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Pima County Medical Society February 2012

Home Medical Society of the 17th United States Surgeon-General

Conrad Murray’s prime error

Training in on Dr. Ken Sandock

How Europe got hooked on our Old West

2 SOMBRERO – February 2012
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Official Publication of the Pima County Medical Society V o l . 4 5 N
Official Publication of the Pima County Medical Society V o l . 4 5 N

Official Publication of the Pima County Medical Society

Vol. 45

No. 2

Pima County Medical Neil Clements, MD Michael Connolly, DO Bruce Coull, MD (UA College of
Pima County Medical
Neil Clements, MD
Michael Connolly, DO
Bruce Coull, MD
(UA College of Medicine)
Alton “Hank” Hallum, MD
Evan Kligman, MD
Melissa D. Levine, MD
Lorraine L. Mackstaller, MD
Clifford Martin, MD
Kevin Moynahan, MD
Soheila Nouri, MD
Jane M. Orient, MD
Guruprassad Raju, MD
Scott Weiss, MD
Victor Sanders, MD (resident)
Cambel Berk (student)
Christopher Luckow (student)
Members at Large
Thomas Rothe, MD,
Society Officers
Kenneth Sandock, MD
Richard Dale, MD
President
Alan K. Rogers, MD
vice-president
Michael F. Hamant, MD,
secretary
Board of Mediation
At Large ArMA Board
President-Elect
Charles Katzenberg, MD
Bennet E. Davis, MD
Ana Maria Lopez, MD,
Vice-President
Timothy Marshall, MD
Thomas F. Griffin, MD
Charles L. Krone, MD
Pima Directors to ArMA
Secretary-Treasurer
John Curtiss, MD
Edward J. Schwager, MD
Eric B. Whitacre, MD
Timothy C. Fagan, MD
R. Screven Farmer, MD
Past-President
Timothy C. Fagan, MD
Arizona Medical
Delegates to AMA
Association Officers
PCMS Board of Directors
Gary Figge, MD,
past president
Diana V. Benenati, MD
R. Mark Blew, MD
William J. Mangold, MD
Thomas H. Hicks, MD
Gary Figge, MD (alternate)

Editor

Stuart Faxon

Phone:

883-0408

E-mail:

tjjackal@comcast.net

Advertising

Bill Fearneyhough

Phone:

795-7985

Fax:

323-9559

E-mail:

bill5199@simplybits.net

Art Director Alene Randklev, Commercial Printers, Inc. Phone: 623-4775 Fax: 622-8321 E-mail: alene@cptucson.com

Printing Commercial Printers, Inc., Andy Charles Phone: 623-4775 E-mail: andy@cptucson.com

Publisher Pima County Medical Society Steve Nash, Executive Director 5199 E. Farness Drive, Tucson, AZ 85712 Phone: (520) 795-7985 Fax: (520) 323-9559 E-MAIL: steve5199@simplybits.net Website: pimamedicalsociety.org

SOMBRERO (ISSN 0279-909X) is published monthly except bimonthly June/July and August/ September by the Pima County Medical Society, 5199 E. Farness, Tucson, Ariz. 85712. Annual sub- scription price is $30. Periodicals paid at Tucson,

Arizona. POSTMASTER: send address changes to Pima County Medical Society, 5199 E. Farness Drive, Tucson, Arizona 85712-2134. Opinions expressed are those of the individuals and do not necessarily represent the opinions or policies of the publisher or the PCMS Board of Directors, Executive Officers or the members at large, nor does any product or service advertised carry the endorsement of the society unless expressly stated. Paid advertisements are accepted subject to the approval of the Board of Directors, which retains the right to reject any advertising submitted.

Copyright © 2012, Pima County Medical Soci- ety. All rights reserved. Reproduction in whole or in part without permission is prohibited.

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CONTENTS



6
6

President’s Page

What Dr. Conrad Murray forgot about the doctor-patient relationship.

9
9

PCMS News

What’s up at Arizona Friends of Chamber Music; Walk With a Doc is here; fund-raising for U.S. Senate candidate Dr. Richard Carmona.

12
12

In Memoriam

Remembering pioneer urologist Dr. Stanley I. Glickman, M.D.

15
15

Behind the Lens

Dr. Hal ‘Travelin’ ’ Tretbar details how Europe goes gaga over our Old West.

18
18

Enthusiasms

What to dig about trains? Dr. Ken Sandock knows.

22
22

Reality Check

Nature-lover Dr. Michael S. Smith performs a checkup on the seasons of his life.

23
23

Perspective

Dr. George Makol has an ‘ObamaCare’ critique

D E P A R T M E N T S

Membership Conferences & Seminars Members’ Classifieds

7

26

26

& Seminars Members’ Classifieds 7 26 26 On the Cover Tombstone NOT. Not even Old Tucson.

On the Cover

Tombstone NOT. Not even Old Tucson. This 1969 photo of a Yugoslavian Western movie set has a little transparency fade from is Kodacolor negative, but it still looks like the American Old West that Europeans came to love. See this month’s Behind the Lens (Dr. Hal Tretbar photo).

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SOMBRERO – February 2012

5

PrESiDENT’S PagE

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Sometimes it’s good to be fired

So what exactly went wrong with Conrad Murray, M.D.? How could an educated cardiologist get so far off track and end up killing someone with a medical treatment no one would do at home? Tucson-trained and financially stressed Dr. Conrad Murray was working out of a shabby clinic in Houston when person- al friend Michael Jackson, one of the most famous people in the world and arguably one of its most eccentric, asked

him to provide medical services for his upcoming tour. Dr. Murray, for $150,000 monthly and a chance to associate with the King of Pop, was attracted enough to leave his patients and practice behind and take the job. Apparently, one of Michael Jackson’s problems was insomnia so intractable (I am speculating here) that he pressured Dr. Murray to give him ever-escalating doses of hypnotics. Normal sleep medica- tions would not work, so Dr. Murray resorted to stronger and stron- ger regimens until Jackson famously stopped breathing and died. Dr. Murray was in the next room on the phone with his girl- friend while the propofol was running. Cell-phone records fix the exact moment trouble started. I imagine the conversation ending abruptly with something like: Oh, sorry baby, something’s come up, gotta go. The call was followed by a long 82 minutes before the embarrassed physician reached 911. I defer to my anesthesiology friends on the following point, but to me propofol-induced unconsciousness is a far cry from healthy sleep. Sleep is a very active process in the brain. Anesthetics simply “turn off” neurons preventing whatever it is the brain does during real sleep. As a result, I am sure, Michael Jackson felt more and

sleep. As a result, I am sure, Michael Jackson felt more and Dr. Alan K. Rogers

Dr. Alan K. Rogers

more sleep-deprived as time went on, and so demanded more and more sleep medication. The issue that stands out so glaringly though, and largely over- looked by media, is Dr. Murray’s failure to do what any of us would have done, and that is to have refused Michael Jackson. And why could Dr. Murray not refuse Michael? Because of an improper doctor-patient relationship. Dr. Murray should have said: “I’m sorry Michael, but propofol is not a good idea.” To which Michael Jackson would surely have replied: “You’re fired, Dr. Murray.” But Dr. Murray did not say the right thing because the patient was in charge of the relationship. Any cautious and ethical physician would have been fired from this job and would have been grateful for it. Fame and fortune cannot become drugs that cloud the physician’s judgment. A doctor-patient relationship that features a patient with more power, fame, money, or influence than the physician is a recipe for disaster. A delicate balance must be maintained between being friend and adviser to the patient, and being the patient’s parent. The physician must always be the authority and must be in com- mand. The patient is free to not heed the physician’s advice, but should never dictate orders to the doctor. So does this issue come up in our everyday practices? All the time. All of us have VIP patients, personal friend patients, and chronic pain patients, to name a few, who challenge the proper doctor-patient rela- tionship. In my practice some patients just have bigger personalities than I do and they bowl me over. Do you have patients like that? None of us likes losing a patient, and particularly not when a patient has fired us and switched to another doctor. But being fired is the right thing at times. When that overwhelming patient wants treatment that is risky or unneeded, it takes character to say no. So now I am bracing myself to say “No” the next time Elvis comes in for a refill of his medications.

myself to say “No” the next time Elvis comes in for a refill of his medications.
myself to say “No” the next time Elvis comes in for a refill of his medications.

MEMbErSHiP

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Our newest members

Please welcome these eight physicians and a medical student to the Pima County Medical Society. Membership is our strength!

Benigno F. Decena, M.D.

Dr. Decena has joined Pima Heart Physicians, PC at 2404 E. River Rd., Building 2, Suite 100. He is board-certified in IM and clinical cardiac electrophysiology, and his clinical practice fo- cuses on the diagnosis and treatment of cardiovascular disease. He graduated from Jefferson Medical College of Thomas Jefferson University, Philadelphia, in 1992, and completed residen- cies in physical medicine and rehabilitation at New York Presby- terian Hospital and in IM at Rhode Island Hospital, Providence. His fellowships include Fletcher Allen Health Care, Burlington, Vt. in cardiovascular disease, and Washington (St. Louis, Mo.) University School of Medicine in clinical cardiac electrophysiology. Dr. Decena’s office phone is 696.4780.

David A. Gortner, M.D.

Dr. Gortner, board-certified in IM, has joined the University of Arizona Health Network at 1891 N. Orange Grove Rd.

He is a 1967 graduate of the University of Minnesota School of Medicine, where he also completed his residency. His office phone is 694.8900.

Shayna Caroline Klein, M.D.

Dr. Klein graduated from University of Albany Medical College in 2003 and has now joined Radiology Ltd. at 677 N. Wilmot Rd. She completed her radiology internship and residency at Albany (N.Y.) Medical Center, and a fellowship in radiology at Beth Israel Deacon- ess Medical Center in Boston. As a board-certified radiologist, her practice focus is diagnostic radiology. She can be reached at 795.2889.

Jason S. Oliphant, M.D.

Dr. Oliphant graduated from Yale University School of Medi- cine in 1998. His practice is at Radiology Ltd., 677 N. Wilmot Rd. He completed his internship at the Hospital of St. Raphael (Yale Medical School), New Haven, Conn., and residency in diagnostic

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radiology and fellowship in musculoskeletal radiology) at Wash- ington University, St. Louis, Mo.

Paul R. Strautman, M.D.

Dr. Strautman currently practices at Radiology Ltd., 677 N. Wilmot Rd. He is a 1985 graduate of the UofA College of Med- icine, and completed his internship at Good Samaritan Region- al Medical Center, Phoenix in 1986, and his residency at the University of Arizona Health Sciences Center. Dr. Strautman is

board-certified in radiology and his clinical interests include vascular and interventional radiology. He can be reached at

795.2889.

Christine C. Pletkova, M.D.

Dr. Pletkova is a 1981 graduate of the University Karlovy in the former Czechoslovakia. Her practice is at University of Ari- zona Medical Center—South Campus, 2800 E. Ajo Way, Tuc- son. The board-certified psychiatrist focuses her practice on general, child and adolescent psychiatry. She completed residencies in psychiatry at St. Elizabeth’s Hospital, Washington, D.C., and in child and adolescent psy- chiatry at Children’s National Medical Center, Washington, D.C. Dr. Pletkova may be reached at 874.7572.

Mary E. Rimsza, M.D.

Dr. Rimsza practices pediatric medicine on a part-time basis. She is a 1974 graduate of Hahnemann University School of Medicine, Philadelphia. She served her residency in pediatrics at Phoenix (Ariz.) Hospi- tal, and is board-certified in adolescent medicine and pediatrics.

Mingwu Wang, M.D.

Dr. Wang currently practices at University of Arizona Medi- cal Center—South Campus, 2800 E. Ajo Way, Tucson. His clinical/research interests include treatment and surgery for common eye problems, cataracts, glaucoma, diabetic retinopa- thy, and age-related macular degeneration. He also specializes in pterygium removal and eyelid plastic surgeries. He is a 1987 graduate of China Medical University, and served an IM residency at Maryland General Hospital, Balti- more, and an ophthalmology residency at University of South- ern California, Los Angeles. Dr. Wang is board-certified in IM and ophthalmology. He can be reached at 321.3677.

Cambel Berk (Student Membership)

Ms. Berk is currently attending the University of Arizona School of Medicine and is scheduled to complete her studies next year.

of Arizona School of Medicine and is scheduled to complete her studies next year. 8 SOMBRERO

PCMS NEWS

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By Jean-Paul Bierny, M.D., AFCM President The Arizona

By Jean-Paul Bierny, M.D., AFCM President

The Arizona Friends of Chamber Music (AFCM) is a presti- gious 65-year-old non-profit organization that brings to Tucson the finest, most exciting chamber music from all over the world. Every year we present three outstanding series of concerts: our Evening Series of six concerts, our Piano and Friends matinee series of three concerts, and in March, our week-long Tucson Winter Chamber Music Festival. All our concerts are in the Leo Rich Theater at the Tucson Conven- tion Center. In addition, we have a unique commissioning program and an extensive educational outreach program. We invite you to take a look at our website by logging onto www.arizonachambermusic.org . We hope you will join our mailing list to receive announce- ments about our concerts. Simply scroll down the homepage of our website to “Please join our email list!” and sign in. We can promise you great music played by musicians of the highest level. Here is the schedule of our coming concerts for this season:

Piano and Friends (Sunday Matinee Series)—3 p.m. 2/5/12: Elena Urioste, violin and Michael Brown, piano (US). Evening Chamber Music Series—7:30 p.m. 2/22/12: Kalichstein-Laredo-Robinson Piano Trio (NYC), with Michael Tree (viola), and Harold Robinson (cello). 3/21/12: Mandelring String Quartet (Germany) with Katarzyna Mycka, marimba (Poland). 19 th Annual Tucson Winter Chamber Music Festival Sunday, March 4, to Sunday, March 11, with a Gala Dinner Concert on Saturday, March 10 at the Arizona Inn.

Balseraks fund-raise for Dr. Carmona

10 at the Arizona Inn. Balseraks fund-raise for Dr. Carmona On Feb. 18, 5:30 to 7

On Feb. 18, 5:30 to 7 p.m., at 6434 E. Santa Aurelia, Tuc- son Country Club Estates, Dr. and Mrs. Jim Balserak will have a fund-raiser for Dr. Rich- ard Carmona, 17th U.S. sur- geon-general, for his run for United States Senate. Please e-mail bladef16@ juno.com by Feb. 12 to RSVP in the positive.

Dr. Spark on tobacco tracking commission

UofA College of Medicine Clinical Associate Professor of Pa- thology Ronald P. Spark, M.D. was recently appointed to the To - bacco Revenue Use, Spending and Tracking Comission. Arizona House of Representatives Speaker Andy Tobin notified Dr. Spark of the appointment Jan. 3. The commission’s purpose is to advise and consult with the Arizona Department of Health Ser- vices on the goals, objectives, and activities or programs that receive funds pursuant to ARS Section 36-722. Organizations represented on the 14-person commission include two legislators, the heart and lung associations, American Family Insurance, Chicanos por la Causa, and the American Cancer Society Action Network.

‘Walks With a Doc’ scheduled

Pima County Medical Society, Carondelet Health Network, and El Rio Health Centers have joined a national organization, Just Walk/Walk With A Doc, and will stage programs for patients to walk with a physician in 2012. “All our missions involve improving public health,” PCMS Ex- ecutive Director Steve Nash said. “We want our neighbors all to be- come more active and one way to do that is to show them that they indeed can walk a mile.” Beginning in this month, PCMS, CHN and El Rio will each host one walk on three different Saturdays every month through May, and probably throughout the summer and into fall. Each walk will be led by a physician who will give a brief overview of the benefits of exercise and answer general questions during the walk. You can send your patients to any of the walks. Sample prescrip- tion pads were sent in the last newsletter. The walks are open to anyone, and the courses are generally flat with some small hills. Advise patients to wear comfortable shoes. They may bring a cane or walking stick, and a bottle of water. Be sure to have them dress for the temperatures. It is often cold by the Rillito. “Patents should be advised that a monthly walk should not be their only physical activity,” Nash said. “They are free to come again, but we really just want to give them the confidence—and a safe place—to start walking.” Walk schedules are posted at www.pimamedicalsociety.org. PCMS and Carondelet will use Rillito River Park. Have patients use the parking lot on the east side of Swan, just south of the bridge. The group will meet at the ramada by the water fountain. PCMS will walk Feb. 11, March 10, April 14, May 12, and June 9. For the February and March walks, please arrive between 7:30 and 7:50 a.m. Those two walks will begin at 8 a.m. April through June, please arrive between 6:30 and 6:50 a.m. Walks will begin at 7 a.m. For any questions, please call 795.7985. Carondelet Health Network will walk Feb. 18, March 17, April 21, and May 19. Please arrive between 7:30 and 7:45 a.m. Walks begin at 8 a.m. El Rio will walk at Rudy Garcia Park, 2 E. Irvington Rd. Walks

scheduled for now will take place Feb. 4, March 3, April 7, and May 5. Please arrive between 7:40 and 7:55 a.m. The walk will be- gin at 8 a.m. Just Walk/Walk With a Doc is a program founded in 2005 by David Sabgir, M.D., a board-certified cardiologist in Columbus, Ohio. It has spread to 40 sites throughout the country. Just Walk is a non-profit organization dedicated to encouraging healthy physi- cal activities for people of all ages and fitness levels. For more information about Just Walk, the website is www. walkwithadoc.org.

Red Cross reports on 2011 services

The American Red Cross reports that it fielded 137 major relief operations in what it called a “disaster-filled” 2011, saying that “at home and across the globe, Red Cross is a large part of the scene.” “The American Red Cross helped hundreds of thousands of people whose lives were forever changed by disasters in 2011, from tornadoes, floods, wildfires and hurricanes in the U.S., to earth- quakes and other disasters around the world,” they reported. “Throughout the year, the American Red Cross supported the people of Japan and Haiti, while launching 137 domestic disaster re- lief operations in 46 states and territories to help people affected by fires, floods, hurricanes and tornadoes in the U.S. In addition, major international disasters included the Japan earthquake and tsunami re- sponse, and continuing work following the 2010 Haiti earthquake.” Red Cross reported that in Southern Arizona in 2011, it provid- ed emergency services, including transitional housing, meals and clothing, to nearly 700 people whose homes were lost to fires, floods and other disasters. About 250 of those served were children. On the weekend after Jan. 8 when a crazed gunman shot 18 peo- ple, killed six and crippled Rep. Gabrielle Giffords (D-8), “Red

Cross dispatched mental health teams to provide debriefing and sup- port. Services were requested not only for Giffords’ staff and col- leagues at Pima County Democratic Party Headquarters, but also for about 200 attendees of a party convention taking place at nearby Rincon High School. Red Cross reached the scene within minutes as the crowd made its way to the headquarters building. In the follow- ing week, additional Red Cross mental health teams provided sup- port during the memorial services of those whose lives were lost.” Events of Jan. 8 inspired the American Red Cross to launch Ga- brielle Giffords Honorary Save-a-Life Saturday, which on March 19 provided free CPR and first-aid training at some 100 locations na- tionwide. “More than 11,000 people learned lifesaving skills that day—the very first-aid skills that saved lives here in our community. About 1,700 people were trained here in Giffords’ Southern Arizona District. “In February, when about 14,000 customers were without natu- ral gas service during a record cold spell, the Red Cross operated two shelters on Tucson’s northeast side for two nights, housing sev- eral dozen people. “As many states struggled with unprecedented numbers of wild- fires in June, the Southern Arizona Chapter fielded relief operations and three shelters in Cochise County during the Monument Fire, which burned more than 28,000 acres of forest. Nearly 60 families lost their homes. The chapter also provided relief workers for the Wal- low Fire, largest in Arizona history, consuming 817 square miles and causing nearly 6,000 people to be evacuated.”

Award honors telemedicine, UA med college

Ronald S. Weinstein, M.D., founding director of the Arizona Telemedicine Program (ATP) and Ana Maria López, M.D.,

M.P.H., ATP’s founding medical director, recently accepted the Association of American Medical Colleges’ inaugu-

ral “Readiness for Reform (R4R)” award for trans- formational programs in medicine, on behalf of ATP and the University of Arizona College of Medicine—Tucson, the university reported. “ATP, established in 1996, was one of only three institutional winners presented with the award at the recent AAMC Annual Meeting in Denver; each institution received $5,000 to forward their inno- vation programs in healthcare delivery. “The AAMC’s R4R Initiative seeks to identify academic programs developing transformative methods of addressing patient care, health educa- tion and research issues related to implementation of the Affordable Care Act. The R4R Award is sponsored by the AAMC’s Council of Teaching Hospitals. “During the award presentation, ATP was cited for creating ‘waves of innovative programs that have made a difference, including: integration of primary care between academic healthcare systems and community networks; revisions of care for spe- cific health disorders oriented to improve care qual- ity; and efforts to reduce care costs while achieving better outcomes.’” ATP developed and operates its own broadband

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PCMS 2012 meetings

Pima County Medical Foundation’s Evening Speaker Series is on the second Tuesdays in February, March, April, May, June, September, October, and November, often including CME. Watch for topic announcements in our “between Sombreros” newsletter. The ArMA Annual Meeting (delegates only) is June 1-2. Our coming Regular Membership Meetings are Tuesday Nov. 8, 7 p.m. including reading of the nominees slate, and Tuesday Dec. 11 after the Board of Directors meets, for ballot count and declaration of election winners. The PCMS Board of Directors and Executive Committee (officers only) meet:

BOARD:

EXECS:

Tues. March 27, 6:30 p.m. Tues. April 24, 6:30 p.m. Tues. May 22, 6:30 p.m. (Memorial Day May 30) Tues. Aug. 28, 6:30 p.m. Mon. Sept. 24, 6:30 p.m. (Yom Kippur starts Sept. 25) Tues. Oct. 23, 6:30 p.m.

Tues. Dec. 11, 6:30 p.m.

Wed. Feb 15 5:30 p.m. Tues. Mar 27, 5:30 p.m. Tues. April 24, 5:30 p.m. Tues. May 22 5:30 pm Tues. June 26, 5:30 p.m. Tues. Aug. 28, 5:30 p.m. Mon. Sept. 24, 5:30 p.m.

Tues. Oct. 23, 5:30 p.m. Tues. Nov. 13, 5:30 p.m. Tues. Dec. 11, 5:30 p.m.

PCMS information

Pima County Medical Society, founded in 1904, is at 5199 E. Farness Drive, Tucson, Ariz. 85712, in Tucson Medical Park off Rosemont Avenue from Grant Road. Office hours are 8 a.m.-4 p.m. Monday through Friday. Phone is 795.7985; fax 323.8558. After hours, an answering service can put you through to see if any- one is answering, or you may leave a message. Our back line for af- ter hours is 795.7986. E-mail: steve5199@simplybits.net. Our holiday closings this year are New Year’s Day Jan. 2, Me- morial Day May 28, Independence Day July 4, Labor Day Sept. 3, Thanksgiving half-day Nov. 21 through Nov. 23, Christmas Dec. 24-26, New Year’s Eve Dec. 30, and Jan. 1. 2013 New Year’s Day.

December monthly report

Referrals to physicians: 143 Meeting rooms occupied: 20.2 percent (8 a.m.-10 p.m., seven days per week) Executive Committee: PCMS President Timothy Fagan MD presided Dec. 13, 5:40—6:07 p.m. On a rainy night, the execs met in the back conference room of Dr. Fagan’s office to set the agenda for the evening and work on budget issues. Board of Directors: PCMS President Timothy Fagan MD pre- sided Dec. 13, 6:40—7:35 p.m. The board heard reports on •  Arizona Medical Board sunset hearing •  An administrative hearing after an AMB decision

•  Disability insurance for physicians •  Nuclear detonation training for first-responders •  Arizona Medical Association legislative efforts The board •  Considered an appeal from a Board of Mediation decision •  A resolution dealing with toys in kids meals and nutrition •  Passed several corporate resolutions to allow new bank signers  in 2012. Board of Mediation: Chairman Edward Schwager MD. An appeal from a Board of Mediation decision was given to the PCMS president. Public Health Committee: Jacob Pinnas M.D. presided Dec. 5, 12:35—1:36 p.m. Although there were no confirmed cases of Pima County influ- enza as of Dec. 5, 2011, the Pima County Health Department ex- plained a little about the process. Rapid tests will be sent to the state lab for confirmation; once one case is confirmed, all positive rapid tests are counted as an influenza case, despite the unreliability of the rapid tests. Committee members will meet with state representative Matt Heinz MD to discuss his mental health reporting bill aimed at stopping incidents like the shooting of Rep. Gabby Giffords. The Arizona Department of Transportation’s bike safety plan will be studied. The committee found that none of the major school districts in Tucson offer bicycle safety as part of the K-12 curriculum. The Bioethics Committee, Chairman David Jaskar MD, did not meet in December. The History Committee, Chairman James Klein MD, did not meet in December. Pima County Medical Foundation, Inc.: James Klein MD, president. Foundation members did not meet in December, but CME Chairman John Krempen MD met with THMEP director Robert Aaronson MD to work out details to make the Evening Speaker Series topics for 2012 better and more educational. Other members worked to make sure all letters and checks had been cashed, deposited or sent. Regular Membership Meeting: Dr. Timothy Fagan presided Dec. 13. Dr. James Klein acted as chief teller and gave the election re- sults. The minutes from November were passed. Odds & Ends: State representative and TMC hospitalist Matt Heinz MD met with Abraham Byrd MD at PCMS in early De- cember to discuss ways to avoid having another crazy man repeat the events of Jan. 8, 2011. Legislation may be proposed. PCMS continued work with Pima Community Access Pro- gram, USHIN, THMEP, Activate Tucson, the National Disaster Medical System, the Medical Reserve Corps, the Joint Technical Education District and the Andy Nichols MD Initiative, all of which had December meetings. PCMS is part of an effort to stage a CME “Exercise is Medi- cine” conference in March. Doctors Charles Katzenberg and Carol Henricks serve on the steering committee. As always, the Arizona Medical Association makes every effort to include Tucson physicians, and the December ArMA Legislative Committee was no different. A phone conference was arranged so PCMS physicians did not have to drive to Phoenix in the rain. Doctors Mike Hamant, William Mangold, Tom Rothe, Screven Farmer and Mary Rimza called in for an overview of the upcoming legislative session.

Farmer and Mary Rimza called in for an overview of the upcoming legislative session. SOMBRERO –

iN MEMOriaM

By Stuart Faxon



Dr. Stanley Glickman, 1917-2012

Dr. Stanley Glickman, 1917-2012 Dr. Stanley I. Glickman in 1984. the nursing staff at

Dr. Stanley I. Glickman in 1984.

the nursing staff at Michigan University Hospital. They were mar- ried in 1948 when they moved to New York City and Stanley took up his position at Mount Sinai.

“Stanley and Ruth had two children, Ran- dolph and Robin. In 1954 the Glickmans moved [north] to New Rochelle” where they lived for more than 20 years. “In 1976 Stanley and Ruth moved to Tuc- son, where Dr. Glickman took a position with the Arizona Health Sciences Center— VA Hospital, where he worked into his mid- ’80s. Ruth died in 1993. In 1997 Stanley married Annette Grubiss.” Dr. Glickman’s sister Sylvia predeceased him. “He will be greatly missed by his second wife, Annette; children Randolph and Robin; grandchildren Margaret, Trainor, Miller, and ZoeRose; and Annette’s sons Fred, Randy, and Stephen. Also surviving him are niece Hilary and nephew Noel.” Services were Jan. 9 at Evergreen Mortuary with Rabbi Thomas Louchheim officiating.

Evergreen Mortuary with Rabbi Thomas Louchheim officiating. Dr. Stanley Irwin Glickman, pioneer urologist who helped

Dr. Stanley Irwin Glickman, pioneer urologist who helped per- fect a common technique, and Associate PCMS member since 1984, died Jan. 5 in Tucson. He was 94. “He was born in New York City in 1917,” the family reported in the Arizona Daily Star, “the son of Victoria Miller Glickman and Joseph Saul Glickman, M.D. He grew up in New York City and at- tended Townsend Harris High School. Stanley then attended Co- lumbia College, where he earned his B.A. in 1937.” Along the way he became fluent in German, Spanish, and French. “He stayed on at Columbia where he earned his M.D. at the College of Physicians and Surgeons in 1941. He then moved to Michigan to take up a residency in urology at University of Michi- gan at Ann Arbor with Dr. Reed Nesbit, one of the most highly re- spected academic urologists in the country. This was a very produc- tive relationship. Doctors Nesbit and Glickman helped to standardize the procedure of transurethral resection of the prostate (TURP) and to overcome an obstacle to widespread adoption of the procedure: intravascular hemolysis accompanied by shock. Called TUR syndrome, it was caused by use of water as the irrigat- ing solution during the procedure. Following laboratory investiga- tions, Nesbit and Glickman identified glycine solution as the solu- tion of choice for bladder irrigation during TUR. Its use made TURP a much safer option for treatment of prostate enlargement.” Dr. Glickman “joined the faculty of Mount Sinai Hospital in New York City in 1948, where he worked for more than 30 years and achieved a reputation as a superb urological surgeon with a large practice. “While in Michigan Stanley met Ruth M. Kaiser, who was on

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bEHiND THE lENS

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Europe and our Old West: a romance

How many movie buffs know that 1960s suave movie star Lex Barker was better known for his cowboy movies that he was for his Tarzan series? How many film cognoscenti know that there were popular Yugoslavian strukli Westerns before Sergio Leone’s “spaghetti” Westerns became popular here? (Strukli is a Croatian sweet pastry similar to ravioli.) I realized all this in summer 2011 when I saw Lex Barker postcards in central Croatia at

the famous Plitivice Lakes. Why was he attired in buckskin? Why was he popular there? I asked our guide about this and he wrote “Winnetou” on a piece of paper, fol- lowed by “Karl May.” In the late 19 th century, German writer Karl May (pronounced My, 1842-1912) wrote cowboy-and-Indian stories even though he had never been to the American West. May was a ne’er-do-well ear-

been to the American West. May was a ne’er-do-well ear- Dr. Hal Tretbar One often hears

Dr. Hal Tretbar

West. May was a ne’er-do-well ear- Dr. Hal Tretbar One often hears German spoken on the

One often hears German spoken on the streets of Tombstone because modern Germans love the American Old West. Here, German re-enactors do a scene from The Treasure of Silver Lake.

ly on. While in prison for stealing a horse, he was assigned to the li- brary, where he began his literary inclinations. It is said that while there, he came up with the name for an Indian character, Winnetou.

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520.742.2845 520.648.3277 www.arizonahearing.com Novelist Karl May (1842-1912) in his prosperous years. He

Novelist Karl May (1842-1912) in his prosperous years.

He eventually became a prolific writer, and of the 13 novels and stories he wrote between 1893 and 1897, six were the adventures of Win- netou and Old Shatterhand. May wrote about a railroad surveyor, Charley, who befriended an Apache chief, Winnetou, and became his blood brother, named Old Shatterhand. Together they fought the archetypal bad guys who wanted to steal the gold mine from the damsel in distress, or to find the treasure of Silver Lake. And course they had to thwart the power-hungry cavalry

Winnetou and Old Shatterhand as Europeans know them. officer who wanted to foment conflict between

Winnetou and Old Shatterhand as Europeans know them.

officer who wanted to foment conflict between the Apaches and Comanches. May became the best-selling author in Germany. Even Hitler was said to be a regular reader. The books have been popular with all European children (and adults) even up to the present time. I talked to several Tucson physicians with European back- grounds. George Sokol, M.D. (Slovakia) is quite familiar with Win- netou and Shatterhand. He says that his cousins back home talk about them all the time. Cardiologist Dietmar Gann, M.D. from Germany was excited to discuss May’s cowboys and Indians: “I have a copy of one of the books, and I’ll let you know if I can find it. These stories may have been one of the reasons I came to Tucson.”

may have been one of the reasons I came to Tucson.” An unlikely Old West, the

An unlikely Old West, the Plitivice Lakes in Valley of Death.

Karl May had another recurrent character in his novels, Kara Ben Nemsi, who had exciting travels through the Ottoman Em- pire, even though May had not been there, either. He finally trav- eled from Egypt to Sumatra in 1899-1900. May did get to the United States in 1908, but didn’t get past the East Coast. May was born in Ernstthal, Saxony in what became, much later, part of communist East Germany that the totalitarians called the German Democratic Republic. In 1895, after he became success- ful, he built his last residence in Radebeul just outside Dresden and named it Villa Shatterhand. He and his wife Klara are buried there. In 1928 it was designated the Karl May Museum. During the Cold War the communists didn’t think much of

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Pierre Brice as Winnetou and Lex Barker as Old Shatterhand in Valley of Death. someone

Pierre Brice as Winnetou and Lex Barker as Old Shatterhand in Valley of Death.

someone who wrote about Indians in the American West, and they closed the museum. However, public opinion was such that it was reopened, and finally permission was given to make movies in Yugoslavia based on the Winnetou and Shatterhand novels. Northwestern Yugoslavia, now Croatia, had the ideal terrain for Western movie sets with both rocky mountains where the bad guys could ambush the stagecoach, and wide open spaces for tepee villages and frontier towns with saloons and sheriff of- fices. The blue-green Plitivice Lakes made for dramatic and col- orful backgrounds but it is a little strange to have an Apache princess paddle a birchbark canoe across the waters. The first, and some consider best movie was shot in 1962. It was taken from the book Der Schatz im Silbersee and retitled for interna-

tional distribution as The Treasure of Silver Lake. In all, 11 films were made between 1962 and 1968. French actor Pierre Brice made an ide- al handsome Winnetou. He usually teamed with Lex Barker as Old Shatterhand, a tall, rugged frontiersman with a wicked right upper- cut. Of course both were outstanding horsemen and rifle marksmen. Barker appeared in only eight of the films, while Stewart Granger was in three as the character Old Surehand. Rod Cam- eron played Old Firehand in one production. Lex Barker, as a blood brother, is the only one to be remembered as Winnetou’s partner. Three of the films had scripts not based on a May novel. As a side note, German actress Karin Dor, who played the Apache princess, took time off in 1967 to play the femme-fatale spy in the James Bond movie You Only Live Twice. The movies were shot in top-quality color, and became so successful in Germany that budgets increased each year for big- ger casts and sets. The famous title melody composed by Martin Boettcher was played on the harmonica by Johnny Muller. The Karl May books have had several Eng- lish translations. The movies with English subti- tles and the books are available on Amazon.com. In Germany today there are places where you can go to live the Old West experience. Sil-

ver Lake City is a Western theme park north of Berlin. No Name City is outside Munich. One of the more popular ones is Indiandorf (Indian Village), close to May’s birthplace of Hohen- stein-Renstthal, near Erfurt. Here is an 1870 village where you can belly up to the bar in the Charles Saloon, and the bank is robbed on schedule at noon, 2, and 4. In the summer, cowboys and the Indians surround the tepees. Jeep excursions are available in Croatia that will take you to the exact spot where Winnetou and Old Shatterhand shot it out with the des- perados. You can check it out on the Internet. In 1969, Dorothy, our son Brian, and I drove from Austria down across Yugoslavia to Monte- negro before taking the ferry to Italy. While driving across a barren plain in Croatia, we spot- ted some buildings that looked familiar. Sure enough, it was a first-class Western town movie set. It was built with intact interiors, but it was

was a first-class Western town movie set. It was built with intact interiors, but it was
was a first-class Western town movie set. It was built with intact interiors, but it was
was a first-class Western town movie set. It was built with intact interiors, but it was
was a first-class Western town movie set. It was built with intact interiors, but it was
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The stagecoach office and church in this movie set from 1969 show realistic buildings that included complete interiors.

starting to fall apart. The saloon, the church, the hotel, and the sher- iff’s office were all there looking as good as Old Tucson. I puzzled about this set for years and only now know it was part of strukli Westerns. And now for the latest on Winnetou and Old Shatterhand: The Aug. 11, 2011 issue of The Hollywood Reporter states that Michael Blake, who wrote the script for Dancing With Wolves, is going to adapt May’s work for a big-screen version to be shot in New Mexi- co starting in 2013.

version to be shot in New Mexi- co starting in 2013.     
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ENTHuSiaSMS

Story and Photos by Stuart Faxon



Love those trains!

Small wonder railroading has so many adherents. The history and romance of trains, and the sheer size and power of locomotives on tracks approach the irresistible. Among most male Baby Boom- ers, it would be odd if Lionel or American Flyer model trains were not part of their youth. In PCMS, physicians associated with local rail organizations in- clude Jim Klein, Ron Spark, George Sokol, and Ken Sandock. Certainly trains were irresistible to Dr. Sandock, of our History and Bioethics committees. The radiologist has been a PCMS mem- ber since 1983 and is board-certified in radiology and nuclear medicine. But had he not gone into medicine, he says he would probably have gone into “some kind of engineering or physics.” As with many enthusiasts, Dr. Sandock liked trains as a kid, “especially around Chicago. They are a blend of interests in travel, history, technology, and mechanics. I have videos of trains in places meaningful to me, and when I show them to people interested in those places, they suddenly like the train videos!” In short, he says of trains, “They’re fun and they go places.” Anyone might merely say they’re into trains. Dr. Sandock walks the walk. He keeps up on everything railroad, from how each part of a steam locomotive works to modern Amtrak operations. He is a member of Old Pueblo Chapter of the National Railway Historical Society, at which members show trip photos, see videos, and learn train lore from each other. He volunteers with the Southern Arizona Transportation Muse- um, and when we first talked to him in November 2011, he was set to go to Vail to help with the local visit of Union Pacific steam lo- comotive No. 844. He says he’s “mechanically inclined,” and that “steam engines have a lot of mechanics to work with.” He has done work for Tucson’s Gadsden-Pacific Division, Toy Train Operating Museum, though he is not a home model railroad- er. “I work for them under the table—literally,” he puns. “Anything they can set up, I can make it work for them with wiring under the table. Their room is bigger than the PCMS conference room.” The lengthily-named GPD-TTOM (www.gpdtoytrainmuseum. com) is a 501(C)(3) non-profit organization dedicated to the model railroading hobby by providing the public with an interactive muse- um of operating toy train layouts and displays.

Anyone who seeks a model engine or car to reminisce can come to one of the GPD swap meets, where many dealers have used model rail cars, equipment, and books at low prices.

Last year the local NHRS chapter took a Verde Valley rail excursion with 15 people, half from PCMS, Dr. Sandock said, including himself and Dr. Stan Levin and his wife.” He notes that “the long-distance railroads helped our National Parks develop as tourism attractions, and in turn the park destina- tion helped grow the number of passengers.” Today’s Grand Can- yon Railway descends from these origins.

Grand Can- yon Railway descends from these origins. Dr. Sandock poses ‘aboard’ steam locomotive No. 1673,

Dr. Sandock poses ‘aboard’ steam locomotive No. 1673, wreathed for Christmas, at the Southern Arizona Transportation museum. Its 1955 dedication to Tucson was on the 75th anniversary of the arrival of the railroad in Tucson.

His favorite trains are the electrics. Of these, his favorite is the Chicago South Shore & South Bend Railroad, now run as a public utility on the same tracks with the same engine. He said he often used it to travel from his home in South Bend, Ind. To Chicago.

“It’s the oldest running inter-urban electric train in the country,” Dr. Sandock said. “There are still lots of

trains serving lots of small towns that have no other regularly scheduled transportation, not

even buses.” The future of train organizations will

require younger people in order for the organizations to grow, “that’s the problem,” Dr. Sandock notes. “Older folks and their parents remember trains, when they served a purpose in their lives. Today, there’s little other than historic and nostalgic romance to Amtrak, but most of the excursion rail- roads are making a go of it. The Grand Canyon Railroad is doing

wonderfully.”

A train is more than something

that stops you from getting there

– Dr. Ken Sandock

at a crossing.

Museum restoring engine

The Southern Arizona Transportation Museum, the muse- um division of Old Pueblo Trolley, Inc., is “dedicated to pre- serving railroad history in Southern Arizona, the Historic Depot, and Locomotive No. 1673” with educational outreach, oral history, and archival collections. It’s at 414 Toole Ave. immediately west of Tucson’s 1941-style “downtown historic depot,” a projected completed in 2004. We might forget that the depot itself, at 400 N. Toole, is still a working Amtrak station, because the preponderance of rail traffic through Tucson is freight. “Rail travel is good for people who simply want to relax and enjoy travel,” Dr. Ken Sandock says. He recommends Amtrak’s Coast Starlight, which runs from L.A. to Seattle to Vancouver, B.C. Steam Locomotive No. 1673 can be seen next to the museum.

It was a branch line engine and the main engine used between Tucson and Nogales. It was also used in the 1955 movie musical Oklahoma! and is undergoing restoration by volun- teers such as those who developed the trolley operation recently in use on University Boulevard and 4 th Avenue. No. 1673 was dedicated to Tucson in 1955 and for many years was in Himmel Park before being moved to the museum grounds. Museum admission is free. Hours are Tuesday, Wednesday and Thursday 11 a.m. to 3 p.m., and Friday and Saturday from 10 a.m. to 4 p.m. Gates to the locomotive are open on Saturdays 10 a.m. to 1 p.m. You can find more information on the museum, and other Tucson, Arizona, and national railroad rides and attractions at www.tucsonhistoricdepot.org.

Living in Train America

Trains magazine “fuels passion for railroads” with industry news,

articles on freight and passenger rail and transit, preservation, “fan op- portunities,” lots of photos and maps, and historical articles (www. TrainsMag.com). Trains issues Trackside Guide as

supplement, full of information on train watching, locomotives and cars, how railroads work and trains move freight, train travel, train photography, historic train rides, safety, railroad parks, and more.

a

It

breaks down a historical timeline

of

this formative American industry

into categories from 1830 to to- day: First Fragments, Western Ex- pansion, Golden Age, Standard Era, Streamlining and Dieseli- zation, Mergers and Bankruptcies, De-regulation and Technology. Westerners are, or should be, familiar with the expansion of rail- roads, and they could hardly been a bigger phenomenon for Tucson, one of many American cities that could be said to have begun with the railroad’s arrival.

could be said to have begun with the railroad’s arrival. An adult and child at extreme

An adult and child at extreme right provide size scale as No. 844 looks you in the face. It was the last steam locomotive built for the UP and was delivered in 1944. As a high-speed passenger engine it pulled widely known trains such as the Overland Limited, Los Angeles Limited, Portland Rose, and Challenger. Weighing 454 tons with tender, No. 844 was saved from being scrapped in 1960, the only engine in service with its original owner.

In 1860 Tucson was just a fron- tier outpost. In 1871 President Ulysses S. Grant and Congress au- thorized a bill incorporating the Texas Pacific Railroad. They were making a best-guess as to how it would be built, though it would not be finished until 1880, and by someone else. Nevertheless, Tucso- nans celebrated the authorization by firing a Camp Lowell cannon 100 times and blowing the steam whistle on a Main Street flour mill for an hour, according to informa- tion at the museum. Construction finally settled on the Southern Pacific Railroad, owner of the Central Pacific and one of the “big four” railroad com- panies of the day. On March 20, 1880, an anniversary the museum always commemorates, a train bearing railroad dignitaries from San Francisco arrived in Tucson to the biggest celebration the town could muster. In 1869 the “golden spike” hammered at Promontory, Utah marked completion of the first

Hundreds of people throughout the day Nov. 11, 2011 stood in line at the Union

Hundreds of people throughout the day Nov. 11, 2011 stood in line at the Union Pacific Railroad yards in Tucson to mount a ladder and see the controls of UP’s steam locomotive No. 844. It had just come from New Mexico, and then to Willcox, Benson, and Vail, and was bound the next day for the Southern Arizona Transportation Museum on Toole Avenue downtown.

Arizona Transportation Museum on Toole Avenue downtown. Dr. Sandock has his arm on the throttle of

Dr. Sandock has his arm on the throttle of steam locomotive No. 1673 at the Southern Arizona Transportation Museum. The Schenectady Locomotive Works built it in 1900, and it logged more than 1 million miles for the Southern Pacific Railroad, mostly in Southern Arizona.

transcontinental railroad. The current AMC TV series “Hell on Wheels” dramatizes the period leading up to completion, including the infamous Crédit Mobilier of America stock scandal of 1872, which involved manipulations similar to those done before 2008 by executives at Fannie Mae and Freddie Mac. In the 1870s and ’80s, Jay Gould and other “robber barons” used railroad companies and our government to build personal and corporate empires. In 1893 New York Central 99 was the first locomotive to exceed 100 miles per hour. Steel began to replace wood construction in railroad cars in the 1910s. In 1917-1910, “World War I traffic congestion prompted the U.S. government to take control of railroads,” the Trains guide notes. “By 1915, railroads were peaking, both in physical extent and soci- etal influence. Electric in- terurban railways boosted mileage during their hey- day of 1890-1920, but mostly took business away from ‘steam’ rail- roads. Automobiles and trucks proved the more formidable and enduring competitors, aided by publicly funded highways and restrictive regulation of railroads.” “Railroads in the post-

World War II era sought to win back travelers with

sleek, lightweight, diesel-powered passenger trains. Once diesels had shown their superior efficiency, the industry rushed to replace steam power. This colorful period saw bright, new passenger trains and diesel locomotives sharing the rails with the last of the great steam engines. “Diesels helped, but the slide continued. Jet aircraft and the Interstate highway system helped to empty the wonderful postwar streamliners. As fewer people rode trains, the railroads sought to discontinue them, and then exited the passenger business altogeth- er. An overabundance of lines in the Northeast and Midwest led to several failures and abandonments.”

While combining small railroads into larger ones was a historic practice, “the late 1950s marked an increase in mergers that saw many familiar rail- road names disappear. Other efficiencies were achieved through new freight hauling equip- ment and practices such as jumbo covered hopper cars for grain, unit coal trains, and piggyback trans- port of truck trailers. “The time since 1980 has been one of rebirth. Several factors have con- tributed to the renais- sance: new traffic sources such as Western coal, re-

renais- sance: new traffic sources such as Western coal, re- Folks love to photograph themselves and

Folks love to photograph themselves and their children next to 844’s huge driving wheels. You would have to be 6-foot-8 to be as tall as one of the wheels.

No. 844 pulls a car with the statehood centennial voyage emblems for Arizona and New

No. 844 pulls a car with the statehood centennial voyage emblems for Arizona and New Mexico. It has run hundreds of thousands of miles as a unique goodwill ambassador.

ductions in employment, technological advances such as the dou- ble-stack container car, reduced regulation, and a new round of mega-mergers. “Today’s railroads are in the best shape they’ve been in decades. They boast more and newer cars, more miles of double track, and lots of traffic. The early 21 st century is an excellent time to enjoy an industry that is experiencing a rebirth.”

t century is an excellent time to enjoy an industry that is experiencing a rebirth.” SOMBRERO
t century is an excellent time to enjoy an industry that is experiencing a rebirth.” SOMBRERO
t century is an excellent time to enjoy an industry that is experiencing a rebirth.” SOMBRERO

rEaliTY CHECK

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Seasons of my life

Seasons of my life Dr. Michael S. Smith I recently took my 59 t h canoe

Dr. Michael S. Smith

I recently took my 59 th canoe trip into the Boundary Waters, having spent more than a year camping on both sides of the border. I’ve paddled more than 300 lakes and traveled 3,000 miles by canoe in the past 30 years. I’ve done half as much traveling in Ontario’s Algon- quin Park back in the spring and early summer of my life. I started 50 years ago and feel more comfortable in a canoe

than in a car. Safer, too.

I no longer travel hard. I used to glory in 20-mile days with 15

portages, carrying a pack under a canoe for up to a mile at a regular walking pace through the woods. Oh, I was good in the summer of my life! I took 20 solo trips, could make camp in 30 minutes, break it in 45. Now, however, my wife and I base camp on a lake we know better than anybody else alive. We spend five nights a year on one campsite so remote that we don’t see anybody else. We drink water right from the lake, unpurified. I’m not as strong as I once was, but I am much more savvy in the wilderness. I don’t waste effort. I am a superb weatherman in the woods, accurately predicting storm onset and ending, reading the sky and the wind. Oh, I could do more if I had to, but I don’t want to. I have

nothing to prove and a lot I could hurt. Do I miss the strength I once had, propelling me miles and miles to the next campsite? A bit. Do I need to do it again? No. I want to see the northern sweep of Agnes Lake one more time, and a fellow teacher, who desperate- ly wants to go, may be my partner. The two of us could do it. Occasionally I still show off. My wife and I paddled 12 miles into our destination lake in six hours, when several people we met, 20 years younger, were unable to get there in three days. Neither of us is strong, but our experience, organization and leveraging of our skills, working together, enables us to still accomplish a good day’s work in a few hours. Neither of us thought it was a difficult day. Do I miss “roughing it”? No. I once liked sleeping under a canoe and thought paddling in a driving rain manly, but now camping means being comfortable. We eat well, stay clean and dry, and sleep better than at home. The midnight bathroom breaks are a chance to look at one of the darkest skies in America and perhaps see an aurora, which we did a few years ago.

I find it interesting that as I have gotten older, my desires have

changed, and I get pleasure doing different sorts of trips I once

wouldn’t have enjoyed. The trips I used to do no longer appeal to me. I am at peace with that. I expect more changes, and hope I still can paddle and portage for many years to come. I expect I will

be doing so in a different fashion, and I believe I will enjoy it just as much. We were in the canoe country in autumn, and present when the colors peaked. In the autumn of my life, I am finding my own in- ner beauty that mirrored the external beauty around me. I still see new country, but I enjoy visiting familiar country the way I like meeting new people but enjoy old friends.

I hope in my 70s I will be still be able to canoe and set up

camp. My body is like a well-used Old Town. It won’t last forever,

the paint is scraped, there are a few cracked ribs, but it is still sound and seaworthy and has seen a lot of wild country. It still needs to paddle in Saskatchewan and Manitoba. And see an eclipse over my seventh continent.

I hope as the winter of my life approaches, the white in my hair

will mirror the brilliance of new snow, untouched, in those areas of Alaska’s Brooks Range that I have been so fortunate to have ex- plored four times. Could I canoe in my 80s or 90s? I dream, for in a recent year two very special people, different sex, different coun- tries and different professions, had a profound influence upon me. From each, and quite by accident, I learned that while I am a scien- tist and statistician, consider myself a practical person, not far be- low the surface lies a kid—a deeply emotional, spiritual dream- er. I’m not planning to ever grow up. When I arrived in Fairbanks, many my age or younger went to the Princess Cruises sign. I picked up my backpack, headed to the remotest river valley in America. I have just started autumn. I hope the winter that follows will be as brilliant as the snow that made Mount Oyukuk so beautiful over the Noatak last August, up in Gates of the Arctic National Park. Eventually, of course, my eyes will finally close forever. I hope at the end I die quietly in the outdoors like Sig Olson, the famous North Country writer, who had written in his typewriter the day he died, “I am ready for the next stage. I know it will be a great adventure.”

Sombrero columnist Dr. Mike Smith’s blog is http://michaelspinnersmith. com, where there are previous Reality Check columns, outdoor writing, descriptions and pictures of National Parks, Alaska hikes, eclipse- chasing, mental arithmetic, op-eds, and two non-technical neurology articles that physicians might enjoy.

arithmetic, op-eds, and two non-technical neurology articles that physicians might enjoy. 22 SOMBRERO – February 2012

PErSPECTivE

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Conservative on ice

By Dr. George J. Makol

I certainly got a lot of suggestions after my recent column [Perspec-

tive, December 2011 Sombrero], but I decided to stay in town anyway.

I do admit, however, that not everything I wrote is related to the

medical field, and this is a medical society publication. So let’s talk healthcare. We have a president who ran for office on a platform of provid- ing medical care for everyone. However, no one I know took the time to check the presi-

dent’s own voting record as an Illinois state senator. Health insurance in Illinois used to cost about $250 per month for a healthy male of age 25 at about the time Barack Obama was elected to the Illinois Senate. During his time in office he voted for 18 separate bills that re- quired all health insurers to provide not just basic coverage that we all need for M.D. visits and hospitalizations, but set mandates for cov- erage. So according to his votes chiropractors, naturopaths, and all kinds of alternative practi- tioners, they were required to be covered by any health insurer offering coverage in Illinois. That’s 18 separate bills, all of which he voted for after being lobbied and receiving contribu- tions from each interest group. Before he left the state, the cost of health insurance for a healthy 25-year-old male jumped to $950 monthy on average! Wyoming has no such mandates passed by its legislature. I checked on Esurance and healthcare insur- ance for a 25-year-old man from Wyoming varies from $150 to 250 per month. No, he did not do this alone, but neither did he vote “nay” on even one of these pieces of legislation. I would say that took a huge group of Illinois citizens out of the healthcare system, and stressed many an employer’s budget. So now we have the Patient Protection and Affordable Care Act of 2010. Try to remember, when the government passes a bill, think ex- actly the opposite of the bill’s name and you will have accurately predicted its effect. For in- stance, the Health Insurance Portability and Accountability Act, also known as the Patient Privacy Act or HIPAA, opens up medical re- cords to government agencies including Homeland Security and many others. A lawyer from the Arizona Medical Association gave a presentation at PCMS shortly after HIPAA passed. He informed that it was his legal opin- ion that as the bill was written, dozens of gov- ernment agencies could access patient records legally under certain circumstances. Patient pri-

vacy no longer exists. If the government passes a bill called “There Will Be No Rain for the Next Month,” I would immediately go out and buy a raincoat. What does this monstrous new healthcare law of 2,300 pages offer, and are there any good ideas within it? Believe it or not, I like the idea of state-run healthcare exchanges! Insurers will be offered a

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slot to provide coverage to all comers, no pre-existing condition ex- clusions allowed. And that is the problem with the bill: Like most laws Congress passes, there was no thought as to the effect the law will have. All the sick persons in the state who have been unable to buy coverage at any price will immediately join. Wonderful, you say. But the rates are set by the insurers and will quickly skyrocket to rates even higher than in Illinois (see above). So, our ever-clever Congress thought of that; they will fine you $700 annually if they find out that you have not obtained coverage, so theoretically near- ly every healthy person will join the exchange, diluting the high cost of taking care of the infirm. Let’s use me as an example, as I seem to have been getting picked on lately anyway. In 2010 my wife and I paid $18,000 for a policy with a deductible so high that I figure it would only pay if a bus fell out of the sky and landed on us. So say I go without insur- ance for three years, save $54,000, and pay $700 per year penalty if they catch me. I have easily made the most profit I could without lifting a finger or becoming a politician. Now say my wife or I suffer a serious injury or illness. We sim- ply go downtown and sign up for the insurance available to every- one with no pre-existing conditions, and we have full coverage. It took me about five minutes after reading this portion of the bill to figure this out, and I am a conservative and we are not supposed to be that smart. It will not take long for everyone else to do the math. This whole bill unfortunately is an upside-down pyramid waiting to collapse. The people of the United States, our patients and col- leagues, deserve a better and more thought-out program. A few parting thoughts. Dr. Michael F. Hamant was kind enough to point out an error in my last column, and he is quite right. I did not specify that I was referring to the projected 2,000- acre deserted tundra drilling sight in the 19- million-acre ANWR as being a postage-stamp-size area on a football-field-sized map of

Alaska. While he is correct that ANWR would have the footprint of a house on such a map, the miniscule 2,000-acre drilling area would better be represented as the size of a mosquito’s kneecap when projected on a football-field-size map of Alaska. I think he made my point better than I did. The average family income in the U.S. is $50,000 according to the most recent government census information. Dr. Hamant may have been accidentally looking at one of the overtaxed socialist countries that he so admires to get the $27,000 figure. In Arizona, the 2010 median family income was $47,279. More worrying to me is that Arizona median family income, as measured in 2010 dollars, was $52,592 in 2001. I know Dr. Hamant and I will dis- agree on solutions to this income decline. My solutions would be market based, not government directed. As for “climate change,” I will remind my colleague that at one time a consensus of scholars were sure that the world was flat, and Galileo was condemned as a heretic and confined to house arrest for the last third of his life for promoting helilocentrism (the earth ro- tates around the sun); scholars of his day believed in geocentrism, or that the planets and sun revolved around the earth. The increasing number of scholars casting extreme doubt on man’s contribution to global warming, and the rife intellectual dishonesty of some sup- porting scientists (see the East Anglia University e-mail scandal and the fake “hockey stick” effect based on erroneous numbers) makes this no slam-dunk issue. The earth warms and then cools in 750 to 800 year cycles; we are in about year 600 of a warming trend. The smog above Philadelphia has nothing to do with this massive pow- erful cycle, but its a great reason to raise taxes. Well, at least I touched on medical matters a little more this time. See you after my trip to Antartica! George J. Makol, M.D. practices at Alvernon Allergy and Asthma, 2902 E. Grant Rd., and has been a PCMS member since 1980.

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SOMBRERO – February 2012
25

CONFErENCES & SEMiNarS

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February

Feb. 23-25: Tucson Hospitals Medical Education Program (THMEP) presents the 23rd Annual Winter Medical Conference at The Peaks in Telluride, Colo. For information, e-mail Dr. Robert Berens at robertrjb@gmail.com, or Dr. Alan Rogers at buck@ultrasw.com.

March

Mar 1-3: The Mayo Clinic Transoral Approaches in Head and Neck Surgery: Laser Microscopic, Robotic, and Endoscopic is at the Westin Kierland Resort, 6902 E. Greenway Pkwy., Scottsdale 85254. CME credits: 22 AMA PRA Category 1 (16 for general course, six for optional workshop); 22 AOA Category 2-A. Course targets otolaryngologists, head and neck surgeons, oral maxillofacial surgeons, and head and neck oncologists for “a fo- cused educational experience in transoral endoscopic techniques to resect primary head and neck tumors. Both transoral laser micro- surgery and robotics will be the primary focus, with additional ed- ucation in other transoral techniques.” Optional cadaveric hands-on workshop offers participants op- portunities to perform various transoral procedures with laser tech- nologies and delivery systems. “Renowned faculty will emphasize fundamental transoral anatomy, microsurgical and robotic tech-

niques, and wound exposure, as well as feature other transoral tech-

niques. Workshop participants will return to their clinical practice with experience in the art of tumor exposure using various retrac- tors and appropriate and safe use of multiple transoral systems.” Website: http://www.mayo.edu/cme/otorhinolaryngology-2012s510 Contact: Barbara LeSuer, Mayo School of Continuous Professional Development, mca.cme@mayo.edu; phone 480.301.4580; fax

480.301.8323.

March 8-10: The 8th Annual Women’s Health Update is at FireSky Resort, 4925 N. Scottsdale Rd., Scottsdale 85251; phone 480.945.7666. AMA PRA Category 1 credits: 18.50. Course consists of three half-days with afternoon workshops and focuses on reviewing the latest medical updates pertinent to women’s healthcare. It targets primary care physicians, general in- ternists, gynecologists, and specialists in preventative medicine. Participants should gain comprehensive insight into recent initia- tives, as well as a basic approach to addressing and improving com- mon health concerns for women. Website: http://www.mayo.edu/pmts/mc8200-mc8299/mc8200- 55w .pdf Contact: Jodi Lee Beert, Mayo School of Continuous Profes- sional Development, mca.cme@mayo.edu; phone 480.301.4580; fax 480.301.8323.

MEMbErS’

ClaSSiFiEDS

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To advertise in Sombrero classifieds, call Bill Fearneyhough, 795-7985.

WANTED: Seeking used medical records shelving system (7ft X 5 ft) in good condition. Contact Roxann, 320-1369.

OFFICE FOR LEASE: Elegant modern medical office suite available for lease. Located on the first floor of the Oro Valley Hospital Medical Offices complex, within walking distance from Oro Valley Hospital. Beautifully decorated 3,158 rentable square feet with 2,789 usable square feet. Four exam rooms, two procedure rooms, staff kitchen and three offices. Most fixtures stay, including furniture if interested. Ample parking. Lease Term and Rate Negotiable. Call Samantha Marques at (520) 293-5757, ext. 7113 for more details. (11-11)

SHELVING SYSTEM FOR SALE: Original purchase price $20,000. Exceptional condition. 20 ft X 9 ft, 7 levels high. Asking $5,000 or best offer. Please contact Cindy, 327-9573, ext. 245. (12-11)

PCMS member, certified physician assistant with alternative medicine background, seeks 32-36 hours of employment in an internal medicine practice starting January 1. Contact PCMS, 795-7985, if interested.

OFFICE SPACE FOR LEASE: Free-standing single-story building with Grant Road frontage. Ample on-site covered parking. Move-in ready; currently configured as medical office space of approximately 4,100. sq. ft. Ideally located across the street from Costco between Tucson Medical Center and St. Joseph’s Hospital. Contact Ted Kalota, 250-5040. (11-11)

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One Area of Focus: Radiology Radiology Ltd. has focused on providing radiology services in the
One Area of Focus: Radiology Radiology Ltd. has focused on providing radiology services in the
One Area of Focus: Radiology Radiology Ltd. has focused on providing radiology services in the

One Area of Focus:

One Area of Focus: Radiology Radiology Ltd. has focused on providing radiology services in the Tucson
One Area of Focus: Radiology Radiology Ltd. has focused on providing radiology services in the Tucson
One Area of Focus: Radiology Radiology Ltd. has focused on providing radiology services in the Tucson

Radiology

Radiology Ltd. has focused on providing radiology services in the Tucson community for over 70 years. Each of our physicians is a specialist in their area of expertise.They, and the rest of our staff, are dedicated to providing quality patient care with an emphasis on both patient comfort and safety. Our imaging is now entirely digital, providing the highest image quality and quick turn around of results.

Radiology Ltd also provides:

RadVision The clear choice for immediate viewing of digital imaging and patient reports via a secure online connection. Images are also available on CD and high resolution paper.

Images are also available on CD and high resolution paper. To get connected to RadVision, please

To get connected to RadVision, please call 901-6747.

Convenient scheduling

– centralized scheduling for all sites by phone or fax

– ability to accommodate STAT requests

– accept all major insurance plans

– insurance verification and appointment confirmation

– a bi-lingual staff

SOMBRERO – February 2012

Easy access to reports

– accurate reports with rapid turnaround time

– faxed preliminary and/or final reports

– recent and remote study reports always available online

Professional RelationsTeam

– rapid staff responses to your needs

– dedicated phone line for physician to physician consultation

– full-time couriers deliver studies/reports to you quickly

Radiology Ltd. is locally owned and operates ten imaging centers in Southern Arizona to serve you and your patients.

Consider working with the radiology specialists at Radiology Ltd.

There Is A Difference

Consider working with the radiology specialists at Radiology Ltd. There Is A Difference radltd.com 733-SCAN (7226)

radltd.com 733-SCAN (7226)

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Through a true partnership of efforts, MICA's Board of Trustees is pleased to announce a $50 million dividend for 2011 - our 7th consecutive dividend.

Thanks again, MICA members.

- our 7th consecutive dividend. Thanks again, MICA members. MUTUAL INSURANCE COMPANY OF ARIZONA MEDICAL PROFESSIONAL

MUTUAL INSURANCE COMPANY OF ARIZONA MEDICAL PROFESSIONAL LIABILITY INSURANCE

(602) 956-5276, (800) 352-0402 www.mica-insurance.com

The dividend declared for any give year reflects MICA’s financial performance during the year. Past performance does not guarantee future dividends.