June 2000

Tenacious D

By Michael J. Katin, MD

We are nearly halfway through this year and only a few months from now we will be overwhelmed with empty promises and comprehensive empty solutions from the politicians of Campaign 2000. While we are trying to maintain a low profile and hoping to be overlooked, we in radiation oncology occasionally are placed in jeopardy by even well meaning attempts at straightening out the medical care system.

It's probably time to take a more aggressive attitude about this. I think we already have a role model that has withstood decades of attempts at revision: the Department of Defense.

Among our potential handicaps is the fact that we use expensive equipment, which becomes obsolete almost as soon as it's delivered. We also are potentially at a disadvantage because we deal in situations, which most people hope never to need to address. It's also obvious that our goal is to destroy living tissue, preferably with the majority of this being enemy rather than friendly, although sometimes-collateral damage is unavoidable.

I think I've proven the analogy, and now we need to look at their method of coping. When the chips are down, someone is always willing to pay for technologic advancement. "Millions for defense, but not one cent for tribute," as a great American once said. I believe it was either Charles Bronson or Garry Maddox. In any event, once you establish a hard line that life as we know it cannot be preserved unless you are allowed to spend $8,000 on a toilet seat for a submarine or $500 on a hammer, you've got it made. As is so eloquently described in another column recently entered in this site, manufacturers of high-priced armaments, er, hardware, go all out to convince everyone that this is essential to preserve the way of life as we know it, and the fiscal conservatives cave royally. Sure, from time to time there are cutbacks, but, on the whole, it's a growth industry. Now all we need to do is make sure it's recognized that you need adequately paid, dedicated people to operate this stuff, and we're home free.

Probably even a mediocre lobbyist for General Dynamics or Lockheed-Martin will be able to protect us. And if you don't believe it's possible, consider that the much-maligned Star Wars project of the Reagan era is now about to become the foundation of strategic policy for the Clinton-Gore Administration and the Gore-Graham Administration. IMRT, anyone?

email: mkatin@radiotherapy.com