Archive for the ‘Uncategorized’ Category

Report of physician shortage, and rise in US grads

December 11, 2010

http://www.amjmed.com/article/S0002-9343%2809%2900680-9/fulltext#sec7

Remember also, that the number of osteopathic graduates will rise by almost 100% in the next 3-4 years

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Who is going to save the world if not us?

November 28, 2010

The United Nations is creating in a month an Agency on Women’s Rights and the prevention of violence against women. The former president of Chile, Michelle Bachelet will be running this. She is a pediatrician who was first Minister of Health, then Minister of Defense then President of her country.

Part of the point of my book ‘Routine Miracles’ was to remind physicians and medical students that we, as a profession, are in a far better position to help the world and the civilization than most. Why do Americans immediately accept a 700 billion dollar military but begrudge 100 billion to implement healthcare reform?

If doctors were as aggressive as the national rifle association, every American would have two healthcare policies. The recent elections, with many, including DOCTOR Rand Paul in Kentucky running on a platform of repealing healthcare reform is a disappointment at best, and disgusting at worst. At the single highest paid, best educated profession in the country, we should be running on a platform of ‘Do the right thing, we will find a way to pay for it.”

It could have been worse, On the other hand, the right time to do the right thing for suffering people is….NOW! On a single shopping day post Thanksgiving, we spent nearly 20 billion dollars. It seems that we always have enough time and money for what is important to us.

If I can find myself a way into the U.N. to work in that Agency, I am going. What do I have to lose? I sent Michelle Bachelet a letter friday. Let’s see.

This is important for those of you out there wondering whether you should try to go for some dream you have. Maybe you think it is only advice I give to others and not myself.

This agency is to make sure that Violence and rape against women as a routine tool of statecraft is stopped. That U. N peacekeepers who did NOT intervene in Congo while women were raped on the doorway get their asses kicked so that they protect those women.

Time for the six foot four inch USMLE teacher to get on the ground in those places and control male bad behavior. I am not experienced, I don’t know that I am qualified, but I know that my cause is just. So, anybody got Michelle Bachelet’s Phone number or email? I need to tell her how I am going to switch from USMLE teacher to U.N. employee.

The worst thing that could happen is that I fail. So what?

How will failing step 2 CS hurt me?

September 15, 2009
 
QUESTION:
I am an IMG with scores of 94 and 95,passed cs on second attempt,1 month observership in a community hospital.I graduated 2 years ago.I have applied for IM.From your above post it looks like the cs attempt is going to be very bad.So do you mean that nothing can compensate for my failure in cs once?What about average programs?

I would be grateful if you could share your thoughts on my case.

 ANSWER:
WIth GOOD step 1 nad 2 scores, I would simply say you had explosive diarrhea on the day of the exam. You will still have a good chance. I think a great step 3 score will help as well.

Fred Fischer Memorial for my father tonight at 7pm at the Nippon Club

August 28, 2009

In “Routine Miracles” I write about the day I told my father I wanted to go to Medical School.  “What do you want to do that for? A Doctor is nothing but a specialized mechanic”.

My father was a very complex man. Strongly intellectual. I never saw my father flustered about anything. Never.

Much of what I have learned has been by learning to overcome this man. A 37 year New York City policeman. Violent, turbulent, generous and with an analytical mind that was able to perceive reality free of illusion.

My father was always concerned about ‘confirmation bias” / He wrote extensively on the subject. His idea was that people decided on a position then selected facts to support a pre-determined position. His greatest counseling was to purposely seek out opposing viewpoints and to test your ideas.

My father’s beliefs were completely NON altruistic. He would understand the lack of universal coverage as ‘The Small guy always takes a beating.” but he would think me foolish to go to war on this. to fight.

He was more skilled at revenge. “THere is NEVER enough revenge’ he would quote from the Merchant of Venice. Yet, despite his rhetoric, his actions were immensely supportive of myself, and my children. Unfailingly generous, and wise…no ….. insightful and analytical. A master tactician.

In the gospels it is said… two lines AFTER the bliblical basis of Routine Miracles (Chapter 10 mathew)  “Be as wise as serpents and as gentle as doves’. If we are to protect this world, we will need the cold, analytical intelligence of Fred Fischer to guide us in how to protect a suffering people from the callous disregard of those unwilling to take 10% from the military budget to solve this issue.
I am not like my father in goals. I have learned much on how to achieve goals he would not have felt obtainable or important.  But, he would have helped me understand evil.

In this world, the forces of mercy and compassion must have a piece of a man like my father, Fred Fischer, to guide us in not being defeated.

My father, a lifelong atheist will have a ceremony I have arranged with the President of the Atheists association, a Zen monk and a catholic priest, the  one “Routine Miracles” is dedicated too.

Although he described Religious people as deluded “So kid, do you REALLY think the whole world is based on a woman who took some bad advice from a talking snake?”

On the other hand. he would have liked me to invite the opposing viewpoint as well.

“Fischer is like a Vulgar Mother Theresa”

July 26, 2009

How do the students in class see me?  What am I a symbol of? For many, many years I have thought of myself as a person who slipped into the Awards Show or the Ball by accident, or unlawfully through the backdoor or the servants entrance. 

I have seen myself as Cinderella

At  the ball through magic, enchantment, luck or blessing.

The photographer is on her way. Time to get a new action shot of me in the class for the brochures for my textbooks.  I ask the class for help. “I need you to help me sculpt my image into what is most useful for the people who read these books. I need a task force of people in these rooms to help me represent myself as what is needed in the mind of the student. Hence, how I see  myself is not as important as how YOU all need to see me. How can I represent myself in this picture that will help you?”

Seeing myself as Cinderella, perhaps, does not help anyone. 

Representing myself as a many in class, up at 7am on another Sunday Morning to reach and teach people   who are anxious about their future is what is needed.

Another day to polish my art. My 18th year in classes for board review and I feel like I am just getting started. The book tour coming up for ‘Routine Miracles” makes me feel like everything has been preparation.

I feel more passionate to get at the meaning of things now, than I did before. Before, I needed to look good. To not look stupid in class.

Now I need to get at the meaning of things. to see the connections more deeply. Like I am an inch away from a sip of an answer. Almost can wet my lips on THE TRuth.

Deeper, so that when the 50 people in the room leave, a few will think about the fact that maybe I am right.
Maybe they ARE better than Doctors in the past

Maybe they CAN be the one to find the cure, the breakthrough, the ability to eradicate the disease. Maybe we really are incredibly fortunate to  have this chance.

Nearly there. A passionate energy illuminates my soul today. Teaching in a class that does not look different from the tens of thousands of students I have been with before.

There is something about asking for help on the presentation of “Routine Miracles”  that has really helped me see myself more objectively, how the students see me and that there just isn’t anyone to talk about these issues.

About their excellent and noble qualities and about the responsibility they have to care for a a suffering humanity.

And the students, interestingly, have told me exactly the same thing.

Like today  “You are like a Vulgar Mother Theresa”

Start your Bucket List now

July 22, 2009

A friendly man comes to class this week. I have met the man before. Jovial, warm and gentlemanly, he sports a shiny newly bald head and we joke about our similar hairstyles. On the second day the man comes to me. ‘YOu know, I was a BIG professor in my country Fischer. I left when I was 54 so my family would have a better life than in Cuba.” 

The man does not complain about the effort of re-learning all of medical school in his 50’s. He does not feel embarrassed to be with student 30 years younger than him. He makes no excuses for having a hard time absorbing all the new information. He does not get defensive or argue points of management in class with me to show everyone in class that he knows something, and ‘is somebody’ as often happens.

He just seems happy.

“I have tongue cancer Fischer. I have metastases to my lung. I got chemotherapy three days ago. But, you know, I want to pass my boards so that my three children who are all doctors will see that their father went all the way. Youknow that movie ‘The Bucket list”? the list of things to do before you die?

‘You are on my bucket list Fischer”

“I am 64 years old now, but the greatest pleasure I have in medicine is the week I sit in class with you. I just have fun. I was a teacher, but just to keep people awake for 8 hours straight is a big accomplishment. I am happy when I am here with you. I just wanted you to know”

This is the most jarring thing I have heard for a while.  THe man says ‘I feel good, I might die this year, I might die next year, but I wanted to spend this week here in class with you”

I think about how people see me. I think about the constant quest for ‘Meaning’ in ordinary things. ANd I think, I will put spending a week with the warm, gentlemanly, Cubano on my bucket list.

What do I see when in class?

July 22, 2009

WHen in class the teacher has to see the future. To feel the future. THe future has to call to the teacher. The effect of what is taught must be felt as if it were the present. Not theoreticlly, but in actuality. Time itself must be conquered THe future must be felt as if it were the present fact. The need of the future, the good of the effect of the information must be felt in the present. The future must call backwards to you who teach. The greatest need must be perceived. It must be as if the future was screaming at you. THen you have the energy you need to make aliveness flow through the material you are presenting.

Facts, data and information, no matter how seemingly powerful and important is not enough. THere isn’t enough energy in a ‘fact’ to make it, by itself, important. Even in the apparent importance of medicine, facts do not have enough power. data is not powerful. The good of the data, the pain relieved, the goodness achieved, the purity of clear translucent knowledge must flow through the teacher into the present.

THe mind of humans is very vast. More than all the computers in New York City, the mind can contain it all. IF what you are teaching does not feel powerful enough to want to shout, to scream, to pour every neurotransmitter, every emotion into your teaching then you are in the wrong job.

Repetion is powerful. Constant study and a passionate desire to purify the message even though filled with the raunchiest metaphors, similes and analogies is necessary. It will deepen. As surely as a pianist plays with passion. deeper and more beautiful.

Starting in the Middle

July 21, 2009

as time goes on, swimming amidst the ordinary facts of the days classes, the details of the books and the desparation of the beginning of the application season, I think about the place I have in people’s minds. It is hard to be cognizant of how others see me, in terms of the place I have for them. the ordinary ones just looking for a good grade, the terrified ones, afraid of the ghosts of the past or the unfertilized gametes looking for something much higher.

Welcome to my blog

June 19, 2009

Hello, everyone. Welcome to the SeeFisch Blog. I hope you enjoy my posts. As time goes on, I will be answering questions from medical students, sharing information about my work, and updating you on news with my new book, Routine Miracles.