Is the Boston Marathon Bombing going to be a marathon tribute?

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Sorry to say this, but, I am tired of hearing about the bombing last year, and frankly the way the nonstop news cycle about it for more than a week now has progressed, it is really diminishing the honest and concerning impact on the victims, in my opinion.

Is this country going to run the risk of being a bit hypocritical and do the exact same thing the terrorists do in their attacks and want martyrs, and then Boston is going to want a memorial tribute every year to be equal to New York’s handling of 9/11?

It seems to run the risk of encouraging attacks at the end of the day, not discouraging them.  Some people are hypothesizing that in fact Al Qaeda is using our yearly memorial of 9/11 as a recruiting tool, so while I am not advocating we forget what happened 12 years ago, I think as a country we need to pay attention to how we remember it publicly.  After all, in working with PTSD matters, usually it is recommended that anniversary events of trauma to individuals be handled as not reinforcing the dread and reenactment from a date, but, to diminish and equalize the discomfort so it is tolerable and acceptable.

But, the way Massachusetts as a state has been handling things of late, like the Pelletier case and using video surveillance as a common method of handling legal matters, they like a spotlight and seem outwardly eager to reestablish the very tyranny that town’s history tried to avoid as being the centerpiece in breaking away from Britain to gain this country’s independence 237 years ago.

Amazing how more things change, they really end up the same!  No, it is sad and pathetic!

addendum, sorry I forgot to include the px of Sports Illustrated this week.  Really, it has to be the cover story of a sports magazine?

marathon on SI

Mark my words, it will be talked about for the rest of week, well after the race is over.

After the past two weeks, you don’t like my referring to issues resembling what Hitler and Nazi Germany did, suck an egg!

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first temple destructionImage (the above is a depiction of the destruction of the First Temple of the Jews in Jerusalem thousands of years ago, but, not much has changed except the architecture, hmm?)

Not that I am the most devout Jew, but, I take issue when I see, hear, read about persecution issues of Jews, and the past week seems to be frank reminders that my religion is still hounded, harassed, and preyed on by the scum of earth, unfortunately in the form of humans.  I have noted issues with Hitler and Nazi Germany in my travels around the Net regarding frank discrimination and attacks on people over the last few years, and at times been told in so many words, “you are making an extreme/poor analogy here”.

Well, here are two stories from the past week to remind all you apologists, defenders, and pathetic excuses of those who ignore history regarding the sociopathy of Nazi Germany and their scum leader simply this:  when someone discriminates against you or a group you strongly identify with as harshly as my predecessors have endured, and then you aren’t concerned or worried from the abuse and threats to yours and your family/group’s lives, then, I guess you are an idiot to not be concerned or worried!

http://www.usatoday.com/story/news/world/2014/04/17/jews-ordered-to-register-in-east-ukraine/7816951/

and the scumbag who shot indiscriminately in Kansas City last weekend:

http://www.ksdk.com/story/news/2014/04/13/3-dead-after-suburban-kansas-city-shooting/7674809/

In the latter link, this piece of crap allegedly shouting “Heil Hitler” when arrested, what does that mean?

You would think people of Christian faith would be sensitive with all the current assaults and murders going on around the world against Christians, in Africa and the Middle East as front and center regions.  Just because assailants today aren’t rounding up millions of people and gassing them doesn’t mean what the scum of Germany did 70 some years ago is an aberration and has no relevance to events today.

Frankly, I think the people who speak the loudest in refuting the analogies to Nazi agendas more likely are tolerant of them at least a bit, if not covertly supportive of them.  Yes, there are times when it is a stretch to call a present day attack just like the work of Hitler/Nazi crimes, but, I think the last week is a disgusting reminder that 70 years is not an eternity ago!

and the rant is over, for now…

Yep, as I told you just prior, this is Number 400 of posts, so, what has changed in the last year?

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Well, I had my 100th post last May, and after reading it today, it is unfortunate to note not much has changed, so I will be a bit lame and cheap in efforts to just replicate it now for this 400th post milestone, but, I hope if you haven’t read it, you will now and perhaps appreciate what I note I have endured in my career.

Here it is:

Someone I work with recently said this at a meeting, and I had to write it down and consider using it at an upcoming blog.  I think it fits well here:

COMMON SENSE IS AN EXCEPTION THESE DAYS.Image

Wow, that just hit home for me, and on so many levels.  For those who have been reading here for some time, maybe since the inception of the blog back after Thanksgiving last year, you know that I write about topics not just mental health in general , but more specifically about personality disorders, addiction, and politics.  Ironic all three seem to have an incestuous relationship, to those who are aware of what those topics mean by themselves.

I have given much thought what to write about for this 100th blog, and I came to the conclusion it should be about my past, present, and future as it stands now.  So, for any and all interested to what I have to say, here is what I see as a psychiatrist regarding my past, my present, and what I hope to see myself doing in the future,  sooner than later.  I hope as well you will see that comment above will have applicability to at least some of what I write about below.

THE PAST:

I finished my residency the end of June, 1993, not a minute too soon.  I had “issues” with the hierarchy of the residency program during my third year, and in the end, I was fortunate to finish my fourth and last year completely off site from the program and work with people at a community general hospital who showed me how psychiatry was to be practiced, not indoctrinated back at the “U”.  At that time, I really hoped to be working a combination of Consult-Liaison psychiatry at a hospital, maybe some community mental health clinic work, and private practice.  I really liked variety, and for at least the simple reason so I could be available to everyone who needed to access a psychiatrist, and make sure I kept up with my influences from both undergraduate and residency that reinforced the Mind-Body connection role to medicine in general.

Well, I am not going to detail my travels, except to say I have practiced in 4 different states, doing inpatient, outpatient, partial hospitalization, urgent care, and even some correctional/forensic work.  My longest tenure at a site was 6+ years, my shortest was just 3 months for a job NOT involving Locum Tenens work.  For those who know the movie “Blade Runner”, at the end when the Rutger Hauer character sits in front of Harrison Ford and says “I have seen things you people would not believe”, well, that is applicable to my travels as a psychiatrist, and not just directed to the public at large, but to colleagues who still think that the field is largely filled with clinicians who care and maintain appropriate boundaries.Image

Don’t misread me, there are good people in this profession, and that needs to be read and heard before you read further.  People who go to Med School and read the Hippocratic Oath at graduation more often do understand and accept the premise to the oath, but, I wish I could say it is at least 50% of people practicing, at least in psychiatry.  And I have said this before, probably not here in so many words, but will say it now so people have some idea of what I have dealt with:

there is something not directly said, nor secretly asked of incoming doctors to sign some type of oath to follow upon starting in a psychiatry residency, but in my dealings, especially with more older colleagues than not, I have to wonder if there is some unspoken expectation that psychiatrists have to have a level of patriarchal, non negotiable directorial attitude not only with patients, but with colleagues who are viewed as juniors or substandards.

I have seen and heard things you people would not believe.  Doctors who don’t give a damn about patient care, administrators who have not only embraced the business/customer model of running health care sites, but would sacrifice a clinician in a heartbeat solely to maintain the alleged good standing of a health care site.  Irregardless if the clinician was in fact clinically and ethically right in a conflict with a patient or outside source of dissent.  I have met therapists who have no clue what psychotherapy is about, yet, crave and covet my training abilities just to have an advantage.  I have worked with patients who have no interest in care, some in fact not even in the office as a patient, but would take advantage of my abilities and standing just to get a drug, a “get out of jail” pass, other outs for court related/legal issues, and even try to get me to tell another person in the room with the patient that overtly inappropriate, immoral, if not illegal behaviors and choices were allegedly right.

Oh, and my interests in C-L work, well, those died within a few years after residency when it became painfully evident not only were consulting psychiatrists not appreciated, but were woefully under-reimbursed and inappropriately utilized.

I have seen and heard things you people should not believe.  I could write many more paragraphs of things I had to take a stand against that were greeted by administrators like I was having a Tourette’s  vulgarity outbreak.  People running programs to help patients who were in fact asking or doing things that did nothing to genuinely benefit patients.   And I can say, with cautious appreciation, I have maintained a level of practice handled responsibly and ethically as trained by supervisors and mentors I knew were directing me appropriately during my training.  That met standards of care, that encouraged collegiality, that was respected by peers of equal concern.

20 years of the past is not the main point of this post.  We can’t undo what we have done, what we have experienced, what we have endured.  But, we can use the past to help us make the present, and the foreseeable future as appropriate and responsibly sought as we can possibly pursue.  I tell that to patients, I write this now, and I hope to practice it onwards after this post.Image

THE PRESENT:

I currently work solely in a Community Mental Health Clinic 3 days a week, I have openly noted I left a private practice opportunity over 6 weeks ago for the better, per what I see private practice is as of now, with insurance continual interferences;  the alleged continuity of care roles of therapists, other psychiatrists in hospitals and other referring sources;  what PCPs and other non psychiatrists are doing with patients dealing with mental health issues prior to referring to psychiatrists; and, as well as what the average patient is willing to pay for psychiatric services that are fair and reasonable costs.  Quite the run on sentence there, eh?  So has been the run on effort to have a private practice these past 10 years at different sites, with different groups, as well as on my own.

I have to say I learned interesting things while working as a Locum Tenens doc for about 2 years from late 2009 to 2011.  Some of it was fun;  I was in Maine for a summer working for a pseudo private practice involved with a hospital, and while I was separated from my family which was unpleasant, I had the beach as a comfort, thank god for that!  And that relates to the present, because I think I have finally learned it is important to have outlets to maintain sanity in what is a more insane world of late, based on what Einstein so well put:  to do the same things over and over and expect different results is insanity.

I see that more clearly now, I can’t expect to find majority acceptance and reassurance with people who are not fully focused on the patient care model I embrace.  It’s not about money first.  For me, it has always been about a variety in patient load, the people I work with both as clinicians and support staff, the physical plant of the office, and then money/benefits/other concrete details.  You have to be comfortable in your own skin, and that has been an ongoing pursuit for me.  It is one of the reasons I started this blog, because I saw the blog as an outlet, as an ability to express my personal beliefs and feelings, after just being a commenter for several years at other sites that control the input.  I realize now having been commenting as a blog author and reading what others write, hopefully more validating than not in their comments, it is important to tell people what you think, IF the audience wants to hear it, and gives you feedback you have a valid opinion.

THE FUTURE:

This won’t be a long section of this post.  What is my future, as well as the future of psychiatry as I would like to see it offer to the public?  I know a few things that are essential elements for this profession succeeding and righting some serious wrongs incurred the past 15 or more years, at least what I have actively participated in that time period:

>First, dump this stupid “biochemical imbalance” garbage that has been erroneously propagated by so many false leaders and alleged advocates.  Gee, there’s a surprise from a site that has as the mission statement “…if you want to get it right, face the truth” and not just take a damn drug!  Why psychiatry allowed managed care to hold us at proverbial gunpoint and disallow us to be therapists, well, whoever signed off on that attitude, go to hell, there is no other way to respond to that sell out!

>Second, psychiatrists are not tyrants, but, we are leaders, and we do have a reasonable directorial role in the mental health system, and all those non psychiatrists who think they are equals, well, you are not!  You are not servants or slaves either, but, you don’t prescribe if you aren’t adequately trained, you don’t have diagnostic equivalency if not well versed, and you don’t have seniority if you don’t have the clinical experience to validate such a position.  Frankly, I really know in my heart there is an inversely proportional equivalency to people who have positions of power in mental health programs but who have little if any real training in mental health, or have allowed their experience to be so far removed they have forgotten what the demands and realities are of the hands on care.

>Third, patients need to realize once and for all that mental health disorders are multifactorial causes in creation, so, require multifactorial interventions to successfully impact on improvement.  How many medication trials that have had no successful resolution must one endure to finally make one realize it isn’t about a biochemical imbalance?!  Are those Axis 4 stressors going to magically go away just because one takes a pill, or pills?  And those interpersonal skills that not only have alienated the alleged significant others in one’s life, maybe one needs to hear from an empathetic and invested provider(s) that the countertransference issues elicited in the office have validity in being a factor to the symptoms.  And it is time for people who have comorbid addiction issues to hear and accept the basic premise:  if you don’t get clean, maintain abstinence off ALL risks of dependency and be in treatment with credible sources to handle the addiction matter at hand, then you are wasting EVERYONE’S time who are trying to help you!!

>Finally, one thing I personally have to start utilizing more in my practice is the role of music.  I am a big fan of movies, and I have realized over the years that one element of the theater experience has been the role of music as the soundtrack.  I won’t go into much detail what I will try to do, but I do know this, it is time for those who have the ability, the sophistication, and interest, to figure out ways to use music to motivate, to soothe, to empower, and to embrace change and efforts to improve.

Look at it this way, we all have what I deem “THE SOUNDTRACK OF YOUR LIFE”, and I will hope to find creative and therapeutic ways to use it to help people help themselves.Image

Hey, isn’t that what it is all about at the end of the day as a provider in mental health, we are catalysts, and we help people get better, to change, without it dramatically altering ourselves the providers as a whole?

Well, I hope those of you who have made the time and effort to read this post have found something of interest.  I know it was worth the time and energy and effort I put into writing it!

So, to me Joel, happy 100th blog, I hope the next 100 are of fun and worth as I have found these first 100 to be.  Yeah, some were easy as copies of pictures or handouts, but, everyone has outs at times.

Genuinely, thank you out there for being a reader.  I don’t take peoples’ time for granted.  I hope I can help people in some way by writing this blog.  Hey, I read other peoples’ stuff, and I know that most of them are not just doing something that takes a couple of seconds to print.

BE WELL, BE SAFE, AND HELP OTHERS AS YOU ARE ABLE!!!Image

BACK TO TODAY APRIL 20 2014:  At other blogs there are ongoing discussions about what the APA is now advocating for integrated/collaborative care by psychiatry and other disciplines.  Here are at least two of those posts to give perspective:

http://www.psycritic.com/2014/04/on-integrated-mental-health-care.html

and

http://1boringoldman.com/index.php/2014/04/18/in-the-comments/

Be sure to read the comments section of those posts, I think you will find some colleagues’ perspectives of interest.  And not mine, as I think I wrote something in each, but the reference is NOT about me.

Integrated/collaborative care has always been there; it is just, to me, so dishonest and disingenuous of not only the APA, but of my psychiatry colleagues who are claiming such collegial dialogue needs to resume when in fact our non psychiatry peers have just taken over our role in health care, and now have realized that playing psychiatrist is no easy task.  And the APA wants to reinforce this non psychiatric game show out there!  Did you fellow psychiatrists forget that the APA is clamoring for a Somatic Provider version of DSM 5?  What the hell is that geared for, or do I have to ask in the first place??!!

So, sorry if you feel this 400th post is a bit of a cheat, but I like the 100th post and am glad to repeat it now.

Happy Easter, Passover, any Muslim holiday occurring around now, and don’t forget the big one on Tuesday, EARTH DAY!

http://www.earthday.org/earth-day-history-movement

May the Force be with you, and be at one with your karma, and Carl Sagan, wherever you are, may the Cosmos give us all peace, without an oncoming asteroid to blast us into pieces!

End of line. (for you Tron fans)

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That great legislative initiative, you know, the one called Obamacare, well, let the hacking begin!

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You gotta love spin, and politicians from both sides of the polluted aisle of Republocrats excel at it.  Take this story being reported this morning, on Easter Sunday of interest (as most of you are celebrating and not watching the news, so, will you know what to do?):

http://www.foxnews.com/politics/2014/04/20/obamacare-enrollees-told-to-change-passwords-after-heartbleed-review/?intcmp=latestnews

“The full extent of the damage caused by the Heartbleed is unknown. The security hole exists on a vast number of the Internet’s Web servers and went undetected for more than two years. Although it’s conceivable that the flaw was never discovered by hackers, it’s difficult to tell.

The White House has said the federal government was not aware of the Heartbleed vulnerability until it was made public in a private sector cybersecurity report earlier this month. The federal government relies on the encryption technology that is impacted — OpenSSL — to protect the privacy of users of government websites and other online services.”

by the way, if you are like me, you have little to no idea what is Heartbleed, so again thanks to the tireless efforts of Wikipedia here is their definition:

http://en.wikipedia.org/wiki/Heartbleed

“Heartbleed is a security bug in the open-source OpenSSL cryptography library, widely used to implement the Internet’s Transport Layer Security (TLS) protocol. This vulnerability results from a missing bounds check in the handling of the Transport Layer Security (TLS) heartbeat extension,[3] the heartbeat being behind the bug’s name.[4] A fixed version of OpenSSL was released on April 7, 2014, at the same time as Heartbleed was publicly disclosed. At that time, some 17 percent (around half a million) of the Internet’s secure web servers certified by trusted authorities were believed to be vulnerable to the attack, allowing theft of the servers’ private keys and users’ session cookies and passwords.[5][6][7][8][9] The Electronic Frontier Foundation,[10] Ars Technica,[11] and Bruce Schneier[12] all deemed the Heartbleed bug “catastrophic”. Forbes cybersecurity columnist Joseph Steinberg wrote, “Some might argue that [Heartbleed] is the worst vulnerability found (at least in terms of its potential impact) since commercial traffic began to flow on the Internet.”[13]

Again, what is worse, the antisocials that rule us outwardly, or the cretins who scurry around the Net and disrupt and destroy insidiously with these viruses?  They both are lame and need marginalized, if not flagrantly removed from society.

But, you might want to change your Obamacare password.  Today.  And then have a plan to change it weekly for the next year or more.  Again, your Democrat assholes thank you for your blind allegiance!

Next post is #400, I’ve done 300 in less than a year.  What is that?!

Ah, Dr Pies, you do pontificate so much, er, so well, er, so usual…

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Ron Pies photo 2 (1)  Dr Ronald Pies wrote an article in this month’s Psychiatric Times, which I link (fortunately, as the Psych Times does make you register at times):

http://www.psychiatrictimes.com/couch-crisis/nuances-narratives-chemical-imbalance-debate

Unfortunately, he does pontificate, and I can only ask readers to set aside some time and read this article and decide what you think it means.  One thing in there I have some trouble seeing as such a pervasive criticism among the net psychiatric critics is this comment:

“Psychiatry’s critics also conveniently omit reference to what was arguably the most prevalent paradigm in academic psychiatry, during the 1980s and beyond—the biopsychosocial model of Dr George Engel.6 Now, the biopsychosocial model has been subjected to much criticism, and some would argue that few psychiatrists nowadays employ the biopsychosocial model in a systematic, evidence-based manner.7,8 In 2001, Drs Glen O. Gabbard and Jerold Kay9 warned that “pharmacotherapy and psychotherapy, the major treatment modalities in psychiatry, have become fragmented from one another, creating an artificial separation of the psychosocial and biological domains in psychiatry.”

These are worrisome observations. But one thing is beyond dispute: the biopsychosocial model can hardly be reduced to a chemical imbalance theory of mental illness. As far back as 1991, in my book on psychotherapy for the general public, I wrote: “In recent years, the ‘biopsychosocial’ model of mental illness has gained prominence. This holds that mental problems have biological, psychological, and social roots. Therapy may therefore involve treatment in all three spheres.”10″

And yet, Dr Pies is one of the quickest and most persistent defenders of the APA and their current agenda, so, if my take on what Dr Pies is trying to relate is  correct, how can he defend the use of the Biopsychosocial model when the DSM 5 took the MultiAxial Classification System out??  Isn’t that what the Biopsychosocial model was built on, or perhaps more appropriately, the MACS was built per the Biopsychosocial model?  Seems a bit incongruent, or perhaps inconsistent, or, just a bit out of touch to defend both today?

At least I still have his Consult Liaison articles from the 1990′s to early 2000′s to savor, before the elitist agenda ensued.  I think the power of being an editor of a well read periodical like the Psychiatric Times either went to his head, made him sell out to his colleagues of the upper echelon in the profession, or, just dumbed him down.  As usual, I always invite him to come here and comment,  and show me where I am wrong, or at least defend his writings in a way that make more sense than how I interpret them.

That hasn’t happened so far, not holding my breath either, but, this isn’t an anonymous site, so there is no excuse not to debate an author who is clearly interested in promoting psychiatry in a healthy, responsible way.  Other readers, feel free to chime in where I am right or wrong in interpreting here.

Joel Hassman, MD

Honesty and transparency are critical to being taken seriously.

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So I have posted about this story before, here they are:

http://cantmedicatelife.com/2013/10/21/a-picture-is-worth-a-thousand-words-or-more-this-is-rebecca-sedgwick/

and

http://cantmedicatelife.com/2013/11/23/and-on-that-note-about-staying-on-the-heels-of-the-antisocials-what-about-rebecca-sedgwick-hmm/

Today as I surf the web for my usual haunts for newsworthy items, I found this at CNN.com, amazingly not dedicating the whole page to flight MH370, for once:

http://www.cnn.com/2014/04/18/living/rebecca-sedwick-bullying-suicide-follow-parents/index.html?hpt=hp_c2

So it is being proposed the teen may have had other factors at hand, besides the bullying which the article does note was a legitimate issue to some degree.  Does having depression and being suicidal trump abuse and justify a negative outcome?

I guess if you shoot a terminally ill person, that isn’t murder.  Leave it to the apologists and defenders of abusive and disruptive behaviors to have their day in defending the indefensible.

For now I still think Rebecca was preyed on, maybe because she was presenting as overwhelmed and meek or uneasy allowed the bullies to move in for the kill.

Poor choice of words there?

CPT coding BS, here we go again!

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So after reading this article in the current Psychiatric Times, by Dr Mark Komrad, who by the works for Sheppard Pratt Health Systems here in Maryland (do a google search about “controversies with Sheppard Pratt Health Systems in Maryland” sometime and see what lurks out there about this mental health monolith that is about money first at the end of the day), wanted to comment again what a pathetic and intrusive exercise this is to know what to use as billing codes.

Here are two prior posts I will offer as links to catch you up to today:

http://cantmedicatelife.com/2012/12/26/pending-cpt-changes-stands-for-creative-psychiatric-treasurehunting/

and then later,

http://cantmedicatelife.com/2013/04/28/psychiatrists-take-up-fight-on-cpt-coding-yeah-is-that-what-the-apa-seminars-were-about/

But, just to be fair, I spent the time cutting and taping to make the article viewable to let you all read what the take is now by the author, hope it isn’t too small:

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You know what, the important question is, why did the APA support this bullshit in the first place?  Dr Komrad ends the article asking “Although the new CPT coding changes might bring certain advantages, such as reflecting our role as physicians who use the same E&M codes intended for all physicians, they equally raise important ethical challenges that call for heightened  attention”.   Is that best for doctors to now have to be worried about looking over our shoulders at these auditors and other people to just snipe and challenge what we are doing, when they just make a system to create problems until proven otherwise in the first place?

You know, now that April 15th is past, just like what the IRS does to all of us US citizens every damn year?

Hope the article is worth the time to read.  I’d say enjoy, but doubtful!

How can you deny that Obama is not trying to ruin this country!?

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2 different links, same damn story:

http://www.usnews.com/news/business/articles/2014/04/18/us-delays-review-of-keystone-xl-pipeline

then a more partisan bent,

http://www.foxnews.com/politics/2014/04/18/obama-administration-extends-review-period-for-keystone-xl-oil-pipeline/

You partisan Democrat assholes, I have no interest to appease or dialogue with you.  I want to ask the other readers here, why does this idiot continue to delay this project?  There is no reason for the public good to claim risks greatly outweigh benefits, and I offer this to reinforce my point has validity:

http://en.wikipedia.org/wiki/Keystone_Pipeline#Keystone_XL_controversies

Yes, there are negatives to completing this project, but, right now there are equally if not more positives, and frankly, the deeds of this criminal in the White House are deeply disturbing, he has no interest in the welfare of this country.  What is most frightening to me is there is a set 30% of Americans who support this man irregardless of what he says and does.  So, again, Carlin is right, it is not just the politicians who suck, but the public who support the incompetent, corrupt, and deceitful until death do they part.

Martial law is still a legitimate option to consider by the end of the year.  What will you do as citizens if he does this?  My bad, go back to your screens, amuse yourselves!!!

Addendum, yeah from a partisan antagonist site, but, read it and wonder if there is more to the point than just my ranting as a concerned citizen:

http://www.foxnews.com/opinion/2014/04/18/obama-deliberately-emboldening-americas-enemies/?intcmp=HPBucket

One of the more shocking events illustrating the growing strength of al Qaeda is the release of a video this week showing what CNN reports as “the largest and most dangerous gathering of al Qaeda in years.” It’s what experts think is a recent gathering of the terrorist group’s leadership and more than 100 fighters in Yemen.

For an administration that does not hide its eagerness to use drones to kill terrorists, experts and journalists alike were wondering whether our intelligence community knew about this meeting, and if so, why didn’t they take the opportunity to kill the most dangerous of them with one drone strike?”

then this, “The dangerous circus created by the Obama regime’s rules doesn’t stop there.

Sept. 11 victims’ families are asserting they think the Obama administration is deliberately sabotaging the trials at Guantanamo, and insist the FBI is meddling in the cases, according to reports in the Free Beacon.

Unfortunately, both Mr. Obama and Attorney General Eric H. Holder have a history with the American people that not only doesn’t engender trust, but suggests efforts that are directly harming the nation and the American people, while pushing an agenda benefiting the terrorists.”

and ends here, “It is a horrible thing when Americans have to consider the possibility that the leadership of this country is purposefully acting in a manner that benefits our nation’s enemies. Yet, when we look around the world, those feeling and acting empowered are the bullies, tyrants and terrorists.

The American president does have power, including the sort that signals to the world’s beasts that they can do as they please.”

Hey, I didn’t write that stuff above in bold.  Think about it.

addendum April 24 PM:  This is from the Washington Post, not exactly a partisan sniper at Obummer:

http://www.washingtonpost.com/opinions/keystone-xls-continued-delay-is-absurd/2014/04/23/81dab79c-c98c-11e3-95f7-7ecdde72d2ea_story.html

Here’s the ending to put it in perspective:

The administration’s latest decision is not responsible; it is embarrassing. The United States continues to insult its Canadian allies by holding up what should have been a routine permitting decision amid a funhouse-mirror environmental debate that got way out of hand. The president should end this national psychodrama now, bow to reason, approve the pipeline and go do something more productive for the climate.”

Psychodrama, nice word there.  It is what characterological schmucks do!

Welcome to the American Health Cost System. Not a typo there, “COST”, not care!

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So, what do you conclude from this article?

http://www.nytimes.com/2014/04/18/business/treatment-cost-could-influence-doctors-advice.html?hp

“We understand that we doctors should be and are stewards of the larger society as well as of the patient in our examination room,” said Dr. Lowell E. Schnipper, the chairman of a task force on value in cancer care at the American Society of Clinical Oncology.”

and then this, “Dr. Steven D. Pearson, a visiting scientist in the ethics department at the National Institutes of Health, said the move by some societies to incorporate economic analysis “heralds an important shift in the way doctors in America are talking about cost and value.”

He said that having societies do such evaluations was better than having a doctor make such trade-offs while treating an individual patient, which is sometimes called bedside rationing.

Still, it is unclear if medical societies are the best ones to make cost assessments. Doctors can have financial conflicts of interest and lack economic expertise.”

So, while I respect and accept that physicians have to consider the role of cost to care interventions, is that what should be front and center in the intervention process?  No, but, you idiots who want Obamacare to continue on as is, that is what politicians want of this legislation, and the indoctrination has begun.

At the end of the day, if things stay as is, do you want your doctor to recommend a treatment because it is appropriate and fits your care needs, or, it is the cheapest option first?

Let Obama and his minions direct the patient-physician interaction, well, you might as well pull out your wallets/purses and then decide what you want to get for care.

Oh, my bad, what you want for cost!

Tired of addendums for the Pelletier case.

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You should know that I have been posting onwards about the Pelletier situation since last month, but, I doubt most readers have bothered to go back and read what I have been noting since the story hit the airwaves en mass that time.  First, here is my earlier post to let you catch up:

http://cantmedicatelife.com/tag/justina-pelletier-verdict-march-25-2014/

Now, here is something Dr Keith Ablow wrote today:

http://www.foxnews.com/opinion/2014/04/17/my-dinner-with-family-justina-pelletier/?intcmp=HPBucket

Ends with this:

“Yet, I also know that a teenager has been taken from her family. I know that she was once a figure skater and has, since her time at Children’s Hospital, been photographed in a wheelchair. I know that she reportedly passed a note to her parents recently that accused the hospital of abusing her. And I am absolutely sure that if the medical records or other evidence cannot prove beyond a doubt that Linda and Lou Pelletier placed Justina in mortal danger by virtue of their psychopathology or willful negligence as parents, Children’s Hospital should be brought to its knees by paralyzing civil suits and criminal complaints, and the Commonwealth of Massachusetts should be exposed for what it may have become: a state that, under the determined leadership of Gov. Deval Patrick (who, by the way, threatened to jail anyone driving during a snowstorm this winter), teeters on the brink of abandoning all pretense of individual freedom.”

watch the video at the top of the Ablow link, illuminating how the pathetic fuck ups by all involved representing Massachusetts are killing this teenager and destroying this family.

If you live in Massachusetts, be afraid, be very f—–g afraid!!!

Addendum April 18 PM:

see the first comment at this post, very interesting that the Boston Marathon Bombing terrorist charged with killing and maiming US citizens has more rights than the Pelletier family.  Shows you what is the political agenda of the Left these days.  Obama is a cretin, and he is a leader of a sizeable portion of his party.  Manchurian Candidate agenda folks, just not flagrantly assassinating people.  Yet!

The silence from the Massachusetts politicians is deafening!

Further addendum today 4/18:

link to educate:  http://www.theblaze.com/stories/2014/04/15/shocking-note-apparently-penned-by-justina-pelletier-to-her-parents/

See what this evokes in readers:  “Pressed for more details about the note, including why some of the content was cut off at the top in the image provided, Lou Pelletier became animated, frequently citing his frustration with the case and said published news reports seem to have resulted in DCF crackdowns on allowing Justina to communicate with them.

“She’s being allowed to be tortured in this country, I’ll leave it at that,” he said.”

and later in there this, ““Sadly, Justina’s own words paint a picture of mistreatment by DCF that we can see for ourselves,” he continued. “Fourteen months ago, when she was removed from her home, she was taking part in ice-skating competitions and living an active life. Under the care of DCF, she is in now a wheelchair and can barely walk. She has not been allowed to attend church, and has not been given her individualized education program which is required by federal law.”

Again, if this child dies, who will be accountable?  Everyone who prevented her release back to her parents, and that includes the loser titled Governor of Massachusetts.  How do you citizens of this state live with yourselves, much less in that state?  Oh, I forgot, you vote for these morons to allegedly represent you, so you get what you deserve!  George Carlin was right, it isn’t the politicians who suck, but, the public!

AND THEN I FOUND THIS LATER!!!

http://www.wnd.com/2014/04/no-easter-visit-for-justina-pelletiers-family/?cat_orig=faith

Evil shit going on in Massachusetts, and it just continues!

Addendum April 19:  yeah, kind of ironic to title the post “tired of addendums…” and then doing addendums, but, this is a story that is not going away, and even after Justina is released back to her parents (hopefully on her legs and not in a box!), the fallout from what the legal system did and what the political system did NOT do, well, I really hope people are chronically unemployed and shunned for the rest of their lives for this case alone!

Anyway, the point to this addendum is for the legal junkies interested:

Ihttp://liftingtheveil.blog.com/2014/04/05/will-the-real-judge-joseph-johnston-please-stand-up/

This Judge Johnston, I think there is enough evidence to show a challenge to his competency to stay on the bench for the questionable rulings he has made even before the Pelletier case.  Isn’t it time for the US to consider that judges need to be retired by a certain age?

Just my opinion.

Oh, and here is the best I can find about Judge Johnston, and isn’t that a red flag his background is so secret, while yes he is a judge, we don’t even have a basic bio to read how he got to the bench at least?!

http://uswatchdogs.net/2014/03/29/judge-joseph-f-johnston-cowardly-lion-massachusetts/

“Let’s start by pointing out what no other news site has: where did the information about Judge Joseph Johnston go? It was posted on the official Mass.Gov website, but the information about him, including his picture, have all disappeared. Anyone who thinks about this should be both shocked and afraid. As you can see for yourself if you search the Mass.Gov website, the Commonwealth of Massachusetts has hidden all information about “The Cowardly Lion”, Judge Joseph F. Johnston. Here is what Lawyers Weekly posted about Judge Joseph F. Johnston:

By: Mass. Lawyers Weekly Staff July 9, 2001 Circuit Justice Juvenile Court Three Center Plaza Suite 520 Boston, MA 02108 (617) 788-8542 Born: 1958 Year admitted to bar: 1985 Year appointed/elected: 2001, by Gov. Jane Swift Education: New England School of Law, 1985 Fitchburg State College, 1980.

When a person is proud of his actions, he rightfully stands up and takes a bow. When a person is caught with his hand in a cookie jar, he can choose from two paths; run and hide, or admit his mistake, and hopefully not make the same mistake twice. When people choose to run and hide, or worse, repeat their mistake, that speaks volumes about the content of their character.”

Well, at least something now, but, the last paragraph there, I definitely agree with that, the deeds do show what the agenda is, so running and hiding reveals much to a person’s character.

Addendum April 24:  this one shows exactly why the Governor of the state of Mass-of-two-shits is an idiot and why the state is just a state of ruin and corruption:

http://bostonherald.com/news_opinion/opinion/op_ed/2014/04/graham_deval_patrick_weighs_in_on_justina_pelletier_case

“After reports in these pages Friday that she was being denied the opportunity to attend Easter Mass with her devoutly Catholic family, Patrick rushed out a letter to state Rep. Marc Lombardo (R-Billerica) about accommodations DCF was making.

“I see in your letter that you continue to misunderstand the role of the commonwealth in Justina’s case,” Patrick wrote the representative. Justina is in DCF custody because “a judge ruled that her parents were unfit to care for her” in February 2013. “[A] decision,” Patrick wrote, “based on a detailed record of the history of neglect in the home.”

Wait … what? What “detailed record”? What “history of neglect in the home”? Where did that come from?

As the governor mentioned, Justina was seized back in early 2013 during her initial visit to Children’s. That hospital and DCF knew literally nothing about the Pelletier family of Connecticut at that time — certainly not about life “in the home.” “

This is why assholes who just make up shit to cover their ass need to be impeached for not only their sheer incompetence for lousy leadership, but they will do anything to cover for equally lame and corrupt cronies in their administration.  It is like watching an Obama Jr, except it only gives disgusting validation to the idiot partisan public who just drone on and on how their party is so wonderful and perfect.  Bullshit!

at the end is this: “The way to get the answers would be for Beacon Hill to do its oversight duty and bring the parties before the Legislature. If the record exists, DCF policy needs to be changed. If it doesn’t, the governor lied and someone at either Children’s or DCF needs to be prosecuted. Either way, an investigation is needed.”

Again, how do you live in Massachusetts and tolerate this scum and villainy around you?  Oh, because you voted it in!

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