Perspective

If I were the only one left on earth, how would my behavior change from what it is now?

Praise for God's Mercy

[at end of the day I "happened" to turn to this psalm] A Psalm of David -- 103 Bless the Lord, O my soul; And all that is within me, bless His holy name! Bless the Lord, O my soul, And forget not all His benefits: Who forgives all your iniquities, Who heals all your diseases, Who redeems your life from destruction, Who crowns you with lovingkindness and tender mercies, Who satisfies your mouth with good things, So that your youth is renewed like the eagle’s. The Lord executes righteousness And justice for all who are oppressed. He made known His ways to Moses, His acts to the children of Israel. The Lord is merciful and gracious, Slow to anger, and abounding in mercy. He will not always strive with us, Nor will He keep His anger forever. He has not dealt with us according to our sins, Nor punished us according to our iniquities. For as the heavens are high above the earth, So great is His mercy toward those who fear Him; As far as the east is from the west, So far has He removed our transgressions from us. As a father pities his children, So the Lord pities those who fear Him. For He knows our frame; He remembers that we are dust. As for man, his days are like grass; As a flower of the field, so he flourishes. For the wind passes over it, and it is gone, And its place remembers it no more.[a] But the mercy of the Lord is from everlasting to everlasting On those who fear Him, And His righteousness to children’s children, To such as keep His covenant, And to those who remember His commandments to do them. The Lord has established His throne in heaven, And His kingdom rules over all. Bless the Lord, you His angels, Who excel in strength, who do His word, Heeding the voice of His word. Bless the Lord, all you His hosts, You ministers of His, who do His pleasure. Bless the Lord, all His works, In all places of His dominion. Bless the Lord, O my soul!

Should...

manage con sub better: contracts, urines, exams, documentation, saying no, etc. manage screening and metrics for aco better more well ex and hum ex evidence based more update prob and med lst do emr etc. yet the energy, time, motivation is lacking so what to do may the angels give me guidance. but one good event today: T.H. visit and discussion of the importance of the spiritual vs the pressures of the moment and the oppressive present. I'll fly away to the Shadowlands.

The Great Gatsby

From the Great Gatsby: Nick had been talking to a man about how they'd each been in the same 3rd division in the war, without knowing the man was Gatsby, whose party he was attending. Then Nick says, "This is an unusual party for me. I haven't even seen the host...." "I'm Gatsby," he said suddenly. "What!" I exclaimed. "Oh, I beg your pardon." "I thought you knew, old sport. I'm afraid I'm not a very good host." [and here is the paragraph that struck me:] “He smiled understandingly -- much more than understandingly. It was one of those rare smiles with a quality of eternal reassurance in it, that you may come across four or five times in life. It faced -- or seemed to face -- the whole external world for an instant, and then concentrated on you with an irresistible prejudice in your favor. It understood you just as far as you wanted to be understood, believed in you as you would like to believe in yourself, and assured you that it had precisely the impression of you that, at your best, your hoped to convey. Precisely at that point it vanished ----“ ………………………….. “Gatsby's wonder.... His dream must have seemed so close that he could hardly fail to grasp it. He did not know that it was already behind him.” "Gatsby believed in the green light, the orgastic future that year by year recedes before us. It eluded us then, but that's no matter -- to-morrow we will run faster, stretch out our arms farther . . .And one fine morning---- So we beat on, boats against the current, borne back ceaselessly into the past."

No Exit

May 21, 2013……..No exit from threat of lawsuits. Leave practice, and don’t have the opportunity to correct deficiencies that may come to light, e.g. a colonoscopy, mammogram, pap smear, or PSA test that wasn’t ordered, or a lab test that wasn’t followed up on in a timely manner. Stay in practice and have the opportunity to make more mistakes of commission or omission. The only way out is to die, get disabled while practicing, go to jail for malpractice, or cease taking any new patients and just focus on the ones already in my “panel.” The latter course doesn’t preclude making errors on these same patients going forward. Another option: my license could be revoked because of narcotic prescribing errors or deficiencies in chart documentation. In that case, I might still be able to review charts of patients previously seen but not take on new patients or deal with new problems in existing patients. I would scan the record for deficiencies before sending the record out to another doctor to take over the “case.”

January 2013

Since this could be an unlucky year, no sp this year. remember 93 and the angels. Despite statements to the contrary this could be the year for RR. It'll certainly be the year for renting at 127, though the date is looking more like May at this time.