Community For Better Health Care

Vol V, No 10, August 22, 2006


In This Issue:

1.                  Featured Article: The Expert Mind by Philip E. Ross, Scientific American

2.                  In the News: Saying 'No' to Medical Treatment by Cal Thomas   

3.                  International Medicine: The United States Ranked Number One, out of 191 Countries

4.                  Medicare: Single-Payer Health Care for the Elderly

5.                  Medical Gluttony: What Is an Extra Year Of Life Worth?

6.                  Medical Myths: The Uninsured Should Take the Money They're Saving and Buy Insurance

7.                  Overheard in the Medical Staff Lounge: Bequests Cannot Keep Up with Law Suits

8.                  Voices of Medicine: Humor Can Be Good Medicine 

9.                  From the Physician Patient Bookshelf: How Men and Women Think Differently

10.              Hippocrates & His Kin: Large Bequests Can Keep Up with Law Suites

11.              Related Organizations: Restoring Accountability in Medical Practice and Society

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The Association of American Physicians & Surgeons (, The Voice for Private Physicians since 1943, represents physicians in their struggles against bureaucratic medicine, loss of medical privacy, and intrusion by the government into the personal and confidential relationship between patients and their physicians. The AAPS is having their 63rd Annual Meeting at the Embassy Suites Hotel in Phoenix, AZ, September 13-16, 2006. Craig Cantoni will present: Confessions of a Corporate Insider: Why American Business Opposes Market-Based Medical Care; Gerry Smedinghoff, an actuary, will present: Criminals, Victims, and Innocent Bystanders: The Prisoner's Dilemma of Health Insurance; Richard Dolinar, MD, of the Heartland Institute will present:  Pay for Performance or Pay for Compliance;  Andrew Schlafly, the legal counsel will present: The American Health Information Community and Other Threats to Private Medicine; Lawrence Huntoon, MD, PhD, Editor-in-Chief, J Am Phys Surg, will present: Scientific Integrity: the Role of the Journal; A Panel will discuss: Cash Based Practices; and there will be a Debate: How Should Medical Care Be Financed: Government v Free Market; plus a number of presentations on Liability Reform, Tort Reform, Malicious Peer Review,  Combating Frivolous Malpractice Suits, Cash-Based Practice, and the AAPS Counsel concluding the three day meeting with Defending Medicine: Civil, Regulatory, and Criminal Fronts. For more info, please go to the website, your gateway to a vast amount of important information. 

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1.      Featured Article: The Expert Mind, By Philip E. Ross, Scientific American, August 2006

Studies of the mental processes of chess grandmasters have revealed clues to how people become experts in other fields as well

[During our clinical clerkships as third year medical students, the Professor of Medicine, leading a half dozen medical students on rounds, would ask the students as they left the elevator with a patient on the gurney, or as a gurney passed by in the hallways, what is that patient's diagnosis? We would start noticing the names on the chart or the intern that was with the patient and after rounds would hunt up that intern or rush to that nurses' station to check the chart. Invariably the professor was correct. That patient did have cancer of the pancreas or the gallbladder ducts, or that patient did had emphysema or interstitial fibrosis, or that patient did have leukemia. How did the professor make the diagnosis and never even talk with the patient? Dr. Ross gives us some clues as to how the master's make augenblick diagnoses or decisions.]

A man walks along the inside of a circle of chess tables, glancing at each for two or three seconds before making his move. On the outer rim, dozens of amateurs sit pondering their replies until he completes the circuit. The year is 1909, the man is José Raúl Capablanca of Cuba, and the result is a whitewash: 28 wins in as many games. The exhibition was part of a tour in which Capablanca won 168 games in a row.

How did he play so well, so quickly? And how far ahead could he calculate under such constraints? "I see only one move ahead," Capablanca is said to have answered, "but it is always the correct one."

He thus put in a nutshell what a century of psychological research has subsequently established: much of the chess master's advantage over the novice derives from the first few seconds of thought. This rapid, knowledge-guided perception, sometimes called apperception, can be seen in experts in other fields as well. Just as a master can recall all the moves in a game he has played, so can an accomplished musician often reconstruct the score to a sonata heard just once. And just as the chess master often finds the best move in a flash, an expert physician can sometimes make an accurate diagnosis within moments of laying eyes on a patient.

But how do the experts in these various subjects acquire their extraordinary skills? How much can be credited to innate talent and how much to intensive training? Psychologists have sought answers in studies of chess masters. The collected results of a century of such research have led to new theories explaining how the mind organizes and retrieves information. What is more, this research may have important implications for educators. Perhaps the same techniques used by chess players to hone their skills could be applied in the classroom to teach reading, writing and arithmetic.

The Drosophila of Cognitive Science
The history of human expertise begins with hunting, a skill that was crucial to the survival of our early ancestors. The mature hunter knows not only where the lion has been; he can also infer where it will go. Tracking skill increases, as repeated studies show, from childhood onward, rising in "a linear relationship, all the way out to the mid-30s, when it tops out," says John Bock, an anthropologist at California State University, Fullerton. It takes less time to train a brain surgeon.

Without a demonstrably immense superiority in skill over the novice, there can be no true experts, only laypeople with imposing credentials. Such, alas, are all too common. Rigorous studies in the past two decades have shown that professional stock pickers invest no more successfully than amateurs, that noted connoisseurs distinguish wines hardly better than yokels, and that highly credentialed psychiatric therapists help patients no more than colleagues with less advanced degrees. And even when expertise undoubtedly exists--as in, say, teaching or business management--it is often hard to measure, let alone explain.

Skill at chess, however, can be measured, broken into components, subjected to laboratory experiments and readily observed in its natural environment, the tournament hall. It is for those reasons that chess has served as the greatest single test bed for theories of thinking--the "Drosophila of cognitive science," as it has been called.

The measurement of chess skill has been taken further than similar attempts with any other game, sport or competitive activity. Statistical formulas weigh a player's recent results over older ones and discount successes according to the strength of one's opponents. The results are ratings that predict the outcomes of games with remarkable reliability. If player A outrates player B by 200 points, then A will on average beat B 75 percent of the time. This prediction holds true whether the players are top-ranked or merely ordinary. Garry Kasparov, the Russian grandmaster who has a rating of 2812, will win 75 percent of his games against the 100th-ranked grandmaster, Jan Timman of the Netherlands, who has a rating of 2616. Similarly, a U.S. tournament player rated 1200 (about the median) will win 75 percent of the time against someone rated 1000 (about the 40th percentile). Ratings allow psychologists to assess expertise by performance rather than reputation and to track changes in a given player's skill over the course of his or her career.

Another reason why cognitive scientists chose chess as their model--and not billiards, say, or bridge--is the game's reputation as, in German poet Johann Wolfgang von Goethe's words, "the touchstone of the intellect." The feats of chess masters have long been ascribed to nearly magical mental powers. This magic shines brightest in the so-called blindfold games in which the players are not allowed to see the board. In 1894 French psychologist Alfred Binet, the co-inventor of the first intelligence test, asked chess masters to describe how they played such games. He began with the hypothesis that they achieved an almost photographic image of the board, but he soon concluded that the visualization was much more abstract. Rather than seeing the knight's mane or the grain of the wood from which it is made, the master calls up only a general knowledge of where the piece stands in relation to other elements of the position. It is the same kind of implicit knowledge that the commuter has of the stops on a subway line. . .  

A Proliferation of Prodigies
The one thing that all expertise theorists agree on is that it takes enormous effort to build these structures in the mind. Simon coined a psychological law of his own, the 10-year rule, which states that it takes approximately a decade of heavy labor to master any field. Even child prodigies, such as Gauss in mathematics, Mozart in music and Bobby Fischer in chess, must have made an equivalent effort, perhaps by starting earlier and working harder than others.

According to this view, the proliferation of chess prodigies in recent years merely reflects the advent of computer-based training methods that let children study far more master games and to play far more frequently against master-strength programs than their forerunners could typically manage. Fischer made a sensation when he achieved the grandmaster title at age 15, in 1958; today's record-holder, Sergey Karjakin of Ukraine, earned it at 12 years, seven months. .  .  .


The preponderance of psychological evidence indicates that experts are made, not born. 

The preponderance of psychological evidence indicates that experts are made, not born. What is more, the demonstrated ability to turn a child quickly into an expert--in chess, music and a host of other subjects--sets a clear challenge before the schools. Can educators find ways to encourage students to engage in the kind of effortful study that will improve their reading and math skills? Roland G. Fryer, Jr., an economist at Harvard University, has experimented with offering monetary rewards to motivate students in underperforming schools in New York City and Dallas. In one ongoing program in New York, for example, teachers test the students every three weeks and award small amounts--on the order of $10 or $20--to those who score well. The early results have been promising. Instead of perpetually pondering the question, "Why can't Johnny read?" perhaps educators should ask, "Why should there be anything in the world he can't learn to do?"

Philip E. Ross, a contributing editor at Scientific American is a chess player himself and father of Laura Ross, a master who outranks him by 199 points.

To read the entire article (subscription required), please go to

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2.      In the News: Saying 'No' to Medical Treatment by Cal Thomas, Sacramento Bee, July 25, 2006

A 16-year-old Virginia boy who suffers from Hodgkin's disease has been told by a state judge he must report to a hospital this week and accept treatment deemed necessary by his doctors. The boy and his parents have chosen to pursue alternative treatment. It consists of a sugar-free, organic diet and herbal supplements supervised by a clinic in Mexico.

On July 21, juvenile court Judge Jesse E. Demps ruled that the boy's parents, Jay and Rose Cherrix of Chincoteague, were neglectful and that they must continue to share custody of their son, Starchild Abraham Cherrix, with the Accomack County Department of Social Services.

I have heard Cherrix interviewed on the radio and he sounds intelligent, articulate, reasonable and capable of making such a major decision. Cherrix says three months of chemotherapy left him nauseous and weak, and he prefers not to repeat that type of treatment. That a court would deny Cherrix and his parents such a choice prompted the family attorney, John Stepanovich, to say: "I want to caution all parents of Virginia: Look out, because Social Services may be pounding on your door next when they disagree with the decision you've made about the health care of your child."

In an age when we continue to debate "a woman's right to choose" when it comes to a girl aborting her baby and we are told that it is the girl's body and no one else should make decisions affecting it, a boy has no such rights. A girl can be given birth control by the school nurse and even abortion information without her parents' knowledge or consent, but a boy can be prohibited from making decisions that affect his life and body. At least the courts are consistent. They forbid parental involvement in either case.

In some states, though, parents are held responsible for their kids' illegal and antisocial behavior. Why is it that parents supposedly have power to keep their kids from committing crimes, but can be denied power when it comes to their child's health and welfare? If a young child (say 10, or younger) is unduly influenced by parents who are members of a religion that teaches that faith alone can heal or prohibits blood transfusions, then the state has an interest in stepping in to protect the child until he, or she, is old enough to make an informed choice.

But in this case, the informed one appears to be Cherrix, who says he has studied his options, experienced the treatment given by his doctors and doesn't want any more of it. He prefers "alternative medicine." That should be his and his parents' right to determine, not a social worker and a court.

The attitude of the state and culture toward the value of human life is in constant flux. Like the Dow Jones Industrial Averages, it is up one day and down the next. Some want to use embryonic stem cells for research into all sorts of afflictions and diseases, though no clinical tests have proved they are effective, and stem cells from placentas and other sources, which cause no harm to human life, are available. Life in the womb -- indeed, life emerging from the womb -- may be destroyed at any time and for any reason. There is pressure at the other end of life to euthanize the elderly and handicapped when they become "burdensome" to family members or "too costly" to the state.

Attorney Stepanovich says Cherrix's parents will appeal the ruling this week. Absent any additional information that has not been made public, which might prove neglectfulness and bad parenting, Cherrix and his parents should decide what is best for them -- not the state of Virginia.

About the writer: Cal Thomas writes for Tribune Media Services, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y. 14207. E-mail:

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3.      International Medicine: The United States Ranked Number One, out of 191 Countries

The 37th place ranking of the United States' health care system by the World Health Organization (W.H.O.) is not an assessment of the quality of American health care, but rather expresses the organization's preference for public financing of health care, says Twila Brase, president of the Citizens' Council on Health Care.

  • The W.H.O.'s June 2000 report, "The World Health Report 2000-Health Systems: Improving Performance," finds the United States ranked number one, out of 191 countries surveyed, in responsiveness to patient's needs for choice of provider, dignity, autonomy, timely care and confidentiality.
  • However, the W.H.O. faulted the U.S. for not requiring mandatory health insurance or offering social welfare programs to all citizens -- thereby failing to meet the WHO's fairness and distribution goals relative to total health-care resources.
  • Fifty-six percent of all American health care expenditures are privately financed -- whereas the majority of health care is government-financed in other developed countries.
  • The U.S. was also faulted for experimenting with medical savings accounts; W.H.O. says MSAs encourage fee-for-service payments, making it difficult to regulate and control the treatment practices of health care providers and preventing centralized pooling of dollars.

W.H.O., which currently receives $96 million from American taxpayers -- roughly 25 percent of its general budget – recommends explicit health care rationing policies, centralized prepayment systems for health care based on household income after anticipated food expenses are subtracted, the placement of health at the center of a worldwide development agenda, and equitable development across and within countries.

Source: Twila Brase, R.N., P.H.N. (president, Citizens' Council on Health Care), "WHO's Hidden Agenda," Ideas on Liberty, December 2000, The Foundation for Economic Education, Inc., 30 South Broadway, Irvington-on-Hudson, N.Y. 10533, (914) 591-7230.

For more on CCHC, see

For more on International Health Care

Canadian Medicare does not give timely access to healthcare, it only gives access to a waiting list.

--Canada's Supreme Court

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4.      Medicare: Single-Payer Health Care for the Elderly

The current system of health insurance for America's elderly population forces seniors into a single-payer health care system that restricts choice and freedom to choose one's own health care, according to author Sue Blevins.

Medicare is the single largest payer for health care in the United States. Enrollment in Medicare is largely mandatory -- giving the federal government the final say on hospital and physician fees. Medicare prevents seniors from contracting privately with the doctors and health providers of their choice.

Blevins says Medicare coverage is not as good as people think:

  • Medicare's limited coverage doesn't protect seniors against catastrophic medical costs.
  • It also fails to cover many routine health services outside the hospitals, such as, dental care, eye examinations, and physical examinations.
  • Seniors now pay about as large a share of their income for out-of-pocket medical costs as they did before Medicare -- and the percentage is projected to rise higher in coming years.

Seniors cannot refuse Medicare hospital coverage without forfeiting all of their Social Security retirement benefits, and there are no insurance products sold to seniors in lieu of Medicare coverage. In addition, the federal government prevents Medicare beneficiaries from paying physicians privately for Medicare-covered services.

Budget analysts have been warning for years that Medicare's financial future is far from secure. Medicare expenditures have grown much faster than originally projected. Without meaningful Medicare reform, seniors will likely face fewer choices and higher prices in the future.

Source: Sue Blevins, Medicare's Midlife Crisis (Washington, D.C.: Cato Institute, 2002).

For more on Midlife Crisis, visit

For more on Medicare Services, see


Government is not the solution to our problems, government is the problem.

- Ronald Reagan

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5.      Medical Gluttony: What Is An Extra Year Of Life Worth?


Is the chance for several more months of life -- maybe a year or more, with luck -- precious enough to spend a small fortune?  Extraordinary care for dying patients can make for inspiring medicine, but its extraordinary costs make it an increasingly debated choice in promoting public health, say observers.

Faced with a lethal disease, more than a third of Americans now would want everything possible done to save their lives, up from just over a fifth in 1990, according to a poll by the Pew Research Center for the People and the Press.

Yet this kind of care costs several times more than the older treatments it supplements or replaces:

  • A mechanical heart pump can cost more than $200,000, with hospital care.
  • A last-resort cancer drug can cost up to $50,000 a year -- if patients survive that long -- but insurance would typically pick up at least two-thirds.

Federal safety regulators evaluate only whether drugs or devices work, not how well they work for their prices.  And Medicare, which insures about 80 percent of dying Americans, makes no acknowledged evaluation of cost in deciding what to cover.  Its coverage umbrella sets a standard for private insurers, say observers.

  • Some insurers refuse to cover a treatment; doctors send patients home to die, sometimes out of mercy, and some patients say enough is enough.
  • One common approach calculates the cost of a treatment for each year of life it saves -- with an adjustment for suffering and side effects.
  • Many health economists view $50,000 to $100,000 as a reasonable upper limit.
  • Many hospitals also partner with drug companies to treat dying patients for free, especially in the early stages of testing, but even some doctors worry that too many patients merely spend, suffer and die.

Source: Jeff Donn, "Dying patients stretch funds to extend lives; New drugs, treatments can buy a few months, but the prices are steep," Associated Press/Kansas City Star, August 13, 2006.

For text (subscription required):

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So what is an extra year of life worth? We will never know until patients determine its value based on what they are willing to pay. Medicare, HMOs and Insurance carriers will never be able to determine its value. As Medicare goes broke, the value of human life will continue to decrease. And as it diminishes below what Medicare and others are willing to spend, it will be extinguished to save funds.

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6.      Medical Myths: The Uninsured Should Take the Money They're Saving and Buy Insurance.

The American Medical Association wants to require everyone who earns more than five times the poverty level to have health insurance.  The thresholds are $49,000+ for individuals and $100,000+ for a family of four. Failure to comply would not earn jail time.  It would result in higher taxes, however.

The AMA's mistake (quite common in health policy circles) is a failure to recognize that the uninsured already pay higher taxes because they are uninsured.  At $49,000 income, an individual who gets a $6,000 health insurance plan from an employer avoids a 25% federal income tax, a 15.3% FICA tax and, say, a 4% state and local income tax.  If he were uninsured, enjoying taxable wages instead of health insurance, the individual would pay $2,640 of extra taxes each year precisely because he is uninsured. 


The problem is not the absence of financial penalties; we already have them.  The problem is that the penalties primarily go to Washington, DC; whereas the free care (if needed) is delivered locally.


The solution is to coordinate tax and spending programs. There is no need for a mandate.


Go to this link to read the full article:


John Goodman, President and CEO, National Center for Policy Analysis, 12770 Coit Rd., Suite 800

Dallas, Texas 75251


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7.      Overheard in the Medical Staff Lounge: Large Bequests Can't Keep Up with Law Suits.

Dr Sam noted the settlement against Sutter Hospital worth $275 million in the Sacramento Bee:

Sutter Health, in a move that reflects a growing trend among hospital chains, agreed Thursday to provide discounts and refunds to uninsured patients it was accused of overcharging. Kelly Dermody, a lawyer for the patients, said the settlement will be worth at least $275 million. In addition, Sutter agreed to keep its current discount policies for the uninsured in place for three years, which will add tens of millions more to the value of the settlement, she said. Sacramento-based Sutter said it hasn't estimated the value of the settlement but indicated that it believed very little money will actually change hands. Instead, Sutter will likely write off significant sums owed by the patients. "The vast majority of our uninsured patients, well over 90 percent, don't pay their bills," said Sutter spokesman Bill Gleeson. The Sutter settlement comes a few weeks after Catholic Healthcare West, which includes the Mercy and Methodist hospitals in the Sacramento area, made a similar settlement with patients represented by Dermody's San Francisco firm.

Dale Kasler, Sacramento Bee on Friday August 4, 2006:

Dr Jay: If the hospitals are writing off 90 percent of their overcharges of private-pay patients, wouldn't the pursuit of these excessive bills for months and years by the hospitals amount to mental cruelty and harassment? Where are the attorneys that are interested in rectifying wrongs?

Dr Rosen noted Charity hits new heights as Sutter hails Oses' $10 million and other big gifts: The family of a Sacramento developer is donating $10 million for Sutter Medical Center's massive expansion project in midtown, hospital officials said Thursday. The donation, by Enlow Ose and Melena Adams Ose, is one of the largest charitable gifts in Sacramento history and, viewed alongside other recent multimillion-dollar gifts, has some observers wondering if philanthropy in Sacramento is rising to a new level. These gifts mark the beginning of a new era in philanthropy in Sacramento," said Ralph Andersen, chairman of Sutter's capital campaign, which received a separate $18 million pledge last year from the family of building industry executive Fred Anderson. "I'm hoping these donations will serve as inspiration to our community and those who would like to step forward."  Todd Milbourn, Sacramento Bee, Friday, August 4, 2006,

Dr. Sam: Looks like Sutter will need 30 or 40 of these huge donations to cover one lawsuit. Donations will have to rise to an astronomical level to cover their business misteps. Why do successful people still feel that hospitals are Institutions of Mercy appropriate to leave a lifetime of success?

Dr. Rosen: When hospitals become wards of the state under single-payer government medicine, they will again become like our old city or county hospitals and even some of our older VA Hospitals with 16 and 32 bed wards.

Dr. Milton: I was trained in a county hospital with several semi-private four and five bed rooms and several 72 bed wards. I was always amazed at the efficiency of nursing such a ward. The chief nurse seemed to know just about every thing about each patient. It was such a pleasure to ask her about any patient and she seemed to always have the answer.

Dr. Rosen: Several years ago when I was in London, I walked into the Brompton, a world famous institution. I asked if I could visit one of their wards and talk to a doctor or nurse. The person at the front desk told me that would not be possible unless I had a specific invitation or appointment with a specific doctor. I mentioned a couple of world famous names. The "prison" guard eyed me suspisciously even after I showed her my credentials. She asked if the doctor knew me. Obviously, he's the one that is famous and known, not me.


Access Denied. I've Often Wondered Why?

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8.      Voices of Medicine: Humor Can Be Good Medicine by Michelle B. Caughey, M.D., President, SAN MATEO COUNTY MEDICAL ASSOCIATION BULLETIN

There is some credible evidence that laughter and therefore humor improves health care outcomes. The laughter referred to is, of course, the patient's laughter. (For some excellent references and a description of laughter as medical therapy, the Web site of has some interesting entries.) If that is true, then perhaps the care provided by physicians is better when we're able to enjoy those funny moments with a private or shared laugh. And the day does seem to be less stressful and more rewarding.

A dermatologist colleague of mine has said to me over and over, "We should write a book." She has three children and I have four. At 7:30 a.m. every day, I dropped the kids at school, often two different schools. I packed four lunches; made brownies or muffins for 38; put together backpacks, instruments, and school music; gave them a check for the fundraiser or activity; and yelled my way to an on-time departure. What a wonderful day it was when we didn't forget something crucial, turn around, race back to the house, and find the missing item! Unfortunately for busy parents, there are the endless special days: pioneer day, Valentine's day, Halloween, field day, half days, winter gift exchange, pajama day, Earth day (ecolunch), picture day, graduation practice, play tryouts, etc. What distracted doctor can remember all the stuff that goes with it? It was often a hilarious start to the day.

Patients often tell us sad and amusing stories, and with a little distance from the moment, the stories can be funny. Humor and tragedy are so tightly linked.

And the stories they make up! "By mistake I gave the insurance information of my wife to be used by my current girlfriend, and I didn't realize that the medical information would appear in my wife's chart." "The dog ate my homework and the Vicodin." "The car wash employees took the Vicodin right out of the glove compartment." The most common is, of course, "They fell into the toilet." Does everyone keep his/her medicines on the toilet seat?

And what about all those things our patients want to show us? I'm all for descriptions, but not all patients will go that route. Various sputum specimens, urine, stool, and vomit are of course the most common. Sometimes nasal discharge "snot" is proudly presented. . .

To read the entire President's message, please go to

What's Your Humor Style? By Louise Dobson, Psychology Today, August 2006
Are you a joker? A teaser? A clown? How you deploy your sense of humor says a lot about how you relate to others and to yourself.

In today's personality stakes, nothing is more highly valued than a sense of humor. We seek it out in others and are proud to claim it in ourselves, perhaps even more than good looks or intelligence. If someone has a great sense of humor, we reason, it means that they are happy, socially confident and have a healthy perspective on life.

This attitude would have surprised the ancient Greeks, who believed humor to be essentially aggressive. And in fact, our admiration for the comedically gifted is relatively new, and not very well-founded, says Rod Martin, a psychologist at the University of Western Ontario who studies the way people use humor. Being funny isn't necessarily an indicator of good social skills and well-being, his research has shown—it may just as likely be a sign of personality flaws. . .

Though humor is essentially social, how you use it says a lot about your sense of self. Those who use self-defeating humor, making fun of themselves for the enjoyment of others, tend to maintain that hostility toward themselves even when alone. Similarly, those who are able to view the world with amused tolerance are often equally forgiving of their own shortcomings. . .

To read the entire article, please go to

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9.      Book Review: Understanding How Men and Women Think Differently

Memoir Vs Memoir By JEFFREY ZASLOW, The Wall Street Journal

Married almost 60 years, Harry and Naomi Zaslow each put their life stories on paper. But revisiting the past, as families are discovering, can be a wrenching experience

My mother recently finished writing a book about her life, and in it, she sums up her past three years with my father. "I felt," she writes, "like I was living with his mistress."

The mistress is my father's 663-page memoir. It has been an obsessive project for him, and my mother worries that he's stuck in the years 1944 and 1945, when he was an American soldier in Europe. He writes far more about his World War II experiences than he does about his 60 years with my mom, and that's painful for her. She doesn't appear in his book until page 500.

She took to writing her life story as a way to reconsider her reflections, as my father was lost in his. They wrote their dueling memoirs on opposite sides of their house in Florida, my dad in longhand, my mom on her computer. Her book makes it clear that she's proud of my father, she still loves him madly, but she also resents that all-consuming book of his.

Older people these days are often encouraged to put their lives on paper. There's been a boom in adult-education classes on autobiographical writing. Web sites and software programs are proliferating to help people store their memories for posterity. And through advances in print-on-demand publishing, people can now have their lives bound into books without paying large fees.

Memoir writing is being celebrated as a cathartic, enlightening, late-in-life exercise that leaves a precious legacy. That's all true. Less talked about, however, are the risks: Memoirs can lead to misunderstandings in marriages, and friction within families. While writing, people need to be aware of the emotional land mines.

Yes, both my dad and mom, at ages 81 and 76, respectively, have produced beautifully written, heartfelt documents that their offspring will cherish. But the process took a toll on their marriage. Memoir-writing experts say this is common.

"Women focus memoirs on their relationships and families. Men focus on their careers or their military service," says Paula Stahel, who teaches "life writing" to senior-citizen groups in Tampa, Fla. "It doesn't mean a husband doesn't care about his family, or that his wife doesn't care about his war experiences. When people realize this, they can get over the hurt."

After hundreds of hours of writing, my parents, Harry and Naomi Zaslow, eventually developed a measure of understanding about how they each chose to chronicle their lives. My mother realized that my dad had never completely come to grips with what he lived through during the war -- the comrades he lost, the scenes he witnessed as a concentration-camp liberator. My father, meanwhile, saw in my mother's book the courage and perseverance that carried her through life: She grew up poor, lost her brother, a U.S. airman, during World War II, and like many women in the 1950s, allowed career dreams to wane so she could focus on her family. . .

Don't miss the rest of these charming life stories at (subscription required)

Mr. Zaslow is a senior special writer in The Wall Street Journal's Detroit bureau.

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10.  Hippocrates & His Kin: Is Medicine Going in the Wrong Direction?

On a trip to London to visit our daughter and see the organization she co-founded (FirstTuesday) go international, we were met at the airport by a driver who proceeded to drive on the "wrong" side of the street. It caused me to reflect on a recent story about an elderly lady who was increasingly concerned over her husband's progressive forgetfulness and his getting lost. In turn, she became anxious about his ability to drive to his weekly golf game and was compelled to buy him a cellular phone, programmed to call home when the send button was pressed. One day, after sending him on his way to golf and extracting a promise to "be careful," she was doing her housework and noted a news bulletin on the TV that some idiot was driving in the wrong direction on the freeway. As the camera closed in, the car became disturbingly familiar. She immediately called her husband on the cellular phone to ask if he was on the freeway going in the wrong direction. He told his wife, "Don't worry, honey. There must be hundreds of cars going in the wrong direction." 

Many patients take their albuterol inhaler ineffectively and frequently don't empty their lungs before taking a deep breath of the medicated mist. So frequently, I ask patients to demonstrate how they take it. In the majority of cases, the medication doesn't get to the voice box, much less the lungs. The other day when I asked a patient to demonstrate her technique, she aimed the mist upward in front of her and then put her nose and mouth into the cloud, took a deep breath and held it. She was from San Francisco where they are use to dealing with "air you can see."

A 40-year-old woman asked for an air purifier. When she was reminded that she was still smoking cigarettes, she said, "That's true. But by cleaning up the air around me, surely the cigarettes wouldn't harm me as much. I know MediCal pays for it."

The Dutch government expands its euthanasia policy to allow doctors to end the lives of terminally ill newborns with parent's consent. They are taking this killing of newborns very seriously according to Annette Dijkstra, Dutch Health Ministry Spokeswoman: "The ending of a life must occur with the utmost of caution." Hence, it must be premeditated.

What a contrast: Premeditated murder by doctors is allowed but premeditated murder by the public is a felony. Why don't doctors recognize the slippery slope of medicine? Isn't it obvious that when the state takes over our lives and those of our patients, if we kill the wrong patient we will be strung up for a felony? Maybe go to the prison? Or even to the gallows?

To read more on HHK vignettes, please go to and scroll down to November.

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11.  Physicians Restoring Accountability in Medical Practice, Government and Society:


                      John and Alieta Eck, MDs, for their first-century solution to twenty-first century needs. With 46 million people in this country uninsured, we need an innovative solution apart from the place of employment and apart from the government. To read the rest of the story, go to and check out their history, mission statement, newsletter, and a host of other information. For their article, "Are you really insured?," go to The Zarephath Health Center submitted its formal proposal to the government of Antigua & Barbuda on June 26th. Our project is huge, but with God's help, this can become a reality, where we will have a premier world class facility and avoid the overly burdensome government regulations and litigious processes that have bogged us down here in the US.  Our intention will be to develop a resort whereby people can purchase a week per year connected with a 2-3 day hospital stay.  This innovative concept will allow us to perform the 90% of operations that are elective on patients who cannot or will not pay the exorbitant health insurance premiums or hospital charges incurred in the US. A knee replacement, hip replacement, TURP, hysterectomy, hernia, etc could be done on the first class hospital on the island with US physicians rotating down or choosing to live there.  In addition, if no surgery is needed, an executive physical can be done. (H & P, stress test, colonoscopy, mammogram PAP smear, blood work EKG's, chest x-rays, etc)  These timeshares would be transferable, so that aunts or uncles or children or friends could avail themselves of the week if need be.  As the Medicare system crumbles, this is a great way for the seniors to get care.  Think about it.  When have you ever heard of surgery or physicals combined with a yearly vacation? Check out the new hospital's website


                      PATMOS EmergiClinic - - where Robert Berry, MD, an emergency physician and internist practices. Here is his story: Three years ago, I left ER medicine to establish a primary care clinic in a town of about 15,000 in northeast Tennessee - primarily for the uninsured, but also for anyone willing to pay me for my care at the time of service.  I named the clinic PATMOS EmergiClinic - for the island where John was exiled and an acronym for "payment at time of service."  I have no third party contracts...not commercial, not Medicare, TennCare or worker's compensation. My practice today has over 4,000 patient charts.  My patients are typically between 5-50 years old, but I do have a significant number of Medicare patients.  A year ago, over 95 percent of the patients I saw had no insurance.  Today, that figure may be 75 percent.  But even those with insurance learn a simple lesson when they come to me: health insurance does not equal healthcare, at least not at my clinic. I clearly tell my patients how much a visit will cost.  Everything is up front and honest.  I will prepare a billing claim for my patients with insurance, for a small fee, but I expect them to pay me when I see them.  Because I need only one employee in my office, my costs are low.  For the same services, I charge about 60 percent of charges made by other local clinics, 40 percent of what the local urgent care clinic charges and less than 20 percent of what the local ER charges.  I am the best bargain in town.  If I can do it, caring for the uninsured in a small rural town, any doctor can.

                      PRIVATE NEUROLOGY is a Third-Party-Free Practice in Derby, NY with Larry Huntoon, MD, PhD, FANN. Dr Huntoon does not allow any HMO or government interference in your medical care. "Since I am not forced to use CPT codes and ICD-9 codes (coding numbers required on claim forms) in our practice, I have been able to keep our fee structure very simple." I have no interest in "playing games" so as to "run up the bill." My goal is to provide competent, compassionate, ethical care at a price that patients can afford. I also believe in an honest day's pay for an honest day's work.  Please Note that PAYMENT IS EXPECTED AT THE TIME OF SERVICE.   Private Neurology also guarantees that medical records in our office are kept totally private and confidential - in accordance with the Oath of Hippocrates. Since I am a non-covered entity under HIPAA, your medical records are safe from the increased risk of disclosure under HIPAA law.

                      Michael J. Harris, MD - - an active member in the American Urological Association, Association of American Physicians and Surgeons, Societe' Internationale D'Urologie, has an active cash'n carry practice in urology in Traverse City, Michigan. He has no contracts, no Medicare, Medicaid, no HIPAA, just patient care. Dr Harris is nationally recognized for his medical care system reform initiatives. To understand that Medical Bureaucrats and Administrators are basically Medical Illiterates telling the experts how to practice medicine, be sure to savor his article on "Administrativectomy: The Cure For Toxic Bureaucratosis" at

                      Dr Vern Cherewatenko concerning success in restoring private-based medical practice which has grown internationally through the SimpleCare model network. Dr Vern calls his practice PIFATOS – Pay In Full At Time Of Service, the "Cash-Based Revolution." The patient pays in full before leaving. Because doctor charges are anywhere from 25–50 percent inflated due to administrative costs caused by the health insurance industry, you'll be paying drastically reduced rates for your medical expenses. In conjunction with a regular catastrophic health insurance policy to cover extremely costly procedures, PIFATOS can save the average healthy adult and/or family up to $5000/year! To read the rest of the story, go to 

                      Dr David MacDonald started Liberty Health Group. To compare the traditional health insurance model with the Liberty high-deductible model, go to There is extensive data available for your study. Dr Dave is available to speak to your group on a consultative basis.

                      Dr. Nimish Gosrani has set up a blend between concierge medicine and a cash-only practice. "Patients can pay $600 a year, plus $10 per visit, to see him as many times in a year as they want. He offers a financing plan through a financing company for those unable to plop down $600 all at once." Patients may also see him on a simple fee-for-service basis, with fees ranging from $70 for a simple office visit to $300 for a comprehensive physical. Dr. Gosrani reports that he saves two hours per day that he used to spend dealing with insurance company paperwork. To read more, go to

·                     Dr. Elizabeth Vaughan is another Greensboro physician who has developed some fame for not accepting any insurance payments, including Medicare and Medicaid. She simply charges by the hour like other professionals do. Dr. Vaughan's web site is at, where you can see her march for Breast Health in a miniskirt (which doctors should not be wearing) and without a Bra. Careful or you may change your habits if you read her entire page.

                      Madeleine Pelner Cosman, JD, PhD, Esq, who has made important efforts in restoring accountability in health care, has died (1937-2006). Her obituary is at She will be remembered for her important work, Who Owns Your Body, which is reviewed at Please go to to view some of her articles that highlight the government's efforts in criminalizing medicine. For other OpEd articles that are important to the practice of medicine and health care in general, click on her name at

                      David J Gibson, MD, Consulting Partner of Illumination Medical, Inc. has made important contributions to the free Medical MarketPlace in speeches and writings. His series of articles in Sacramento Medicine can be found at To read his "Lessons from the Past," go to For additional articles, such as the cost of Single Payer, go to; for Health Care Inflation, go to

                      Dr Richard B Willner, President, Center Peer Review Justice Inc, states: We are a group of healthcare doctors -- physicians, podiatrists, dentists, osteopaths -- who have experienced and/or witnessed the tragedy of the perversion of medical peer review by malice and bad faith. We have seen the statutory immunity, which is provided to our "peers" for the purposes of quality assurance and credentialing, used as cover to allow those "peers" to ruin careers and reputations to further their own, usually monetary agenda of destroying the competition. We are dedicated to the exposure, conviction, and sanction of any and all doctors, and affiliated hospitals, HMOs, medical boards, and other such institutions, who would use peer review as a weapon to unfairly destroy other professionals. Read the rest of the story, as well as a wealth of information, at

                      Semmelweis Society International, Verner S. Waite MD, FACS, Founder; Henry Butler MD, FACS, President; Ralph Bard MD, JD, Vice President; W. Hinnant MD, JD, Secretary-Treasurer; is named after Ignaz Philipp Semmelweis, MD (1818-1865), an obstetrician who has been hailed as the savior of mothers. He noted maternal mortality of 25-30 percent in the obstetrical clinic in Vienna. He also noted that the first division of the clinic run by medical students had a death rate 2-3 times as high as the second division run by midwives. He also noticed that medical students came from the dissecting room to the maternity ward. He ordered the students to wash their hands in a solution of chlorinated lime before each examination. The maternal mortality dropped, and by 1848 no women died in childbirth in his division. He lost his appointment the following year and was unable to obtain a teaching appointment Although ahead of his peers, he was not accepted by them. When Dr Verner Waite received similar treatment from a hospital, he organized the Semmelweis Society with his own funds using Dr Semmelweis as a model: To read the article he wrote at my request for Sacramento Medicine when I was editor in 1994, see To see Attorney Sharon Kime's response, as well as the California Medical Board response, see Scroll down to read some very interesting letters to the editor from the Medical Board of California, from a member of the MBC, and from Deane Hillsman, MD.

To view some horror stories of atrocities against physicians and how organized medicine still treats this problem, please go to

                      Dennis Gabos, MD, President of the Society for the Education of Physicians and Patients (SEPP), is making efforts in Protecting, Preserving, and Promoting the Rights, Freedoms and Responsibilities of Patients and Health Care Professionals. For more information, go to

                      Robert J Cihak, MD, former president of the AAPS, and Michael Arnold Glueck, M.D, write an informative Medicine Men column at NewsMax. Please log on to review the last five weeks' topics or click on archives to see the last two years' topics at This week's column is on "Proposed National Health Information System Won't Protect Patient Privacy" The U.S House of Representatives is now debating and is scheduled to vote on H.R. 4157, the Health Information Technology Promotion Act of 2006. If passed, this bill will greatly reduce your personal freedoms and privacy. Some of your concerns should be: 1. There are no provisions for patient privacy or consent for disclosure. This bill would enable the development of a national electronic health information system. Unfortunately, there are no provisions to protect patient privacy or security. Further, the bill doesn't require patient consent for your medical information to be disclosed to government or private parties. In summary, the bill recognizes neither your right to privacy nor your right to be informed if there has been a security breach. To read the column, go to

                      The Association of American Physicians & Surgeons (, The Voice for Private Physicians Since 1943, representing physicians in their struggles against bureaucratic medicine, loss of medical privacy, and intrusion by the government into the personal and confidential relationship between patients and their physicians.  Be sure to scroll down on the left to departments and click on News of the Day. The "AAPS News," written by Jane Orient, MD, and archived on this site, provides valuable information on a monthly basis. Scroll further to the official organ, the Journal of American Physicians and Surgeons, with Larry Huntoon, MD, PhD, a neurologist in New York, as the Editor-in-Chief. There are a number of important articles that can be accessed from the Table of Contents page of the current issue. Don't miss the excellent article on Sham Peer Review or the extensive book review section.

                      Be sure to Attend the 63rd Annual Meeting of the AAPS, in Phoenix, AZ, September 13-16. For info, please go to, your gateway to the medical practice as well as good scientific information. 


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Words of Wisdom: Memory

The secret of a good memory is attention, and attention to a subject depends upon our interest in it. We rarely forget that which has made a deep impression on our minds. –Tyron Edwards

Memory is not wisdom; idiots can by rote repeat volumes. Yet what is wisdom without memory? --Tupper

Memory is the cabinet of imagination, the treasure of reason, the registry of conscience, and the council chamber of thought. –Basil

Some Recent Postings

The Encyclopedia of Stress and Stress-Related Diseases by Ada P. Kahn, PhD, has now been published. To read the foreword we wrote, please go to Published by Facts On File: Enter Kahn in the search box.

OpEd/Cinematic Reviews:

Did Presbyterian Hospital Discriminate? You Decide,

In Memoriam

Robert Brooks and Mickey Spillane, suppliers of fantasies to American males, died on July 16th and July 17th, aged 69 and 88.

[Mike Hammer] had heard of Mickey Spillane's death on the TV news as he took a shower. Sad, and hard to believe. Only weeks ago he had seen him in some fishing village in South Carolina, still looking like a street brawler from Elizabeth, New Jersey. Hammer could hear his voice now, a snarl of contempt for the writers who thought his books were repulsive and illiterate. What the hell, they sold. He was maybe the most popular fiction writer ever. A literary type once complained to him that seven of his books were among the ten top sellers of all time. "Lucky I only wrote seven books," growled Mr Spillane. . .

He and Spillane went back a long way, ever since Spillane had starting banging out his adventures on the trusty Smith Corona. That was 1946, with "I, the Jury." Two dozen more had followed. The formula was no secret. Plenty of violence—guns, fistfights, gougings, torture, select amputations. Communist villains, just right for the 1950s. Oodles of sexual titillation, with luscious girls instinctively undressing as soon as Hammer appeared. So much sex and so much violence had never been seen before. Hammer was a private dick without hang-ups, as calm and laconically witty when staring down the barrel of a .45 as when urging a female DA to tie up her bathrobe. Every red-blooded American male could identify with him. . .

Only an hour ago he had been tied to a chair, blood on his face, while some gonzo had forced a sodium pentothal injection into his resisting arm. Now he was on his way to meet a man who had information. He was taking no chances. They were meeting at a joint called Hooters, on the fairly good side of town. "Delightfully Tacky, Yet Unrefined", the billboard said, He could deal with that. And if things got hot, there were no rules of engagement for private cops like him. . . .

He found a table and, to calm himself down, read the promotional literature. The whole Hooters idea, he learned, had been an adolescent fantasy in which six men in 1983 had tried to recreate in Clearwater, Florida, the dream restaurants of their youth. The money ran out, and Robert Brooks had rescued them. Without him, this Paradise would never have reached New York. . . .

As he left he slid into his newspaper a Hooters menu, damp but intact. Inside it, courtesy of his mystery companion, lay the recipe for the secret sauce. Adjusting his rod under his ice-cool armpit, he made for the door.

Read the whole obituary at

On This Date in History – August 22

On this date in 1851, in English waters, a U.S. yacht named the America won the race against the British yacht Aurora and won the trophy which became known as the America's Cup.  It was defended by American sailors and yachts for well over a century thereafter, always remaining in U.S. possession.

On this date in 1903, Barney Dreyfuss, owner of the Pittsburgh Pirates National League base ball team, wrote a letter to the an American League club owner, "The time has come for the National and American Leagues to organize a World Series," and the first World Series was held later that year. Although misnamed since it was held in one country, this did not prevent other sports from doing the same. Americans frequently mistake our world for the entire world.

Speaker's Lifetime Library, © 1979, Leonard and Thelma Spinard