Writing to enlighten…NOT!

My publicist thought this would be a good topic for a blog: What 3 Lessons can be learned from Too Much Blood?

Wait. I write to entertain, not to enlighten. But just by the nature of my profession, I’m enlightening readers about what pathology is and what pathologists do. Things that are old hat to me may be absolutely fascinating to someone else. This isn’t limited to Too Much Blood, though. It’s common to all my mysteries, and probably shouldn’t count.

I suppose the most obvious lesson is not to invest in a Ponzi scheme. Anybody who reads the papers has read about Bernie Madoff and his $65 billion Ponzi scheme. In a Ponzi scheme, only the person who starts it gets any money out of it. Everybody else who invests is just paying off the original investors. The problem is, more investors are required all the time to put enough money in to support the scheme, or else it collapses and most investors never see their money again.

Doctors are prime targets for financial schemes of all kinds. They earn lots of money and are in a high tax bracket. So they gravitate to schemes that purport to protect their money from taxes, or to guarantee massive growth, or both. They’re smart people, but way too busy to read the fine print.

Back in the eighties, my medical staff was targeted by someone with a supposedly foolproof scheme. Everyone invested except me. I held on to my money, but the repercussions down the road from all my colleagues losing theirs adversely affected our ability to keep up with all the changes we needed to make, that were mandated by changing federal law. I really think it was part of the reason that we allowed ourselves to be bought out by the county hospital in 2002. We simply couldn’t afford to stay open otherwise.

Another lesson might be for people not to get too excited about drugs advertised on TV. Case in point: people who take anticoagulant drugs or “blood-thinners” are especially vulnerable to bleeding problems. The drug rivaroxaban, which killed Jay Braithwaite Burke and his partner and almost killed Toni was in clinical trials back in 2008. In 2010 it was FDA approved and is now advertised ad nauseam on TV as Xarelto. That doesn’t necessarily make it safe. Although patients don’t have to get their blood tested every month, they can still have bleeding problems from it. A friend of mine was put on Coumadin, and continued to throw clots; so then he was put on Lovenox, which he tolerated well. When Xarelto came out, he was switched to it, and developed GI bleeding and hematuria. Now he’s back on Lovenox. On the other hand, some patients have bleeding problems with Lovenox, too. I’ve actually autopsied a couple of them. The point is, I suppose, that no one drug is perfect for everybody. Patients are all different.

The third lesson might be that married people need to talk to each other. If Hal had been up front with Toni about his problems finding a lab assistant and the teasing he endured over Bambi’s looks, Toni might not have had to go through so much angst about Hal having an affair. She would have known about Bambi from the get-go. Although that may have backfired on Hal, Toni being the hothead that she is. Not like me at all. Hard to say.

That’s all I can think of, but then, I wrote the book to tell a story, not to teach lessons.

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