Beruflich Dokumente
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FEBRUARY 2015
Humanism in medicine
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Pima County Medical
Society Officers
President
Melissa Levine, MD
President-Elect
Steve Cohen, MD
Vice-President
Guruprasad Raju, MD
Secretary-Treasurer
Michael Dean, MD
Past-President
Timothy Marshall, MD
Board of Mediation
Timothy C. Fagan, MD
Timothy Marshall, MD
R. Screven Farmer, MD
Timothy Fagan, MD
Thomas Griffin, MD
Evan Kligman, MD
George Makol, MD
Mark Mecikalski, MD
Delegates to AMA
William J. Mangold, MD
Thomas H. Hicks, MD
Gary Figge, MD (alternate)
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Vol. 48 No. 2
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Inside
5 Membership: We introduce our new Board of
Directors members.
On the Cover
From the Stafford County Museum in Stafford, Kan., birthplace
of Dr. Hal Tretbar, this image from summer 1909 shows B.W.
and Rachael Snyder of St. John, Kan. in their Sunday-go-tomeetin togs, while showing off their 1908 Buick with its carbide
headlights, kerosene cowl lights, and squeeze-bulb horn under
the drivers right hand. Note the right-side steering and four
valve stems per tire. In this issues Behind the Lens, Dr. Tretbar
looks back at the days when the local photo studio was the
one-stop for portraits, developing, printing, and all things
photographic (Image permission Stafford County Museum).
Correction
Well, last month we said it was a mere reckoning, but were told that
Dr. Melissa Levine is not our 105th, but 106th president of PCMSs
112 years.
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7
PCMS News
Makols Call
ts 2022 or somewhat
thereafter. Dr. Smith, a
young surgeon known to his
patients as Dr. Smitty, strolls
into his new, totally solarpowered office. The morning
was overcast, so there was not
enough overhead lighting to
see patients yet, but Dr. Smitty,
like most folks, had become
accustomed to such
inconveniences.
It was April and tax time, so he
got out the governmentprovided postcard that everyone used to file taxes. Using a
flashlight, he filled in his net proceeds from the practice,
multiplied by 15 percent, and filled in with those figures the only
two spaces on the card, and he was done with tax preparation.
He naturally had deducted the expenses required to run the
office, but since there was no malpractice insurance anymore, he
was planning to use the savings to take his family on a second
vacation this year.
He had noted on the way in today that there were more
homeless people on the streets. He had passed his former
accountant, his tax attorney, and a once-famous TV advertising
tort lawyer, all together in line at the food bank. It seems that
without hundreds of pages of tax law, all thrown out after the flat
tax was passed, that they had seen their lucrative professions
evaporate. Congress had also passed laws reinstating the British
tort system, where no one could sue without putting up
expenses, and then paying the other partys costs if they lost.
They had also outlawed payments for pain and suffering after
an Omaha jury awarded $1 trillion to a man who had chipped his
tooth at a restaurant.
Dr. Smitty glanced at his schedule and noticed that his first
patient was a formerly spectacularly rich real estate investor, now
barely making do, as Congress had repealed the notorious
exchange clause 1031 for real estate, allowing an investor to take
the profits from one project and within 18 months, roll them in to
a new larger venture, deferring virtually indefinitely paying
federal income tax on the capital gain. Now, a huge backlog of tax
revenue came due.
The doctor laughed because the real estate lobby had previously
convinced lawmakers that apartments, hotels, houses, and
vacant lots were all like properties. In fact, so much tax revenue
was generated by eliminating such ridiculous writeoffs that there
was virtually no national debt!
Dr. Smitty was not sure if he had enough time this morning to file
to run for U.S. Senator from Arizona, which he could now afford
10
to do, since it only cost $10,000 to enter the race and media
outlets had agreed years ago to provide free airtime to all
candidates. Lobbyists, those practitioners of legal bribery, had all
been eliminated awhile back. No more political contributions
were allowed, as no U.S. Senator or Representative could be
elected to more than one term.
Holy back to the future! you are probably saying Makol has
gone off the deep end again! You might be justified in this,
because none of the aforementioned is likely ever to happen. It is
likely we will never realize the day where a flat tax is accepted,
where tort reform will occur, where a certain class of individuals
because of lobbying cannot get preferred tax treatment, and
never, ever will we see the American royalty we call Senator
and Representative vote themselves out of a virtual lifetime
cushy job.
Who says theres no free lunch? Not only do congressional
elected officials get free lunches at a posh Capitol dining facility:
They also have free gym membership, free haircuts (not the kind
they give us), government-supplied automobiles, blue-chip
healthcare free of ObamaCare mandates, unlimited franking
privileges (free mail to constituents), and the ability to make as
many airline reservations as they wish, only taking the flight they
need with no cancellation fees for multiple reservations.
Almost as an afterthought, their compensation averages more
than $200,000 annually. But the real power they have is to
control tax policy, giving members of the U.S. Senate and House
the power to tell the common man and woman how to spend his
or her money, how to save, when to give to charity, and how
much you must take out of your own retirement accounts when
you do retire.
A Washington Post article of July 13, 2014 reported that
companies that donated to members of the powerful House
Ways and Means Committee, who control tax policy, received an
average of $3.3 million in tax savings over six years. Incumbents
get the big money, and get re-elected again and again. We in
Arizona had 34 years of Rep. Jim Kolbe in office, and only were
spared 34 more years because he resigned. Similarly, Sen. Jon Kyl
resigned after 18 years in office. Sen. John McCain may be there
forever! Are these the only people competent to run our
government, or should I ask, are any of them competent to run
our government?
We desperately need term limits for our elected officials. A U.S.
Senator should serve six years and be done, barred from reelection. A U.S. House of Representatives member should serve
four years and never run again. Regular people who are not
millionaires or billionaires could run for office instead. In my
whole professional life I have met one U.S. Senator, mainly
because I took care of his wife as a patient. Wouldnt it be great
SOMBRERO February 2015
Steven J.
Blatchford,
MD
A. J. Emami,
MD, FACS
James D.
Gordon,
MD
(520) 792-2170
Adam D. Ray,
MD
Green Valley
Sierra Vista
Marana
David T.
Miyama
MD
11
Time Capsule
A Superior trip
By Nick Mansour, M.D.
Donald Hammer, Dr. Klein and I met for lunch shortly thereafter
and discussed what would be of interest, and my brother-in-law
and I went there in August 2014, toured the area, and mapped
out points of interest, though we did not find Mattie Earp
Blaylocks grave. Superior is in a valley, surrounded by formidable
mountains west and east of town.
About a month later Don and I made a second trip to retrace our
steps, and spent more time looking for the Pinal cemetery where
Mattie Earp Blaylock was buried. We re-traced our route and
came to a fork, the left branch of which we took the first time,
but decided to take the right branch the
second time. We traveled abut a mile and
came upon a wrought-iron fence with the
sign Historical Pinal Cemetery. This time we
found the grave location.
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This stone in Historical Pinal Cemetery memorializes lawmanoutlaw Wyatt Earps common-law wife, before he met the love
of his life, Josephine Sarah Marcus.
70. When I was in high school, this stretch of road had been
abandoned for the newer highway which now is US 60, and it was
where high school boys would drag-race their souped-up cars.
deep ruts remain from the wagons that transported silver ore
from the mine to the town. There also appear to be several
metates in the rocks between the ruts, about two feet apart. We
speculated that these could be remains of where Native
Americans ground grains, since space between them appeared to
be about two shoulders width.
Picket Post Trailhead, the site marked with a plaque, is also where
the Arizona Trail passes through. For hikers this is the start to hike
to the top of Picket Post Mountain. The trail is fairly good at first,
is later marked with arrows, and the last 1.3 miles is a rugged,
From there, we proceeded east about a mile east on 60 and
Gnot go to
almost vertical climb up to the top of the mountain. There is a red
turned north onto Silver King Mine Road.BThe
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INNITUS
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the mine, but veered off to the west and up a hill. On the top of
the hill, we were able to retrace our route to Historical Pinal
Cemetery. We noted many graves, some of which had
headstones, but most did not. A plaque noted that Mattie Earp
Blaylock is buried in this cemetery, but that the gravesite is
unknown. Apparently a larger memorial to her had been taken
down. A local resident told me and Don Hammer that there was a
tendency for people to defile the grave.
Allergies
Nasal/sinusitis problems
Hearing & balance disorders
Hearing aids & tinnitus
Endocrine & salivary gland disease
Voice disorders
Snoring and sleep apnea
Thyroid and parathyroid gland surgery
Cosmetic/Aesthetic surgery
Jonathan Lara, DO
Thomas S. Kang, MD
About three miles east of Superior we turned onto the road to Oak
Flat, a picnic ground developed in the 1930s by the Civilian Conservation Corps and containing picnic tables and two erosion control
dams. We stopped a few yards inside the area and Don Hammer gave
a talk on the mines development of the mine, whose two headframes
could be seen in the distance. To the north is Magmas No. 9 shaft, in
use from 1972 until the mine was closed in 1996.
The newer headframe a few yards to the south is over
Resolutions No. 10 shaft, the location of present mine
development. Don Hammer gave a brief history of how the mine
was discovered, and about some of the development done to
reach the ore body more than 4,000 feet below.
We left Oak Flats and returned to Superior on U.S. 60, which
descends westward along Queen Creek Canyon across a high
bridge going south, then takes a long curve of about 90 degrees
and a long span until it reaches the town. To get to the town, one
has to veer off to the right and at the bottom there is a very sharp
90-degree turn onto Magma Avenue.
In 1952, at about 7:30 a.m., I heard a truck honking its horn in the
distance. My first thought was that a runaway truck had burned
out its brakes coming down the mountain, and so it might not
make the curve. But it did, and roared up Magma Avenue
stopping about a quarter-mile from the turn. My neighbor, owner
of a drugstore, was leaving to open his pharmacy when the truck
came to a stop and the two drivers emerged.
From what I remember, he said they were white as sheets. I
nicknamed this place suicide curve because at about 9 a.m.,
SOMBRERO February 2015
another truck also lost its brakes and came down at a very speed.
It did not make the curve and turned over. I recall that about 32
trucks wrecked on that curve. The highway department built a
runaway-ramp at the beginning of the curve. One truck made it
up the ramp but still turned over. No one was killed in any of the
crashes, but the fuel tanks of the one truck that turned over on
the runaway- ramp caught fire. The driver was badly burned and
died later of his injuries. Had his truck not caught fire, he
probably would have lived.
Another time, a car with several children as passengers lost its
brakes, went up the ramp and turned over. The occupants were
ejected, and fortunately no one was killed. To stem these tragedies,
the highway department had built a wide pullout area across from
the entrance to Oak Flats, and warned truckers of the curves
danger, and that they should check their brakes and go down in low
gear. This essentially ended the runaway truck problem. The
highway department later straightened the road, which now goes
straight through the town of Superior but south of Queen Creek.
Superior has several interesting buildings. The old high school still
stands, and I believe is one of the few high schools that had
Greek-revival columns in front, which became so typical of our
public buildings. Mine tailings can still be seen, though covered
with earth to make them more aesthetically pleasing. To the west
of town is the slag dump, and just north is the old smelter stack,
still standing although the furnace buildings were razed.
Superior had two grade-schools. Harding School, was at the west
end of town and is no longer used for classes. Roosevelt School,
more uptown and a block north of Main Street, is still in use. This
school had two classes for each grade, A Class for the Englishspeaking students, and B Class for those who did not primarily
speak English.
On Main Street toward the east end of town stands the old
Coleman Hotel, no longer in use. It burned down in the late 1950s
and was rebuilt. One man died in the fire and his body was found
in the stairwell.
Superiors main hotel was the Magma, which fell into disrepair,
and part of it is being rebuilt. This was where some of the stars of
the 1963 MGM film How the West Was Won stayed. The movies
railroad scene was filmed on the Magma Railroad. The old
Uptown Theater is gone, the drugstores have closed, and many of
the buildings are boarded up. We stopped at the Bob Jones
Museum, named for Bob Jones, Arizona governor in the late
1930s who had a drugstore in Superior. Id hoped we could have
gone in, but it was closed.
We toured some of the backstreets going by Roosevelt School
and down Pinal Street. On the way out we stopped at the location
of the old train depot. The depot building is no longer there, but
some of the tracks are still visible, some covered by the roadway.
This was effectively the entrance to the smelter area. The
company built housing there in 1924, and this section was called
Smelter Town. The company also built housing near the main
mine yard, and all these homes were occupied by administrative
personnel of Magma Copper Co.
The tour ended about 4 p.m. as we had planned, but we did not
SOMBRERO February 2015
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these images you can find clues to what was important to the
people who lived there almost a century ago.
I still have the portraits of my family taken in Staffords Durham,
and later Rader studios. The image is usually sepia-toned and
presented in a firm cardboard mount with a folding cover.
Last fall I was back in my hometown to visit the Stafford County
Museum. I wanted to see the unique collection of W.R. Gray
images. He had had a studio for many years in St. John, the
nearby county seat.
Here is my father, J.J. Tretbar, M.D. when he was the towns
most eligible bachelor, in 1920 at age 35. He is looking suave
and relaxed with a half-smoked cigar. He is fashionably dressed
in a vested suit. His necktie puffs out a little to show a pearl
stickpin. The collar appears to be detachable, one that allows
collars to be changed so a starched shirt can be worn longer.
Finally there is the gold watch-chain from the coat button hole
to the left chest pocket. Note the soft lighting, partially sharp
focus, and Durham studio background.
SOMBRERO February 2015
In August 1908, Fred Van Lieu posed with his bicycle. This
handsome guy with a derby and fancy watch-fob holds a pant clip
in his left hand. Another clip is on the cycle frame. The bike has a
bell on the right handle and is equipped with a carbide headlight,
a tire pump, a rear wheel brake, and has ridged pedals.
Miss Gould, Clara Dunn, Merle Smith, and Eva Dunn of St. John put
on their fancy hats for a group photo on March 27, 1909. For some
reason Clara Dunn and Smith are wearing mens suits and hats.
18
The Forsyth Library at Fort Hays State College in Kansas has put
the images that have been processed so far on its website.
Youll find fascinating what was going on in the American
Midwestern early 1900s by pulling up: http:/contentcat.fhsu/
cdm/landingpage/collection/Stafford. The Stafford County
Museum website is museum.staffordcounty.org.
n
SOMBRERO February 2015
Humanism
19
20
Perspecve
Dr. Murthy is a gifted young physician, still early in his career, and
already has significant accomplishments, but no formal public
health training, and little management or senior leadership
experience. His nomination became controversial due to this, and
his political advocacy and perceived bias on several issues.
21
CME
February
Feb. 16-19: The 2015 Update on Psychiatry: Continuing a Proud
23-Year Tradition is at the JW Marriott Star Pass resort in Tucson.
Event targets physicians, NPs, RNs, PAs, RNs, psychologists, allied
health students and interested community members.
This four-day live activity will provide an overview and
practical summary of the latest information on psychiatry and
psychopharamcology, organizers said. This is a multi-accredited
course with 23.25 CME hours. The course is designed to keep you
current in your daily practice and help you prepare for MOC by
the American Board of Psychiatry and Neurology.
Conference website is www.psychofarm.arizona.edu for a
complete course schedule and list of speakers, and to register
online.
March
March 5-7: The 11th Annual Mayo Clinic Womens Health
Update is at Firesky Resort, 4925 N. Scottsdale Rd., Scottsdale
85251; phone 480.945.7666 or 1800.528.7867.
Accreditation: 18.5 AMA PRA Category 1; 18.5 AOA Category
2-A.
Course addresses needs of female patients and their
healthcare providers. Participants should gain comprehensive
insight into relevant medical problems uniquely found in women
as well as a basic approach to addressing and improving common
health concerns. Topics include cardiovascular health, breast
health, Ob-Gyn and menopause, infectious disease,
22
June
June 27-July 3: February is not too early to think about
summer, especially because there are only four spots left for
THMEPs Fifth Bi-Annual Colorado River Medical Conference.
This trip-of-a-lifetime runs down the Colorado River through the
Grand Canyon, leaving at 8 a.m. Saturday June 27 from Lees
Ferry, and returning there Friday July 3.
The trip is mildly strenuous and potential dangerous due to
large rapids, Dr. Dick Dale said, but its extremely fun and
educational. I need a commitment from 23 people in order to
schedule the conference for 12-14 CME credits. Deadline is fast
approaching for the four more spots to fill, so please call me at
721.8505, or e-mail rdale9136@aol.com about your interest as
soon as possible.
Significant others and children 8 and older are invited. Cost is
$2,600 per person (not payable to Tucson Hospitals Medical
Education Program) for the full trip plus registration fee (payable
to THMEP) exclusive of one nights lodging at Marble Canyon.
Registration fee is $200 for physicians and dentists, and $100 for
nurses, residents, allied health professionals, and physician
retirees.
The events education component will have physicians
presenting updates in IM, orthopedics, ENT, vascular surgery,
general surgery and traumas.
Members Classifieds
SHARED SPACE FOR RENT: Active Neurology office in Northwest Tucson
has office space to lease. Renter does not need to be in Neurology field. If
interested, contact Mike at Northstar Neurology at 520-229-1238 or e-mail
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SOMBRERO February 2015
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Who should be screened?
Smokers age 55 - 74 with a 30 or more pack-year history of smoking.
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23
TH CONSECUTIVE DIVIDEND
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