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I have been a General Surgeon/Trauma Surgeon since 1981. I am out. The dimunition of pay, the constant threat of lawsuit, the angry patients. You know, Obama did not ask if I wanted to be a part of his medical army. I am getting out. No more night calls to come in the treat a gunshot wound for which I will not be paid. No more threat from that same drunk that he will sue me.

I will tell you a true story. In 1986, or thereabouts, I was called to the ER where I met a crying, snivelling drunk. In his hands and lower arm was about 4 feet of coiled up small intestine. He was crying and screaming, "Doc, don't let me die!" "Don't let me die!" The reason he was holding his guts is that he was caught by an irate husband of a woman who this guy was.....amorous. So I took him back to OR and repaired several perforations in his bowel, washed his peritoneal cavity, drained the belly and he went to recovery. Postoperatively he was a pain in the ass, timing his demands for morphine IV q4h. He did well, not so much as a fever. He was discharged about 5 days later with instructions to see me in my office in 2 weeks. He called my office or had me paged almost every day demanding drugs. I told him he should not be having much pain, sore..yes, but visceral pain....no. But I did refill his prescription twice over the ensuing 6 weeks post op. I discdharged him from my care with instructions to follow up with his family physician.

Word got back to me that he had showed back up at the Armadillo Lounge two weeks after the stabbing, was seen with his feet up on a table, leaning back in a chair, drinking a 'screwdriver', and declaring, "The Doc has me on a strict orange juice diet."

So, he brought it on himself, he obtained surgical care and paid nothing, either to me or the hospital,...but he had plenty of money for vodka and cigarettes.

Another story.....I received a call that I had 2 gunshot wounds in the ER. These two (one male and one female) had tried to invade an old black gentleman one Halloween night, got him down, and was trying to beat and rob him. He was no stranger to this type of activity. He pulled a 38 out and shot the male who had him on his back...the bulled went through his groin penetrating his femoral vein, on into the urinary bladder, through several loops of small bowel, through the sigmoid colon, exited the back posteriorly and then entered his female accomplice going into her belly, hitting only a few loops of small bowel.

The male was bleeding like a stuck hog from the femoral vein injury. Once that vessel had been addressed, I then repaired the bladder, and then addressed the peritoneal cavity. I clamped the perforation of the sigmoid colon to stop any fecal leak, then repaired the perforted small bowel, then performed a barrel colostomy with a blind poudch (surgeons will know this as a Hartmann Proceedure).

Now, unless you have dealt with a large vein massive injury, you cannot understand the volumn of blood which is lost. I had blood soak through my gown, my underwear, my shirt. It took quiet a while to get that under control. My assistant nurse, who was 8 months pregnant (excellent surgical nurse)...she was soaked in blood. We gave him 12 units of packed RBCs, platelets, and fresh frozen plasma. Finally we got it controlled and we felt we had a good chance. After about 5 hours of surgery we finished.

After surgery this nurse came to me while I was writing orders and said he thought this was a fellow she had gone to high school with. Indeed she had. His first name was Chris. She said, while in high school he was known as Christine. He was homosexual. Turned out he was under treatment for AIDS. He also tested positive for syphilis. He never told us in the EF. So....my nurses baby was put at risk, the nurse, myself, were all soaked in HIV blood. (After this I took the female to the OR.....repaired her bowel she was fine). My nurse told me that was her last surgery.

I never got paid, I did get the liability...The patient did recover...and went to prison. But after 6 months his sister came to me...said he was doing fine in prison, and that he wanted me to take down his colostomy and reanastomose the colon to the rectal stump. I told her I did not work in the prison system...that they had surgeons to do this....but he did not want that....he wanted me to do. Now, mind you he had not paid me. But at my refusal, he instructed his sister to tell me that he was going to sue me. He never did, but that did not abate the fear for months that I would be expecting a server come to my office and serve papers on me. He had no downside. Any threat of lawsuit requires I report it immediately to my insurance company. My premiums went up $12,000 that next year.

So....I am out. It is a risk/reward thing.

What Obama has visited on the public, they will not like. It will rapidly become rationed, then denial of care. It will be paid for in mysery, paid for in early and unnecessary death, and it will be what has been forseen and fortold and that the public has been forwarned. But,...ITS FREE! That is all that counts.

Obama said, "I'm from the government and I am here to help you." The most boistrous of the public has said they will vote themselves borrowed money from the future children's largess. This cannot and will not be without social forces which will be unleashed. The young, through no fault of their own, but through fault of their partents and grandparents will be required to pay or service this debt. They should refuse to do so.

I have always thought the American Dream was that parents had the opportunity to provide a better future for their kids that they had. That dream is dead. A nearly 16 trillion dollar short-term debt has seen to that. As that great poet, Robert Earl Keene said, "The Road Goes on Forever, and Party Never Ends". So far, so good. But even Q/E to infinity will have to fall to earth. And Robert Earl needs to study a little cosmology and understand that there are no actual infinits....only in the abstract does infinity exist. There is going to be one hellova hangover.