Healthcare 101

Healthcare is the single most important subject we should all be thinking about. NOW. 47 million Americans are without it. If my dear friend (see this post and this one, too) wasn't covered under his wife's plan, he would be dead by now. Do I have your attention?

You know, I never understood that between State and Federal taxes taking nearly 50% of our wages, somehow, we Americans have allowed our representatives to convince us that we don't all deserve healthcare. DO NOT be fooled by the argument that we can't allow the federal government to control our healthcare. For starters, there's Medicare (which everyone receives when they reach 65). Medicare is one of the most successfully run federal government programs of all time (and getting better with plenty of choice). For the rest of us, we can indeed have universal healthcare NOW and let the government pay for it (with the taxes we already pay). We will still have choice. We will still have our own doctors and specialists. But the bill is picked up by the federal government (at the risk of repeating myself: with the taxes we already pay.) Is that really too much to ask? So ask. No, demand. From your Representatives. From your Presidential candidate.

Once you've lost your health, well, nothing else much matters does it?

Truth in Publishing

Although they've been with us for a while, apparently we have a category of writers badly in need of a name. I shall call them the Literary Fabricators.

Recently, there was James Frey. His four-million copy best selling bogus 2003 memoir A Million Little Pieces (purportedly pitched originally as a novel by Frey to his agent and several publishers, including Nan A. Talese, who leads the imprint at Random House’s Doubleday division and who subsequently published A Million Little Pieces). Initially rejected as a novel, someone at Random House supposedly made the suggestion that Mr. Frey's work would sell better as a memoir.

Sean McDonald, the Random House editor ultimately assigned to the project, assured Nan Talese and Oprah Winfrey (the single most powerful - and important - name in publishing) that he was confident the events in A Million Little Pieces did, in fact, occur because he had personally checked them out. "I made sure that everything actually happened," he said as the book was being edited.

Of course, Oprah was subsequently embarrassed (a big no-no in that universe) for being so very much taken in by Frey's fabrication of 'his' sordid tale of drug addiction and rehabilitation. Frey endured a humiliating public spanking by Winfrey on her show (the same show that weeks before presented James Frey as the latest writer to win the coveted "Oprah Loves This Book More Than You Can Possibly Imagine" prize.

Now we have a new Fabricator: [from The New York Times]

In “Love and Consequences,” a critically acclaimed memoir published last week, Margaret B. Jones [a pseudonym for Margaret Seltzer] wrote about her life as a half-white, half-Native American girl growing up in South-Central Los Angeles as a foster child among gang-bangers, running drugs for the Bloods.

Turns out it was all a lie. And what an unnecessary one, too: if the book is critically acclaimed, a fictional approach often possesses a much more powerful 'truth' to tell (Sinclair Lewis' Mainstreet and George Orwell's Down and Out in Paris and London come to mind).

But a publisher's nimbleness should never be underestimated:

Sarah McGrath, the editor at Riverhead who worked with Ms. Seltzer for three years on the book, said she was stunned to discover that the author had lied. “There’s a huge personal betrayal here as well as a professional one,” she said.

Riverhead Books, a unit of Penguin Group USA, is recalling all copies of the book and has canceled Ms. Seltzer’s book tour. Ms. Jones/Seltzer was about to embark on a nationwide book tour. Could Oprah have been far behind? I suppose that's the breaks: she has little left but her infamy while Frey has his millions, a penthouse in Manhattan, a house in The Hamptons and, of course, the infamy as the garnish on that particular cocktail.

We wonder why talented writers just don't do it the old fashioned way: a writer writes a great story that gets published as is. Sure, it's harder to get published today; but isn't that the reason you've got your thesaurus earmarked and the entry "perseverance" highlighted in yellow? There are many, many success story each year. And if you don't by now understand that "the Internet has changed everything" then your chances of getting noticed will be straight-jacketed from the start. The author has never had so many tools at his or her disposal.

But, the Literary Fabricator succumbs to the curse of the mendacity of the modern age (or what one well-known publishing personality revealed at 3:00 in the morning over her eighth Cosmopolitan as "my livelihood, dear.") Indeed. And who can deny the appeal of center ring in the circus?
But somehow, despite this allure, I simply can not imagine Fitzgerald, Hemingway or Faulkner (who's debut novels were This Side of Paradise, in 1920, The Torrents of Spring in 1925 and Soldier's Pay in 1926 respectively) producing anything fake. Their 'reality' was intense enough for us all.

And if immortality is the goal, well, you can't really fake that. And if money and fifteen minutes of fame is the goal, what a sad waste of talent.

Healthcare Professionals Extraordinaire!

My blogging has taken a back seat - again - to watch over the recovery of my dear friend whom I wrote about on February 25th. Turned out there was a serious, life-threatening complication that developed after the original cervical laminoplasty: a complication that the surgeon in all of his of 33 years practicing had never seen before. Two words: cervical kyphosis. And if you want to look it up, it's as bad as bad can be. Fortunately because the severe curvature of the cervical spine (neck area) developed so rapidly (five weeks after surgery) it was not the type of deformity termed 'fixed' and the Gardner-Wells tong traction technique in hospital straightened the spine after 24 hours; this fact alone was very encouraging to the surgeon, enough so because my dear friend's head was no longer so severely pushed downward on his chest (kyphosis can eventually sever the spinal cord causing total paralysis or even death - yes, it can get as bad as that). So, the surgeon placed my dear friend in the Halo mobile traction device, a serious, state-of-the-art contraption held in place by four ultra-sharp pins that are screwed one-eighth of an inch directly into the skull (quadruple ouch!). Now, he'll be in traction at home for two months, after which - if all goes well - the neck muscles will adhere to the spine and heal properly.
But that's not the main point of this post.

This time, however, the five days in hospital were as different as night and day from before, during the initial operation in January '08. This time, my dear friend had 'round the clock care; aggressive pain management; a private room; and more doctors and nurses in and out that it was dizzying. The staff even allowed me to sleep in the room for three of the five nights.

While my previous post (below) stands I would like to gratefully acknowledge the many superlative health-care professionals who made such a profound difference during my dear friend's second hospital stay. I cannot name the hospital or the doctors' and nurses' full names (for all the obvious legal reasons), but here are some of the wonderful professionals that turned my dear friend's life around.

Michael, the lead ortho-technician (and an angel on this Earth), made us feel from the start that we were the center of attention and insisted we maintain a positive attitude. His was a take charge personality that filtered down to his entire team.

The Registered Nurses: Margaret, Don, Brenda, Jeff, Tori, et al (I wish I could remember even the nurses aides' names) were in the room within minutes when called upon.

The doctors: Dr. R. you know who you are! Dr. Y's second opinion proved most informative - but we went with Dr. R. this time.

Sonny, the physical therapist, convinced my dear friend he could actually overcome the pain as well as the top-heavy Halo-vest to get out of bed and walk (sounds easy until it's your turn!).

I know that I will update this post as the memories of those five days become even clearer. Suffice it to say that we shall never forget the compassion and care received.

And my dear friend is well on his way to recovery...

Missing in Action

I don't know if there is a better, more polite way to put what can only be described as a soul shaking, life changing experience: For the past month I've been in hospital and home-care, helping a dear friend recuperate from spinal surgery and the Healthcare Industry.

As so many of these stories begin, the medical gods (surgeons to the non-believers) performed their miraculous skills that most of us find incomprehensible as they are explained in those intense pre-operative surgical consultations. But the problems with my friend began during the post-operative period when he was moved from intensive care, (where the pain was treated with care and compassion) to the general ward where neither attitude nor care prevailed. Logically I know I am overreacting somewhat here as there are doubtless many fine, caring Registered Nurses devoted to their patients. But watching my friend go through his searing agony overwhelms my sense of logic and enrages one to tears. Unfortunately all it takes is a few 'bad apples' combined with a serious national labor shortage that exposes the uncaring for who and what they are. And this problem isn't going away. In fact, quite the opposite: the U.S. alone will be short some 340,000 Registered Nursing positions by 2020 when most of the 'baby boomers' will begin to enter their seventies.

Here's a modest proposal: free nursing education to anyone who agrees to work at a hospital in their community for four years. The incentive? The national average annual base salary after four years on the job is $54,000! And this pay increases considerably in the ten largest U.S. markets. Talk about writing your own ticket! But - and this is a big but - psychological testing MUST be an important part of the process. Society deserves to know for certain that these folks have a real vocation for such an important job. Vocation may be an old fashion term, but in this context it means just one thing (beyond aptitude) - and that one word would be Compassion.

Surf Was Up at Mavericks!

I admit to an unhealthy fear of the water: the one time I did try swimming (after being pushed into a canal in Venice), I sank like a waterlogged bolt of fine wool gabardine. However, I discovered an utter fascination with surfing (watching, that is) on a long-ago vacation in O'Hawaii. The big wave riders at the North Shore breaks such as Waimea Bay, Sunset Beach and the Bonzai Pipeline are amazing athletes in what many professional commentators consider the most dangerous sport on the planet.
Living in Carmel, California, I regularly walk down to the beach and sit for an hour or so to watch the locals rip. But yesterday, I motored up Coastal Route 1 to Half Moon Bay to see this year's Mavericks Surf Contest at Pillar Point. The magnitude of what these intrepid acquamariners face is documented below.

Mercury News event coverage

New York Times article

A Doctor in the Mouse?

There's a really interesting article in Salon today about patient access to medical information on the web. It's written by an M.D. and is a counter to the petulance (I almost said flatulence) that appeared in Time magazine (and online) titled "When the Patient Is a Googler." The Time article is also by an M.D. I never thought I'd hear an intelligent, educated person (a scientist, no less) turn 'Googler' into a dirty word.

I have a close friend who goes in for a four-level cervical laminoplasty next week. Since this is spinal surgery, he wanted to learn as much as possible about the procedure and the recovery and the success rates and all the, you know, really pertinent stuff. So he turned to the Web. Now he feels much better (though he did have a tough time seeing a video of this operation on YouTube).

So, raspberries to you, Time medicine man - time for a upgrade!

Quadrophenia (and other great music)

Finally got around to ripping one of my holiday presents: Quadrophenia, The Who's second rock opera. And I thought Tommy was great with its amazing musicianship (just listen to Townsend on the acoustic guitar in the Overture) and tight thematic orchestrations that made that album one of the sixties classic rock set pieces. Quadrophenia though is, I believe, The Who's crowning achievement. This is immortal music and a must listen. Definitely something I would take if stranded on a desert isle (and still able to play my iPod).

Here are my music (re)discoveries in 2007:

1. Led Zeppelin (all of it)
2. The Who (Tommy, Quadrophenia)
3. The Beatles (anything and everything)
4. Schubert (the piano sonatas)
5. Bach (the cello suites - Rostropovich, naturally)
6. Jan Klemmer (Touch - the most romantic jazz album ever)
7. Al Di Meola (Kiss My Axe - no explanation required)
8. Lee Ritenour (Stolen Moments is a jazz classic)
9. Dave Brubeck (Time Out)
10. Jane Monheit (the best of the young jazz singers)