Dr. Sour Puss

Last night, as many of my high school friends whom I hadn't seen in years gathered to celebrate Kevin's 40th birthday, I was stuck in the hospital, sitting at the foot of the bed of one of my favorite patients. I was on call, attending for the residency, and trying to figure out how to deliver this patient's baby who'd arrested at 8 centimeters dilation. Her temperature was rising and the fetal heart rate was showing signs of distress. For 40 weeks, this patient had greeted me with a huge smile at each prenatal visit. She was so excited to be pregnant again, having miscarried her last pregnancy at 13 weeks the year before. She had no insurance, and most of her family was in Mexico, so for her the care and support she received from the clinic each week was literally a lifeline. Each visit, I'd work so hard to reassure her that things looked normal, diffusing her anxiety with humor. I knew she and her husband had wanted a boy and so early on, long before her ultrasou

Matt Haughey , founder of Metafilter and user #1, is in the hospital and twitter is probably going to crash with the flood of well wishing. -->: #mathowielove Guy tweeted his own seizure. That's hardcore geekery. Get well soon, Matt. Metafilter is the only website that matters.

I love Wonkette's headline this morning: "House Votes to Kill Your Grandmother & All Christians, 220-215." The House bill, which has to go through further watering down in the Senate and is a *long* way from becoming law , is a step in the right direction. Problem is, I think we are *far* past the point where "steps in the right direction" are going to take us where we want to be: quality, accessible, evidence based health care. I honestly think that, with the exception of health care providers and people with serious medical problems, very few Americans understand how far we are from that goal and how entrenched the institutions are that are trying to keep us from this goal. I am all for market based approaches that improve quality and drive down costs. The problem is that quality and cost aren't where insurance companies are competing. They compete with strong arm negotiations with hospitals, denials of coverage, and lobbying money. This bill, while s