Miramar families - hundreds of them - live in tiny shacks made with found materials, such as car hoods, cardboard, old doors, scrap metal; you name it. Some are "nicer" than others. Mothers with babies on their backs search through garbage bags looking for edible morsels, like fish heads, to make soup. The heat is stifling; the dust unbearable; and the noxious smoke reminded me a bit of Fairchance in those early years.

Unlike the children of Fairchance, these children did not have shoes, they were hungry, and they did not have their own rooms. They did seem happy. Miramar families did have lots of dogs, though. The dogs were poor and skinny; but they seemed happy and loved. In a way, the dogs were rich because they had people that cared for them the best that they could. In Mexico, there were other wandering dogs that were not so fortunate.

When you see those smiling, little faces, clutching the clothes and shoes that we gave them, you want to cry. This is real poverty. I grew up sort-of poor, but didn't really know it. These Mexican families are really impoverished, but somehow, as I look at the large haciendas lined up along the beach in the distance, I think they know they are aware that they are poor.

These poor people love their children and their dogs. They walk miles to attend mass because they love, not blame, God. Few children attend school because the families cannot afford the $20 for a required uniform, but they learn the necessary life skills to survive. There is no running water, so the children don't bathe, but they seem to be relatively clean. Bathing has always been optional for kids. These children can play in an ocean, throw stones, and find sticks to build makeshift cabins. The only difference is that they must live in those cabins as their home. They accept this and do the best that they can with what they have.

Yesterday, a wealthy woman in my practice was telling me about her five million dollar home she was building. She was stressed out over the carpet and the delay in her cabinets. She was not smiling or happy. She was late to pick up her two children in daycare. I suspect the children were not happy either. I bet they do not have a dog... or rocks to throw. I bet they would like to have a big cardboard box to play in. Those poor kids...

Related Topics:

• The Greatest Threat to Children's Well-Being
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Life is an Open Blog

For a busy clinician, I have done my share of writing. I have published more than a few hundred medical articles in lay and medical periodicals. I have written, edited, and published six books, including four medical textbooks. I edited a professional association newsletter for many years, was "Children's Health Editor" for a magazine, and still serve as an editorial advisor for a few more. As an educator, I have written hundreds of classes, lectures, and presentations, as well as many grant proposals. I have written poignant letters to the editor and a smattering of other rants and rages that still surface from time to time. I have written love letters and, of course, letters of apology to my wife. As a 12-year-old, I was a junior reporter for our local newspaper. Basically, I have written things since I learned to write.

When WebMD first approached me about doing a blog, I was not even sure what a blog was. Then, I was not sure I would have the time to do it, along with my busy clinic schedule and, of course, the ENT Board. I agreed to try it. Now, I am hooked.

I don't advertise my blog to my patients, but many have found it. Some will ask, "How's your daughter?" Or, "Did you kill those turkeys yet?" At first, I am amazed that they know these things. Then, I quickly realize they are reading my blog. It is a rare patient interaction when a patient knows that much about their medical provider.

I have shared personal stories with my patients for my entire career. They know I once smoked poison oak. Many know my father died of lung cancer at an early age. Many know about my klutzy son that broke his arm dancing at a wedding, and many will know that I nicknamed my new grandson, Elmo, and why.

There are few secrets when you grow up in a small town. Everyone knows everything about you. My life has always been an open book. Now, my life is an Open Blog. No difference.

Openly talking about your family or patients in a public blog can be tricky. You cannot disclose any confidential information about patients, although I do disclose a lot of family secrets. If I was running for Vice President, there would be little they could uncover. If I had written a personal diary for my entire life, there would be little left to uncover should someone find and read it.

Do I have secrets that I have not disclosed? You bet. We all have embarrassing secrets. We all have past events in our lives that we regret. Knowing that you cannot change the past, requires that we exercise a high degree of forgiveness - for others and for ourselves. We only have the ability to change the present, and the motivation to change certain aspects of our future.
Allowing people to know who you are as a person is more important than having your professional credentials on your office wall. Yes, people are interested in your educational background, but as humans - curious humans - people like to know your character. I am not afraid to share what makes me happy, or what makes me cry. I am still reluctant to discuss the two taboo subjects - politics and religion- with people I do not know. I feel that I know my blog readers well enough to give it a try.

My political beliefs are deeply personal. I cherish honesty and commitment. I will accept a President who exhibits both. I like to see things "get done", not just talked about. I would love to have a President that listens, and one who is articulate when he speaks on my behalf in front of the world. All Presidents have speech-writers, but some truly touch your heart. I grew up listening to John F. Kennedy. He was no angel, for sure, but people loved to hear him speak and he was trusted. I remember many wonderful speeches by Reagan. When I listen to Bush, I just listen for mistakes or errors. As a charismatic speaker, Obama is better than McCain, but I question his ability to lead a very troubled and damaged nation. If McCain is to be our next President, he needs to start working on his speaking ability. You are not supposed to judge a book by its cover, but crappy covers do not sell books. As a people, we often judge a leader by their ability to speak, and of course, their actions. Actions do speak louder than words, but I still like to her the words - the correct words; the reassuring words; the heart-felt words. I am proud of my imperfect country, and just want to love (and trust) a President again.

A physician colleague of mine (Jewish), moved to rural Ohio to practice. When the first words uttered by a patient are "Where do you go to church?" you know you are not in California anymore. People would not see this fine, wonderful man because he was Jewish. Disillusioned by the intolerance of the townsfolk, he eventually moved his family to a more ethnically and religiously-diverse college town in North Carolina. He and his family are so much happier. Ohio lost a good doctor.

I grew up Baptist in a tiny town with a dozen or more different churches. I went to a Baptist college (because they gave me a scholarship, not because of religion). My first wife was strict Catholic (Shi'ite Catholic!). My mentor was Jewish. I absorbed gifts from all of them. My Aunt Norine (now, 95) was my religious teacher. She took me to Church, taught me enough of the bible that I can still answer all of the Jeopardy questions when this category comes up. I took the required religion courses in college and got A's. My Catholic ex-wife introduced me to a community of people who are committed to their ancient faith. Many go to Mass every day, refuse to eat meat on Friday, and send their kids to Catholic schools. My children were raised Catholic. We used to say that the streets are empty in my town on Sunday because the Catholics are at Mass, and the Protestants are in bed sleeping. We didn't have any Jewish people in our town.

My first boss and dearest friend/mentor was Jewish. He invited me to Seder and shared with me the significance of the many Jewish holidays. I sat with his family at Passover. Until his death a few years ago, he was among the most important and influential people in my life. I would have converted to Judaism if he would have invited me.

One of my best friends is a Buddhist. My exchange student's family are Shinto. We had neighbors who were Muslim (and held services in their home) and many friends who are Mormon. I had one aunt who was Adventist. I have colleagues who are Hindu and patients who probably represent every religion on earth. They are all good people, but not because of their chosen religious. They are good people because they are... good people.

I consider myself deeply religious, but I am not a Baptist, a Catholic, or a Jew. I guess I am a combination of all that I have learned and all that I have experienced in my life so far - maybe I am a congregation of one. I do not attend an organized church anymore (I haven't really found one that "fits"), but I feel that I live a good life with the same morals and ideals that encompass all religions. I believe that this is really what a spiritual God intended.

Now, you know even more about me. I feel naked.

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Not a Good Week - Horrible, in Fact

Photo Credit: Rod Moser

It was late Saturday night when I received the call. Late night calls are either bad news or someone does not understand time zones. It was my best friend, John, and it was bad news. I could tell that by his voice. If you read my blog post on Time Capsules posted a few weeks ago, you saw John's family. In the back of the photo, sitting next to him, is his 25-year-old son, Sam. He is the muscular one with the tattoo on his arm. John was calling to tell me that Sam had suddenly died a few hours prior.

Sam was preparing to watch a TV show with his mother when he seemed to be getting sleepy. When he stood up, he collapsed to the floor. He held on to the wall and went outside for some fresh air. A very short time later, he was found unconscious in the front yard. John tried desperately to resuscitate his son as Sam's mother called 911. So far an autopsy and toxicology report have not revealed the cause of his untimely passing. Sam was just 25 years old and he was just getting his life in order after a few set-backs. Tomorrow, I will give the eulogy at Sam's memorial service.

There is no pain greater than the loss of a child and my heart was literally bursting with sadness for our friends. Our five (adult) children are equally as saddened, since they were literally raised with John's sons. They swam together; played together; and ate together. We were family. Two of our grandchildren, Shelby and Dylan, were present when that Time Capsule was opened, so they remember Sam very well. He was the happy one; the one that talked to them and the one that laughed with them.

Yesterday, while returning early from a car trip to Southern California, we received a call that our grandson, Dylan, age 10, was rushed to the hospital and admitted to intensive care after collapsing after church. Dylan was playing basketball with some other children when he suddenly felt dizzy. He collapsed to the floor, striking his head, and remained unconscious for about twenty seconds. For unknown reasons, his pulse rate dropped to 40; he was vomiting and confused. Concerned that his unconsciousness was triggered by an unknown cardiac event, perhaps complicated by his head injury, he has been undergoing some extensive heart tests as I write this Blog. So far, all tests have been normal.

My PA wife is beside herself in worry. She did not sleep a wink last night. Dylan is her "boy". Of course we rushed directly to the hospital. This was the first time that my wife did not complain about me driving too fast. By the time we arrived, Dylan was complaining about being hungry. He had ordered some movies from the hospital library and was requesting someone to scratch his back (my wife's primary job when they are together). He is wearing a 24-hour heart (Holter) monitor and will be getting a stress test (treadmill) this evening. This event IS my wife's stress test.

Queen Elizabeth used to term Annus horribilis, referring to her horrible year. I am not a scholar of Latin, but I think these last seven days can be termed Septimanis horribilis, or horrible week.

Tomorrow, I must keep my composure long enough to give the eulogy that I have prepared for Sam. On the way home from the memorial service, we will visit Dylan. I suspect that he will be playing basketball again, like nothing has happened.

Life is so short and so precious. Why must it be so painful?

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