(I cribbed this from my post on a website, one that commented about the Dr. Hendricks character in Ayn Rand’s Atlas Shrugged)

Yes, good Dr. Hendricks; and I was surprised to find that Ayn Rand’s book would turn out to be, not a lengthy farrago on an impossible future, but rather a handbook, a “Fascism for Dummies” that would be stunningly accurate.
I like Ayn Rand – not as the cartoonish, dyspeptic shrew she seems to have become later in life, or her oafish followers, the “Objectivists” – they alone can put one off her writing for twenty years, as happened to me.
Rather, I like her as Alice Rosenbaum, her early self, from whom one can see all her early thoughts arising.  “If we do all this only because we love life,” one of her characters offered, “why do THEY do what they DO, to oppose us?”  That is a profound moral question.  The roots of her thought began in the basis that human life is an awesome thing, and to be respected and cared for.  Sounds a lot like the original days of medicine.
It grieves me when I pick up a learning objective in medicine, and do it because I am forced to, that it is a chore.  I used to love the profession!  I would read even what other branches would do and discover, not because it was practical to me, but because it was part of the great tree of Medicine.
I had an ethical twinge yesterday – merely the transit of some moral gas, it turns out.  I had to Obtain an Active BLS Card.  I have resuscitated quite a number of folks, and perhaps it’s immodest, but I’ve only lost the ones who were bound and determined to wind up dead.  It’s really the patient who makes that decision, combined with whatever lies Beyond. 
But back to the BLS Card.  There are now firms that offer it online, and it merely is a cash transaction, viewing the movie and reading the script, taking the test, and all that jazz.  The American Heart Association has the audacity to update its recommendations, such as – “The rate of compression is no longer 100 compressions per minute, but AT LEAST 100 compressions per minute.”  Anyone who says this has never been at a code.  I tell the ancillary resuscitators to check for peripheral pulses when resuscitation – useless compressions are useless.  I guess I made that up myself, or heard it from someone during a discussion.  It’s not authorized, I can tell you that much.
Was it less than moral to take a canned test solely for the BLS card?  No, I was not told to be good at resuscitation, as I am by experience.  I was told to purchase a $50 card from the American Heart Association and their financial distributors, which I did.
The certification is legitimate – I am quite good at Basic Life Support.  And I have a card that the bureaucrats Require.
BLS is a fiction, for a doctor.  A doctor needs to do “nisi quamquam” (mandaturus est patiens ad salutem, per totam suam facultatem).  Nisi quamquam, a useful and arcane phrase, means in Latin, “specifically that which is necessary” (for the survival of a patient, by means of all one’s ability).
BLS, ACLS, all that says is to do whatever you know to make a patient not-die.  It is a sad little fiction that it can be described and a circle drawn around it.  I’ve seen a patient or two come back Through The Door, where they were getting fitted for the Heavenly Robes.  Never seen one ungrateful to be back, but boy are they surprised!  I was clearly interrupting them from something.
“Maintenance of Certification” is a sad mockery of Medicine, I fear.  Apres moi…..

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