Yes Virginia, there is a God.

There is a God, but not the human male depicted by Michelangelo on the Sistine Chapel. Instead, God is the spirit of the universe and all that the universe contains. God consists of the principles of physics: gravity (or the curvature of space-time), matter, light, time, velocity, speed, space, nuclear interactions and the laws of thermodynamics. God consists of forces, accelerations and the laws of collisions; the laws of nuclear physics: radiation and disintegration. God consists of the laws of probability, genetics and evolution and many more principles.

A spirit is our emotional attachment to an idea: the spirit of Christmas, the Spirit of St. Louis, and the spirit of forgiveness. Man has a natural tendency to spiritual attachments handed down by heredity through thousands of generations. Since man developed a cerebrum he has understood that a superior being, his father, controlled his activities and punished him for wrongdoing. In adults, this translates into a higher unseen being who controls the outcome of his endeavors, a God.

Religions that started two to three thousand years ago have not kept up with modern science. We know that earth was assembled over a period of four billion years or so and that it was done with the laws of gravity, the laws of motion and the thermodynamics of collisions. The problem arises with the attempt to interpret the Bible too literally. God, the assemblage of all physical principles, built the earth; and we can say it took six days if we define a day as seven hundred million years. But to imagine a human-like being, as did Michelangelo, constructing earth with his hands is a difficult undertaking.

The universe is some 93 billion light years in diameter, about 13.7 billion years in age and probably originated in the Big Bang. Modern religions do not acknowledge this; they insist than an ethereal God who can be everywhere and know everything built the universe with his hands or through magic. We know modern man evolved from ape-like ancestors but modern religions still adhere to the idea than God constructed man from dirt with his hands. God, the spirit of the universe did create everything but it was done with the natural forces and laws that we observe everyday.

And so Virginia there is a God.

Yes Virginia, there is a God.

There is a God, but not the God depicted by Michelangelo on the Sistene Chapel. God is the spirit of the universe and all the the universe contains. God consists of the principles of general physics: gravity (or the curvature of spacetime), the electromagnetic radiation of light, time, velocity, speed and distance. God consists of forces, accelerations and the laws of collisions, the laws of nuclear physics, radiations and disentergration. God consists of the laws of probability, genetics and evolution and many many more principles.

Religions that started two to three thousand years ago have not kept up with modern science. We know that earth was built over a period of four billion years or so and that it was done with the laws of gravity, the laws of motion and the thermodynamics of collisions. The problem arises with the attempt to interpret the Bible too literally. God, the assemblance of all physical principles, built the earth; and we can say it took six days if we define a day as seven hundred million years. But to imagine a human like being as did Michelangelo constructing earth with his hands is a difficult undertaking.

Ignore the US Preventive Service Task Force Recommendations

It is important that all women in this country ignore the recent US Preventive Service Task Force recommendations regarding breast cancer and mammograms. They are totally wrong and incompetent.

I treated breast cancer for thirty years. It is treacherous, devastating and deadly. It is important to do everything possible to detect and eliminate it as early as possible. When detected it must be treated aggressively. At the time of detection the cancer is systemic, i.e., spread throughout the body so that chemotherapy will be necessary along with (1) lumpectomy and radiation or (2) surgical radical mastectomy.

Get mammograms every year starting at age 40. Start sooner if you have a family history of breast cancer. Breast cancer has a nasty habit of appearing earlier in younger members of a family with a positive family history. If grandmother had it at 70, mother can have it at 50 and you can have it at 30. Don't hesitate. The mammogram is your best defense.

A Hard and Fast Rule: lumps or masses in the breast must come out and be put under the microscope. No exceptions. The doctors cannot tell by examination, needle biopsies can miss, and the mammogram is not perfect in excluding cancer. The microscope is the gold standard.
Find a good surgical oncologist and work closely and repeatedly with him/her.

If you have a strong family history; mother, two sisters and three cousins with breast cancer, consider having bilateral subcutaneous mastectomies now. The nipple and skin can be preserved and implants put in to match your expectations of size, shape and uplift. If there is history of duct cell cancer the nipples must be watched closely so you still have to be checked every year or if there is a change in the nipple. The removed breast tissue must be thoroughly studied under the microscope. If there is cancer it is better to remove the skin that would overlie the breast along with the nipple and lymph nodes. If there is no cancer, you are as well protected as is possible.

A lump of cancer in the breast presents three problems; (1) the cancer mass itself, (2) floating cancer cells in the fatty tissue surrounding the breast and in the skin and (3) cancer cells in the lymph nodes between the muscles and near the collar bone. Lumpectomy gets the tumor mass and radiation can be given to the chest wall muscles and collar bone area. Late effects of radiation are dense scarring, blood shot skin and a hard breast. Radical mastectomy surgery removes the breast containing the tumor mass, the skin and fat from the chest wall and the lymph nodes between the muscles and near the collar bone. Surgery leaves a flat chest, a long scar and danger of swelling in the arm. Neither method leaves a pretty and normal looking breast. The effort here is to stop the cancer and save a life.
Do not minimize the threat of this disease to life.

How Exposure to Cold Air Brings On a Cold.

Colds are caused by a virus infection; usually the rhinovirus or one of a host of others. Cold air does not give you the virus, it's already in your respiratory system but held under control by the immune system.
The immune system is severely inhibited by exposure to to cold air or other cooling; the virus is much less affected so can gain strength and cause a symptomatic infection.
If we go out in cold weather without a hat and coat or sleep under an air conditioner we inhibit the immune system and the virus gets a foothold. We wake up with a sore throat, a runny nose or a cough with or without a fever. Full cold symptoms follow and last about a week.
It is important that to avoid a cold we should always protect the upper respiratory system with a cap, a scarf and a warm jacket. Babies and young children are particularly vulnerable because their immune system is not fully developed. For all children (especially blondes) it is particularly important to cover their heads, neck and chest when taking them out, even if for just a few minutes. The cold air cold shocks their upper airways (nose, throat, sinuses and bronchial sysyem) and they become ill. Always: !! A Hat and Jacket in cold weather !! Grandmother was right when she said wear a hat and coat when you go out in cold weather.

Best Medical Centers in USA

One Website on the Internet evaluates Medical Centers and lists them in the following order:

Johns Hopkins, Baltimore
Mayo Clinic, Rochester, Minnesota
Ronald Regan, UCLA, Los Angeles
Cleveland Clinic
Massachusetts General Hospital, Boston
New York Presbyterian University Hospital of Columbia and Cornell
University of California, San Francisco Medical Center
Hospital of the University of Pennsylvania, Philadelphia
Barnes-Jewish Hospital/Washington University, St. Louis
Brigham and Women's Hospital, Boston
Duke University Medical Center, Durham, N.C.
University of Washington Medical Center, Seattle
UP MC-University of Pittsburgh Medical Center
University of Michigan Hospitals and Health Centers, Ann Arbor
Stanford Hospital and Clinics, Stanford, CA
Vanderbilt University Medical Center, Nashville
NYU Medical Center, New York
Yale-New Haven Hospital, New Haven, Connecticut
Mount Sinai Medical Center, New York, NY
Methodist Hospital, Houston
Ohio State University Hospital, Columbus, OH

If you are able, use one of these medical centers for your medical care. Call on the telephone and ask for outpatient appointments to the Specialty Clinic if you know which one you need; or to a general medical clinic if you don't know. Not only will they accept your call and questions, they will help you with your request. Don't be intimidated because they are large clinics. Treating people is what they do.

All Doctors should be on a Salary !

Physicians can be paid a straight fixed salary by a clinic or hospital (not the doctor's P.C.) or they can collect a fee per case. The salary (plus bonuses for exceptional services) has always provided the best level of medical care. The doctor doesn't have to hurry or constantly scrounge for more cases, and he is not rewarded for unnecessary treatment. He can do what is best for the patient and not what is best for his bank account. Seek your treatment at a large medical clinic where the doctors are salaried.

What about the patient who lives in a small town? Most large well run medical centers have satellite clinics in small towns; seek them out. If there is nothing in your town travel to the nearest large medical center and have them work with a cooperative General Practitioner or Nurse Practitioner in your town who will help with day-to-day care under the direction of the clinic physicians. Do not submit yourself or your patient to a fee-for-service scheme of $75 per office visit for allergy shots or some such.

The solution for the country is to have large well run medical clinics in the large cities in each state with satellite clinics in the small towns; and with ALL repeat ALL doctors on a fixed salary. Many large clinics are doing this; seek them out. Be sure the doctors are salaried. Ask the question. If you don't get an answer, go elsewhere.

Be particularly careful to avoid the fast moving hard to understand doctor who has a jammed wating room and who does 10 tonsillectomies or 10 arthroscopies on his operating days. You don't want to be tenth in line for anything. If he is doing 10 precedures three days or more days a week you can bet half of them are unnecessary. This physician may have a good reputation; he created it and paid for it himself. Pay no attention when the front desk clerk tells you how good he is, she works for him . Further, he probably rewards his referring doctors with a generous Christmas gift to their wives and children. This is FEE SPLITTING and is strictly against the ethical codes of all professional associations (AMA, etc.). Beware !

Why Costs are kept Secret !

For the Hospital:
For-Profit Hospitals will almost never attempt to quote you a cost for a given procedure -- for instance gallbladder removal. The reason is that most for-profit hospitals work on a Cost-Plus billing scheme that allows them to apply a usually marked up fee for every item allotted to the patient and then add a margin for profit and to help cover other unpaid bills. In addition, the hospital doesn't know ahead what your treatment will require. They may be willing to quote you an average cost for uncomplicated gallbladder removal but many hospitals will simply say they don't know what you will require. The really good well run hospitals will quote you a fixed price and stick to it. A few years ago a large airline negotiated the cost for heart by-pass operations with several large medical centers. These hospitals set fixed prices for heart by-pass operations and stuck to them. Most for-profit hospitals will not even consider this. The hospital medical staff really has to know what they are doing to be confident that they can carry out treatment without a mishap. For-profit hospital administrators like to see well insured patients have a complication or become seriously ill; the hospital makes more money that way.

For the Doctor:
The doctor knows full well what his charges are but he is reluctant to tell you. If you ask the cost he may say he doesn't know right off the top of his head and that his accountant or billing clerk set the prices; but don't be deceived, the doctor has full control over charges. In addition, the doctor may simply not want to explain why he is charging $10,000 for a 15 minute arthroscopy or a 1 hour gallbladder removal. When you get the bill and call to ask about it you are directed to a billing clerk who has had a lot of practice explaining charges and can give you a thousand reasons for the charge -- or she may be gone for two weeks and you will have to call back.
The simple answer is that this doctor is greedy and in the business to get rich, not to provide the best possible care in the interest of the patient. The two objectives are incompatible and mutually exclusive.

The bottom line is that it is best to ask the cost ahead of time. If you don't get an answer or the price is too high, go somewhere else. Try to find a large well-run non-profit clinic where the doctors are salaried and not paid a fee per case.

Advice for the doctor's WIFE .

Get into the office and stay there. Work as bookkeeper, assistant or receptionist; but be a permanent presence in the office.
There are two reasons for you to be present: the money and the honey.
If you aren't there watching the money, it will soon start to disappear. Sooner or later the doctor will find at the end of the month there is no money left for him. No matter how honest the employees seem, they believe that all doctors are rich and they will soon help themselves to the money. Beware.
The honey: that cute young well built little assistant is doctor hunting. It will go like this: One afternoon when everyone else is gone she will plead to the doctor in a very frightened demeanor that she has a lump in her breast. She will quickly strip to the waist and sit on his desk for an examination. He will examine her professionally and reassure her that she is okay. Two weeks later same scenario. This time she gets a little cozy and admits that she loves having him touch her. Soon the two are having regular petting sessions in the office and before long sexual intercourse in the exam room. She may get pregnant on purpose for a big law suite or she may make a play to become the new second wife. If the doctor hits mid-life crisis, wife number one is in deep trouble. She will find herself divorced, 40 years old and with four or five children. Not exactly romance material. Remember the famous words of the last such divorcee: "Oh, my husband would never do that to me!"
Beware!

The subject for today is the $10,000 arthroscopy of the knee. The principles apply to arthroscopies of the hip, shoulder, elbow and other joints; but the knee is most commonly overcharged.
The problem begins when you or your son or daughter sprains a knee playing sports. The knee is swollen and painful and the patient can't bear weight on the leg.
You consult an orthopedist who gets an x-ray (entirely appropriate) and examines the knee briefly. He then recommends arthroscopy. The patient is admitted to day surgery at the local day surgery center and arthroscopy performed. The doctor comes out after the procedure and says the knee has no major damage and will be okay. Further, no follow-up is needed.
The doctor's bill arrives a few days later and the surgeon's charge is $10,000!!
This is pure extortion. The fee is exorbitant. This examination in the office took fifteen minutes, the arthroscopy took fifteen minutes. But what about overhead: malpractice insurance, office rent, and office staff. The orthopedist does at least 300 cases per year and a generous allowance for overhead would no more than $2000 per case.
So the doctor wants to charge $8000 for thirty minutes professional services. This is simply too much. There is nothing he did or can do that is worth $16,000 per hour.
The solution for you is to find out ahead of time what the doctor plans to charge. If he says he doesn't know his own charge schedule -- he's lying. Go somewhere else. Go to a large well known clinic where the doctors are salaried and not paid a fee per case. Good Luck.

The GP Surgical Assistant

The family doctor general practitioner as a surgical assistant. This is a bad and expensive idea. The situation usually develops when the patient is seen by the GP for a problem that requires surgery; for instance, a 60 year old lady with gallstones and severe pain after meals. An ultrsound study of the gallbladder shows numerous small stones. Her gallbladder tries to contract after meals and a stone obstructs the gallbladder outlet and causes pain. Removal of the gallbladder cures the problem and prevents serious complications like obstruction of the bile ducts.
The GP refers the patient to a general surgeon for gallbladder removal with the agreement that the GP will perform as surgical assistant. He is not required, a nurse can perform as well or better but the GP plans to bill a fee equal to 1/4 the amount the surgeon charges. Further, the GP plans to stay in the operating room the shortest posssible time so he can get back to his office.
Some GP's are good surgical assistants, some are poor; no matter, they aren't needed. This is simply a money maker.
If your GP tells you he needs to help with the operation so he can perform better post-opertive care in years to come, tell him to read the operative note and the pathology report. He simply doesn't need to be scrubbed in at the operation.

$25,000 Pacemaker for 105 Year Old Lady

I recently heard on the radio a story about a 105 year old lady who needed a pacemaker. The cost of the pacemaker was $25,000!
This is pure exploitation. Several companies make simple fixed rate non-programmable units that are only a few thousand dollars, maybe even a few hundred dollars.
The doctor who recommended the high cost unit probably a financial relationship with the pacemaker company; there is something going on. The doctor may say he has to have a programmable unit, but that is baloney.
When this elderly heart is sick enough for a pacemaker it will probably last only a year at the most. The little lady is going to die soon because the heart is old and sick. The conduction system has gone out. She won't last long. There is no need for a $25,000 pacemaker.
If the doctor will not cooperate call one of the pacemaker companies (Google: "pacemaker manufaturers") and get the model number for their simple non-programmable pacer. Then ask for the names of doctors in your area who use the company's pacemakers.