DJP 10-12-2005 Update * more correspondence about hospital privileges and reflections

I write this as I fly above the clouds en route to Oregon for a meeting.  I am listening to Willie Nelson sing The City of New Orleans.  I will catch the redeye flight back to Baton Rouge to be in the audience for the meeting Friday of the Louisiana State Medical Society leadership and the Katrina-delayed installation of the incoming president of the LSMS, Dr. Floyd Buras.  Then will leave for New York on Saturday to give a speech there.  Doing my best to earn funds to pay for repairs.

A doctor replied to an email sent by my colleague, Dr. Jim Brown, requesting that Jim ask me to forward his (Soh) response to my letter (DJP Update 10-10-2005).

write palmisano and ask him to forward my response to his letter.  Soh

(Jim's letter is below that caused Soh to send the note above.)

I feel like John the Baptist crying in the desert or like the ancient mariner, who regaled the wedding guests with his tale of woe. Why does not the OPMS and LSMS issue immediate strong statements encouraging and even demanding that surrounding hospitals issue temporary privileges to any displaced physician in good standing with his prior medical staff? This certainly would take the moral high ground. Why should we have to document sinful behavior before embracing moral principles? Perhaps, some hospitals are issuing temporary privileges even as we ponder this. However, not all. Why should there be a 30 or 60 day wait for privileges in this time of strife? No harm would ensue from espousing principles of good and right behavior. Why, at this critical juncture in the history of medicine in New Orleans, should good and decent people and physicians be denied unfettered access to medical care? What does it cost to promulgate virtue?
 
jim brown

(Now Soh commenting on DJP 10-10-2005 Update)
I expected nothing less from a responsible and knowledgeable advocate for the fading professional.  I believe his discourse to accurately profile his passion for form and order, detail and substance, preparation and execution as an elective strategy.  But, I side with Jim Brown, that the mass displacement of over 6000 physicians over a 48 hour catostrophic natural disaster does not leave room or time for a measured elective response to an overwhelming need.  Greatness needs no introduction to act selflessly for the greater good of the fraternity(and sorority) of fellows all of whom recited the same oath and all of whom who should help each other as they would a stranger in need.  Some of us wear the mantle of leadership; some of us wear the mantle of activist followers rather than selfish consumers.
Stephen Owen Harkness, MD,FACS  Hurricane evacuee Physician and Surgeon willing to help with direction when called upon.
comment to be distributed as desired.


I thus have complied with the request of Dr. Harkness (Soh). The leadership of LSMS and AMA also are on my megalist so they are aware of these email discussions.

I do not plan to continue to send my megalist future various responses as time is of the essence in these critical times.  I write now only because I have the time on this plane flight.

But I do have some reflections and will share them because of my current location in a plane high above our great land of America.

Dr. Jim Brown's quest to get hospital privileges without delay for displaced physicians is a good one.  My previous observation in my 10-10-2005 was the methodology and my belief that the goal will have a greater chance for success if we quickly document the facts and have that information as ammunition in the debate ahead.  As you have heard me say in my AMA inaugural address in 2003, my Father taught me an important principle for success: Do your homework, have courage, and don't give up!  In our current situation, getting the facts is part of doing one's homework.

I also believe if one has an important goal to be accomplished, one has to get involved.  I will not repeat what I said in the 10-10-2005 Update.

I will say, in response to Jim's mention of John the Baptist and The Ancient Mariner, that the prophet John the Baptist lost his head and the Ancient Mariner worked hard but not necessarily in the smartest way to spread the word.

I will share some of my favorite poetry and a couple of songs that I believe illustrate some important recurring themes.

The words of those who lived in yesteryear ring true today, and, in my opinion, are appropriate for the terrible crisis wrought by Hurricane Katrina.

Have all of the elected officers in the medical society received the request?  Have you heard the obstacles to such a request?  Is there another way to quickly get it done?  Reasoned discussion surely will advance the cause.  As for "no time for a measured elective response" raised by Dr. Harkness, what about a reasoned emergency response?  A scientist makes decisions on facts.  In war, the leader of the warriors relies on intelligence gathering and planning done with the best available information.  If you want a reminder about that, read about the continued losses by the brave General George Washington in the revolutionary war that gave us this great land of liberty.  He was faced with many handicaps but overcame them with lessons learned and won a significant battle, his first win, when he crossed the Delaware into Trenton.  This reflection reminds me of a comment by Alexander Pope in his Essay on Criticism.

A little learning is a dangerous thing;
Drink deep, or taste not the Pierian spring;
There shallow draughts intoxicate the brain,
And drinking largely sobers us again.
>From an Essay on Criticism by Alexander Pope

Future generations may say the following quote from Ozymandias and substitute New Orleans if effective leadership at the national, state, and local level does not rise to the occasion.

I met a stranger from an antique land,
Who said: Two vast and trunkless legs of stone
Stand in the desert**.

And on the pedestal these words appear:
"My name is Ozymandias, King of Kings:
Look on my works, ye Mighty, and despair!"
Nothing beside remains.  Round the decay
Of that colossal wreck, boundless and bare
The lone and level sands stretch far away.
Ozymandias by Percy Bysshe Shelley
-------

But who, if he be called upon to face
Some awful moment to which Heaven has joined
Great issues, good or bad for human kind,
Is happy as a lover; and attired
With sudden brightness, like a man inspired;
And, through the heat of conflict, keeps the law
In calmness made, and sees what he foresaw;
Or if an unexpected call succeed,
Come when it will, is equal to the need*.
Character of the Happy Warrior by William Wordsworth
--------

Through all our history, to the last,
In the hour of darkness and peril and need
The hurrying hoofbeats of that steed,
And the midnight message of Paul Revere.
Henry Wadsworth Longfellow
--------

It matters not how strait the gate,
How charged with punishments the scroll,
I am the master of my fate:
I am the captain of my soul.
Invictus by William Earnest Henley

And in the song "I Believe" by Frankie Lane that followed the Willie Nelson selection on my IPOD are the words "Someone will come and show the way" as he sings about people going astray and the darkness of the night.
And that is why he believes.

So, I hope to see Dr. Jim Brown, my beloved friend and teacher, and Dr. Steven Harkness as well as all of the others who offer opinions, come to the LSMS meeting Friday and share their strong views on what needs to be done.  Learn what the obstacles are and how you can help overcome them.  Time is of the essence.  No one is too busy if the issue is important enough. 

If the poetry is not appreciated, well, that's life.

Stay well.
Donald

Donald J. Palmisano, MD, JD
DJP@intrepidresources.com

Lagniappe: By Thursday, at noon, our new roof will be completed!  I bought a trailer and a pickup truck and will be moving the trailer into our driveway for living quarters so that Robin and I can oversee the repairs in the months ahead.
Already had an experience of what can happen when one is not present during the repairs.  Won't bore you with that tale.