Monday, February 25, 2019

Chemotherapy Ward: Facing My Worst Fears

Shafts of light from rows of windows illuminate the sterile room. A sallow-faced woman hooked up to an intravenous drip slouches in a oversized lounge chair.  Her bald head, cloaked by a crocheted hat, droops on her chest.  A toxic cocktail of drugs surges through her body as she naps.

A tube winds from a plastic bag to a port, a small disk inserted under the skin in her chest.  The drugs sap her strength and drain her energy.  From her looks, she appears to be in her 70's.  It's only a guess because cancer and chemotherapy sabotage the body, affecting your physical appearance.

As I approach the petite woman, I observe the hushed conversations swirling around patients seated in adjoining chairs.  Some patients read to pass the time.  Others watch television or listen to music.  The fortune ones have family sitting in comfortable chairs next to them, chatting quietly.

When I reach the woman, I see a blanket hugs her tiny frame.  She is experiencing chills. However, there are worst side effects.  Vomiting and nausea are the most common.  But the list of reactions is long: fatigue, infection, anemia, loss of appetite, digestive distress, anxiety and hair loss.  And more.

The anonymous woman is in the Infusion Center at the Mays Cancer Center in San Antonio, a facility affiliated with the UT Health Center and MD Anderson. I am present as a volunteer, offering snacks to patients.  It isn't my first visit to a chemotherapy ward.  But I still feel awkward and nervous.

The woman opens her sleepy eyes as I roll the squeaky snack car near her chair.  I tick off a list of snacks and surprisingly she opts for the ice cream.  With seemingly great effort, she stretches out her withered hand to receive the plastic cup.  She offers her thanks and a smile that warms the room.

As I move from patient to patient, I am amazed by their spunk, their grit.  They are determined to battle this cruel disease on their own terms.  One patient is dressed as if she is attending a fancy charity ball.  I remark on her colorful outfit.  "I won't let cancer define who I am," she says.

Some family and friends faithfully accompany patients to each treatment.  These angels of mercy kibitz with their loved ones, providing a welcome distraction. But it is the patients who are fighting alone who tug at my heartstrings.  Who consoles these souls?  I pray they will be comforted.

These patients are hidden from most of society who will never view the inside of a cancer treatment facility.  Their sufferings go unnoticed and unrecorded except by the doctors, nurses and families who care for them.  Perhaps, if more people witnessed, the war on cancer would be our nation's priority.

According to the American Cancer Society, the latest figures show there were an estimated 1,688,780 new cases of cancer reported in the United States in 2017.  That same year cancer claimed 600,920 lives.  It is our nation's second leading cause of death, eclipsed only by heart disease.

Older Americans, like the fragile patient snuggled in the blanket, are especially prone to the disease as they age. Seventy-five percent of all newly diagnosed cancers occur in people aged 60 and over, according to research by the World Health Organization (WHO).

For many patients, chemotherapy is the regimen of treatment.  A powerful legion of drugs is administered to patients to target cancer cells.  Unfortunately, these drugs also affect healthy cells, weakening the immune system.  In the best outcomes, chemo wipes out cancer cells forever.

Those are the lucky ones.  For others, the chemotherapy cannot cure or arrest the spread of cancer. Potent drugs may temporarily shrink tumors, but they often return with a vengeance.  However, if the cancer is detected early enough, chemo saves lives, even as it ravages the body, mind and soul.

I focus on good outcomes as I greet each patient in the Infusion Center. I find hope in this place that once depressed me. Suffering exists but so does healing. I cringe when I contemplate I may end up here one day.  Good health is no guarantee. Cancer is an insidious evil always hunting new victims.

There are even occasions of joy in this antiseptic place.  When patients complete their last course of treatment, they ring a Victory Bell as they exit the Infusion Center.  Often family and friends are there to celebrate.  A loved one usually videos the ceremony to preserve this triumph of life.

Now that I have been roaming the cancer treatment facilities at the Mays center for several years, I have a new perspective.  I see the patients as part of our community, not diseased, anonymous individuals. They are fathers, mothers, sons and daughters.  Their sole purpose is to beat cancer.

Their lifespan is measured not in years or months or even days.  Each hour is a blessing to be cherished.  My brief encounters with these courageous patients are inspirational.  I forget whatever troubles have squeezed into my life.  They are trivial compared to fighting for another day of life.

When I reflect on the beginning of this volunteer journey, I am embarrassed I was reluctant to venture into the unknown realm of a cancer ward.  However, with introspection and time, now I look forward to seeing these warriors.  I realize I am among heroes and heroines.  That is my reward.

Sunday, February 17, 2019

Medicare For All: Surest Way To Bankrupt America

Democrats, egged on by the party's rising socialist wing, are recycling a free health care idea with a shiny new label.  They are advocating "Medicare for All" with the lure of no co-pays, no deductibles and no-cost sharing.  Free healthcare for everyone.  It's political seduction.

A similar idea was first trotted out in 2016 by former presidential candidate Vermont Sen. Bernie Sanders, an avowed socialist. The 77-year old independent won over swooning young people with his Utopian idea of free healthcare.  But the scheme faded along with Sanders' presidential aspirations.

Then 29-year-old first-term Democrat Rep. Alexandria Ocasio-Cortez burst onto the political scene in January, resuscitating the concept with a catchy twist, "Medicare for All."  When the idea fueled flattering media coverage, many Democratic presidential candidates leaped on the bandwagon.

Ocasio-Cortez, a member of the Democratic Socialists of America, is a fervent disciple of a single-payer system.  Under her plan, all healthcare financing is provided by one entity, in this case the federal government.  Everyone receives coverage, regardless of income, occupation or health status.

With single-payer, about 156.1 million people covered by employer health insurance would be forced to give up their plans.  Private insurance firms would cease operations leaving every American solely dependent on the federal government for primary health coverage.  There would be no other choice.

Despite the allure of a government freebie, healthcare would not magically become free.  People may not pay the doctor, however, Americans will be on the hook for a steep bill for healthcare in the form of higher taxes and budget deficits.  The tab for the plan worries economists and financial experts.

Bloomberg News, a liberal media voice, unveiled an analysis of "Medicare for All" prepared by the libertarian Mercatus Center at George Mason University in Virginia.  Assuming the program was launched in 2022, the price tag for the first ten years ranged from $24.7 trillion to $34.7 trillion.

All those zeroes are difficult to grasp without some perspective.  For instance, the total federal spending for providing Medicare coverage in fiscal year 2018 was $712 billion.  Expanding the plan to cover all Americans would append an estimated $3.7 trillion annually to the cost of the program.

The government can barely afford its existing healthcare obligations.  The latest Medicare Trustees report released in 2017 calculated that the Part A Trust Fund, which covers payments for hospital care, will be exhausted in 2026.  That's three years earlier than the previous year's estimate. 

Consider in fiscal year 2018 total federal government spending stood at $4.1 trillion. Adding another $3.7 trillion would increase the nation's debt while triggering catastrophic tax hikes. America's debt has already crept past $22 trillion, double the amount at the end of 2008.  More debt is not free.

In the last fiscal year, taxpayers ponied up $364 billion in interest payments for the nation's ballooning debt.  That represented 8.3 percent of the federal government's total budget.  With interest rates rising, each new dollar of debt will be more costly to finance, hiking future interest payments.

Democrats' solution is to raise taxes on billionaires.  That always polls well with voters.  However, even if the Internal Revenue Service confiscated the current entire wealth of American billionaires--$2.39 trillion-- the figure would not even cover one year's worth of costs for "Medicare for All."

The economics of "Medicare for All" have already discouraged a several states from enacting their own ambitious single-payer healthcare programs. Last month North Carolina deep-sixed its plan after the costs were estimated at $101 billion a year.

Even that liberal bastion of free, California, pulled the plug on single-payer legislation even after it was approved in the state senate because questions cropped up about the source of funding $400 billion in annual costs.  Vermont also abandoned a copycat plan over the bloated expenditure.

For the sake of argument, let's assume "Medicare for All" becomes a reality.  The plan will exacerbate a problem no proponent ever talks about while plugging the virtues of Medicare, a program originally designed to cover seniors 65-years old and up.

Medicare coverage is no panacea.  It pays for substantially less services than private insurance plans offered by companies to their employees.  For example, it will not bear the expense for long-term care, most dental care, eye exams for prescription glasses, hospice care or routine foot care.

Ocasio-Cortez counters her plan will tack on vision and dental care under "Medicare for All." A grandiose gesture but Medicare reimburses doctors anywhere from five-to-40 percent less than private insurers for the same services. As a result, thousands of doctors no longer accept Medicare.

It is inconceivable dentists and ophthalmologists would agree to reduced reimbursement schedules after never having to take such a haircut for fees.  Physicians have operated under the Medicare burden for years and they are bailing.  Why would these specialists accept Medicare patients?

In 2013, an annual report by the Medicare Payment Advisory Commission, an independent congressional agency, found that nearly one-third (28%) of its beneficiaries had trouble finding a primary care physician willing to treat patients with Medicare coverage.

Every year more doctors are hanging out signs in their lobbies that read: "Not Accepting New Medicare Patients." According to the Centers for Medicare and Medicaid Services, 9,539 doctors quit serving patients with Medicare in 2012 because of lower payments for fees.

If millions of Americans are added to the rolls of Medicare, there is the looming threat more doctors will follow suit.  What good will Medicare coverage be if your primary care physician no longer accepts the plan?  "Medicare for All" advocates appear unconcerned about this prospect.

Even if doctors are coerced into taking patients with Medicare, there will be an insufficient number of primary care physicians to handle the anticipated increase in office visits.   According to national projections, there will be a shortage of 200,000 primary care physicians by 2025.

Before Americans fall in love with "free" healthcare, they would be advised study the consequences of such a plan. However, don't expect politicians to enlighten the populace.  They believe they can dupe naive American voters by just repeating the word "free" over-and-over-and-over.

Monday, February 11, 2019

What's Driving Push For Late Term Abortions?

Democrats are unfurling legislation in states across the country to expand laws allowing abortion up to the point of birth.  An early success in New York state has ignited a wave of similar proposals, fueling a simmering national debate that is roiling an already contentious political climate.

The initial shot was fired last month when the Democratic-controlled New York legislature authorized sweeping new measures to allow so-called late-term abortions.  The bill was promoted under the pretense to save women from traveling out of state for abortions after the 24th week of pregnancy.

The bill doesn't just preserve abortion rights, which are legal in every state, it allows the procedure past the 24th week if the health of the mother is endangered, which can be interpreted as mental or emotional conditions.  Governor Andrew Cuomo, a Catholic, championed the legislation.

A similar law was voted down in the Virginia legislature after an advocate, Kathy Tran, described the grisly details of a life-or-death decision occurring even as the baby is being born.  That chilling prospect had opponents labeling the law "infanticide." Virginia's Democrat governor backed the law.

Vermont lawmakers are considering a bill that would go beyond the New York law. The proposal would allow for the procedure to be performed up until the point of birth for any reason.  The proposed law states "a fertilized egg, embryo or fetus shall not have independent rights" in Vermont.

Americans might be bewildered by this blitzkrieg for extending term limits on abortion.  A Marist poll of adults nationwide found that 76 percent of Americans favor limiting abortion to the first three months of pregnancy. That number included 60 percent of adults who self-identified as pro-choice.

No evidence was presented during the New York debate to suggest women are clamoring for the right to abort babies up until the moment of birth.  It begs the question: Why was the Democratic dominated legislature aggressively pushing this agenda?

No factual argument can be made there is limited access to abortions in the United States.  Just since 2000, there have been 11,204,207 legal abortions, according to the Center for Disease Control and Prevention (CDC). The abortion rate in 2015 was 118 abortions for every 1,000 live births.

In New York, the state's figures were among the highest in the nation.  A CDC report shows New York City preformed 544 abortions for every 1,000 live births. That means about one in three unborn babies were aborted.  Abortion access is a red herring to promote the aggressive expansion.

To justify their campaign, Democrats are spreading fear that the current Supreme Court will limit the right to an abortion.  This smoke screen is one Democrats have used ever since the landmark Roe vs. Wade high court decision in 1973 confirmed a women's right to have an abortion.

After 46 years, the decision remains intact.  To demonstrate the folly of their claims, last week the Supreme Court voted 5-4 to temporarily block a Louisiana law that placed restrictions on abortion clinics, requiring providers to have admitting privileges at a nearby hospital.

Isn't it time for Democrats to stop using this canard?  The late-term abortion issue has nothing to do with their fabrication of a Roe vs. Wade reversal. The party is eyeing the pivotal 2020 presidential election and planning to once again play identity politics with a "women's right to choose."

Their new tactic is to force Republicans to try to defeat this legislation so Democrats can smear the party as misogynist, Neanderthals who want to enslave women and deny them the right to control their bodies.  It is right out of the Democrats antiquated playbook to galvanize their female base.

But Democrats may have miscalculated Americans' sentiment on this issue.  As polling suggests, there is little support even among pro-choice advocates for ending the lives of babies seconds before birth. When the procedure's macabre details are explained, most Americans recoil in horror.

The latest CDC data found 91.1 percent of all abortions are performed less than 13 weeks after pregnancy.  Fewer than 1.3 percent are done after 21 weeks.  There are no facts to suggest there is an unmet demand among women for late-term abortions.  Any "evidence" is anecdotal at best.

Democrats and their accomplices in the news media appear to be guilty of overreach on this issue.  They may be surprised by the blowback from voters outside liberal states such as New York.  Virginia is a case in point.  But don't expect that prospect to alter their political skulduggery.

Monday, February 4, 2019

Writing The Great American Novel

When I retired, a slice of my identity died. For the first time in 40 years, I was unemployed.  What would I do the rest of my life? The question lingered for months while I over indulged in my favorite pastime golf. Soon almost daily rounds of golf became too much like a job. Now what? 

Then one day a thunderbolt of inspiration struck.  My passion has always been writing.  No longer shackled to an office desk, I could pursue my dream of becoming an author.  Fantasies of a best-selling novel danced in my head.  Book tours.  Autographs.  A blockbuster movie.  I was smitten. 

My first move was to gather data.  I pored over books on how to become a published author.  I boned up on what themes and genres appealed to publishing houses. Along the way, I discovered the odds of getting a novel published are astronomical.

Consider the facts: there are a few thousand literary agents.  Each one receives an estimated 10,000 queries from aspiring writers.  Do the math.  About 65,000 new books are published annually, most by established authors.  A new writer has a better chance of winning the lottery.

Undeterred, my fingers flew across my keyboard as I drafted my first novel.  It was exhilarating as the shape of a book appeared on my computer screen.  After I completed the masterpiece, I handed it to Dianna to read, expecting breathless praise.  Instead, she uttered the sad truth.  It reeked.  Skunky.

My ego shattered, I stewed over her assessment.  In reviewing the work, I arrived at the same conclusion.  It lacked drama, empathetic characters, structure and a few colons.  It was consigned to the trash along with leftover pizza.  In hindsight, I had little enthusiasm for the subject matter.

Being an author was harder work than I imagined.  Just before admitting defeat, we were vacationing in New York City when Dianna announced she had a dream the previous night about diamonds.  She thought it would be a good subject for a book.  I politely smiled and nodded absently. Whatever.

While she shopped, I ducked into a book store and scanned the shelves for tomes about diamonds to satisfy my curiosity.  I flipped the pages of a few books.  Then I spotted a magazine with an article speculating that Bin Laden had been peddling raw diamonds to finance his terror network. 

Arriving back in San Antonio, I researched every news article, book and archive for information about the Bin Laden story.  There were tantalizing tidbits but mostly hearsey.  That meant, as a novelist, I had a license to write my own fictionalized story based on a smidgen of facts.

As I dug deeper, I discovered evidence.  According to news reports, Bin Laden's jihadists had struck deals to acquire $30 million in so-called blood diamonds before the attacks of 9/11.  The diamonds came from mines in Sierra Leone.  The stones route from Africa to Bin Laden remained a mystery.

I pounded the keyboard for nearly a year, writing chapter-after-chapter.  The pacing of the book was much faster than my flawed original.  I wanted a page-turner no reader could snooze through. The copy was littered with facts about diamonds, ruthless dealers and secretive diamond trading.

The finished product in hand, I began the process of marketing the book, contacting a carefully researched cadre of agents who handled new authors.  A one-page letter and a one-page synopsis of the book was shipped to a dozen literary highbrows.  Then the waiting game began.

Agent replies dribbled into the mailbox.  The first to land were a couple of form letters with the salutation, "Dear Author."  That was the certain kiss of death.  Then a few brighter notes showed up.  One agent praised the idea of the book, but declined because she wasn't accepting new clients.

Just when my hopes were fading, two agents dispatched encouraging letters seeking the first two chapters of my book, titled "Terror Diamonds."  My pulsed quickened.  My ego soared.  I dashed off the chapters and waited.  And anxiously fretted.  Finally, two emails dropped into my inbox.

There were platitudes about the writing style, the plot and the research.  But the two agents passed.  No reasons were given for their decisions.  I fumed for a couple of weeks before working up the courage to query the agents for explanations.  Both declined.  "We don't do that," was the answer.

In a last ditch attempt to salvage my book, I fired off another round of letters to dozens of agents. More rejections knocked the stuffing out of my ego.  Deflated, I reluctantly surrendered my dream. I wasn't going to be a best-selling author.  I wasn't even going to get a single word published.

Today I have reconciled myself to treasure the experience of writing a book. Lots of folks talk about penning a novel.  Not many actually finish one.  I feel better for having tried and failed.  I never have to regret what might have been.  That provides a scintilla of balm for my journalistic self esteem.

I remain a voracious consumer of books.  Once in a while, when I read a novel I discern a fuzzy plot or misplaced comma.  I think, "My book is better than this dribble."  But so what?  This writer won the publishing lottery. That's something to admire because most of us will never experience it.