Dog Days

Everybody, say hello to Denver Pickles!

The dog, the legend, here he is...

He would love to jump out of the screen and into your lap, if you'd only let him...He won't bite, he doesn't pee in the house (well, um, usually), and he's an adorable wiggle-butt and snuggle-puppy.

It's Denver Pickles!

We don't care how they do it in New York, and apparently the feeling is mutual

I caught a glimpse of the NBC Nightly News last week and was surprised to see a feature story about Dr. Persharon Dixon, a pediatrician who left Atlanta to work with the local community health center here after the storm. The health center has her riding around in a mobile van, a rather ingenious setup. The van and her work is sponsored by the Children's Health Fund out of New Yawk.

The broadcast gave me a peculiar feeling of pride, revulsion, and anger.

Only the first emotion is directed at Dr. Dixon. I've met her, and she's a wonderful woman and pediatrician, very sincere and caring. I have nothing but good things to say about her.

The latter two emotions I reserve for the Children's Health Fund.

A mobile health van is a good thing. A community health center is also a good thing. But so are local pediatricians. I don't claim to know the timeline or organization of CHF's involvement with healthcare on the MS coast after Katrina, but I do know this: CHF sure as hell never called me. Not to ask what I thought the kids might need, not to ask how CHF might integrate into the existing health structure, not even how we might work together.

All right, Dr. Scott: be reasonable! They have no obligation to call every pediatrician on the coast. You are a private practice, they hooked up with a non-profit. Besides, they're here helping out, just be grateful and appreciative!

First, there aren't that many pediatric practices on the coast. Here in Hancock County there are three pediatricians, and one of them already works for the community health center. How hard would it have been to pick up the phone and call the other 2 pedi's here?

Second, and more importantly, good intentions are no excuse for arrogance, particularly when intruding on someone's home turf. The CHF has a press release which notes that Mississippi already had pathetic medical care before the storm, and a shortage of primary care physicians. That may be true, but not on the coast. Me and my colleagues are not ignorant back-woods hicks who need us a little edumacation from the big city experts. We need help, not competition. Yes, we can learn from CHF's experience, but they can also learn from ours.

And so, once again, the locals continue to toil for (what somedays appears to be) naught while the out-of-towners grab the attention. "Look! Look at what we are doing for these poor Mississippi children! Look how we are helping when no one else will!"

Go ahead, call it sour grapes. I know I have it coming. But when the spotlight leaves, will the local providers leave also? Having exhausted our resources, with no outside help for us, what will happen then? I hope CHF has a fleet of those mobile health clinics ready, because that's all that may be left for health care on the coast.

Tweaking

"We should meet. And we will meet. But I'm in the middle of a project that needs...tweaking."
--Joe Fox (Tom Hanks), "You've Got Mail"

The accountant is perusing my tax information, perhaps as we speak. But Dr. Scott has still been quiet and neglecting his blog.

I am in the middle of a major project that needs...tweaking.

Actually, two projects. One is a conference next month. I have been invited to speak about Katrina. I had a talk already prepared, it just needed updating. Then the conference organizer asked if I would prepare a second talk as well. So now I am dividing my talk in two: the first, as a "general interest" for pediatricians and spouses and invited guests, tells the Katrina Story from the days before August 29 through the present (and the future). It describes my personal experiences, as well as what the community as a whole has faced (and continues to confront). And I thank y'all for giving me the impetus to put Katrina Story in writing (even if a meager 7 chapters so far); it has been great rehearsal and even better organization for my scattered thoughts.

The second talk will now be about the medical lessons from Katrina: the illnesses, injuries, and environmental hazards after the storm (including, but not limited to: "Katrina Cough," MRSA, mosquitoes, black widow and brown widow spiders, and formaldehyde in FEMA trailers), the mental problems (PTSD, depression, anxiety, and "Katrina Brain"), and...for the first time anywhere...a critical look at long-term healthcare delivery in a disaster area.

I'm getting psyched just thinking about it, but I've got a couple of work-heavy weekends ahead in preparation for this.

I mentioned a second project. That one is actually far bigger and more important. But I am not at liberty to share the details with you at this time. Soon. It needs...tweaking. A lot of tweaking. Sorry to tease you like this, dear reader, but when I reveal my secret you will understand all. For now, I just wanted to let you know that you have not been forgotten; I've just been preoccupied with other matters of importance.

TTFN.

Death and Taxes

Yes, the blog has been quiet recently. I spent last week (especially the weekend) gathering receipts and whatnot for my accountant. It took many many hours, to which my wife asked, "if you've spent this much time already, why not just finish the tax form yourself?" To which I replied:

1. I don't know enough about depreciation, nor the items that may have been depreciated over the last 2 years.
2. I'd feel more comfortable handing it over to the accountant (transfer of responsibility).
3. I've got more important things to deal with right now.

Now I have to find a way to pay for the taxes. And that was another thing I did this past weekend: signed the final paperwork on my SBA loan. (This is the "Death" part.)

I am now owned by the SBA. Or rather, in a few weeks, my house will be. The SBA requires they be listed on the mortgage and deed. They also need receipts to verify all money has been used "appropriately." On the last, I pointed out that the loan is "payback" on money that was spent over a year ago. Still: no receipts, no more money. And if I get any future insurance settlements related to Katrina, it gets applied against the SBA loan. None for me.

It took 18 months to get to this point. And all so I can get 4% interest on a 30-year note.

I realize the government is trying to limit fraud and to make sure that the money is spent only on replacement needs caused by disaster. But, consider this:

At the same time I completed my SBA application - October 2005 - I went to my local bank for a "GO Loan." These were special short-term Katrina-zone loans issued by banks, with no interest, but they were due in 6 months. The GO Loan had a two-page application. I was approved, and received $25,000, in about 2 weeks.

While the SBA officer was very helpful and friendly, the SBA as an organization brings to mind the worst of sadistic bureaucracies. It makes the IRS look like a model of efficiency and kindness. There has GOT to be a better way to get money to people. And don't forget, we're talking LOANS, not GRANTS. Why couldn't the local banks handle this, just like they did the GO Loans? Just a thought.

Meanwhile, I need to think how to repay the SBA Loan, which is paying my taxes, which are the price I pay for starting and continuing my practice on the Gulf Coast. My, don't I feel privileged being here right now.