December 1999

Is That All There Is?

By Michael J. Katin, MD

We have now come to the end of a full three years' worth of this column. Three years is not a long time relative to other things (waiting on hold for an authorization number, for example), but keep in mind that if this column were a hamster, it might have already died of old age. This is my final opportunity to emphasize that this is not the last column of the millennium, since that would be at the end of next year, and probably not the last column of the century, since probably the 20th Century ends next year also. At least it's my last column of the 1900's.

Although I have every intention of continuing this column, webmaster permitting, there was some incentive to make this as memorable as possible since at least 20% of the population expects the end times to arrive next month. It's not easy to try to write about interesting aspects of radiation oncology (a contradiction in terms, some critics may say) but there were multiple topics available for this month. One possibility was a definitive expose of managed care, with Thomas Paine-like qualities resulting in reprints in the New York Times, Newsweek, or even Martha Stewart Living. Another possibility was the soon-to-be annual Raddy Awards, for the leading accomplishments and practitioners in our field for the past year. These topics need to be postponed until next year, however, due to the events of this past week.

The conclusion is obvious, but I'll tell you what it is, anyway. The Battle in Seattle resulted in driving the World Trade Organization to make its deals underground and not deterred, even though temporarily inconvenienced, by hundreds and probably thousands of turtle-suit-wearing protesters, tanked up on Starbucks coffee, making an effort to save the planet. Let's see...a Presidency rocked by scandal, the Yankees in the World Series, Cher with a Number 1 single, protesters in the streets...is this the 70's or the 90's???? But what was the difference between then and now? Do you know any of the names of the protesters? Did you ever hear of Mike Dolan of Global Trade Watch? I didn't until today. And why was this story covered only minimally in most newspapers compared to the protests of the 60's and 70's? In our local newspaper, and probably in yours, at the height of the protests the space dedicated to coverage was only slightly longer than the article on the birth of an artificially inseminated elephant in the Springfield, Missouri zoo. I wish I were making this up.

The previous day, there was a huge article about the report by the Institute of Medicine that "Medical Mistakes Kill Thousands." This story was picked up by every major news service and personally telephoned to every one of your patients. The conclusion was that 30% of our population is killed every year by mistakes due to indecipherable handwriting, sleep deprivation of medical personnel, and lack of weeding out of incompetent practitioners, among other reasons. Well, maybe it wasn't 30%, but it was a lot (between 44,000 and 98,000 hospitalized Americans per year...I guess outpatients are sturdier). This means that if you haven't personally killed somebody at least every other year you're not doing your share. Fortunately, nobody else makes mistakes like this, as the occupants of the Chinese embassy in Belgrade can testify. Heard from the Mars lander today? Checked your Visa bill? Anybody remember Waco? Y2K all straightened out?

And the point of this...it means The Man is still in charge. And the WTO is on the favored list and we're not. We can be doing great things in medical science and the decision-makers in the media will still take every opportunity to dump on us. I truly doubt you'll hear any rebuttals to the articles about the Institute of Medicine report, but I would encourage that we learn who was on this panel and who commissioned this study before we let it go into the bank of references to be taken for granted as correct. And if it's true, I'll gladly go for classes in calligraphy, sleep at least eight hours a night, and get fingerprinted (oops--we already have to do this in Florida to be relicensed). But only if I can keep wearing the turtle suit.

email: mkatin@radiotherapy.com