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Wednesday, February 20, 2002

A few weeks ago I took a weekend trip to Denver from my home in Billings, Montana. I arrived at the airport 90 minutes early as directed. Three minutes later I was ready to board, as things are a little slow in Billings at 0600 on Saturday morning. Two baby faced National Guard conscripts patrolled the airport trying to look tough.

Coming home from Denver was different. There were security checks everywhere with long lines. There was one line for people with no carry on baggage, so I skipped out of the long line and headed toward the mysteriously empty other line. It turns out it was closed. I looked like I was trying to run the gate. I was stopped and escorted to another screening area.

I took off my jacket, then my shoes. The humorless attendant then asked me to remove my belt. My pants won't stay up if the belt comes off, and I told him, which made him more irritable. Okay, I said, then hold up my pants. No. So I took off my belt, expecting the worse. By kind of bowing my thighs, I managed to hold it together.

What is effective terrorism? Some guy with a tablecloth on his head in a cave in Loserstan can force me to get up in the middle of the night to check into a community airport one day, and then force me to moon the Denver airport the next. Effective terrorism means not only killing thousands of people and collapsing huge buildings, it changes life for all of us.

A series of events over the last couple of weeks has me thinking along similar lines. The kickoff was the letter from the malpractice company announcing a 35% increase in premiums. Every three months each of my two partners and I will pay the equivalent of a new Chevrolet Suburban for something as utterly useless as malpractice insurance. With three small children eating fudge bars in the back of my 'Burb, I need a new one every three months to prevent spontaneous explosions. And unless I fly to Salt Lake City to attend a malpractice seminar, they will add 10%. (New underwear this trip for sure.)

Then there's the newspaper. Big ads with red borders and selective red lettering: Have you been in the ER lately? Have you had major surgery? Let us look at your medical record, we might find something. Not even bothering to mention whether you were injured or not. Just let us look.

Next my daughter hauls in the new phone book off the front porch. Now, of course, they sell advertising on the phone book, and guess what. Another law firm pushing medical malpractice, on half the front cover of the phone book I have to use for the next year. Now I know you guys in Florida and California are used to this toxic cloud, but when it hits Hooterville, its serious.

A summons arrived last week inviting me to sit on one of those medical-legal screening panels to hear a case about some poor guy in another town getting it for a sternal wound infection. Have you ever sat on one of those panels? Some lawyer reads to you from a three-edition-old Sabiston and mispronounces all the words. Please.

It changes life for all of us. Like the rock singer Sting quoth "Every breath you take, every move you make." Every interaction I have with a patient or really anyone in the business carries the greasy veneer of this stuff. Each patient you see could be THE ONE that dominates your life for the next three to five to seven years. It also seems (like the WTC and the Pentagon) that it is the one you don't see coming that gets you.

Is it harsh to call this predatory medical legal swamp a form of terrorism? Does it generate fear and mistrust? Does it cost untold billions? Do the lawyers get 50 virgins for every verdict over one million dollars?

So sue me. I am not going to scare the #$%& out of every little old lady I see about a valve or some terrified young father who's failed a couple of angioplasties. Yeah, there's risk, but enough is enough and I'm not going to let them make me take my belt off. My pants will remain defiantly up when some day, as I probably will, I rise to face the Judge.

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