I’m not going to get into the habit of writing brief comments on current news stories, but I had to throw this one out there. Alanis, this is irony. Oh, how I laughed and laughed.
You know, it’s funny how things can strike you. I’ve always been far less tolerant of cruelty or violence towards animals than I have towards humans. Of course, I’d prefer that neither humans nor animals were on the receiving end of such behaviour, but such is the world we live in.
Accordingly, I’m more than a little irritated by a video reportedly showing a puppy being tossed over a cliff by a couple of Marines. Now, I understand that they’re in a high-stress environment where normal rules of civility are often non-existent, but they knew what they were doing. Evidently an observer even commented that it was “sick”.
To be blunt, someone should have tossed those bastards over the cliff to see if the dog was okay. They’re clearly not worthy of being called Marines. What an embarrassment to the Service.
I have, as I’m wont to do, been thinking a great deal lately. The topic over the last few days has been on the progression of life, and our relationships within it. I am, as I’ve noted elsewhere, starting medical school in August. My path to medical school was such that it ripped almost everything away from me that I’d had before then, for the promise of newer experiences to come. A career, a relationship, financial security, friends, time, and a vision of myself–all have been sacrificed upon the bloodied altar of medical school admissions, mingled with the blood of countless others who have walked the same path or, worse, fell by the wayside, unable to summon the necessary strength to go on.
Holding On
I’m moving out of my apartment right now, and the experience is already wearing on me. Despite brutal cullings of my possessions in previous moves, I still have too much stuff. I understand now why those monks in saffron robes decline to own anything. It has nothing to do with spirituality, they just don’t want to move the crap when it’s time to change monasteries. Harder, though, are the reminders of my past.
Here, an origami flower, kept safe after she’d made it for me, just for fun. She didn’t know then that I liked her, nor that we’d end up in an eight-year relationship. Eight years, and the flower is less crisp than before, but it has travelled over 4000 miles and its colour is still bright. It’s a reminder of her, as she heads to the other side of the planet, and I disappear so thoroughly that I might as well have. Medical school was the final hammer-blow to that relationship, although the friendship that began our journey together somehow survived, and we part as friends with rueful glances.
A picture of my grandfather. An infantryman in the Second World War, he was so proud of my flying. Watching the aircraft overhead in the war, they’d represented a higher craft than he’d ever been able to do. He’d been almost a father to me as I grew up, and held me highest in his regard. I recall his disappointment when I stopped flying to pursue admission into medical school, and I was never able to express to him the driving urge, right at my core, that made any other path less fulfilling. He never heard that I got accepted–he died almost a year before that decision was made.
Piled high, endless textbooks, mementos of my academics over the years. Each yields a memory of where I lived when I took that course, and of the people I knew.
In a tin, military insignia, coins, and my beret. A host of images arises unbidden. Laughter, tears, struggle, and happiness. Voices from the past tease me, remind me of faces I knew in the service, scattered now across the country and the world.
My flight-bag. Old maps, a line marking the course of a flight. My headset. A set of wings. My log-book, most perilous of all.
Photographs–of friends, of family, of old lovers. Smiling at the camera, in eternal embraces in the light of yesterday’s sun. Each with its special feeling, each with a story known only to myself and one other.
I realise that, despite an almost pathological cynicism and well-accustomed enjoyment of solitude, my life is very much a collection of the things that have gone before. That each step I’ve taken has been witnessed by someone else, and thus the threads of our lives have intertwined. To do a thing is to simply do it, but to have one’s actions witnessed by others is to have meaning attached to what we’ve done. In some instances, the act of witnessing provokes little more than a laugh, or a frown of disapproval. In others–more rarely–our actions create a ripple effect that can quite literally redirect the lives of others. To reflect on those who have walked beside us for a while is, in some ways, to reflect on oneself.
Letting Go
And yet, despite this, one must eventually let go of the past, surrendering ourself to what we are today. Too often we live in the past, or in the future, never realising the full savour of the present moment. How strange it is that the gentle discipline of acceptance should be so wrought with difficulty and pain. To remember the happy times with past friends and lovers invites that heart-bound pang of regret that we no longer see their smiles or hear their laughter, and yet who would give up their memories to avoid that bittersweet pain?
Better then, to learn to appreciate what has come before without being bound to it. To accept that even the most hardcore, cynical, and absolutist amongst us have been shaped in some measure by past experiences, but also that we are not constrained by them. The ephemeral future contains immeasurable potential, and we cannot grasp it with both hands if we continue reaching one hand back into the past for what once was, or we wished once was.
When we have come to terms with our experience, when we have assimilated the lessons of past endeavours and come a place of peaceful gratitude for the good things we’ve experienced, then it is possible to live completely. Unbound by what came before, we can freely walk our path, open to what will come next.
And should we sometimes stop a while on our path, to linger over a person or time from our past, this too is okay. Though we have shrugged off the shackles of regret, we have not forgotten the value of those we loved or the experiences we’ve had. And if, briefly, we still experience a moment of sadness, we should understand that it’s because a particular person or experience was especially meaningful for us, and such momentary sadness is the price we pay for so valuable a thing.
Somewhere in Moscow
So there I was, watching the cold grey light of a new day filter through the windows of the luxurious Moscow apartment belonging to the exhausted Russian beauty laying next to me. Opening her eyes and seeing me awake, she stretched like a cat and then, nestling close, asked what was on my mind.
“I have one of the most read blogs on the planet,” I replied, “but I haven’t posted to it in some time.” Her eyes widened, clearly not understanding.
“But you’ve just saved the free world from a threat that, at the request of major world governments, the general populace will never know of.”
“I know.” I shook my head. “But those ungrateful bastards will undoubtedly assume that I’ve been sitting around watching re-runs of Scrubs while neglecting their clamouring for more of my words.”
“Surely your millions of readers must understand that a man of your calibre has limited time to dispense wisdom, in between world-saving military missions, paradigm-shifting scientific discoveries, and the complete satisfaction of women all over the world!” she cried.
“You’d think so,” I mused, “but I’ll make it up to them. While I was sitting here contemplating how to improve the bronzed magnificence of my rippling abs, I decided to solve the health-care crisis in the United States.”
“Incredible!” she breathed. “You satisfy me in every way, including intellectually! Can you tell me what the solution is?”
Of course I can.
It’s like this
There’s something like 47 million uninsured people in the nation, if the breathless caterwauling of the press is to be believed. In a completely unexpected turn of events, posturing by congressional politicians–who incidentally have a superb healthcare plan that shockingly isn’t available to the peasants general public–has been completely ineffective at solving, well, anything. Fortunately for you, faithful reader, I’m around to sort things out. My ridiculously powerful intellect will light the way, leaving politicians to pursue their own noble tasks (liquor and prostitutes) in their natural habitat (expensive hotel rooms). Bastards.
Economics
People with no real schooling and/or liberal arts degrees (but I repeat myself) can’t seem to grasp basic economic principles, such as supply and demand. Medical professionals, especially doctors, are in limited supply. This is going to become especially true once the baby-boomers truly start sucking the life out of the medical system, as they have for just about every other aspect of life as they’ve whined their way through their self-absorbed, self-righteous, petty little lives.
Doctors will become rarer than a straight model in an Aber-Crombie catalogue. For those of us holding the coveted title of doctor, it means that we’ll be able to demand high salaries, fast cars, and a hooker allowance in any employment contract. For you, the teeming masses of the sick, it means that you’ll either have no access to care, have access to care that will destroy everything you’ve built up over your lifetime, or you’ll be making friends with the strange, smelly guy in the ER who is perfectly content to spend twelve hours sitting there because it’s air-conditioned and the nurses have nice arses.
Not ideal, I think you’ll agree.
Thus, crying “free healthcare for everyone!” is not only moronic, but completely impossible. Not only does everything have a cost, but it ignores a very simple fact: when something is free, people don’t value it.
Incidentally, arguing that people have a “right” to healthcare is also grounds for being slapped like the weeping socialist that you are, because you can’t have a right to something that is the product of other people’s labour. This is called slavery and a lot of people have died to prevent this pestilential idea from spreading. Rights are inherent, and do not require other people. In the wilderness, you can exercise every real right: say what you like, worship as you choose, carry a weapon if you want, and wander around without restrictions. But try demanding that someone take care of your health needs in the middle of nowhere and you’ll suddenly understand that healthcare isn’t a right, it’s a service.
But shouldn’t we take care of each other?
You know, I really do think we should. But we need to do so rationally, taking into account the foibles of human nature that guarantee free-loading and abuse of the system if we allow it. First, we need to acknowledge some fundamental principles:
1) Medical professionals are in limited supply, perform a valuable service to the community, and are not our slaves.
2) When something is free, people will use/take it, even if they don’t really need it. There’s no motivation to preserve the resource, as self-interest trumps group interest in a phenomenon known as the Tragedy of the Commons.
3) Medical care costs money, which has to come from somewhere. There is no free ride.
4) We, as a society, have to decide where our priorities lie. What do we want our society to look like?
Fair enough, I’m ready to hear the solution.
Two problems exist with the current system.
For those paying for medical care, it’s ridiculously expensive. Insurance often will not cover the full costs of procedures and, in an effort to increase profits for shareholders, will often dictate medical decisions that they have absolutely no business being involved with. For those without health insurance, especially those with major health problems (e.g. cancer), medical treatment can wipe out a lifetime’s worth of work and cause people to lose their homes.
In contrast, those who have their medical bills paid for by various government programs have little incentive to limit their use of the medical system. The slightest health-problem, even if caused by poor life-style choices, can be presented to a physician for little more than the cost of their time. The payment scheme of these programs towards physicians is appalling at best, involving labyrinthine paperwork (for which the physician is not paid) and time-consuming hoops through which the harassed doctor must jump. Unsurprisingly, primary physicians are telling the Medicare program and its ilk to get stuffed at an ever-increasing rate. Good luck finding a medical doctor willing to put up with such idiocy in ten years.
That wasn’t a solution.
Shut up, I’m getting to it. Those of you with college degrees that didn’t have classes in which you talked about your feelings will be familiar with the concept of a rationing mechanism. Essentially, we need a filter to take a limited resource and ensure that it reaches the people who really need it. Simultaneously, we need to ensure that people with serious health problems don’t shy away from seeking medical care due to cost considerations. In short, we need to decide that we, as a society, want a country in which no-one loses their life-savings or their house due to an illness, but also a country in which the lives of the working populace aren’t sacrificed upon the altar of the sick, old, or infirm.
How can such an impossible task be accomplished, you ask? Can even my piercing intellect truly have a solution? Yes indeed.
A two-tiered system.
One of the tiers will be a comprehensive catastrophic national heathcare system, paid for by increased taxes. Socialists, you can hug yourself for joy now, if you like. Capitalists, I’d remind you of the concept of value for value. There is no free ride, and increased taxes are the price we’d have to pay for such a society as I described above. Fortunately, the tax rate wouldn’t have to be nearly as high as is seen in Europe, because I’m smarter than that.
The rationing mechanism for the national healthcare system would be the health problems themselves. I’m not entirely sure when the line would be drawn, but I’m thinking probably anything more serious than a simple fracture of the arm, or long-term illnesses such as Lupus. Such injuries are self-limiting, as few people deliberately get into serious car accidents, develop cancer, or have a heart-attack.
And the second tier?
Is the one that deals with everyday medical care and the part that makes this whole thing so bloody brilliant. For everything less serious than an arm fracture (say), such as coughs, colds, flu, and so on, medical care would be a purely private system. Families would still have health insurance, but it would be drastically more affordable (I’m talking like $10 a month) because there would be no possibility of the health-insurance company having to pay out exorbitant sums of money for major medical problems.
With a small co-pay for each doctor visit (say, $5 to $10), the rationing mechanism is that people are suddenly drastically less likely to visit the doctor for a minor cold that will go away by itself with a few bowls of hot soup and a day in bed. For those who couldn’t afford even that small amount, the cost is low enough that community groups (churches and the like) could afford to help out the truly needy. Suddenly, the community is taking care of itself again.
The final change I’d make is to require all health insurance companies to be non-profit. Now, I’m a hardcore capitalist in many ways, but insurance companies haven’t been subject to actual capitalist economic pressures for a very long time and they’ve abused their position. The current situation, in which the cost of patient care is competing with the interests of shareholders is intolerable and must not continue.
I’m…stunned.
Of course you are. This comprehensive overhaul will drastically reduce the workload of the primary care system and remove one of the main reasons why new physicians are shunning that speciality. It provides a rationing mechanism for basic care, allowing full access to healthcare at an affordable price while avoiding the mess that a full-on socialised healthcare system has wrought in Europe. It simultaneously allows people to work and live without worrying about losing everything if they are injured or become sick, creating a society in which we all look out for each other when things get serious.
Of course, you realise that this will never happen.
Probably not, but I might send along a copy to the Obamarama team on the off-chance they’re looking for ideas. In all likelihood though, it’ll only happen when I am King.
So I took the MCAT a while back and did pretty well. Well enough to get into my top-choice medical school anyway, which I suppose is all that counts. Now, it’s been driven home to me that people love success, and assume that anyone successful must have mounds of useful advice for people who are on a similar path. My friends, you came to the right place.
Now, it’s widely acknowledged the MCAT is, to use a technical academic term, a bit of a bastard. Premeds, hitherto having sailed unmolested through the sea of mediocrity that claims to be our nation’s education system, suddenly find themselves being bent over and used roughly by a test that is living proof of the seething hatred for premeds that dwells in the heart of the medical establishment. Indeed, I have it on good authority that the writing of MCAT questions involves a lot of dubious arcane paraphernalia wielded by people in black robes who cackle more than is probably healthy for well-adjusted citizens. Other theories propound that the MCAT is written by failed applicants, the ink comprised of the blackened husk of their spirits mixed with their bitter tears of rage. Alternatively, I suppose you could say that the MCAT is merely a test designed to bring a measure of standardisation to a group of applicants from diverse academic institutions, and contains difficult but fair questions answerable by the calibre of students expected to attend medical school. Such a wild and unlikely speculation as that, however, is something that I can’t be associated with.
So, here’s my advice for the MCAT: relax.
“But Coldstream,” I hear you cry, “it’s the most important test I’ll ever take before being admitted to medical school. Not to mention that you just scared the crap out of me with all that black-robe ranting”
Yes, yes, the MCAT is important. Many things are important, but none of them should reduce us to the quivering mass of stress, fear, and pure venom that many premeds turn into when faced with the MCAT. Before beginning your study period for the MCAT, you should do a few things. First, take a deep breath, find your mental space that keeps you centred, and then go and get good and drunk. Enjoy being drunk, as it’s just like the moment when you’ve finished the MCAT: you’re staggering, incoherent, surrounded by strangers in much the same condition, and feel slightly ill with the absolute knowledge that tomorrow’s headache will be the worst since you bought that slightly dodgy mushroom from the bloke in the alley.
Lest you think that this entire post is entirely full of mocking analogies, however, permit me to offer a bit more advice.
1) Decide on your learning style. If you’re the sort of person happiest in a classroom full of people, waving your hand to eagerly answer a question posed by a lecturer, then consider a Kaplan or Princeton Review course. Also, smack yourself as hard as you can, as I hate you lot. If, on the other hand, you’re a bitter, cynical recluse with surplus brain-power who prefers to study at your own pace, I cannot highly enough recommend Examkrackers. Despite the criminally stupid name, the material is well-presented and is everything you’ll need to do well. Taking an overpriced class isn’t mandatory, despite what some neurotic premeds will tell you.
2) For the love of whatever improbable deity you believe in, get the 101 Verbal Passages Examkrackers book, even if you’re taking Kaplan or PR. You wouldn’t believe the number of perfectly intelligent premeds who do really well on the Physical and Biological sections, and then completely bugger up the Verbal Reasoning. Friends, if you’re saying to yourself “I had a great score on the SAT/GRE” then you’ll be the one curled into a fetal position on the floor come results day, with my disembodied mocking laughter ringing in your ears. Do you think those black-robed MCAT bastards give a crap if you know what a bunch of words mean? No, they ask questions related to supernaturally boring passage and if, like the ignorant science nerd that you are, you start pecking around the passage for specific words, the fuckers will have an answer waiting for you. Dismiss this advice at your peril! If you don’t believe me, check out some of the profiles on MDapplicants and note that the Verbal scores are…shall we say suspiciously low.
3) Give yourself a bit of time to study. Two months is fine, three perhaps better. Don’t try to cram all of your studying into a couple of weeks. All of those effortless ‘A’s you earned in college while barely studying don’t mean a thing to the MCAT. That thing is hungry and it will eat you if you screw around.
4) Take a practice MCAT at the AAMC website after you’ve been studying for a bit. They have a nice breakdown of where you’re strong and where you’re wobblier than a unicyclist with a razorblade for a seat. When you’re about two weeks out from the MCAT, take another and see if you’re scoring well. Treat it as a real test, which means that your loser friends who are just dying to see that new movie will just have to deal with your voicemail for once. If you get a decent score, do a last bit of studying to fill any last weak points and then call it good. If you screw it all up, wave off and reschedule your MCAT a bit further back.
5) Take at least a few days off before the MCAT to let your brain recover. If you don’t know it by now, you won’t know it. Sure, there’ll be some pasty premed gunner who’ll tell you that he was listening to some MCAT podcast up until the moment that the test administrator ripped the headphones from his ears, but piss on that guy. While he was doing all that useless last minute studying to try to silence the screaming insecurity that churns in his soul, you were out remember what sunshine and sex felt like. Good for you. Now go make the MCAT your bitch.
Much love,
-C.
So, I’ve been trying to get signed on with the Navy to do a stint as a doc for them. In a fit of what I can only describe as the most egregious display of pure optimism since Bush landed on an aircraft carrier, waved a flag, and said “right boys, nice work, we’re off home soon,” I imagined that my prior service would make it easy to go back in. After all, the administrative harpies that rule the U.S. military with an iron claw already have every piece of information about me that they possibly could. Hell, I seem to recall having every wrinkle in my body inked and pressed into paper at some point, although that might just have been a really good party, now that I think about it. I mean, how many bloody times do you need to take someone’s fingerprints? Do they change? Wouldn’t it be better just to ask where I’d lived and worked since I’d been in and, just in passing, had I planned the violent overthrow of the United States Government (hello FBI! Sorry about that last sentence, but glad you’re here) in the meantime? I actually filled out more paperwork to get back in than I did when I was running around with automatic weapons on a fine USAF installation.
On a related note, it seems that the U.S. military is having a bit of trouble recruiting enough doctors to serve. Here’s a thought: don’t make me fill out more paperwork to get into the military than I did to have to get into medical school! Here I am, motivated as crap to don the uniform, and a bunch of administrative wankers are holding up the process. Now I was in the military long enough to know that, in the event of a national crisis, we can all shelter behind the massive stacks of paperwork that admin types use to justify their jobs, but I can’t help but wonder if a brand-new applicant faces the same hurdles. Pictures of servicemen grinning like idiots, playing golf, and riding around on jetskis with improbably good-looking girlfriends will only carry recruiters so far before the more astute applicant begins to notice a marked propensity for bugger-all getting done on the paperwork front. Streamline the bloody process and you might find that a few more people are willing to step up and fix the broken bits on those who have been put in harm’s way.
Christ, second post and it’s already turned into a rant. You lot are in for a right treat, it seems.
Yes, that’s the reason I’ve decided to write a blog. To be absolutely honest, it’s mostly because I’m entirely too lazy to actually sit with something as archaic as a pen and paper to write out my thoughts. While I have no illusions that anyone other than myself will give a monkey’s about what’s going through my head, I do derive some amusement from the idea that occasionally some errant internet traveller, lost beyond hope of redemption in the internet wilds, will stumble across my words and then head screaming back into the wilderness. Since I’m also off to medical school here shortly, and will be spending some time in the military (again), perhaps the occasional post I make will cause Google to send a unsuspecting denizen my way. If that’s you, welcome. If you’re interested in my military or medical experiences, I’m happy to relate them. If you’re here to complain, bugger off; this is my party and I’ll dance how I like. Right then, off we go.
