Saturday, May 8, 2010

Dr. Reece’s Pieces – May 8 Medinnovation Blog – A 20/20 Health Reform Re-Vision


Key words – puns, ophthalmologists, otolaryngologists, head and neck surgeons, health reform, Obamacare, Medicare


During a visit to my ophthalmologist after cataract surgery, the opthalmologist asked what I thought about health reform.

Would I, he asked, be willing to share my opinion in a presentation before the local academy of Ophthalmology, Otolaryngology, and Head and Neck Surgeons? And, he added, would I please keep it light? Spouses and significant others would be there. My talk would be after dinner. He wanted my remarks to be digestible. He wanted my thoughts to go down easily.

Keeping “light” a talk on health reform before an audience of specialists would not be easy. How would I do that? Health reform is a deadly serious subject.

Obama promises to cut $575 billion out of Medicare over the next ten years. Medicare patients are the bread and butter, nuts and bolts, dollars and cents staples of typical ophthalmologist, otolaryngologist, and head and neck practices. A "light” health reform talk would not be easy to pull off before a skeptical audience of specialists who depend on older patients for their livelihood.

Clearly, a fourth down punning situation would confront me.

Here is how such a talk might go.

Members of the Academy of Ophthalmology, Otolaryngology, Head and Neck Surgeons, Spouses, and Significant Others


Thank you for inviting me to speak on health reform. I have been asked to deliver a light-hearted visionary view of what lies ahead. My mission is to provide you with an earful of information, supply you with penetrating 20/20 insights, to act at an anonymous Deep Throat observer, and to do all of this without offending or worrying any of you.

This is difficult to do. Health reform affects everybody. It offends somebody. Everybody has an ax to grind. Everyone has turf to defend. Health reform is deeply personal. It is not funny.

But apun my word. I will seek to an eye lid apun my puns without raising eye brows, looking down my nose, or cramming anything down anybody’s throat.

On my way here, as I left my home’s posterior chamber – the room where my posterior resides, amd I arrived at this anterior chamber – in front of you at this podium , I plotted how to come up with appropriate global humor. Which makes sense. For you ophthalmogists, the world of medicine of medicine is global. The optic globe is your cloister, your oyster, your diagnosis and treatment center, your cash register.

Before I cleft home, I earnestly promised my wife I would go lightly on eye, ear, nose, throat, head and neck puns.

I told her I would be judicious and balanced.

I said U would keep one eye on the horizon, my other eye on the rear view mirror, my nose high in the air above the fray, my biases and septum undeviated, and my tongue inside my cheek.

But, alas, I confess I may not be able to contain my puns. After all, to ear is human to have 20/20 foresight malign. In any case, I will give my audience my two senses worth.

Puns, below all else, are a form of vitreous humor, not vit for serious people. Each pun is cornea than the next. But puns are lenses fun than you blink. There’s only a Schlemm chance listeners will understand how atrocious my puns really are, for puns are the lowest form of humor.

My wife dislikes my puns. But at least they break up the monogamy of our marriage. I never let my puns go doormat. Otherwise, people would consider me henpecked.

I promised her I would not tell the tale of the ophthalmologist who fell into the lense-making machine and made a spectacle of himself. He rushed into the temples of justice. But the jury could not decide which vision of the case to accept – his or the lense-maker. You might say the jury was hung, bifocaled and bifocused.

I said to her I would not mention the ophthalmologist who retired to Alaska and became an Optical Aleutian.

I promised I would not carry on about the cheap eye surgeon who was always cutting corneas, nor would I speak of the otolaryngologist who have never heard of health reform,but the thought of it left a bad taste in his mouth. Nor would I dare relate the story of the head and neck specialist who retired just in the neck of time before reform set in.

I promised to omit the story of the Head in the Bar. As you head and neck surgeons know, many cancers of the tongue, mouth, larynx, and pharynx, have histories of excessive smoking and drinking. In this case, the smoking Head had too much to drink. The Head lost its balance, rolled off the Bar into the street, and was crushed by a passing car. The moral of the tale is: Quit when you’re a Head.

Perhaps you don’t care to hear anymore about reform. It is such a Tragusy of justice. It simply ENT the way life ought to be. But reform, whether you like it or not, is a sinus of the times.

I told my wife my puns wouldn’t deviate anybody’s septum. My puns are so oculist, nobody knows how to cataract them anyway. Beside, this crowd – a detachment of ophthalmologists, a snoutful of otolaryngologists, and mass of head and neck of surgeons – will be refractory pupils with cerumen in their lumens.

They will be maculadensa, with pinpoint understanding and a complete lack of focus after eyeballs before dinner. After these eyeballs, they will be glassy-eyed, lost in ciliary and ciliary fantasies, such as hunting rhinoplasties in Africa or cultivating irises in January.

Oh, I might have to explain my puns, stapes by stapes. Maybe I’ll even have to write them out with pin and incus. My puns will not please everybody’s palate. You’ll never uvula know how they will respond. Some will never appreciate my puns, not now, not tonsil Hell freezes over.

But who knows? My puns may tickle the cochlea of some of your hearts and sooth the labyrinths of some of your sinuses. Uvea never can tell how people will react when I go chorion around the globe like a wide-eyed wild young punster.

Enough pontificating, enough fundra on your tundra.

I shall stop. I don’t wish to punish you further. You might decide to toss me into the punitentary.

I will quite just in the neck of time. It is laser than I think.

In conclusion, note that I have not spoken directly about reform. Why not? I was told to keep it light. Unfortunately, I cannot. The Office of Management and Budget and the Medicare Chief Actuary, already project Obamacare will run $331 billion over budget. The costs of Obamacare, the so-called “The Patient Protection and Affordability Act,” an oxymoron if I have ever heard one, will explode, raising the premiums and taxes of us all, i.e., those of us who pay taxes.

But not to worry. When it comes to our national health, and to our financial or personal wealth, money is no object because it involves spending or cutting other people’s money, not the government’s money.

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