I am an emergency physician with an apolitical message in this rather politically charged, polarized time in our country. I have worked for some time in this profession, and have noticed a disturbing trend about which I must speak out — the growing number of emergency department scenarios in which the selfishness and entitlement of those without real emergencies drown out the quiet suffering of those in real need.

This morning a middle-aged woman came into the emergency room in cardiac arrest. ACLS was performed to keep her alive. Other patients were in the ED before she even arrived, certainly with what they felt were emergencies, but treatments for these individuals were placed on hold as this event took precedence. After 75 minutes of continual heroic measures and life-saving interventions, with her grief-stricken husband crying, holding her hand for the last time, and stroking her face, she died.
This was no movie, no reality TV show. This was as real as it gets. Real life and real death. Family huddled around the bed to say their goodbyes and wished they or we could have done more.

I walked to my office, emotionally drained and exhausted, and from across the emergency department another patient, upset that she had to wait, spoke out brashly in tones that carried to every room in the department. “I know someone's dying and all, but I am in real pain here.”
What most of America don't know is the emergency department staff are graded with a nationally based report card by hospital administration. A survey is sent only to those who are discharged from the ED, not to those who actually needed admission to the hospital for an emergency or to those, like this new widower, whose loved one passed. This survey is a customer service tool used to see if people like coming to our ED and asks whether we did a good job. The ED staff know this survey is skewed because of the population to which it is sent, and certainly it is not the only tool hospital administrators use to evaluate us. That is another topic for another time.
But you must understand, the real emergencies are rarely graded or surveyed; they only go to those vast hoards of folks who were sent home, many of whom did not get their narcotic medication refilled, like Ms. “I'm-in-real-pain-here” who screamed her needs for all to hear, just within earshot of a new widower.

Mitt Romney recently was secretly taped speaking to his party base about the 47 percent of the nation that feels entitled to health care, to homes, to handouts, and to ever-present help from the government. If this lady represents that 47 percent, I have a few things to say.

The widower and his wife were also in need of care and financial aid. They came to the hospital for emergency care and received it. He was gracious about it, even when the scenario ended in a way he did not want. He and his family were thankful for the care. They will not be asked how they felt the care was, but screamer lady will be. It is doubtful that screamer lady would have been happy short a lifetime supply of narcotics, free ambulance rides, meals, and immediate gratification of all perceived needs. In fact, she and her friend raided the refrigerator for food and beverages without asking permission of staff or being cleared for eating or drinking prior to her labs and tests returning.

This widower and his family behaved in a way that acknowledged that there were others in the ED. They realized a limited but adequate number of doctors and staff were available. They were calm in the face of a real emergency, but never acted as though the world should stop for them, even though it ended tragically. They knew how to play fair even though their real emergency was not fair.

We live in a society that David McCullough Jr. describes as rewarding mediocrity because everything fairness and equality. Everyone is special, so nobody is. Everyone should get a prize for participating. And even though Johnny didn't win, we're going to give him a trophy for trying because he is special, too. Competition is bad because there is a winner and loser, and that's not fair. This fundamentally wrong notion breeds false equality and ultimately false fairness and entitlement. We do no one a favor by preaching this. We are lazy parents if we can't find a constructive way to celebrate the winner and help our children be happy for him. Instead, we have chosen an easier road: to make all things fair and equal. If nothing can rise above, be more important, or be first, then all must be mediocre. If all must be fair and equal, all will assume the position of being just as important and just as entitled as everyone else despite the real emergency or the real need.

The government mandates I evaluate and treat everyone who steps foot in our emergency department, regardless of the ability to pay or the acuity of the complaint. The government has passed health care legislation that makes it so everyone must have insurance. Now everyone is equal, everyone is the same — the broken physically, the broken emotionally, the broken spiritually, the broken psychologically, and even the broken culturally. Many have primary care doctors, but they storm the ED at 2 a.m. with the Burger King entitlement of having it their way rather than waiting for their own doctor to see them the following day. They will demand to be treated equally regardless of the acuity of their emergency. And you know what? They will probably get it because we don't want a bad report card from the feel-goods upstairs intent on establishing great PR or the lawyers who will use government mandates to take away your pain and make the other guy pay.

Were I to say something to screamer lady about her behavior, she likely would fall back on the clichéd finger-pointing canard, and say, “You're a doctor. You are well off. You don't understand. You can't relate. And you are the one responsible for the high cost of health care. It's your fault.”

As a young, married medical student, my family and I participated in Medicaid because having insurance was a requirement for my rather expensive medical school. I felt grateful, not entitled, to be able to sign up for the program. I know poverty in America because I lived it for a decade despite help from family. Government programs can help for a time. But know this, I spent my high school years working on grades and homework and at a job. I went to four years of college, working on grades and a job. I went to four years of medical school working on grades and leaning on the government for help, which I am now paying back. Then, I worked four years as a resident on call, on 12- or 36-hour shifts with just enough sleep to go back and start again. Now I work. And I work. Work and making good life decisions result in prosperity. No one — I repeat, no one — becomes prosperous on government programs. Student loans, food stamps, Medicaid, and unemployment benefits are there to help temporarily, but for heaven's sake, government aid is not a right and living your life like you are entitled to eternal government care is not right.

Anyone who wants to can go to school for 12 more years after high school and work, incur student loan debt, drive a 14-year-old car for 12 years, and study (while passing on TV, movies, parties, conversation, family life, sleep, and eating to study some more). They can then make a living that buys a nice home, clothes, insurance for family, and, hey, a new car. Anyone who can work can do this. And I'm all for government help for those who, through no fault of their own (and not their poor choices), can't work.

This woman, however, would reach into my pocket and take my hard-earned money while tapping impatiently on my watch to give her more of my immediate time and attention when others need it more, still claiming I am a cold-blooded heartless rich guy intent on robbing her of all the government assistance that is her due while simultaneously stiffing the hospital for what she considers an unconscionable medical bill. I am not cold-blooded or heartless, just tired and beat from the work I do and proud and gratified that I can do it. The same is possible for anyone here in the land of opportunity.

Are we so far gone as a society, in the name of popular progressivism, that we now don't view work as something to be valued, specifically when the work requirement is removed from the welfare bill? Are we so far gone as a nation that we vilify someone for their hard-earned wealth and elect a national leader who believes in taking that away to pay for those who would act as drains and not aquifers to the national pool of prosperity? Have we developed a national mindset that makes it normal to expect others to take care of us?

I think we develop a self-absorption that is callous in the face of anyone else's need when we rely on the government to handle our every need. No respect. No decency, no restraint, no responsibility, and no apology for it.

Frankly, our government cannot fix this, they cannot mandate a solution to this, and they cannot legislate against this. Nor should they. The solution to selfishness and entitlement can only be fixed with a mother and father (who know how to model character) teaching a child that work is hard and rewarding, that life is not fair and never will be, and that the freedoms you enjoy in this life are because someone else paid the price. Get up and get fixing.
Sincerely,

Michael E. Jacobson, DO

First, this guy is a doctor. That means that his work ethic is on the extreme high end of the scale, or he'd never have survived his residency.

I have no personal problem with the laziness of others in and of itself. As long as a person is self-sufficient, their time is all their own, and I have no just claim in dictating how they choose to spend it, even if I would spend it differently. My problem arises when cocksuckers like you show up and demand my time be spent to provide for those who are unwilling, simply because I have a better wprk ethic; all the while failing to acknowledge that the main reason Ihave a better work ethic is because you insist on a public policy which allows them to rest light in their poverty.

As to the amount of bullets it would require, it's cheaper to simply stop feeding them.

Now hold on there. I never claimed that you should be forced to provide for them. I just absolutely despise the extreme dishonesty involved in blanket labeling all public assistance takers as "lazy." A lot of people love to create a construct where they can both claim to SUPPORT public assistance, but at the same time not pay a dime for it. They do this by claiming to support government assistance, as the author of this piece does, but only if it goes to people that are not "lazy." They then proceed to effectively redefine "lazy" as "anyone on public assistance" so nobody qualifies for the assistance. That way they can seem progressive and charitable without having to pay a dime for it.

I'm totally fine with it if you want to kill public assistance. Just be honest about it and don't demonize everyone currently on it, so you can claim to avoid "killing" anyone that isn't "worthless". Nobody is entitled to public assistance. If you drop it, some people who, despite not being lazy, won't have the combined skillset/work ethic to succeed and will starve.

First, its incredibly dishonest to talk about how hard Americans don't want to work and the work ethic involved based on agricultural jobs whose wages are artificially depressed by illegals, whose necessity is then claimed based on that same situation.

Second, it is absurd to claim this doctor's high work ethic makes his expectations unrealistic, when his expectation is that people not complain about thepromptness of free treatment when the delay is caused by trying to save someone's life. As usual, you try to pretend its somehow unrealistic to expect those receiving free help to do so graciously, even when another's life is on the line.

Yes, nobody would take an 80 hour a week job for sub-minimum wage when they have public assistance programs available to them.

But, newsflash. It's not their work ethic that's the problem there. It's the availability of the public assistance. If the options were starve on the streets or afford room and board, even lazy Americans would be leaping at those Agri-jobs.

Yes, nobody would take an 80 hour a week job for sub-minimum wage when they have public assistance programs available to them.

Transient allegedly robs Yelm bank of single $20 bill, waits outside to be arrested
A "down on his luck" 54-year-old transient is accused of robbing the Yelm Timberland Bank of a single $20 bill Wednesday afternoon, then leaving the bank, lighting a cigarette, and waiting or police to arrive to arrest him, court papers state.

The transient was being held Friday at the Thurston County Jail on suspicion of a single count of first-degree robbery.

According to court papers: About 4 p.m. Wednesday, the man entered the bank, wrote a note on a deposit slip and handed it to the teller. The note read, "This is a robbery, place all the twenties on the counter." The teller looked up at the man, and he said, "It's real. Just do it now."

The teller opened the till drawer and placed all the $20 bills, totaling $200, on the counter. The man picked up a single bill and said, "I just want one." He stepped back and said, "Go ahead, push your button." He then walked outside, lit a cigarette and waited for police.

When Yelm police arrived, the man placed the $20 bill on the ground. Officers recognized the man. He told one officer that he "had nowhere else to go." While being taken to jail, he said, "I did it as nice as I could. It's a poor man's retirement."

During a subsequent interview with officers, he said he was basically "down on his luck and had lost the drive." He added, "I couldn't off myself so I did what I did."

The man said he had been planning the bank robbery for a couple of weeks. He said "it wasn't about the money, "and described his motive as "being on hard times, having been divorced, out of a decent paying job and not wanting to impose any further on family or friends."

Jeremy Pawloski: 360-754-5445

jpawloski@theolympian.com

Read more here: http://www.thenewstribune.com/2012/11/0 ... rylink=cpy

Some yes, but some would also resort to crime I'd imagine. Why work like a slave for just enough money to keep from starving, when you can just break into someone's house and steal their goods? Why not just wait outside BB&Beyond, and whack some old dude in the head and take his wallet? Sure, there are risks involved, but at that point some people would take the risks. And if they get arrested? Free room and board for no work!

/slightlytongueincheek

As to the physician? Grow a sack. People have been acting this way for decades now, and it comes with the territory. Working in the ER is like working in a circus atmosphere. You get a few real emergencies, then you get a whole lot of non-emergencies which include all the crack heads and drunks and low-lifes. Hell, when I worked nights in the ER we had a list of "regulars" who came in every week at least once, for years. It was like Otis on the Andy Griffith show....they had their own room.

The medical system is fubar in this country. The system upholds a self serving ration on physicians, which makes a shortage to increase price. I've known several guys who did very well on their MCAT, and had everything ready to go to med school, but were denied because the list was "full". One who became a cardiac surgeon, had to wait until the following year to get in. One guy waited for 2 years, and then said **** it and did something else.

First, people were STILL calling unemployed Americans that didn't take the jobs "lazy," DESPITE the fact that the wages were artificially depressed by illegals. That was sort of part of the point.

Second, while that specific lady is an *******, this doctor's rant isn't about her. She's just used as an example and then generalized to all government assistance recipients, whom he proceeds to disparage throughout the rest of the piece.

Some yes, but some would also resort to crime I'd imagine. Why work like a slave for just enough money to keep from starving, when you can just break into someone's house and steal their goods? Why not just wait outside BB&Beyond, and whack some old dude in the head and take his wallet? Sure, there are risks involved, but at that point some people would take the risks. And if they get arrested? Free room and board for no work!

/slightlytongueincheek

As to the physician? Grow a sack. People have been acting this way for decades now, and it comes with the territory. Working in the ER is like working in a circus atmosphere. You get a few real emergencies, then you get a whole lot of non-emergencies which include all the crack heads and drunks and low-lifes. Hell, when I worked nights in the ER we had a list of "regulars" who came in every week at least once, for years. It was like Otis on the Andy Griffith show....they had their own room.

The medical system is fubar in this country. The system upholds a self serving ration on physicians, which makes a shortage to increase price. I've known several guys who did very well on their MCAT, and had everything ready to go to med school, but were denied because the list was "full". One who became a cardiac surgeon, had to wait until the following year to get in. One guy waited for 2 years, and then said **** it and did something else.

Because in the first case, sooner or later you'll probably get your head blown off and in the second you'll be taking it in the pooper. The geezer in the article cited most likely won't go to prison (thus backfiring his scheme) and if you do something serious enough to get a long sentence and guaranteed room and board you'll most likely be going to a guaranteed hard case joint where you'll be too old to be of much use to a prison gang that might protect you.

As for this "grow a sack" bullshit, wait until your *** is going down from a heart attack or because someone stabbed you. Then tell the guy that tried to work on you to "Grow a sack" because he doesn't like some shithead yelling at him for saving your *** instead of looking at her ingrown tonail.

Yes, nobody would take an 80 hour a week job for sub-minimum wage when they have public assistance programs available to them.

But, newsflash. It's not their work ethic that's the problem there. It's the availability of the public assistance. If the options were starve on the streets or afford room and board, even lazy Americans would be leaping at those Agri-jobs.

So......I think my "***" is quite qualified to say "grow a sack". Working in the ER isn't for pansies like this guy. It's a tough *** job that requires thick skin, a strong stomach, and a hard heart.

Except if you ask a good percentage of the moralizer conservatives, it IS their work ethic that's the problem. They think these people have some kind of moral obligation to take ANY job, regardless of how **** it is, despite the fact that public assistance exists. Some will even tell you that the simple fact that you are on public assistance, regardless of the reason, makes you a morally bankrupt individual because you are now "enslaving" others. (lol) You see, a "moral" person, if totally unable to find any kind of work, would shoot themselves in the head before stooping so low as to take the public dole and forever mark themselves as human scum.

So......I think my "***" is quite qualified to say "grow a sack". Working in the ER isn't for pansies like this guy. It's a tough *** job that requires thick skin, a strong stomach, and a hard heart.