SOMBR ERO

P i m a C o u n t y M e d i c a l S o c i e t y Fe b r u a r y 2 012
Home Medical Society of the 17th United States Surgeon-General

Conrad Murrays prime error Training in on Dr. Ken Sandock How Europe got hooked on our Old West

SOMBRERO February 2012

Official Publication of the Pima County Medical Society

Vol. 45 No. 2

Pima County Medical Society Ofcers

President Alan K. Rogers, MD President-Elect Charles Katzenberg, MD Vice-President Timothy Marshall, MD Secretary-Treasurer John Curtiss, MD Past-President Timothy C. Fagan, MD

PCMS Board of Directors

Diana V. Benenati, MD R. Mark Blew, MD Editor Stuart Faxon Phone: 883-0408 E-mail: tjjackal@comcast.net Advertising Bill Fearneyhough Phone: 795-7985 Fax: 323-9559 E-mail: bill5199@simplybits.net

Neil Clements, MD Michael Connolly, DO Bruce Coull, MD (UA College of Medicine) Alton Hank Hallum, MD Evan Kligman, MD Melissa D. Levine, MD Lorraine L. Mackstaller, MD Clifford Martin, MD Kevin Moynahan, MD Soheila Nouri, MD Jane M. Orient, MD Guruprassad Raju, MD Scott Weiss, MD Victor Sanders, MD (resident) Cambel Berk (student) Christopher Luckow (student) Art Director Alene Randklev, Commercial Printers, Inc. Phone: 623-4775 Fax: 622-8321 E-mail: alene@cptucson.com Printing Commercial Printers, Inc., Andy Charles Phone: 623-4775 E-mail: andy@cptucson.com

Members at Large
Kenneth Sandock, MD Richard Dale, MD

Thomas Rothe, MD, vice-president Michael F. Hamant, MD, secretary

Board of Mediation
Bennet E. Davis, MD Thomas F. Griffin, MD Charles L. Krone, MD Edward J. Schwager, MD Eric B. Whitacre, MD

At Large ArMA Board

Ana Maria Lopez, MD,

Pima Directors to ArMA Timothy C. Fagan, MD R. Screven Farmer, MD Delegates to AMA

William J. Mangold, MD Thomas H. Hicks, MD Gary Figge, MD (alternate)

Arizona Medical Association Ofcers

Gary Figge, MD, past president

Publisher Pima County Medical Society Steve Nash, Executive Director 5199 E. Farness Drive, Tucson, AZ 85712 Phone: (520) 795-7985 Fax: (520) 323-9559 E-MAIL: steve5199@simplybits.net Website: pimamedicalsociety.org
SOMBRERO (ISSN 0279-909X) is published monthly except bimonthly June/July and August/ September by the Pima County Medical Society, 5199 E. Farness, Tucson, Ariz. 85712. Annual subscription price is $30. Periodicals paid at Tucson,

Arizona. POSTMASTER: send address changes to Pima County Medical Society, 5199 E. Farness Drive, Tucson, Arizona 85712-2134. Opinions expressed are those of the individuals and do not necessarily represent the opinions or policies of the publisher or the PCMS Board of Directors, Executive Ofcers or the members at large, nor does any product or service advertised carry the endorsement of the society unless expressly stated. Paid advertisements are accepted subject to the approval of the Board of Directors, which retains the right to reject any advertising submitted. Copyright 2012, Pima County Medical Society. All rights reserved. Reproduction in whole or in part without permission is prohibited.

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SOMBRERO February 2012

CONTENTS

6 9 12 15 18 22 23

Presidents Page
What Dr. Conrad Murray forgot about the doctor-patient relationship.

DEPAR TMEN TS
Membership................................... 7 Conferences & Seminars................ 26 Members Classieds..................... 26

PCMS News
Whats up at Arizona Friends of Chamber Music; Walk With a Doc is here; fund-raising for U.S. Senate candidate Dr. Richard Carmona.

In Memoriam
Remembering pioneer urologist Dr. Stanley I. Glickman, M.D.

Behind the Lens

Dr. Hal Travelin Tretbar details how Europe goes gaga over our Old West.

Enthusiasms
What to dig about trains? Dr. Ken Sandock knows. On the Cover
Tombstone NOT. Not even Old Tucson. This 1969 photo of a Yugoslavian Western movie set has a little transparency fade from is Kodacolor negative, but it still looks like the American Old West that Europeans came to love. See this months Behind the Lens (Dr. Hal Tretbar photo).

Reality Check
Nature-lover Dr. Michael S. Smith performs a checkup on the seasons of his life.

Perspective
Dr. George Makol has an ObamaCare critique

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SOMBRERO February 2012

PResIdents pAGe

Sometimes its good to be red

So what exactly went wrong with Conrad Murray, M.D.? How could an educated cardiologist get so far off track and end up killing someone with a medical treatment no one would do at home? Tucson-trained and nancially stressed Dr. Conrad Murray was working out of a shabby clinic in Houston when personal friend Michael Jackson, one of the most famous people in the world and arguably one of its most eccentric, asked Dr. Alan K. Rogers him to provide medical services for his upcoming tour. Dr. Murray, for $150,000 monthly and a chance to associate with the King of Pop, was attracted enough to leave his patients and practice behind and take the job. Apparently, one of Michael Jacksons problems was insomnia so intractable (I am speculating here) that he pressured Dr. Murray to give him ever-escalating doses of hypnotics. Normal sleep medications would not work, so Dr. Murray resorted to stronger and stronger regimens until Jackson famously stopped breathing and died. Dr. Murray was in the next room on the phone with his girlfriend while the propofol was running. Cell-phone records x the exact moment trouble started. I imagine the conversation ending abruptly with something like: Oh, sorry baby, somethings come up, gotta go. The call was followed by a long 82 minutes before the embarrassed physician reached 911. I defer to my anesthesiology friends on the following point, but to me propofol-induced unconsciousness is a far cry from healthy sleep. Sleep is a very active process in the brain. Anesthetics simply turn off neurons preventing whatever it is the brain does during real sleep. As a result, I am sure, Michael Jackson felt more and more sleep-deprived as time went on, and so demanded more and more sleep medication. The issue that stands out so glaringly though, and largely overlooked by media, is Dr. Murrays failure to do what any of us would have done, and that is to have refused Michael Jackson. And why could Dr. Murray not refuse Michael? Because of an improper doctor-patient relationship. Dr. Murray should have said: Im sorry Michael, but propofol is not a good idea. To which Michael Jackson would surely have replied: Youre red, Dr. Murray. But Dr. Murray did not say the right thing because the patient was in charge of the relationship. Any cautious and ethical physician would have been red from this job and would have been grateful for it. Fame and fortune cannot become drugs that cloud the physicians judgment. A doctor-patient relationship that features a patient with more power, fame, money, or inuence than the physician is a recipe for disaster. A delicate balance must be maintained between being friend and adviser to the patient, and being the patients parent. The physician must always be the authority and must be in command. The patient is free to not heed the physicians advice, but should never dictate orders to the doctor. So does this issue come up in our everyday practices? All the time. All of us have VIP patients, personal friend patients, and chronic pain patients, to name a few, who challenge the proper doctor-patient relationship. In my practice some patients just have bigger personalities than I do and they bowl me over. Do you have patients like that? None of us likes losing a patient, and particularly not when a patient has red us and switched to another doctor. But being red is the right thing at times. When that overwhelming patient wants treatment that is risky or unneeded, it takes character to say no. So now I am bracing myself to say No the next time Elvis comes in for a rell of his medications.

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memBeRshIp

Our newest members

Please welcome these eight physicians and a medical student to the Pima County Medical Society. Membership is our strength!

Benigno F. Decena, M.D.

Dr. Decena has joined Pima Heart Physicians, PC at 2404 E. River Rd., Building 2, Suite 100. He is board-certied in IM and clinical cardiac electrophysiology, and his clinical practice focuses on the diagnosis and treatment of cardiovascular disease. He graduated from Jefferson Medical College of Thomas Jefferson University, Philadelphia, in 1992, and completed residen cies in physical medicine and rehabilitation at New York Presby terian Hospital and in IM at Rhode Island Hospital, Providence. His fellowships include Fletcher Allen Health Care, Burlington, Vt. in cardiovascular disease, and Washington (St. Louis, Mo.) University School of Medicine in clinical cardiac electrophysiology. Dr. Decenas ofce phone is 696.4780.

He is a 1967 graduate of the University of Minnesota School of Medicine, where he also completed his residency. His ofce phone is 694.8900.

Shayna Caroline Klein, M.D.

Dr. Klein graduated from University of Albany Medical College in 2003 and has now joined Radiology Ltd. at 677 N. Wilmot Rd. She completed her radiology internship and residency at Albany (N.Y.) Medical Center, and a fellowship in radiology at Beth Israel Deaconess Medical Center in Boston. As a board-certied radiologist, her practice focus is diagnostic radiology. She can be reached at 795.2889.

Jason S. Oliphant, M.D.

Dr. Oliphant graduated from Yale University School of Medicine in 1998. His practice is at Radiology Ltd., 677 N. Wilmot Rd. He completed his internship at the Hospital of St. Raphael (Yale Medical School), New Haven, Conn., and residency in diagnostic

David A. Gortner, M.D.

Dr. Gortner, board-certied in IM, has joined the University of Arizona Health Network at 1891 N. Orange Grove Rd.

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radiology and fellowship in musculoskeletal radiology) at Washington University, St. Louis, Mo.

Paul R. Strautman, M.D.

Dr. Strautman currently practices at Radiology Ltd., 677 N. Wilmot Rd. He is a 1985 graduate of the UofA College of Medicine, and completed his internship at Good Samaritan Regional Medical Center, Phoenix in 1986, and his residency at the University of Arizona Health Sciences Center. Dr. Strautman is board-certied in radiology and his clinical interests include vascular and interventional radiology. He can be reached at 795.2889.

Christine C. Pletkova, M.D.

Dr. Pletkova is a 1981 graduate of the University Karlovy in the former Czechoslovakia. Her practice is at University of Arizona Medical CenterSouth Campus, 2800 E. Ajo Way, Tucson. The board-certied psychiatrist focuses her practice on general, child and adolescent psychiatry. She completed residencies in psychiatry at St. Elizabeths Hospital, Washington, D.C., and in child and adolescent psychiatry at Childrens National Medical Center, Washington, D.C. Dr. Pletkova may be reached at 874.7572.

Mary E. Rimsza, M.D.

Dr. Rimsza practices pediatric medicine on a part-time basis. She is a 1974 graduate of Hahnemann University School of Medicine, Philadelphia. She served her residency in pediatrics at Phoenix (Ariz.) Hospital, and is board-certied in adolescent medicine and pediatrics.

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pcms news

Dr. Spark on tobacco tracking commission

By Jean-Paul Bierny, M.D., AFCM President
The Arizona Friends of Chamber Music (AFCM) is a prestigious 65-year-old non-prot organization that brings to Tucson the nest, most exciting chamber music from all over the world. Every year we present three outstanding series of concerts: our Evening Series of six concerts, our Piano and Friends matinee series of three concerts, and in March, our week-long Tucson Winter Chamber Music Festival. All our concerts are in the Leo Rich Theater at the Tucson Convention Center. In addition, we have a unique commissioning program and an extensive educational outreach program. We invite you to take a look at our website by logging onto www.arizonachambermusic.org . We hope you will join our mailing list to receive announcements about our concerts. Simply scroll down the homepage of our website to Please join our email list! and sign in. We can promise you great music played by musicians of the highest level. Here is the schedule of our coming concerts for this season: Piano and Friends (Sunday Matinee Series)3 p.m. 2/5/12: Elena Urioste, violin and Michael Brown, piano (US). Evening Chamber Music Series7:30 p.m. 2/22/12: Kalichstein-Laredo-Robinson Piano Trio (NYC), with Michael Tree (viola), and Harold Robinson (cello). 3/21/12: Mandelring String Quartet (Germany) with Katarzyna Mycka, marimba (Poland). 19th Annual Tucson Winter Chamber Music Festival Sunday, March 4, to Sunday, March 11, with a Gala Dinner Concert on Saturday, March 10 at the Arizona Inn. UofA College of Medicine Clinical Associate Professor of Pathology Ronald P. Spark, M.D. was recently appointed to the Tobacco Revenue Use, Spending and Tracking Comission. Arizona House of Representatives Speaker Andy Tobin notied Dr. Spark of the appointment Jan. 3. The commissions purpose is to advise and consult with the Arizona Department of Health Services on the goals, objectives, and activities or programs that receive funds pursuant to ARS Section 36-722. Organizations represented on the 14-person commission include two legislators, the heart and lung associations, American Family Insurance, Chicanos por la Causa, and the American Cancer Society Action Network.

Walks With a Doc scheduled

Pima County Medical Society, Carondelet Health Network, and El Rio Health Centers have joined a national organization, Just Walk/Walk With A Doc, and will stage programs for patients to walk with a physician in 2012. All our missions involve improving public health, PCMS Executive Director Steve Nash said. We want our neighbors all to become more active and one way to do that is to show them that they indeed can walk a mile. Beginning in this month, PCMS, CHN and El Rio will each host one walk on three different Saturdays every month through May, and probably throughout the summer and into fall. Each walk will be led by a physician who will give a brief overview of the benets of exercise and answer general questions during the walk. You can send your patients to any of the walks. Sample prescription pads were sent in the last newsletter. The walks are open to anyone, and the courses are generally at with some small hills. Advise patients to wear comfortable shoes. They may bring a cane or walking stick, and a bottle of water. Be sure to have them dress for the temperatures. It is often cold by the Rillito. Patents should be advised that a monthly walk should not be their only physical activity, Nash said. They are free to come again, but we really just want to give them the condenceand a safe placeto start walking. Walk schedules are posted at www.pimamedicalsociety.org. PCMS and Carondelet will use Rillito River Park. Have patients use the parking lot on the east side of Swan, just south of the bridge. The group will meet at the ramada by the water fountain. PCMS will walk Feb. 11, March 10, April 14, May 12, and June 9. For the February and March walks, please arrive between 7:30 and 7:50 a.m. Those two walks will begin at 8 a.m. April through June, please arrive between 6:30 and 6:50 a.m. Walks will begin at 7 a.m. For any questions, please call 795.7985. Carondelet Health Network will walk Feb. 18, March 17, April 21, and May 19. Please arrive between 7:30 and 7:45 a.m. Walks begin at 8 a.m. El Rio will walk at Rudy Garcia Park, 2 E. Irvington Rd. Walks
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Balseraks fund-raise for Dr. Carmona

On Feb. 18, 5:30 to 7 p.m., at 6434 E. Santa Aurelia, Tucson Country Club Estates, Dr. and Mrs. Jim Balserak will have a fund-raiser for Dr. Richard Carmona, 17th U.S. surgeon-general, for his run for United States Senate. Please e-mail bladef16@ juno.com by Feb. 12 to RSVP in the positive.
SOMBRERO February 2012

scheduled for now will take place Feb. 4, March 3, April 7, and May 5. Please arrive between 7:40 and 7:55 a.m. The walk will begin at 8 a.m. Just Walk/Walk With a Doc is a program founded in 2005 by David Sabgir, M.D., a board-certied cardiologist in Columbus, Ohio. It has spread to 40 sites throughout the country. Just Walk is a non-prot organization dedicated to encouraging healthy physical activities for people of all ages and tness levels. For more information about Just Walk, the website is www. walkwithadoc.org.

Red Cross reports on 2011 services

The American Red Cross reports that it elded 137 major relief operations in what it called a disaster-lled 2011, saying that at home and across the globe, Red Cross is a large part of the scene. The American Red Cross helped hundreds of thousands of people whose lives were forever changed by disasters in 2011, from tornadoes, oods, wildres and hurricanes in the U.S., to earthquakes and other disasters around the world, they reported. Throughout the year, the American Red Cross supported the people of Japan and Haiti, while launching 137 domestic disaster relief operations in 46 states and territories to help people affected by res, oods, hurricanes and tornadoes in the U.S. In addition, major international disasters included the Japan earthquake and tsunami response, and continuing work following the 2010 Haiti earthquake. Red Cross reported that in Southern Arizona in 2011, it provided emergency services, including transitional housing, meals and clothing, to nearly 700 people whose homes were lost to res, oods and other disasters. About 250 of those served were children. On the weekend after Jan. 8 when a crazed gunman shot 18 people, killed six and crippled Rep. Gabrielle Giffords (D-8), Red

Cross dispatched mental health teams to provide debrieng and support. Services were requested not only for Giffords staff and colleagues at Pima County Democratic Party Headquarters, but also for about 200 attendees of a party convention taking place at nearby Rincon High School. Red Cross reached the scene within minutes as the crowd made its way to the headquarters building. In the following week, additional Red Cross mental health teams provided support during the memorial services of those whose lives were lost. Events of Jan. 8 inspired the American Red Cross to launch Gabrielle Giffords Honorary Save-a-Life Saturday, which on March 19 provided free CPR and rst-aid training at some 100 locations nationwide. More than 11,000 people learned lifesaving skills that daythe very rst-aid skills that saved lives here in our community. About 1,700 people were trained here in Giffords Southern Arizona District. In February, when about 14,000 customers were without natural gas service during a record cold spell, the Red Cross operated two shelters on Tucsons northeast side for two nights, housing several dozen people. As many states struggled with unprecedented numbers of wildres in June, the Southern Arizona Chapter elded relief operations and three shelters in Cochise County during the Monument Fire, which burned more than 28,000 acres of forest. Nearly 60 families lost their homes. The chapter also provided relief workers for the Wallow Fire, largest in Arizona history, consuming 817 square miles and causing nearly 6,000 people to be evacuated.

Award honors telemedicine, UA med college

Ronald S. Weinstein, M.D., founding director of the Arizona Telemedicine Program (ATP) and Ana Maria Lpez, M.D., M.P.H., ATPs founding medical director, recently accepted the Association of American Medical Colleges inaugu ral Readiness for Reform (R4R) award for transformational programs in medicine, on behalf of ATP and the University of Arizona College of MedicineTucson, the university reported. ATP, established in 1996, was one of only three institutional winners presented with the award at the recent AAMC Annual Meeting in Denver; each Plan ahead for your increased patient load and physician institution received $5,000 to forward their innoshortages due to: vation programs in healthcare delivery. The AAMCs R4R Initiative seeks to identify Retirement academic programs developing transformative Recruitment methods of addressing patient care, health educa Vacation tion and research issues related to implementation Illness of the Affordable Care Act. The R4R Award is Sabbatical sponsored by the AAMCs Council of Teaching Maternity Leave Hospitals. CME During the award presentation, ATP was cited for creating waves of innovative programs that CMR has provided permanent and locum tenens have made a difference, including: integration of services in Arizona since 1991. With over 300,000 Catalina Medical Recruiters, Inc. primary care between academic healthcare systems active candidates in all specialties, we provide P.O. Box 11405 and community networks; revisions of care for spepersonal, professional, and proven service! Glendale, AZ 85318 cic health disorders oriented to improve care qualphone: 602-331-1655 ity; and efforts to reduce care costs while achieving fax: 602-331-1933 joan@catalinarecruiters.com better outcomes. www.catalinarecruiters.com ATP developed and operates its own broadband
SOMBRERO February 2012

10

telecommunication system, staffed 24/7 by engineers, and services a network of more than 100 health service facilities. More than 60 clinical subspecialty services have been provided through the network, with more than 1 million consultations.

PCMS 2012 meetings

Pima County Medical Foundations Evening Speaker Series is on the second Tuesdays in February, March, April, May, June, September, October, and November, often including CME. Watch for topic announcements in our between Sombreros newsletter. The ArMA Annual Meeting (delegates only) is June 1-2. Our coming Regular Membership Meetings are Tuesday Nov. 8, 7 p.m. including reading of the nominees slate, and Tuesday Dec. 11 after the Board of Directors meets, for ballot count and declaration of election winners. The PCMS Board of Directors and Executive Committee (ofcers only) meet: BOARD: EXECS: Wed. Feb 15 5:30 p.m. Tues. March 27, 6:30 p.m. Tues. Mar 27, 5:30 p.m. Tues. April 24, 6:30 p.m. Tues. April 24, 5:30 p.m. Tues. May 22, 6:30 p.m. Tues. May 22 5:30 pm (Memorial Day May 30) Tues. June 26, 5:30 p.m. Tues. Aug. 28, 6:30 p.m. Tues. Aug. 28, 5:30 p.m. Mon. Sept. 24, 6:30 p.m. Mon. Sept. 24, 5:30 p.m. (Yom Kippur starts Sept. 25) Tues. Oct. 23, 6:30 p.m. Tues. Oct. 23, 5:30 p.m. Tues. Nov. 13, 5:30 p.m. Tues. Dec. 11, 6:30 p.m. Tues. Dec. 11, 5:30 p.m.

PCMS information
Pima County Medical Society, founded in 1904, is at 5199 E. Farness Drive, Tucson, Ariz. 85712, in Tucson Medical Park off Rosemont Avenue from Grant Road. Ofce hours are 8 a.m.-4 p.m. Monday through Friday. Phone is 795.7985; fax 323.8558. After hours, an answering service can put you through to see if anyone is answering, or you may leave a message. Our back line for after hours is 795.7986. E-mail: steve5199@simplybits.net. Our holiday closings this year are New Years Day Jan. 2, Memorial Day May 28, Independence Day July 4, Labor Day Sept. 3, Thanksgiving half-day Nov. 21 through Nov. 23, Christmas Dec. 24-26, New Years Eve Dec. 30, and Jan. 1. 2013 New Years Day.

December monthly report

Referrals to physicians: 143 Meeting rooms occupied: 20.2 percent (8 a.m.-10 p.m., seven days per week) Executive Committee: PCMS President Timothy Fagan MD presided Dec. 13, 5:406:07 p.m. On a rainy night, the execs met in the back conference room of Dr. Fagans ofce to set the agenda for the evening and work on budget issues. Board of Directors: PCMS President Timothy Fagan MD presided Dec. 13, 6:407:35 p.m. The board heard reports on Arizona Medical Board sunset hearing An administrative hearing after an AMB decision
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Disability insurance for physicians Nuclear detonation training for first-responders Arizona Medical Association legislative efforts The board Considered an appeal from a Board of Mediation decision A resolution dealing with toys in kids meals and nutrition Passed several corporate resolutions to allow new bank signers in 2012. Board of Mediation: Chairman Edward Schwager MD. An appeal from a Board of Mediation decision was given to the PCMS president. Public Health Committee: Jacob Pinnas M.D. presided Dec. 5, 12:351:36 p.m. Although there were no conrmed cases of Pima County inuenza as of Dec. 5, 2011, the Pima County Health Department explained a little about the process. Rapid tests will be sent to the state lab for conrmation; once one case is conrmed, all positive rapid tests are counted as an inuenza case, despite the unreliability of the rapid tests. Committee members will meet with state representative Matt Heinz MD to discuss his mental health reporting bill aimed at stopping incidents like the shooting of Rep. Gabby Giffords. The Arizona Department of Transportations bike safety plan will be studied. The committee found that none of the major school districts in Tucson offer bicycle safety as part of the K-12 curriculum. The Bioethics Committee, Chairman David Jaskar MD, did not meet in December. The History Committee, Chairman James Klein MD, did not meet in December. Pima County Medical Foundation, Inc.: James Klein MD, president. Foundation members did not meet in December, but CME Chairman John Krempen MD met with THMEP director Robert Aaronson MD to work out details to make the Evening Speaker Series topics for 2012 better and more educational. Other members worked to make sure all letters and checks had been cashed, deposited or sent. Regular Membership Meeting: Dr. Timothy Fagan presided Dec. 13. Dr. James Klein acted as chief teller and gave the election results. The minutes from November were passed. Odds & Ends: State representative and TMC hospitalist Matt Heinz MD met with Abraham Byrd MD at PCMS in early December to discuss ways to avoid having another crazy man repeat the events of Jan. 8, 2011. Legislation may be proposed. PCMS continued work with Pima Community Access Program, USHIN, THMEP, Activate Tucson, the National Disaster Medical System, the Medical Reserve Corps, the Joint Technical Education District and the Andy Nichols MD Initiative, all of which had December meetings. PCMS is part of an effort to stage a CME Exercise is Medicine conference in March. Doctors Charles Katzenberg and Carol Henricks serve on the steering committee. As always, the Arizona Medical Association makes every effort to include Tucson physicians, and the December ArMA Legislative Committee was no different. A phone conference was arranged so PCMS physicians did not have to drive to Phoenix in the rain. Doctors Mike Hamant, William Mangold, Tom Rothe, Screven Farmer and Mary Rimza called in for an overview of the upcoming legislative session.
11

In memoRIAm

By Stuart Faxon

Dr. Stanley Glickman, 1917-2012

Dr. Stanley Irwin Glickman, pioneer urologist who helped perfect a common technique, and Associate PCMS member since 1984, died Jan. 5 in Tucson. He was 94. He was born in New York City in 1917, the family reported in the Arizona Daily Star, the son of Victoria Miller Glickman and Joseph Saul Glickman, M.D. He grew up in New York City and attended Townsend Harris High School. Stanley then attended Columbia College, where he earned his B.A. in 1937. Along the way he became uent in German, Spanish, and French. He stayed on at Columbia where he earned his M.D. at the College of Physicians and Surgeons in 1941. He then moved to Michigan to take up a residency in urology at University of Michigan at Ann Arbor with Dr. Reed Nesbit, one of the most highly respected academic urologists in the country. This was a very productive relationship. Doctors Nesbit and Glickman helped to standardize the procedure of transurethral resection of the prostate (TURP) and to overcome an obstacle to widespread adoption of the procedure: intravascular hemolysis accompanied by shock. Called TUR syndrome, it was caused by use of water as the irrigating solution during the procedure. Following laboratory investigations, Nesbit and Glickman identied glycine solution as the solution of choice for bladder irrigation during TUR. Its use made TURP a much safer option for treatment of prostate enlargement. Dr. Glickman joined the faculty of Mount Sinai Hospital in New York City in 1948, where he worked for more than 30 years and achieved a reputation as a superb urological surgeon with a large practice. While in Michigan Stanley met Ruth M. Kaiser, who was on

Dr. Stanley I. Glickman in 1984.

the nursing staff at Michigan University Hospital. They were married in 1948 when they moved to New York City and Stanley took up his position at Mount Sinai. Stanley and Ruth had two children, Randolph and Robin. In 1954 the Glickmans moved [north] to New Rochelle where they lived for more than 20 years. In 1976 Stanley and Ruth moved to Tucson, where Dr. Glickman took a position with the Arizona Health Sciences Center EL DORADO INTERNAL MEDICINE VA Hospital, where he worked into his midE Luis Aguilar, M.D., Alan Rogers, M.D., Norman Epstein, M.D. Leslie Willingham, M.D. Family Medicine 80s. Ruth died in 1993. In 1997 Stanley Welcomes married Annette Grubiss. Leslie Willingham, M.D. Dr. Glickmans sister Sylvia predeceased Family Medicine him. He will be greatly missed by his second wife, Annette; children Randolph and Robin; Wellness for the whole family On site lab grandchildren Margaret, Trainor, Miller, and Sports Physicals Convenient location, just north of ZoeRose; and Annettes sons Fred, Randy, Immunizations Speedway on Wilmot and Stephen. Also surviving him are niece Same day appointments available Hilary and nephew Noel. Services were Jan. 9 at Evergreen Mortuary 1500 N Wilmot, Suite A110 Tucson, Arizona 85712 with Rabbi Thomas Louchheim ofciating.

Phone 520-886-4181

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SOMBRERO February 2012

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BehInd the Lens

Europe and our Old West: a romance

How many movie buffs know that 1960s suave movie star Lex Barker was better known for his cowboy movies that he was for his Tarzan series? How many lm cognoscenti know that there were popular Yugoslavian strukli Westerns before Sergio Leones spaghetti Westerns became popular here? (Strukli is a Croatian sweet pastry similar to ravioli.) I realized all this in summer 2011 when I saw Lex Barker postcards in central Croatia at Dr. Hal Tretbar the famous Plitivice Lakes. Why was he attired in buckskin? Why was he popular there? I asked our guide about this and he wrote Winnetou on a piece of paper, followed by Karl May. In the late 19th century, German writer Karl May (pronounced My, 1842-1912) wrote cowboy-and-Indian stories even though he had never been to the American West. May was a neer-do-well ear-

One often hears German spoken on the streets of Tombstone because modern Germans love the American Old West. Here, German re-enactors do a scene from The Treasure of Silver Lake.

ly on. While in prison for stealing a horse, he was assigned to the library, where he began his literary inclinations. It is said that while there, he came up with the name for an Indian character, Winnetou.

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He eventually became a prolic writer, and of the 13 novels and stories he wrote between 1893 and 1897, six were the adventures of Winnetou and Old Shatterhand. May wrote about a railroad surveyor, Charley, who befriended an Apache chief, Winnetou, and became his blood brother, named Old Shatterhand. Together they fought the archetypal bad guys who wanted to steal the gold mine from the damsel in distress, or to nd the treasure of Silver Lake. And course they had to thwart the power-hungry cavalry
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Winnetou and Old Shatterhand as Europeans know them.

An unlikely Old West, the Plitivice Lakes in Valley of Death.

fcer who wanted to foment conict between the Apaches and o Comanches. May became the best-selling author in Germany. Even Hitler was said to be a regular reader. The books have been popular with all European children (and adults) even up to the present time. I talked to several Tucson physicians with European backgrounds. George Sokol, M.D. (Slovakia) is quite familiar with Winnetou and Shatterhand. He says that his cousins back home talk about them all the time. Cardiologist Dietmar Gann, M.D. from Germany was excited to discuss Mays cowboys and Indians: I have a copy of one of the books, and Ill let you know if I can nd it. These stories may have been one of the reasons I came to Tucson.

Karl May had another recurrent character in his novels, Kara Ben Nemsi, who had exciting travels through the Ottoman Empire, even though May had not been there, either. He nally traveled from Egypt to Sumatra in 1899-1900. May did get to the United States in 1908, but didnt get past the East Coast. May was born in Ernstthal, Saxony in what became, much later, part of communist East Germany that the totalitarians called the German Democratic Republic. In 1895, after he became successful, he built his last residence in Radebeul just outside Dresden and named it Villa Shatterhand. He and his wife Klara are buried there. In 1928 it was designated the Karl May Museum. During the Cold War the communists didnt think much of

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Pierre Brice as Winnetou and Lex Barker as Old Shatterhand in Valley of Death.

someone who wrote about Indians in the American West, and they closed the museum. However, public opinion was such that it was reopened, and nally permission was given to make movies in Yugoslavia based on the Winnetou and Shatterhand novels. Northwestern Yugoslavia, now Croatia, had the ideal terrain for Western movie sets with both rocky mountains where the bad guys could ambush the stagecoach, and wide open spaces for tepee villages and frontier towns with saloons and sheriff ofces. The blue-green Plitivice Lakes made for dramatic and colorful backgrounds but it is a little strange to have an Apache princess paddle a birchbark canoe across the waters. The rst, and some consider best movie was shot in 1962. It was taken from the book Der Schatz im Silbersee and retitled for international distribution as The Treasure of Silver Lake. In all, 11 lms were made between 1962 and 1968. French actor Pierre Brice made an ideal handsome Winnetou. He usually teamed with Lex Barker as Old Shatterhand, a tall, rugged frontiersman with a wicked right uppercut. Of course both were outstanding horsemen and rie marksmen. Barker appeared in only eight of the lms, while Stewart Granger was in three as the character Old Surehand. Rod Cameron played Old Firehand in one production. Lex Barker, as a blood brother, is the only one to be remembered as Winnetous partner. Three of the lms had scripts not based on a May novel. As a side note, German actress Karin Dor, who played the Apache princess, took time off in 1967 to play the femme-fatale spy in the James Bond movie You Only Live Twice. The movies were shot in top-quality color, and became so successful in Germany that budgets increased each year for bigger casts and sets. The famous title melody composed by Martin Boettcher was played on the harmonica by Johnny Muller. The Karl May books have had several English translations. The movies with English subtitles and the books are available on Amazon.com. In Germany today there are places where you can go to live the Old West experience. Silver Lake City is a Western theme park north of Berlin. No Name City is outside Munich. One of the more popular ones is Indiandorf (Indian Village), close to Mays birthplace of Hohenstein-Renstthal, near Erfurt. Here is an 1870 village where you can belly up to the bar in the Charles Saloon, and the bank is robbed on schedule at noon, 2, and 4. In the summer, cowboys and the Indians surround the tepees. Jeep excursions are available in Croatia that will take you to the exact spot where Winnetou and Old Shatterhand shot it out with the desperados. You can check it out on the Internet. In 1969, Dorothy, our son Brian, and I drove from Austria down across Yugoslavia to Montenegro before taking the ferry to Italy. While driving across a barren plain in Croatia, we spotted some buildings that looked familiar. Sure enough, it was a rst-class Western town movie set. It was built with intact interiors, but it was
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The stagecoach ofce and church in this movie set from 1969 show realistic buildings that included complete interiors.

starting to fall apart. The saloon, the church, the hotel, and the sheriff s ofce were all there looking as good as Old Tucson. I puzzled about this set for years and only now know it was part of strukli Westerns. And now for the latest on Winnetou and Old Shatterhand: The Aug. 11, 2011 issue of The Hollywood Reporter states that Michael Blake, who wrote the script for Dancing With Wolves, is going to adapt Mays work for a big-screen version to be shot in New Mexico starting in 2013.

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enthUsIAsms

Story and Photos by Stuart Faxon

Love those trains!

Small wonder railroading has so many adherents. The history and romance of trains, and the sheer size and power of locomotives on tracks approach the irresistible. Among most male Baby Boomers, it would be odd if Lionel or American Flyer model trains were not part of their youth. In PCMS, physicians associated with local rail organizations include Jim Klein, Ron Spark, George Sokol, and Ken Sandock. Certainly trains were irresistible to Dr. Sandock, of our History and Bioethics committees. The radiologist has been a PCMS member since 1983 and is board-certied in radiology and nuclear medicine. But had he not gone into medicine, he says he would probably have gone into some kind of engineering or physics. As with many enthusiasts, Dr. Sandock liked trains as a kid, especially around Chicago. They are a blend of interests in travel, history, technology, and mechanics. I have videos of trains in places meaningful to me, and when I show them to people interested in those places, they suddenly like the train videos! In short, he says of trains, Theyre fun and they go places. Anyone might merely say theyre into trains. Dr. Sandock walks the walk. He keeps up on everything railroad, from how each part of a steam locomotive works to modern Amtrak operations. He is a member of Old Pueblo Chapter of the National Railway Historical Society, at which members show trip photos, see videos, and learn train lore from each other. He volunteers with the Southern Arizona Transportation Museum, and when we rst talked to him in November 2011, he was set to go to Vail to help with the local visit of Union Pacic steam loDr. Sandock poses aboard steam locomotive No. 1673, wreathed for Christmas, comotive No. 844. He says hes mechanically inclined, and that at the Southern Arizona Transportation museum. Its 1955 dedication to Tucson steam engines have a lot of mechanics to work with. was on the 75th anniversary of the arrival of the railroad in Tucson. He has done work for Tucsons Gadsden-Pacic Division, Toy Train Operating Museum, though he is not a home model railroader. I work for them under the tableliterally, he puns. Anything they can set up, I can make it work for them with wiring under the His favorite trains are the electrics. Of these, his favorite is the table. Their room is bigger than the PCMS conference room. Chicago South Shore & South Bend Railroad, now run as a public The lengthily-named GPD-TTOM (www.gpdtoytrainmuseum. utility on the same tracks with the same engine. He said he often com) is a 501(C)(3) non-prot organization dedicated to the model used it to travel from his home in South Bend, Ind. To Chicago. railroading hobby by providing the public with an interactive museIts the oldest running inter-urban electric train in the country, um of operating toy train layouts and displays. Dr. Sandock said. There are still lots of Anyone who seeks a model engine or car to trains serving lots of small towns that have no train is more than something other regularly scheduled transportation, not reminisce can come to one of the GPD swap that stops you from getting there even buses. meets, where many dealers have used model Dr. Ken Sandock at a crossing. The future of train organizations will rail cars, equipment, and books at low prices. require younger people in order for the Last year the local NHRS chapter took a organizations to grow, thats the problem, Dr. Sandock notes. Verde Valley rail excursion with 15 people, half from PCMS, Dr. Older folks and their parents remember trains, when they served Sandock said, including himself and Dr. Stan Levin and his wife. a purpose in their lives. Today, theres little other than historic He notes that the long-distance railroads helped our National and nostalgic romance to Amtrak, but most of the excursion railParks develop as tourism attractions, and in turn the park destinaroads are making a go of it. The Grand Canyon Railroad is doing tion helped grow the number of passengers. Todays Grand Canwonderfully. yon Railway descends from these origins.

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Museum restoring engine

The Southern Arizona Transportation Museum, the museum division of Old Pueblo Trolley, Inc., is dedicated to preserving railroad history in Southern Arizona, the Historic Depot, and Locomotive No. 1673 with educational outreach, oral history, and archival collections. Its at 414 Toole Ave. immediately west of Tucsons 1941-style downtown historic depot, a projected completed in 2004. We might forget that the depot itself, at 400 N. Toole, is still a working Amtrak station, because the preponderance of rail trafc through Tucson is freight. Rail travel is good for people who simply want to relax and enjoy travel, Dr. Ken Sandock says. He recommends Amtraks Coast Starlight, which runs from L.A. to Seattle to Vancouver, B.C. Steam Locomotive No. 1673 can be seen next to the museum. It was a branch line engine and the main engine used between Tucson and Nogales. It was also used in the 1955 movie musical Oklahoma! and is undergoing restoration by volun teers such as those who developed the trolley operation recently in use on University Boulevard and 4th Avenue. No. 1673 was dedicated to Tucson in 1955 and for many years was in Himmel Park before being moved to the museum grounds. Museum admission is free. Hours are Tuesday, Wednesday and Thursday 11 a.m. to 3 p.m., and Friday and Saturday from 10 a.m. to 4 p.m. Gates to the locomotive are open on Saturdays 10 a.m. to 1 p.m. You can nd more information on the museum, and other Tucson, Arizona, and national railroad rides and attractions at www.tucsonhistoricdepot.org.

Living in Train America

Trains magazine fuels passion for railroads with industry news, articles on freight and passenger rail and transit, preservation, fan opportunities, lots of photos and maps, and historical articles (www. TrainsMag.com). Trains issues Trackside Guide as a supplement, full of information on train watching, locomotives and cars, how railroads work and trains move freight, train travel, train photography, historic train rides, safety, railroad parks, and more. It breaks down a historical timeline of this formative American industry into categories from 1830 to today: First Fragments, Western Expansion, Golden Age, Standard Era, Streamlining and Dieseli zation, Mergers and Bankruptcies, De-regulation and Technology. Westerners are, or should be, familiar with the expansion of rail roads, and they could hardly been a bigger phenomenon for Tucson, one of many American cities that could be said to have begun with the railroads arrival.
SOMBRERO February 2012

An adult and child at extreme right provide size scale as No. 844 looks you in the face. It was the last steam locomotive built for the UP and was delivered in 1944. As a high-speed passenger engine it pulled widely known trains such as the Overland Limited, Los Angeles Limited, Portland Rose, and Challenger. Weighing 454 tons with tender, No. 844 was saved from being scrapped in 1960, the only engine in service with its original owner.

In 1860 Tucson was just a frontier outpost. In 1871 President Ulysses S. Grant and Congress authorized a bill incorporating the Texas Pacic Railroad. They were making a best-guess as to how it would be built, though it would not be nished until 1880, and by someone else. Nevertheless, Tucsonans celebrated the authorization by ring a Camp Lowell cannon 100 times and blowing the steam whistle on a Main Street our mill for an hour, according to information at the museum. Construction nally settled on the Southern Pacic Railroad, owner of the Central Pacic and one of the big four railroad companies of the day. On March 20, 1880, an anniversary the museum always commemorates, a train bearing railroad dignitaries from San Francisco arrived in Tucson to the biggest celebration the town could muster. In 1869 the golden spike hammered at Promontory, Utah marked completion of the rst
19

Hundreds of people throughout the day Nov. 11, 2011 stood in line at the Union Pacic Railroad yards in Tucson to mount a ladder and see the controls of UPs steam locomotive No. 844. It had just come from New Mexico, and then to Willcox, Benson, and Vail, and was bound the next day for the Southern Arizona Transportation Museum on Toole Avenue downtown.

Dr. Sandock has his arm on the throttle of steam locomotive No. 1673 at the Southern Arizona Transportation Museum. The Schenectady Locomotive Works built it in 1900, and it logged more than 1 million miles for the Southern Pacic Railroad, mostly in Southern Arizona.

transcontinental railroad. The current AMC TV series Hell on sleek, lightweight, diesel-powered passenger trains. Once diesels Wheels dramatizes the period leading up to completion, including had shown their superior efciency, the industry rushed to replace the infamous Crdit Mobilier of America stock scandal of 1872, steam power. This colorful period saw bright, new passenger trains which involved manipulations similar to those done before 2008 and diesel locomotives sharing the rails with the last of the great by executives at Fannie Mae and Freddie Mac. In the 1870s and steam engines. 80s, Jay Gould and other robber barons used railroad companies Diesels helped, but the slide continued. Jet aircraft and the and our government to build personal and corporate empires. Interstate highway system helped to empty the wonderful postwar In 1893 New York Central 99 was the rst locomotive to exceed streamliners. As fewer people rode trains, the railroads sought to 100 miles per hour. Steel began to replace wood construction discontinue them, and then exited the passenger business altogethin railroad cars in the 1910s. In 1917-1910, World War I trafc er. An overabundance of lines in the Northeast and Midwest led to c ongestion prompted the U.S. government to take control several failures and abandonments. of r ailroads, the Trains While combining small guide notes. railroads into larger ones By 1915, railroads was a historic practice, were peaking, both in the late 1950s marked an physical extent and sociincrease in mergers that etal inuence. Electric insaw many familiar railterurban railways boosted road names disappear. mileage during their heyOther efficiencies were day of 1890-1920, but achieved through new mostly took business freight hauling equipaway from steam railment and practices such roads. Automobiles and as jumbo covered hopper trucks proved the more cars for grain, unit coal formidable and enduring trains, and piggyback transcompetitors, aided by port of truck trailers. publicly funded highways The time since 1980 and restrictive regulation has been one of rebirth. of railroads. Several factors have conRailroads in the posttributed to the renaisFolks love to photograph themselves and their children next to 844s huge driving wheels. You World War II era sought sance: new trafc sources would have to be 6-foot-8 to be as tall as one of the wheels. to win back travelers with such as Western coal, re20 SOMBRERO February 2012

No. 844 pulls a car with the statehood centennial voyage emblems for Arizona and New Mexico. It has run hundreds of thousands of miles as a unique goodwill ambassador.

ductions in employment, technological advances such as the double-stack container car, reduced regulation, and a new round of mega-mergers. Todays railroads are in the best shape theyve been in decades. They boast more and newer cars, more miles of double track, and lots of trafc. The early 21st century is an excellent time to enjoy an industry that is experiencing a rebirth.

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REALITY CHECK

Seasons of my life
I recently took my 59th canoe trip into the Boundary Waters, having spent more than a year camping on both sides of the border.Ive paddled more than 300 lakes and traveled 3,000 miles by canoe in the past 30 years.Ive done half as much traveling in Ontarios Algonquin Park back in the spring and early summer of my life. I started 50 years ago and feel more comfortable in a canoe Dr. Michael S. Smith than in a car.Safer, too. I no longer travel hard. I used to glory in 20-mile days with 15 portages, carrying a pack under a canoe for up to a mile at a regular walking pace through the woods.Oh, I was good in the summer of my life!I took 20 solo trips, could make camp in 30 minutes, break it in 45. Now, however, my wife and I base camp on a lake we know better than anybody else alive.We spend ve nights a year on one campsite so remote that we dont see anybody else. We drink water right from the lake, unpuried. Im not as strong as I once was, but I am much more savvy in the wilderness.I dont waste effort. I am a superb weatherman in the woods, accurately predicting storm onset and ending, reading the sky and the wind. Oh, I could do more if I had to, but I dont want to. I have nothing to prove and a lot I could hurt. Do I miss the strength I once had, propelling me miles and miles to the next campsite?A bit.Do I need to do it again? No. I want to see the northern sweep of Agnes Lake one more time, and a fellow teacher, who desperately wants to go, may be my partner.The two of us could do it. Occasionally I still show off.My wife and I paddled 12 miles into our destination lake in six hours, when several people we met, 20 years younger, were unable to get there in three days.Neither of us is strong, but our experience, organization and leveraging of our skills, working together, enables us to still accomplish a good days work in a few hours.Neither of us thought it was a difcult day. Do I miss roughing it?No.I once liked sleeping under a canoe and thought paddling in a driving rain manly, but now camping means being comfortable. We eat well, stay clean and dry, and sleep better than at home.The midnight bathroom breaks are a chance to look at one of the darkest skies in America and perhaps see an aurora, which we did a few years ago. I nd it interesting that as I have gotten older, my desires have changed, and I get pleasure doing different sorts of trips I once wouldnt have enjoyed. The trips I used to do no longer appeal to me. I am at peace with that.I expect more changes, and hope I still can paddle and portage for many years to come. I expect I will be doing so in a different fashion, and I believe I will enjoy it just as much. We were in the canoe country in autumn, and present when the colors peaked. In the autumn of my life, I am nding my own inner beauty that mirrored the external beauty around me.I still see new country, but I enjoy visiting familiar country the way I like meeting new people but enjoy old friends. I hope in my 70s I will be still be able to canoe and set up camp.My body is like a well-used Old Town.It wont last forever, the paint is scraped, there are a few cracked ribs, but it is still sound and seaworthy and has seen a lot of wild country. It still needs to paddle in Saskatchewan and Manitoba. And see an eclipse over my seventh continent. I hope as the winter of my life approaches, the white in my hair will mirror the brilliance of new snow, untouched, in those areas of Alaskas Brooks Range that I have been so fortunate to have explored four times.Could I canoe in my 80s or 90s? I dream, for in a recent year two very special people, different sex, different countries and different professions, had a profound inuence upon me. From each, and quite by accident, I learned that while I am a scientist and statistician, consider myself a practical person, not far below the surface lies a kida deeply emotional, spiritual dreamer.Im not planning to ever grow up. When I arrived in Fairbanks, many my age or younger went to the Princess Cruises sign.I picked up my backpack, headed to the remotest river valley in America. I have just started autumn.I hope the winter that follows will be as brilliant as the snow that made Mount Oyukuk so beautiful over the Noatak last August, up in Gates of the Arctic National Park. Eventually, of course, my eyes will nally close forever.I hope at the end I die quietly in the outdoors like Sig Olson, the famous North Country writer, who had written in his typewriter the day he died, I am ready for the next stage.I know it will be a great adventure. Sombrero columnist Dr. Mike Smiths blog is http://michaelspinnersmith. com, where there are previous Reality Check columns, outdoor writing, descriptions and pictures of National Parks, Alaska hikes, eclipsechasing, mental arithmetic, op-eds, and two non-technical neurology articles that physicians might enjoy.

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SOMBRERO February 2012

peRspectIVe

Conservative on ice
By Dr. George J. Makol
I certainly got a lot of suggestions after my recent column [Perspecvacy no longer exists. If the government passes a bill called There tive, December 2011 Sombrero], but I decided to stay in town anyway. Will Be No Rain for the Next Month, I would immediately go I do admit, however, that not everything I wrote is related to the out and buy a raincoat. medical eld, and this is a medical society publication. So lets talk What does this monstrous new healthcare law of 2,300 pages healthcare. offer, and are there any good ideas within it? Believe it or not, I like We have a president who ran for ofce on a platform of providthe idea of state-run healthcare exchanges! Insurers will be offered a ing medical care for everyone. However, no one I know took the time to check the presidents own voting record as an Illinois state senator. Health insurance in Illinois used to cost about $250 per month for a healthy male of We are Tucsons homegrown law firm providing age 25 at about the time Barack Obama was legal services for Southern Arizona since 1969. elected to the Illinois Senate. During his time We can assist with all legal needs, from Business in ofce he voted for 18 separate bills that reand Real Estate, to Bankruptcy, Family Law, quired all health insurers to provide not just Estates and Trusts, and Personal Injury. basic coverage that we all need for M.D. visits Barry Kirschner is recognized as an AV and hospitalizations, but set mandates for covPreeminent attorney by his peers for his 30 erage. So according to his votes chiropractors, years of legal work in Tucson including as a naturopaths, and all kinds of alternative practipartner at Waterfall Economidis since 2003. tioners, they were required to be covered by As a member of the firms Litigation Practice any health insurer offering coverage in Illinois. Group, Barry represents disabled persons whose Thats 18 separate bills, all of which he voted claims have been denied or terminated by for after being lobbied and receiving contribudisability insurance carriers. Successful verdicts, tions from each interest group. settlements and administrative appeals come Before he left the state, the cost of health from knowing how to approach the problem effectively with clear, convincing and honest insurance for a healthy 25-year-old male medical assessments by treating physicians. jumped to $950 monthy on average! Wyoming When an insurance company inappropriately has no such mandates passed by its legislature. relies on a doctor who has never seen the I checked on Esurance and healthcare insurpatient, Barry supports the treating physician ance for a 25-year-old man from Wyoming to ensure his or her opinion is not over ridden varies from $150 to 250 per month. No, he did by the insurer. not do this alone, but neither did he vote nay on even one of these pieces of legislation. I Barry practices law with the conviction of a man who has dedicated his life to helping others. would say that took a huge group of Illinois Passion like that cannot be duplicated and is citizens out of the healthcare system, and part of what makes Barry a preeminent lawyer. stressed many an employers budget. So now we have the Patient Protection and Affordable Care Act of 2010. Try to remember, For more info on Barry or the firm visit: when the government passes a bill, think exactly the opposite of the bills name and you will have accurately predicted its effect. For instance, the Health Insurance Portability and Accountability Act, also known as the Patient Privacy Act or HIPAA, opens up medical records to government agencies including Homeland Security and many others. A lawyer from the Arizona Medical Association gave a presentation at PCMS shortly after HIPAA passed. He informed that it was his legal opinion that as the bill was written, dozens of government agencies could access patient records Williams Centre | 8th Floor | t 520.790.5828 legally under certain circumstances. Patient pri-

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slot to provide coverage to all comers, no pre-existing condition exclusions allowed. And that is the problem with the bill: Like most laws Congress passes, there was no thought as to the effect the law will have. All the sick persons in the state who have been unable to buy coverage at any price will immediately join. Wonderful, you say. But the rates are set by the insurers and will quickly skyrocket to rates even higher than in Illinois (see above). So, our ever-clever Congress thought of that; they will ne you $700 annually if they nd out that you have not obtained coverage, so theoretically nearly every healthy person will join the exchange, diluting the high cost of taking care of the inrm. Lets use me as an example, as I seem to have been getting picked on lately anyway. In 2010 my wife and I paid $18,000 for a policy with a deductible so high that I gure it would only pay if a bus fell out of the sky and landed on us. So say I go without insurance for three years, save $54,000, and pay $700 per year penalty if they catch me. I have easily made the most prot I could without lifting a nger or becoming a politician. Now say my wife or I suffer a serious injury or illness. We simply go downtown and sign up for the insurance available to everyone with no pre-existing conditions, and we have full coverage. It took me about ve minutes after reading this portion of the bill to gure this out, and I am a conservative and we are not supposed to be that smart. It will not take long for everyone else to do the math. This whole bill unfortunately is an upside-down pyramid waiting to collapse. The people of the United States, our patients and colleagues, deserve a better and more thought-out program. A few parting thoughts. Dr. Michael F. Hamant was kind enough to point out an error in my last column, and he is quite right. I did not specify that I was referring to the projected 2,000acre deserted tundra drilling sight in the 19- million-acre ANWR as being a postage-stamp-size area on a football-eld-sized map of

Alaska. While he is correct that ANWR would have the footprint of a house on such a map, the miniscule 2,000-acre drilling area would better be represented as the size of a mosquitos kneecap when projected on a football-eld-size map of Alaska. I think he made my point better than I did. The average family income in the U.S. is $50,000 according to the most recent government census information. Dr. Hamant may have been accidentally looking at one of the overtaxed socialist countries that he so admires to get the $27,000 gure. In Arizona, the 2010 median family income was $47,279. More worrying to me is that Arizona median family income, as measured in 2010 dollars, was $52,592 in 2001. I know Dr. Hamant and I will disagree on solutions to this income decline. My solutions would be market based, not government directed. As for climate change, I will remind my colleague that at one time a consensus of scholars were sure that the world was at, and Galileo was condemned as a heretic and conned to house arrest for the last third of his life for promoting helilocentrism (the earth rotates around the sun); scholars of his day believed in geocentrism, or that the planets and sun revolved around the earth. The increasing number of scholars casting extreme doubt on mans contribution to global warming, and the rife intellectual dishonesty of some supporting scientists (see the East Anglia University e-mail scandal and the fake hockey stick effect based on erroneous numbers) makes this no slam-dunk issue. The earth warms and then cools in 750 to 800 year cycles; we are in about year 600 of a warming trend. The smog above Philadelphia has nothing to do with this massive powerful cycle, but its a great reason to raise taxes. Well, at least I touched on medical matters a little more this time. See you after my trip to Antartica! George J. Makol, M.D. practices at Alvernon Allergy and Asthma, 2902 E. Grant Rd., and has been a PCMS member since 1980.

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B U S I N E S S A N D H E A LT H C A R E AT T O R N E Y S

Edward Comitz
PRACTICE AREAS: Disability Insurance Consultation and Litigation, primarily for medical and dental professionals; Healthcare and Commercial Litigation; Insurance Bad Faith WH WHY YOU CHOSE THIS PRACTICE AREA: After a severe neck injury, I learned how painful it is to not be able to do what you love. The medical community helped me get back to work, but not everyone is as fortunate as I am. Now I use my experience to help doctors who can no longer practice and are being taken advantage of by disability insurers. ACHIEVEMENTS: Martindale-Hubbell AV-Rating, Avvo Superb Rating, AZ Business Magazines Top Lawyers 2011 (Healthcare, Commercial Litigation), Arizona Dental Association Business Affiliate, Arizona Osteopathic Medical Association Endorsed Partner

Michael Beethe
PRACTICE AREAS: Real Estate Transactions and Leasing; Financing Arrangements; Medical and Dental Practice Transitions FAVORITE ASPECT OF YOUR PRACTICE: I received my MBA along with my J.D., then worked as a trial lawyer for years. I gained a lot of experience litigating commercial contracts that went bad. This perspective allows me to identify pitfalls up front. I enjoy creating value for my clients by negotiating, structuring and closing solid transactions. ACHIEVEMENTS: AZRE - People to Know in Commercial Real Estate, AZ Business Magazines Top Lawyers 2011 (Real Estate), Avvo Excellent Rating, Former Editor-in-Chief of the American Bar Associations The Urban Lawyer, Arizona Bar Exam Top Three Score Commendation

Patrick Stanley
PRACTICE AREAS: Healthcare, Business and Insurance Disputes; Healthcare Regulatory Compliance; Employment-Related Claims BIGGEST CHALLENGE FACING YOUR CLIENTS: Governmental regulation and the insurance industry create a great deal of uncertainty, especially for healthcare professionals. Physicians, dentists and other providers need help navigating the maze of insurance, regulatory, and business issues they face. I enjoy helping doctors solve their legal problems so that they can focus on treating patients. ACHIEVEMENTS: Avvo Superb Rating, AZ Business Magazines Top Lawyers 2011 (Healthcare, Commercial Litigation), AzDA Services Business Affiliate, 2009-2010 AFS-USA Liason

6720 North Scottsdale Road, Suite 150 | Scottsdale, Arizona 85253 p. 480.998.7800 | f. 480.219.5599 www.cobelaw.com | www.disabilitycounsel.net

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ConfeRences & SemInARs

February
Feb. 23-25: Tucson Hospitals Medical Education Program (THMEP) presents the 23rd Annual Winter Medical Conference at The Peaks in Telluride, Colo. For information, e-mail Dr. Robert Berens at robertrjb@gmail.com, or Dr. Alan Rogers at buck@ultrasw.com.

March
Mar 1-3: The Mayo Clinic Transoral Approaches in Head and Neck Surgery: Laser Microscopic, Robotic, and Endoscopic is at the Westin Kierland Resort, 6902 E. Greenway Pkwy., Scottsdale 85254. CME credits: 22 AMA PRA Category 1 (16 for general course, six for optional workshop); 22 AOA Category 2-A. Course targets otolaryngologists, head and neck surgeons, oral maxillofacial surgeons, and head and neck oncologists for a focused educational experience in transoral endoscopic techniques to resect primary head and neck tumors. Both transoral laser microsurgery and robotics will be the primary focus, with additional education in other transoral techniques. Optional cadaveric hands-on workshop offers participants opportunities to perform various transoral procedures with laser technologies and delivery systems. Renowned faculty will emphasize fundamental transoral anatomy, microsurgical and robotic tech-

niques, and wound exposure, as well as feature other transoral techniques. Workshop participants will return to their clinical practice with experience in the art of tumor exposure using various retractors and appropriate and safe use of multiple transoral systems. Website: http://www.mayo.edu/cme/otorhinolaryngology-2012s510 Contact: Barbara LeSuer, Mayo School of Continuous Professional Development, mca.cme@mayo.edu; phone 480.301.4580; fax 480.301.8323. March 8-10: The 8th Annual Womens Health Update is at FireSky Resort, 4925 N. Scottsdale Rd., Scottsdale 85251; phone 480.945.7666. AMA PRA Category 1 credits: 18.50. Course consists of three half-days with afternoon workshops and focuses on reviewing the latest medical updates pertinent to womens healthcare. It targets primary care physicians, general internists, gynecologists, and specialists in preventative medicine. Participants should gain comprehensive insight into recent initiatives, as well as a basic approach to addressing and improving common health concerns for women. Website: http://www.mayo.edu/pmts/mc8200-mc8299/mc820055w .pdf Contact: Jodi Lee Beert, Mayo School of Continuous Professional Development, mca.cme@mayo.edu; phone 480.301.4580; fax 480.301.8323.

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WANTED: Seeking used medical records shelving system (7ft X 5 ft) in good condition. Contact Roxann, 320-1369. OFFICE FOR LEASE: Elegant modern medical ofce suite available for lease. Located on the rst oor of the Oro Valley Hospital Medical Ofces complex, within walking distance from Oro Valley Hospital. Beautifully decorated 3,158 rentable square feet with 2,789 usable square feet. Four exam rooms, two procedure rooms, staff kitchen and three ofces. Most xtures stay, including furniture if interested. Ample parking. Lease Term and Rate Negotiable. Call Samantha Marques at (520) 293-5757, ext. 7113 for more details. (11-11) SHELVING SYSTEM FOR SALE: Original purchase price $20,000. Exceptional condition. 20 ft X 9 ft, 7 levels high. Asking $5,000 or best offer. Please contact Cindy, 327-9573, ext. 245. (12-11) PCMS member, certied physician assistant with alternative medicine background, seeks 32-36 hours of employment in an internal medicine practice starting January 1. Contact PCMS, 795-7985, if interested. OFFICE SPACE FOR LEASE: Free-standing single-story building with Grant Road frontage. Ample on-site covered parking. Move-in ready; currently congured as medical ofce space of approximately 4,100. sq. ft. Ideally located across the street from Costco between Tucson Medical Center and St. Josephs Hospital. Contact Ted Kalota, 250-5040. (11-11)

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One Area of Focus:

Radiology

Radiology Ltd. has focused on providing radiology services in the Tucson community for over 70 years. Each of our physicians is a specialist in their area of expertise. They, and the rest of our staff, are dedicated to providing quality patient care with an emphasis on both patient comfort and safety. Our imaging is now entirely digital, providing the highest image quality and quick turn around of results.
Radiology Ltd also provides: RadVision The clear choice for immediate viewing of digital imaging and patient reports via a secure online connection. Images are also available on CD and high resolution paper. Easy access to reports accurate reports with rapid turnaround time faxed preliminary and/or nal reports recent and remote study reports always available online Professional Relations Team rapid staff responses to your needs dedicated phone line for physician to physician consultation full-time couriers deliver studies/reports to you quickly Radiology Ltd. is locally owned and operates ten imaging centers in Southern Arizona to serve you and your patients. Consider working with the radiology specialists at Radiology Ltd.

To get connected to RadVision, please call 901-6747. Convenient scheduling centralized scheduling for all sites by phone or fax ability to accommodate STAT requests accept all major insurance plans insurance verication and appointment conrmation a bi-lingual staff

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radltd.com 733-SCAN (7226)
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MICA_Sombrero02'12ad_MICA_Sombrero05'04ad 1/13/12 3:36 PM Page 1

G R E A T

N E W S !

Through a true partnership of efforts, MICA's Board of Trustees is pleased to announce a $50 million dividend for 2011 - our 7th consecutive dividend.

Thanks again, MICA members.

MUTUAL INSURANCE COMPANY OF ARIZONA MEDICAL PROFESSIONAL LIABILITY INSURANCE

(602) 956-5276, (800) 352-0402 www.mica-insurance.com
The dividend declared for any give year reflects MICAs financial performance during the year. Past performance does not guarantee future dividends.

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SOMBRERO February 2012