Archive for February, 2013

ADHD and Dylexia: problems that run in my family, but not past me.

February 7, 2013

It’s a problem that cannot be fixed

When you read, your letters are mixed

It’s harder to ponder

When you attention can wander

But the drugs I’m going to have nixed.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  In May 2010, I left my position of 23 years, and honoring my non-compete clause, traveled for a year doing locum tenens work.  In June of 2011 I joined up with the Community Health Center, which provides care for the underserved.  I’m now working part-time, which, for a doctor, means 54 hours a week.

Dyslexia and ADD run in my family.  I have 6 dyslexic siblings.  On revealing her problems reading, one sister tearfully announced, “But the words dance on the page!”  My grandmother said, “I thought they only danced for me.”

Dyslexia has a spectrum.  During med school, we all knew that the best car mechanic in town had the problem; his wife had to read the manuals to him.  Yet he could disassemble, overhaul, and reassemble any American engine in an afternoon. 

All seven of us figured out strategies to get past the sequencing errors and all of us count literacy as a prized asset.  One brother can sing backwards. 

I can write backwards and upside down.  With lack of practice my upside down and backwards reading has slowed.  Nonetheless while driving in southern Alaska I read an exit sign and said, “All I saw” (Wasilla spelled backwards).

One of our daughters’ dyslexia kicks in with fatigue, another got early treatment in the school system and did well.

Attention deficit/hyperactivity disorder also runs a spectrum, and not all who have one have the other.  A language student of mine never stopped fidgeting but he never lost his focus; he stayed on task and he pushed the class to learn at maximal speed. 

My personal problem with attention deficit comes down to easy distractibility, and however energetic I might be I have never suffered from hyperactivity.  Yet I went through school long before this learning disability became trendy.  I had to develop coping strategies.

I did my best studying after everyone else went to sleep.  In college my serious studying didn’t start till midnight.  Most lecture situations limit distractions; in contrast I cannot learn with a TV on.  In the course of my daily work I talk to one person at a time, and things go well.

But if two people talk at the same time I get very uncomfortable, and if someone wants to tell me something important while the PA plays an announcement I want to scream.  I have stood up in meetings and said, “We have 9 people in the room, and just now 7 were talking at the same time, and no one is listening.”

Imagine my discomfort during small group computer training when a trainer and a trainee had a loud, spirited discussion right behind me.  I had to leave the room, which constitutes a learning, coping strategy. 

Beats getting an ulcer.  Or taking amphetamines.

Contrast and meaning at a gun show: a doctor weighs in on gun control

February 3, 2013

Don’t be too quick on the draw,

Is there a statistical flaw?

When it comes to a gun,

Let people have fun,

Just enforce existing law.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  In May 2010, I left my position of 23 years, and honoring my non-compete clause, traveled for a year doing locum tenens work.  In June of 2011 I joined up with the Community Health Center, which provides care for the underserved.  I’m now working part-time, which, for a doctor, means 54 hours a week.

The US has lots of firearms and lots of firearms deaths; in the current gun control debate, a lot of statistics have been thrown back and forth.  When listening to the statistics, one must remember to think critically.  The question has arisen if firearms deaths constitute a public health issue.

Tobacco remains the big killer in our country.  Close to 450,000 people die per year from tobacco, 10% of them from passive smoking.  Thus on the day of the Sandy Hook killings more children died from passive smoking than died from bullets. 

Effective legislation should decrease the death rate from firearms, rather than regulate for the sake of regulation.  In our country, lightning kills about as many people as succumb to high-capacity clips. 

While in Barrow, I met a number of people who guarded their whale camp with assault style firearms.  Certainly if I lived in polar bear and wolf country, I would want a lot of firepower. 

As the number of firearms in the country increases, the number of deaths from firearms decreases.  This trend has remained steady for more than 20 years. 

The vast majority of firearms deaths in our country occur in the demographic of young minority men aged 15 to 25 who have not been accorded equal protection under the law.  Made outlaws by our society, they behave as outlaws; they shoot each other.

Prohibition should have taught us that passing laws without providing for enforcement does more harm than good; people learn to disrespect the law.

Accidental firearms deaths happened fewer than 200 times per year, despite our 300,000,000 guns.

If we really want to do something about saving lives, we would increase the taxes on tobacco by a dollar a pack per year, indefinitely.

I helped staff a gun show earlier today.  While there, a number of people spontaneously remarked to me about how they’re doing after their cancer surgeries.   One fellow admitted he smoked 3 to 4 packs a day until breathlessness during a golf game drove him to give up his cigarettes.  Shortly thereafter, he was diagnosed with lung cancer.

As hundreds of people browsed through the show’s offerings, ordinary rifles, shotguns, pistols, and revolvers, a few stepped outside to smoke.  The real public health problem contrasted with the much maligned “assault rifles,” (which really are weapons whose biggest failing is in aesthetics).  Contrast is still the essence of meaning.

On a personal basis, I have no use for the black rifles with pistol grips, bayonet lugs, and the capacity to accept 30 round magazines.  But I’m glad I know people who like them.  They keep the government honest.