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So many lawyers, so little time...

"The prospect of hanging focuses the mind wonderfully"--Samuel Johnson

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Location: Louisville, KY, United States

Gastroenterologist, cyclist, cellist, Christian, husband, father, grandfather.

Friday, April 29, 2005

Rocking the bridge

In the mid '80s San Francisco threw a party to mark the 50th anniversary of the opening of the Golden Gate Bridge, and I was there.

When the bridge opened in the '30s it was initially closed to cars so that the citizens could stroll leisurely about, enjoying the magnificent view of the Bay, the city and the Marin Headlands. What better way, the city planners thought, to mark the 50th anniversary of the bridge than to close it to traffic and allow the citizens once again to stroll about the bridge?

It was a great idea; so great in fact that on the morning of the Great Stroll, about 500,000 people gathered at the south end of the bridge (one of which was me) and an additional 300,000 souls assembled at the north end. When the signal to let us on the bridge was given the two huge masses of humanity rushed upon it, met in the middle, and came to a complete halt. 800,000 people were on the bridge, all standing shoulder to shoulder, unable to move.

Had this happened in less civilized climes like Malaysia or New York City, it could have resulted in tragedy. Just a small group of people in a state of panic could have started a stampede that might well have resulted in thousands of deaths, people getting trampled and crushed by a human tsunami. Fortunately, the reaction of the Californian crowd to this hopeless gridlock was "Cool. Let's watch the airshow." And there we all stood for about three hours.

Two things happened on that bridge that were henceforth and evermore seared, and I mean seared into my memory. I had the misfortune to be standing near a group of Irish women who passed the time away by singing "The Hokey Pokey". It was cute to begin with, but after about an hour and a half of it my mind was filled with dark fantasies of dragging them over to the guardrails and tossing them into San Francisco bay. I have since contacted the CIA telling them that if they need a nonviolent way to extract information from a Wahabist, just lock him in a room with a group of Irish women singing "The Hokey Pokey" for hours on end. He'd sing like a canary in short order.

As we all stood in the middle of bridge without the prospect of going anywhere anytime soon, someone got the idea to see if we could get the bridge to rock from side to side. It is, after all, a suspension bridge. First a few people began to shift their weight from side to side. They were joined by hundreds more until about two or three thousand people were moving in perfect harmony, shifting the weight to the east side, then the west side, then back to the east side of the bridge.

The bridge began to move an inch or two, then several inches, and then what felt like a yard or two, swinging back and forth like a giant Foucault's pendulum. Initially the crowd was exhilarated by their power to move such a massive structure. As the bridge swayed back and forth more and more, the collective consciousness of the crowd visualized the bridge snapping in two because of the motion and the weight of the crowd, with untold thousands plunging to their death in the frigid waters of the Pacific Ocean.

"Maybe we shouldn't really be doing this", somebody called out. Proving that consensus is possible in our pluralistic society, we all instantly stopped and the bridge settled down.

This blog is a therapeutic exercise, a Primal Scream into Cyberspace if you will. But our medicolegal system is profoundly dysfunctional and needs to be rocked and shaken to its very foundations. The actions of one lonely blogger railing against the system will not change anything, though it'll help me feel better. I have very little weight to throw around these days. If someone reads this blog and is moved to express his or her own experience, and then more and more doctors take up the challenge of blogging or writing for the nonmedical community, our collective weight can rock the system and promote legal reform.

The death of one man is a tragedy; the death of a million is a statistic. If an entire hospital gets closed down for lack of liability insurance, its a statistic unless you happen to go to that hospital. If your own doctor faces a year to year difficulty with liability insurance, then it becomes a problem. If your own doctor is like a trusted friend to you, then its a crisis.

Stay with me; see the human "face" of the malpractice crisis. Don't feel sorry for me, but get angry, join me and push for reform.


Anonymous rab said...

A timorous approach to malpractice reform will not cut the mustard or in your case mustard gas. The lawyers need to feel some serious hurt. Certainly the most qualified physicians don't need additional patients. Make the lawyers and their minions search for their medical care amongst those who can arrange an appointment the same day and received their degree offshore.

6:17 PM  
Blogger Elliott said...

Fix all the problems with healthcare first that are more important than malpractice and then I'll fight with you to fix malpractice. More important to me are:

1. Uninsured.
2. Arrogant doctors who make mistakes, but refuse to admit it or learn.
3. Costs skyrocketing out of control, but quality and outcomes not getting any better.
4. Administrative costs and burdens.
5. Antiquated information systems that contribute to medical errors.

After these get fixed then we can talk about malpractice.

5:37 AM  
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