November 2011

Occupy Walmart

By Michael J. Katin, MD

This months' column is somewhat unusual since it's being written in the midst of an ongoing news event, namely, the encampment in Zuccotti Park of the Occupy Wall Street movement. Although I was not present at the outset (September 17), I felt as if I should be here after hearing their slogan: "What is our one demand ?" It seemed that if one demand would be forthcoming, it might as well benefit the field of radiation oncology. In retrospect, is seems as if their one demand was either to have the total reorganization of society, or else to be allowed to stay in Zuccotti Park as long as they want. Support has been forthcoming from a variety of organizations, including MoveOn.org, CAIR , the United Federation of Teachers, SEIU , Up with People! , the Working Families Party, the AFL-CIO , the Traveling Wilburys , Hines, Hines and Dad, and the players and coaches of the Miami Dolphins. It seemed to me that before the announcement was finally made of what was the "one demand," that it was urgent for a representative of ASTRO, ACRO, or AFROC to have the opportunity to supply that demand. I volunteered .

There was a dilemma in that we are heavily dependent on Wall Street to allow technology to progress. Without financial support, companies such as Varian , Siemens and Elekta would not be able to develop new models of linear accelerators that, strangely, cannot be reproduced by simply upgrading previous models. Without financial support, pharmaceutical companies would not be able to come up with complex new molecules to treat cancer and be able to charge so much for them that they make radiation therapy look inexpensive. In addition, there would be inadequate support for insurance company executives if finances could not be administered through the free market system. Regardless, while it may be hazardous to disrupt the system, sometimes you have to cover your bets .

I realized that I had only one chance to supply a demand that might be adopted by the group as a whole. I quickly consulted by colleagues in radiation oncology and came up with the following possibilities: Only Demand #1: Repeal SGR (just a spoonful of SGR makes the practice of medicine go down . . . possibly to extinction). Only Demand #2: Require that protocol groups remember the use of radiation therapy as a part of definitive treatment even when more and more exciting investigational systemic agents are made available. Only Demand #3: Eliminate terminology referring to the administering of radiation therapy as "frying," "cooking," "zapping," "incinerating," and, of course, "nuking." Only Demand #4: Prohibit attributing everything that goes wrong with someone for the rest of his or her life as being due to the radiation therapy delivered to a different part of the body ten years earlier or the radiation therapy course considered but never started. Only Demand #5: Assign stimulus money to support shovel-ready projects such as funding radiation oncologists' pension plans or forgiving loans for radiation oncology equipment.

Unfortunately, after having been hanging out in the park for the last five weeks, it seems that none of these are going to have a chance of getting to the first tier of Only Demands. This sabbatical, however, has allowed me to commune with my brother and sister reconstructionists and we have reached a consensus, unrelated to the fact that the weather is turning really intolerable , that we may have the wrong target . It is time to fight the real enemy .

Three reasons that our country has fallen on hard times are that the manufacturing base is disappearing, skilled jobs are being replaced by brainless service jobs, and we are becoming heavily indebted to the People's Republic of China. The primary perpetrator: Walmart. By starting Occupy Walmart, we can prevent people from buying tons of useless gadgets , inane wall decorations , accessories , pet food , toys , electronics , clothing , and a myriad of other items manufactured in China and require that domestic industries that can produce these goods will be resuscitated. We will keep our assets in the United States and become self-sufficient. In addition, hanging out at Walmart will provide a lot more access to shelter, food, and drinks than sitting out in the open in the middle of the city, especially now that winter's coming.

And, guess what? There are no Walmarts in New York City ! I'm heading for Palm Springs .