Remember Vioxx? Isn't it remarkable that the crappy expensive, still under patent drug only morphed into a cardiotoxin after the largest pool of potential litigants were already taking dirt naps, and therefore unable to file suit? Kudos to satan's actuary. Vioxx is ilustritive of how gangsters think, but right off the bat, I can think of two even more sinister medical superscams, TMAP and tenet healthsystems. TMAP is doubya's thank you to big pharm, and since he actually got elected this time (I think) his expensive and ill conceived mental health program will be enacted nationally. And when the victim's money runs out, there is always Jesus or dianetics. Of course suicide is also a cost effective measure. Tenet also had a money outlook, and they did unnecessary heart surgery at the Redding facility among others to rake it in. And with stakes like that, whats the big dealio with a few bits of understudied nerve tissue. C'mon, wisdom teeth are superfluous, and they actually sound important. So, let's go, Sympathectomy for the Devil, hell Sympathectomy for everyone. To quote the Governor, "If it bleeds, we can kill it." And as any responsible fiduciary officer, even enron's, knows,sudden death is way cheaper than chronic treatment.

So now I am going to indulge in Eine Kliene legal theory, a boiler room mentality, a lot of bad medicine, bad debt, and hippocratic hubris, driven by crystalline weapons grade arrogance and possibly an unfortunate over-extension in imclone, and the few lousy shares of Martha Stewart Living the wife insisted on. Briefly stated, money is tight. Eleven years of residency, Fucking insurance and price fixing HMO's, and minimally invasive techniques netting next to nothing. Cardio-thoracic surgery, of all the stupid specialities. Wheezy middle class working folk with crappy insurance nicotine stained teeth boggy smooth lungs with three impaired cilia to clean out the tar. Charming. Three and a half hours clipping and patching archie bunkers cyanotic lung (at least now it matches his wife's hair color) and for what? Insurance won't pay, actuaries consider breathing experimental. So, what makes a good surgery candidate? Low morbidity/mortality (no actual sick people) Youngish, gainfully employed, private insurance, trusting, busy, and most important of all; positive wallet biopsy. Now, what can I do to this guy. Doesn't appear to be any extraneous thoracic bits except depressing old neoplasms: no tonsils, no appendix, no carpal tunnel, spinal fusion, the ability to pass a lie detector test has limited application, and the DoD pays lousy civil wages. So unless the gallbladder in gerrymandered to the thoracic precinct, I need an offensive symptom, and something easy to ablate. Too bad there is no fart nucleus... Let me give this some time... I'll think of some thing, no sweat...