An oldie but a goodie...

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The Invisible Work

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Of the thousands upon thousands of pages of policy I’ve been reading for school lately about health care reform, one recurring theme is how primary care is going to save healthcare. With our almighty power of coordinating the care of patients, paying attention to their quality metrics, making them do preventive care, switching them to the cheapest generic meds on their health plans, and viewing the latest fancy high tech interventions with our skeptical scientific eyes, we, the simple heirs to the old GPs, favor the time tested and cost effective evidence based care over the shiny and glamorous expensive new stuff that pays for our colleagues' Italian sports cars but makes little difference in the quantity or quality of our patients' lives. In his account of the Affordable Care Act’s design and passage, one of the key advisors in the Obama administration, Dr. Ezekiel Emanuel (Rahm's brother) writes of the role envisioned for primary care doctors in the Accountable Care Or...
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So so sad

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7/2/03-11/30/09 Shireesha and I both commented that we'd never lost anyone as close to us as her. Leela Lou. Little Lou. The littlest little. Little Scoop. Leela-pants. Little Fluff. She played the foil to Kali's straight man. She was the playful one, carrying her favorite ribbons up and down the stairs all day long. No twist tie or string was safe with her around, and no empty box left unsat in. Little tufts of fur could be found all over our house, left over from some sudden pounce on something, often on her sister Kali. There was just no end to the fur. I'd said before that you could construct a new Leela from what we would vacuum up on a weekly basis. Sometimes we'd catch her munching on giant ball of it after cleaning herself. I could be traveling in some far off place and pull out a sweatshirt and find it covered in traces of her hair. Now there are bits of her everywhere in places like India. She was the most interactive, personality-filled, friendliest little ki...
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20 miles

So I am sitting here with a beer, 800 mg of ibuprofen, and a Vicodin -- the preferred cooldown regimen for us marathon athletes. I have successfully completed my peak training week with a 20 mile run today. It's all downhill from here as I taper my runs until the Vancouver Marathon on May 4. Honestly, I believe I should get some kind of extra credit for doing this in Seattle. 6 months ago, I came up with a training schedule (largely lifted here ) and entered it into my calendar and since then I haven't missed a single workout. I have run in rain. I have run in snow. I have run in hail. I have run in the dark. I have run hungover. I have run at 10 pm on a Friday night. I have run and run and run. I spent weeks planning for today's run, testing out clothing, trying different routes, sucking down different kinds of energy gel on different schedules (Clif Shot with 25 mg caffeine taken at 1 hour, 2 hours, 2.5 hours, and 3 hours if you must know). I ate pasta all day yesterday...
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