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    Tuesday, November 28, 2006

    "Hello, I'm the chief of neurotrauma surgery for the city of San Francisco, and I'd like to join the Navy." Said this man:

    Holland took a pay cut of more than 50 percent to join the Navy, but he brushes aside the topic with a wave of his hand.

    "The pay isn't as good as it would be in private practice, but that's not the point," he said. "Obviously, I didn't do it for the money. I didn't get into medicine for the money. Otherwise I'd be in private practice.

    Or consulting.

    posted by Sydney on 11/28/2006 07:54:00 PM 9 comments


    Heh. I went into private practice to get out of San Diego and into the boonies. So the pay's not great, but the scenery and the traffic are.

    I had the pleasure of working at the old Balboa hospital, the set-up was poor but the buildings were beautiful. And they treat the lady doctors very well! I never had so many doors opened for me in my life.

    Good luck Dr. Holland, and God bless you.

    By Anonymous danie, at 5:40 AM  

    Hi,I AM HOLLAND!!!
    You are so ....

    By Anonymous Anonymous, at 8:04 AM  

    This is obviously a fake story.

    Charles Rangel said so.

    By Anonymous Anonymous, at 11:14 AM  

    Okay. Let's assume that Dr. Holland is real, and that his story is as represented.
    I'm troubled by this article on several levels. Way back when (at a time when ALL decisions seemed momentous), I opted for Family Practice, even when I was being urged by colleagues to enter a more lucrative field. I had the grades and evals to do whatever I wanted, but I felt compelled by a misplaced sense of altruism (it burdens me to this day) to take a different path. Perhaps it is true that specialists in private practice can make a lot of money, but rubbing shoulders with them over the years only convinced me that-- no matter what medical field you pursue-- overhead is overhead, and you're going to get eaten by it. Now, a neurosurgeon has some pretty impressive bills to pay (I can only imagine what their malpractice coverage costs), and many of those financial woes would dissolve when a doc signed up with the military. Thus, a military doc may actually have more money in his or her pocket than a civilian, despite the lower "wage." And those who think that military red tape is a headache haven't done their share of wrestling with hospital administrators, CEO's, HMO's, PPO's, IPA's, and other undesirables... and God help any physician who has been sued, for there is no easy way out of bloodied waters when the lawyers start circling (no, I haven't been sued; I just know a few good people who have been). Hence, "administrative" difficulties might be lessened once a doctor shrugs into that uniform, too.
    All things considered, then, an individual like Dr. Holland might enjoy more latitude to practice his art, accompanied by less stress, were he to join the military.
    This report, however, presented Dr. Holland's decision in a rather distasteful light.
    No matter what this man's reasoning for enlisting may have been (and let's just suspend any arguments about the necessity for maintaining a military in the first place), the thing that really bugs me is how-- yet again-- we're expected to believe that war is somehow a glorious thing, and that there are people who yearn to participate in it. And even those of us who know better are being asked to believe that when some young, vibrant man or woman gets shredded in a senseless act in a place far from home, there's a miracle awaiting them... when it's really only a highly motivated, skillful individual with neither the hope nor the means to knit all the pieces back together.

    By Anonymous Anonymous, at 4:51 PM  

    Oh for Pete's sake, Doom, you don't happen to be an editor for the NEJM, do you? "Let's assume Dr. Holland is real." Well, I guess as real than anything else presented in the media, or maybe more so- this one's pretty easy to verify. So your statement is clearly placed there for rhetorical purposes. Well, actually, so are most of the statements in your comment.

    The mere fact that this piece came from the Chronicle, of all papers, gives it a less rah-rah flavor than it might have gotten from other sources. Like, the San Diego Union-Tribune, for starters. Of course, the Chronicle come to the defense of the Jr. ROTC the other day, too. Did you weep & grind your teeth then? I didn't grind my teeth- because my jaw had dropped!

    Good for Dr. Holland. He's doing what he wants to do, and he's happy about it. Between your comment and your nic, I'm guessing neither one of those apply to your current situation. However, I bet you are as smart as Dr. Holland. It's never too late to change your life, but first you need to take off the tinfoil hat.

    By Anonymous Local, at 10:30 AM  

    Well, for cryin' out loud, "local," I can only say that I took the time to read the three comments that preceded mine, one of which called into question the validity of the report. Would that you had done the same.
    If I WAS an editor for NEJM, I would have resigned long ago; being at least a little egocentric, my credibility is too important to be associated with any medical journal these days.
    Beyond that, I won't comment. Sorry you missed the point.

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    By Anonymous Anonymous, at 10:56 AM  

    The preceding comments were obviously a joke. You take yourself so seriously, I had to assume you took them seriously, as well. Now, what was that point you were trying to make?

    By Anonymous local, at 7:51 PM  

    Local! Good to hear from you.
    Yeah, if I took myself any more seriously I'd be doing stand-up comedy down at the morgue.
    You're certainly entitled to your snap judgements.
    Okay, I'll haul my tongue from my cheek (I'm occasionally reminded that not everybody appreciates that approach, and sometimes it's just poorly delivered), and I'll try to make my point as succinctly --and concretely-- as possible:
    There are many reasons why a physician might choose to join the military. It is unfortunate when that decision is given a "rah-rah" spin...by ANY medium.
    By the way, in your first post you indicated that you read the Chronicle on a regular basis, and you inferred that I might do the same (perhaps another hasty and inaccurate assumption). Now, is the Chronicle some sort of well-known periodical, or something??

    By Anonymous Anonymous, at 2:39 PM  

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