Anjobyg.com

So here’s the big dilemma. You’ve been having pain and problems “down there” and, finally after much argument and debate, you go see a doctor. There’s prodding and even more embarrassing tests. Finally, a big gun surgeon appears and confirms your worst fears. You have prostate cancer, but it’s treatable. So this surgeon is just getting into the spiel about the new advances in robotic prostatectomy and you interrupt with the most important question. “How will this affect my sex life?” There’s a pause. Now does the surgeon tell you the truth or does the surgeon smile with the magic confidence that comes from having perfect teeth and tell you that all his/her patients are “fine” after the procedure?

In the midst of this, of course, there’s an assumption the surgeon actually knows the truth. The reality is more likely to be that, after the surgery (which is the easiest part of the whole process), you get passed on to the urology department and our famous surgeon never follows up on what happens to you afterwards. That explains why the perfect smile of confidence is so convincing. He/she is protected by a lack of information and so can appear sincere. More importantly, there have been very few research studies looking at significant numbers of men going through the surgery. That’s just changed. Now surgeons have no excuse for not knowing the “truth”. But that brings us back to the dilemma.

Every year, about 240,000 men are diagnosed with prostate cancer. Suppose you’re only in your 40s and have been expecting an active sex life for the next twenty or thirty years. Loss of hard erections would seriously affect your quality of life. But if you’re already in your 60s and sex has become a slightly distant memory, the potential loss of erections is not going to be so troubling. The tendency among older men with active sex lives has been to refuse surgery. They apparently believe they would prefer a few more years of happiness. They hope to die of natural causes before the inconvenience and pain of the cancer comes to dominate their lives. So which is better from your friendly neighborhood surgeon? Reassuring confidence you’ll be just fine, or total frankness about the risks? (more…)

As we emerge from the recession, we find the nation in crisis. Think of the bursting of the housing bubble and the loss of credit as like a wound. Now the nation has to endure the pain of unemployment with more people living in poverty in 2010 than at any other time since we began keeping records. To give you an idea of just how bad the situation is, a recent survey of the hundred most prosperous city areas by the Brookings Institute found only 16 have managed to replace more than half the jobs lost during the recession itself. That means increasing financial pressures to pay unemployment benefits at a time when tax revenues are low. Except, ask yourself whether just paying unemployment benefit is a sufficient treatment. If your body had just received a wound, would you think it sufficient if the only treatment was sewing you back together and leaving you to get better? No! You would expect there to be follow-up treatment through physical therapy to help rebuild muscles and improve mobility. If there was continuing pain, you would expect experts to help you find better ways to live your life with less discomfort. This might involve redesigning your home, changing the way you work, offering you various drugs to keep the pain under control, and so on.

When you move beyond the original cause but still have consequences flowing from it, you hope and expect there will be an expert in consequences. Just talking to the surgeon who sewed you up is not really the right person to be talking to. That’s why we’re all frustrated with Washington right now because none of the politicians can agree how to treat the pain. The result? There’s no treatment for the pain as they fight among themselves about whether FEMA should have money to deal with emergencies like hurricanes and other minor issues. (more…)