Sunday, November 11, 2007

And the attempts to recruit subjects for clinical research trials continues. The next phase of the study has started up, and with it the relentless search for more patients. First, only people who have had two very specialized and expensive tests in the past month are eligible; second, these people must have a sufficiently severe heart condition to justify this testing, but not have really really bad heart disease, lest the 'stress' part of the trial--using a drug that dilates blood vessels and thus makes the heart beat harder and faster to compensate--could actually push them into having a heart attack. Needless to say, the procedure is pretty damn safe, which is why it's the standard cardiac stress test protocol, but there's always the chance that someone with pulmonary hypertension or sever aortic stenosis or a 90% LAD blockage will end up on the wrong end of it, and we don't want that to happen. So, long story short, once I make sure that people are sick but not too sick, I check to see they've had an angiogram and a nuclear stress test. If they have, then I go on to see where they live. Since our hospital is kind of a big deal, people from all over two states get life-flighted to us. Someone who lives 50 miles away is probably not going to drive up for an appointment and two follow-ups. Next, I assess age: people under about 60 are usually working and either can't get away from work or don't answer my (daytime) phone calls anyway; people over 80 are generally considered too old to be in the study. So that narrows it down. Of course, the unemployed 45-year-old is a good option, since he has time and would probably like to have the study stipend. And that makes me feel like a horrible person, an exploitative asshole. A lot of the people I recruited last time were unemployed or disabled. Of course, they didn't get hurt, they got paid for their time, and in the end it was a mutually beneficial partnership. However, once this technology makes it out into the real world and physicians are charging a couple hundred bucks a pop to use it, unemployed folks without insurance aren't going to be the ones benefiting from it. One of the principles of human testing ethics is that the people who are ultimately going to benefit from the drug/procedure should be adequately represented in trials, and people who aren't going to use it shouldn't bear much of the burden of testing it. I dunno. Am I still young and idealistic? I guess.

Wednesday is our department's "Spirit of Thankfulness" catered lunch. Which means everyone else will eat turkey, and I will make a meal of cranberry sauce, green bean casserole, and stuffing. Which is fine with me; when you don't eat the main dish, you can get away with taking more of the side items (which are usually what I REALLY want, anyway). That's the calculus of the buffet line, right? Or am I committing some horrible breach of self-serve etiquette? And why can I not remember how to spell etiquette? Oh, right. It's 2:14 a.m.

Several people at work are really bummed out. One guy's dad died; a woman who shares my office has been taking time off to be with her dad, who's dying too. I know there's not a cure for grief other than time and loving care...but in the interest of superficially sprucing things up, I'm thinking I'll make hand-turkeys for the other women who share my office (there are five of us--it'll be like third grade!!) and possibly bake some pumpkin bread for the bereaved. Because baked goods heal all. Unless you're diabetic.

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