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The United States of Babylon

Is this the place where freedom lies
Beneath the wicked cocaine skiesThe land of the free
Freedom to sin and create miseryThe love of God and country has long grown cold
For most in this Satanic foldWhere have you gone halcyon days
Now we live in a hazeWrong is right and the insane are sane
This is the madness of America’s brainVice rules the days
Pursued with zealousness in myriad waysOnce we had a godly nation
Now it has become an abominationDo as thou wilt has become the slogan of our time
This demonic refrain should be a crimeThe strong prey on the weak
Yet Jesus said blessed are the meekGod is not mocked
This nation shall soon be defrockedA small remnant of God’s family is still here
The Lord’s return is nearer every day so let’s cheerChrist shall appear at the last trumpet’s blast
Godly people stand steadfastThe armies of Satan shall fall like wheat being chaffed
By the power of Jesus’ words shall they be slayedBut for now the United States of Babylon continues its descent
The only hope for America is for its people to repentby Zachary Uram
(c) 2023 -
Christmas in Yellowstone

I arrive at Yellowstone
On a cold and sunny morning
It’s Christmas Eve
Here I will celebrate Christ’s birthI spot a majestic eagle
Soaring above
If only I could see with its eyes
To experience such freedom and exhilarationThe eagle circles above
It’s on the hunt
Suddenly the great bird swoops down
And catches a plump rabbit in its talonsI walk into a valley
Covered in two feet of snow
My snow shoes help but my progress is slow
Pine trees tower above the ridgeI came across a mother grizzly and her cubs
I’m sure to stay upwind from them
My distance is respectful
The cubs are enjoying the snowI see an energetic red-tailed fox
It leaps into the air
And down under the snow
It emerges with a mouse for its mealAfter traversing the valley
I come across a grove of pine trees
I’ll make my home here for the night
It has cover from the wind and snowI create a hut using pine branches
And the tarp I brought in my backpack
Good thing I have a sleeping bag
This shall make for a cozy homeAt the lake I catch some rainbow trout
I make a fire and fry the fish in a pan
I season it with a pack of herbs and spices I had
It was the best fish I ever ateEvening is now approaching so I go back to my hut
There by kerosene lamp I read the Christmas story
In the Gospel of Luke
I feel at peace and thankful for my Lord and Savior JesusI am struck by the blissful silence of my environment
I enjoyed the solitude, but only for a season
I have a wonderful feeling of serenity
I am happy to be aliveI wake up after a sound night’s sleep
It’s Christmas day
I pack up my things and head home
This was an experience I’ll never forgetby Zachary Uram
(c) 2023 -
A Spring Journey

The rain falls gently down
Covering hills of green and brown
The air smells fresh and new
Like early morning dewA songbird chirps a sweet melody
It seems to recognize me
I love being connected to nature
There is nothing greaterObserving God’s glorious creation
Fills me with elation
All this was made for man
Following God’s master planWe must be good stewards of the earth
From our dying days to our birth
Pollution must be limited
In this task, we must be committedWalking slowly in the park
I spotted a lone lark
It was standing near a daisy
Looking rather lazyEventually subsides the rain
I noticed I feel less emotional pain
A dazzling rainbow stretches across the sky
It delights my eyeI rest under a mighty oak tree
Free from misery
What history this oak has seen
Rivaled only by the secrets in my geneI slowly make my way home
Today ’twas lovely to roam
I’ll cherish these memories forever
They shall always bring me such pleasureby Zachary Uram
(c) 2023birds, green hills, journey, nature, oak, Pennsylvania, personal, Pittsburgh, rainbow, roam, Spring, Springtime, stroll, trees -
My Broken Mind

I am crazy and barking mad
I’m quite insane
This is my sad refrainAt the turn of the millennium
‘Twas a score and three
Since I lost my sanityNow my days are troubled
Filled with pain and woe
We truly reap what we sowMy thoughts are speeding past
It’s a superluminal race
I can’t keep up the paceDelusions and hallucinations
Rule the day
I’m left with feeling dismayWhat’s it like
To be in a psychotic state
It ain’t greatMy mind is not well
Thoughts are disjointed and broken
Am I forsakenI’ll take my meds
See my psychiatrist and pray
And dream of a better daySometimes I get
A dissociative event
At least it’s not permanentI zone out
And lose all touch with reality
It’s very scaryMy depression makes me lie
In bed like a beached whale
Here ends my sad taleby Zachary Uram
(c) 2023 -
Thoughts on a Sunny Day
Woe is me
From happiness I doth flee
Time races past
I’m a ship without a mast
The days are dark and filled with pain
Will I ever be sane
Days turn into years
Who can erase my fears
I cling to hope and pray
Of a future happy day
For now I’ll bide my time
And dream of green hills I may climb
With no strength or energy
I’m a prisoner of my own body
I’ll retreat into my mind
What wonders I will find
Traveling the universe faster than light
I’ll return in a fortnight
If you care pray for me
Of a day when I’m happy and fancy free
By Zachary Uram
(C) 2023
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Compromised Care

There has been, sadly, a disturbing trend of more medical doctors and psychiatrists being replaced by nurse practitioners (NPs) or physician assistants (PAs).
Administrators and doctors who own a private practice where they employ other doctors love it because it’s a way for them to reduce operating costs and increase profits.
I posit that the quality of care is compromised with respect to the patients and consumers.
There is simply no way that a nurse who takes extra classes and goes through some additional training is in any way equivalent in expertise or understanding to a trained medical doctor who has studied medicine for 7 years plus 3-4 years of residency. That lack of knowledge and lack of experience are critical factors.
On a personal level, I can relate that I’ve seen this compromised care play out. The place I go to for mental health treatment was 90% psychiatrists when I started going there 20 years ago. Today it is just 10% pscychiatrists. I have an extremely complex case. I have 4 severe mental illnesses, and I take 5 psychiatric drugs which have over 8 potential contra indications (bad ways the medications interact). There is simply no way a nurse practitioner is qualified to deal with my case, yet that’s the reality I’m in. I’ve noticed psychiatric care with a nurse practitioner become mainly maintaining current medication levels and a general assessment that one is not suicidal or homicidal (again they lack the expertise to gauge this as well as a psychiatrist). I used to spend 20-30 minutes discussing my psychiatric symptoms when I was seeing a psychiatrist there, such as: lethargy, lack of motivation, irregular sleep, feeling sad and crying a lot, taking no pleasure out of daily activities, hearing constant inner voices which bother me 24×7, intense visual hallucinations as well as both visual and audio at the same time, pressure/tactile hallucinations, deep seated delusions, paranoia, etc. All of that is now gone. The nurse practitioner is beyond her depth and unable to offer me high quality psychiatric care. We the consumers have complained about this problem for years, yet things are only getting worse.
I realize we have a shortage of doctors, as our aging population expands. New data released in April 2018 by the Association of American Medical Colleges notes that the shortage could climb as high as 120,000 doctors by 2030. But compromising patient/consumer care with nurse practitioners and physician assistants is not the solution.
Apologists argue that NPs and PAs allow for greater efficiency in a doctor’s office and allows more patients to be seen. The bottom line here is that these are financial considerations, not considerations that impact the improved quality of care.
Here is an article about a good book, written by 2 MDs, that highlights the issues in utilizing PAs and NPs and how this results in compromised care for their patients.
Physician authors explore what rise of NPs, PAs means for patients
Jul 21, 2022
As Alexus Ochoa-Dockins, a 19-year-old college athlete, was being rushed to the hospital, the responding paramedic contacted the emergency department to alert them that a patient with a suspected pulmonary embolism would be arriving shortly.
The family nurse practitioner (NP) who would see Alexus in the ED ordered an array of tests, including a chest CT scan that would have confirmed the paramedic’s suspicions. But the scan was postponed after Alexus fainted and a urinalysis showed “presumptive positive detection” for methamphetamine even though the test was negative for amphetamine.
Ten hours later, the CT scan was performed and was misread by the NP as a crushed sternum. While the diagnosis was wrong, it led to Alexus being transferred to a larger hospital where a physician correctly diagnosed her pulmonary embolism and began treatment. But it was too late, and she died two hours later.

Rebekah Bernard, MD
Rebekah Bernard, MD, uses Ochoa-Dockins’ story as a thread that ties together the issues she reports on in Patients at Risk: The Rise of the Nurse Practitioner and Physician Assistant in Healthcare, the book she co-wrote with Niran Al-Agba, MD, a pediatrician in Silverdale, Washington. Their book details how care from nonphysicians is dangerously being promoted as “just as good” as that provided by doctors—despite the huge differences in education and training requirements.
“The more we dug through the case, the more we realized that everything that we were talking about of concern, seemed to happen in her case—just so many perfect examples of just so many things going wrong,” Dr. Bernard said in an interview last year with the AMA.
“The sad thing is that this is not an isolated incident, it’s just an incident in which everything kind of came together to create this horrific outcome,” she added.
Who’s behind the white coat?
The book by Drs. Bernard and Al-Agba delves into how many patients don’t know that—despite their white coat—the person in the exam room with them is not a physician.
“Unfortunately, most Americans have remained dangerously unaware of this revolution in health care,” the book says. And, “if patients do wonder about being treated by a non-physician, they are reassured that their nurse practitioner or physician assistant is ‘just as good’ as a doctor, an idea reinforced by multimillion-dollar direct-to-patient advertising campaigns.”
An Oklahoma jury awarded Alexus’ estate $6.19 million, and their attorney said that there was hope that the verdict would lead to changes to ensure that “appropriately qualified medical providers” were on hand at all the state’s hospitals.
“If only this were the case,” Dr. Bernard wrote.
It’s the third book written by Dr. Bernard, whose parents were both registered nurses. Her solo practice, Gulf Coast Direct Primary Care, is in Fort Myers, Florida, where she also serves as president of the Collier County Medical Society and president of the grassroots advocacy group Physicians for Patient Protection.
Find out why physician-led care teams are key to battling the doctor shortage.
It’s about protecting patients
Dr. Bernard said her passion for the scope-of-practice issue is “about making sure that patients have the right quality of care and making sure that we’re going to have the care for ourselves because, ultimately, we’re all going to be patients someday.”
Dr. Bernard is a member of the Florida Medical Association and the AMA, and research from the AMA is cited throughout her book.
She also cited a 2019 study, “Potential Crisis in Nurse Practitioner Preparation in the United States,” published in the peer-reviewed journal Policy, Politics, & Nursing Practice.
That study analyzes the American Association of Colleges of Nursing’s list of accredited doctorate of nursing practice (DNP) programs. Of the 533 DNP programs established between 2005 and 2018, researchers found, only 15% were clinical in nature, while the others focused on leadership and administration topics.
“That means 85% don’t give them any additional clinical training, yet now they have doctor in front of their name,” Dr. Bernard said. “Patients don’t know that it’s almost more like an academic type of a doctorate than a clinical doctorate.”
The AMA’s truth-in-advertising campaign aims to ensure that all health professionals clearly and honestly state their level of training, education and licensing.
An AMA-led coalition of 108 national, state and specialty medical societies, has been active in dozens of states this year working to block legislation that would provide inappropriate expansion of the medical services and procedures nonphysician health professionals are allowed to perform.
Learn more about the AMA’s wide-ranging fight against scope creep.
https://www.ama-assn.org/practice-management/scope-practice/physician-authors-explore-what-rise-nps-pas-means-patientsClearly medical practices and hospitals can do better for their patients.
I’ve also noticed the increased use of PAs and NPs in speciality doctor practices! This is outrageous.
PA/NP advocates are pushing for total autonomy with NO oversight/management by Medical Doctors!!!




