Dread and Awful Czar,

Dr. J. has been battling an outbreak of Yeti flu in New Atlantis. We finally have them buggers under control and it’s time to return with some Gormotastic commentary. So pour some oil on Dr. J’s head and kill the fatted calf. Dr. J’s back.

Given that Dr. J. has been out of commission for a while, his commentary will have to be reminiscent of a Larry King ellipsis column from USA Today (i.e. ‘I like cheese…that Teri Garr is some little actress…), so please forgive his style. Dr. J. is feeling a little ranty today…

First and foremost, Happy 100th Birthday to Ronald Reagan. While there are many reasons to salute this great man, and the greatest president in Dr. J’s (or his parent’s) lifetime, there is one moment that crystalized his greatness. By way of context, Dr. J. went to a private school in the northeast where he was educated by liberals who thought that President Reagan would bring us to nuclear war. Indeed, The Day After was required viewing in junior high and our school was declared a ‘nuclear free zone’ and had a peace pole planted as well. Anyway, the Reykjavik summit was that moment. Dr. J remembers watching Saturday morning cartoons on a rainy Saturday in 1986. The news was reporting that the talks broke down because Reagan, the hated warmonger he was, refused to concede our Strategic Defense Initiative (aka SDI, aka Star Wars) to SG Gorbachev. Dr. J witnessed the young Glastnostlicious Gorbachev walk out of the summit with his head down and disappointed, a weakened man. President Reagan walked out appearing 10 feet tall, with his head held high and with a spring in his step. It was at that point that Dr. J. knew that the Soviet Union was on bought time and that nuclear annihilation by a Cold War rival was not in Dr. J.’s future. Dr. J. felt safe and secure and it was because President Reagan pursued his belief in peace through strength (which made more sense than Dr. J’s teacher’s lines regarding arms being for hugging). Also, following that up with a request asking Mr. Gorbachev to tear down the Berlin Wall was pretty bad ass. Thank you President Reagan!

Second, regarding Friday’s unemployment numbers. Unemployment is down to from 9.8% 9.0% with 36K new jobs created according to the folks who keep track of that sort of thing. That would make mathematical sense if there were 4.5 million working Americans. What these numbers reflect is more ominous and that is that more people are giving up looking for jobs. Thank you lame duck congress for extending unemployment benefits! I guess President Hope-and-Change has added Hopelessness to his economic policies, because making the unemployed hopeless is the only way his team can come up with to lower unemployment.

Third, Dr. J. admires President and Mrs. Obama’s chutzpah on Super Bowl Sunday! They hosted a party serving bratwurst, kielbasa, cheeseburgers, Chicago Deep Dish Pizza (preferably from Gino’s East and not Giordano’s), Wings and various and sundry other menu items that would help keep Dr. J. very busy unclogging coronary arteries. He is happy to see them stamping out obesity one ‘sometime food’ at a time!

Fourth, Snowmageddon ’11. Dr. J. hopes his Gormobuddies have been able to shovel out their driveways on the Plateau of Leng. This is clearly the result of man-made global warming, as Dr. J. has spent the winter tooling around in his V8 truck.

Fifth, Young Justice, on Cartoon Network, is one hell of a cartoon.

Sixth, regarding Puter’s link to the unconsented breast, genital and rectal exams by medical students in Oz. Dr. J. has to clarify the article and reality. The report describes a research article where medical students were interviewed with regard to being asked to do said exams in situations where they did not have explicit consent of the patient. A lot of the news article takes even some passages out of context from the article (natch) and even then we don’t have access to all of the interview quotes in context. That being said, some of the situations students were put in were pretty appalling. Other’s not so much. Dr. J., believe it or not, went to medical school. While he was in medical school, he participated in some intimate exams. Certainly all conscious exams were with done with the direct express approval of the patient given to then Mr. J. The unconscious exams, so to speak, are a little tricky with regard to the explicit obtaining of consent. Dr. J. will give you an example. Dr. J would introduce himself to the patients he would be helping operate on, as a med student and explain that he would be assisting the doctor. The doctor also obtains a more detailed consent for the operation including the exam under anesthesia. For Gyn surgery, there is often an exam under anesthesia prior to the hysterectomy or other such operation. The reason for this is largely to help us correlate the exam finding with the surgical findings. In those cases, Dr. J. would be performing an exam under anesthesia even if he didn’t say, “Oh, BTW I am going to be doing a pelvic while you’re out….” Consent was obtained for a student helping and an exam under anesthesia. You probably prefer the student doing that than wielding the scalpel.The reality is that this is done in part to teach the student what fibroids (for example), or ovarian cysts feel like on exam so that the student may identify them in their future practice. The operative theatre is a a ‘target rich environment’ for pathology, so the student can learn to identify pathology. In the clinic environment, a student will see a lot of normal findings but will not see as much abnormal findings. It’s no different clinically than listening to a patient’s murmur and then looking at an echocardiogram of the cause of the murmur. Regardless, it’s made Dr. J. think more about how we obtain consent for student participation in surgery.

Seventh, Dr. J. likes duck.

Eighth, regarding Volgi’s vaccine article. In New Atlantis, there was some trendiness among mommybloggers and such to ‘space out the vaccines’ rather then have them administered on schedule. The problem with this is that vaccines will invariably be missed, and these vaccines DON’T cause autism anyway, so it’s just more trips to the pediatrician or more non-compliance. Folks who don’t follow the AAP vaccine schedule recommendations are ass-hats that put the rest of our kids at risk by messing with the herd-immunity safety net. Dr. J. will come after you with his +5 vorpal sword if your kid gives one of his kids a preventable illness due to your own ignorance, narcissism and self-centeredness.

Finally, that Natalie Portman (left wing prattlings aside) is a fine little actress…

Best,

Dr. J.
Erstwhile Royal Surgeon to the Gormogons

The Czar of Muscovy

Божію Поспѣшествующею Милостію Мы, Дима Грозный Императоръ и Самодержецъ Всероссiйскiй, цѣсарь Московскiй. The Czar was born in the steppes of Russia in 1267, and was cheated out of total control of all Russia upon the death of Boris Mikhailovich, who replaced Alexander Yaroslav Nevsky in 1263. However, in 1283, our Czar was passed over due to a clerical error and the rule of all Russia went to his second cousin Daniil (Даниил Александрович), whom Czar still resents. As a half-hearted apology, the Czar was awarded control over Muscovy, inconveniently located 5,000 miles away just outside Chicago. He now spends his time seething about this and writing about other stuff that bothers him.