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Sunday, June 20, 2010

Make a difference

The nice thing about America is that even stupid people get to vote. Even the stupid get to have an opinion or not have an opinion at all. In fact, even smart people can have an opinion or not have one at all. Yet, in the end, we all need to be careful what we do with our opinion.

One of my friends wore a McCain/Palin sticker to school during the last election cycle, and one student came up to her and said, "I'm voting for Obama."

"Why are you voting for Obama?" My friend said to the kid.

"Because my dad said he wanted to make a difference."

Of course some of you could turn this around and wear republican for President sticker on your coat, and you'd think the opposite. My point is the same.

I get tired of hearing people say "I want to make a difference."

I watched the Mrs. U.S.A. pageant once, and about half the women on stage said, "I want to make a difference."

Well, Hitler and Stalin both made a difference. They created fascist governments and social reform that many here in the U.S., even our own Presidents, were envious of until they learned what Hitler and Stalin were really up to.

FDR made a difference. Conservatives say that difference was to create a more socialistic America. Liberals say that difference was to create a more just society. Conservatives think the liberal view is stupid. Liberals think the Conservative view is stupid and should be shut up.

Many doctors believe in the hypoxic drive theory. I would say that 8 out of every 10 doctor who works at Shoreline Medical won't give a patient enough oxygen just based on that theory alone. Yet, I bet 8 of every 10 respiratory therapist have become aware, or will become aware, that the hypoxic drive theory is a hoax.

So are we RTs stupid, or are all those doctors stupid. Hitler had good intentions in that he wanted to create a more just society, and so did Stalin. FDR had the same good intentions, and so does Barack Obama when he decided to create his health care program. Although he probably thinks I'm stupid in that I call it stupid, yet that's beside the point.

George W. Bush had good intentions when he opted to call terrorists on their bid for war. Yet he was called stupid by many in the media and Washington, just like those who supported Bush called those who spoke out bad about the War were anti-American and, well, stupid.

So, what are good intentions then?. First of all, if you create a program or a policy or a belief based on good intentions, then you are assuming you have the right answers based on the facts. If you have the wrong answers, then you are doing something that will not benefit anyone. In this way, you are creating a stupid program or belief. Does that make you stupid?

Good intentions do not always create good results. As we saw with FDRs National Recovery Act and his high taxes (which were up to 80% on the upper class), which actually made the great depression last longer than any depression in the history of the U.S. He had good intentions just like Bush had good intentions when he took us to War with Iraq.

Doctors want to make a difference too, as did Dr. Marsha the other day. The patient was awake and alert and oriented and chomping at the bit to come off the ventilator. She passed her weaning screen with flying colors. Yet, because her heart rate spiked when the doctor came in to see her, the doctor decided to keep this poor patient on a vent for another day.

Too me this doctor's decision was stupid, because I believe the patient's heart rate spiked because she was pissed at the doctor and the nurse, and not because she was "failing the wean," as Dr. Marsha told me. Well, I actually KNOW the patient was pissed, because she told me so.

I begged the doctor to extubate the patient. The doctor said, "Rick! I am not extubating today!"

So am I stupid, or is she? One of us is.

My good intentions made me spend extra time with that patient to make her look good for the doctor so the doctor wouldn't make a "stupid" decision based on some "stupid" dogmatic protocol she has set in her head. Yet I failed the patient.

I wanted to get a job as an RT so that I could support myself and my family. I write because I want to make a difference. Although I don't just say, "I want to make a difference." I believe that making a difference is knowing that if you work hard and become good at what you do, making a difference will come naturally.

So when I hear a kid say, "I want to make a difference," I just think that if he keeps doing what he's doing he'll definitely make a difference. He might go home and throw a brick through a window and make a difference all right. Or he could become President some day and make a difference too, and if he's stupid it might not be good.

That's the neat thing about our country is you can vote for whomever you want, and you can believe in any theory, or you can do whatever you want. You do not need to have any measure of logic or intelligence or reasoning or goodness behind your decision either.

I come from the school of thought - or the hope -- that the best way to move forward as a nation or as an institution or whatever you're referring to, or to sustain the greatness, is a massively informed public. That is why I blog. And I bet I'm making a difference with one or two of you.

And, if we had a massively informed public, we would not have a nationalized health care program, and we wouldn't have all these entitlement programs that we can't afford, and that actually make health care more expensive, and add to unemployment.

If we had a massively informed public, people wouldn't do things just because "that's what my doctor said." Because they would reason.

I had a patient the other day who was going to a nursing home. I said, "Why are you going to the nursing home." She said, smiling, "Because my doctor said so."

You see, to me, that's not good reasoning. I get the same response when I ask the patient, "Why do you think you're getting a breathing treatment if you're not having trouble breathing?"

Do you ever twist reality in this way? Turn a question back on the patient. Make them think. Well, I did this, and my patient said, "Because my doctor says I need one."

To me that's not good reasoning. One of the reasons we have stupid doctor orders is because the public is not informed. One reason we have high health care prices is because the public is misinformed.

If we had a well informed public, politicians who ignore our Constitution and create laws telling you and I what we "have to do" for the better of society wouldn't have a chance. Also, misinformed doctors would be forced to better educate themselves, and politicians too.

As I wrote a while back, going to school does not make you smart. There are people in Washington who went to the best schools in the world, like Harvard or Yale, and they continue to create laws that are not the the benefit of you and me or America or our hospitals or whatever. So schools do not make smarts. What makes smarts is effort and logic and facts and the ability to listen, to read, and to understand facts.

Because for every one of you who are informed and enlightened and smart who "make a difference," remember: The ignorant can make a difference, too -- and when they do, it ain't good.

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