Thursday, February 8, 2018

Modern Medicine -- Essential To Me, And Probably You, Too

Tomorrow morning I will be at Alta Bates Hospital here in Berkeley, and my friend and colleague Joel Piser will be operating on my prostate, which has grown too big for my britches in an excess of manliness, I guess. It should be a minor laser procedure, and here's hoping that that's all it is.

It has led me to reflect, once again, on the proclamation of the public health community that the major advances in health have not been personal medical services, but advances in hygiene, cleanliness, food safety, immunizations, and other mass programs. While I'm sure that is true as far as it goes, it should not lead to a derogation of the importance of medicine. Without them, I wouldn't be here, and neither would millions of others who overpopulate our world.  In the near term, facing this newly available prostate surgery, I reflect that without it, I would sooner or later be in the situation faced by Peter the Great, who died after 13 days of not being able to pee, in great distress as we can imagine, as especially I can imagine.

Indeed, my medical adventure started early.  When I was born, I had tight tendons in my right foot and bony abnormalities that must have resulted from malposition in the womb as my foot was forming. The tendons were released by an orthopedist – I believe by Richard Kaplan, whose wife later became my father's companion when my mother died at age 72. Without that surgery I would have been crippled with a permanent limp. In primitive times I would not have survived.

At the age of 14 I broke my right tibia and fibula sliding into home plate in a misguided attempt to steal home – I still remember my friend John Raezer, my third base coach, saying, “You can do it, Budd! Steal home!” Out by a mile as Jimmy Laird blocked the plate with ball in glove. Off to the hospital to have my leg set and casted by my father's colleague Dr. Kim. Again, were we in primitive times (pre-baseball), perhaps death.

Same thing at age 40 when I fell off a skateboard and was taken to Merritt Hospital where friend Mal Barer put a pin in to stabilize that right fibula.  Not so much danger when Mal operated twice on my right knee to trim the meniscus, nor years later when my left knee had similar surgery, but still, seemed helpful to my walking without pain.

In 2009 I had my right hip resurfaced; otherwise I would have been crippled; now, I'm pretty good. 

In 2011 I was going blind from a pituitary macroadenoma, fixed by miraculous surgery that is now routine. Death would have been certain without he surgery.

In 2016 my melanoma was removed, which I appreciated, and again were it untended, it would have killed me.  Still could, though I doubt it.

I currently take two blood pressure medicines daily. Without these I would have been long gone from hypertension complications. These medicines were unavailable 50 years ago.

I currently take a statin for hypercholesterolemia and hypertriglyceridemia. I would probably have had a fatal heart attack or stroke without these.

I take thyroid replacement and androgen replacement medicines because of the destruction wrought by the pituitary tumor. I would be severely impaired by lack of thyroid hormone, and I guess the absence of testosterone wouldn't be good for me either.

In sum, the point I'm making is this: complain that personal medical care is overemphasized, complain that it is far too costly, complain that public health is underfunded and underappreciated, complain all you want. But personally, I wouldn't be here without it, and neither would many of you reading this.

How we pay for it is optional and could be a lot better. How luxuriously we are treated is likewise optional. But as for me, give me personal medical care or give me death.

Budd Shenkin


  1. Budd,
    I wish you the best possible and a stream that is a dream.
    I would not be alive without modern medicine either. Thank you for being present for me during my own recovery. Bruce Gach,M.D.

  2. Hey, Bruce! I remember your ordeal well, and your insistence on a proper diagnosis, your search for the best treatment, and your bravery. Admirable!