Muhammad Ali was one of the greatest boxers ever to step into the ring and, in many ways, also one of the most important political figures of the 20th Century.
He was a tremendous fighter, who was absolutely unbelievable when he was young--quick as a cat with skills not normally associated with a Heavyweight. He lost his prime time years as a boxer, too, because he was man enough (and I believe it was because he was a man and NOT a coward) to stand up for what he believed in with the Army and Vietnam.
He could have been a poster child and never done anything but he refused and he has always, to me anyway, been a man of great character who has stood up for people and given a lot of people hope for a brighter future.
His gift for language, his looks, his speed (FAST--like a GREAT middleweight) were incredible. Ali was an artist in the ring--not some big killing machine like Liston but a brilliant fighter who could adapt and box however he needed to in order to win.
His stuff with Cosell, his poetry, the Ali Shuffle. I love Leonard and I loved Hagler as a pure fighter and there are many fantastic fighters but I am old enough to have watched him when he was young and there is nobody like him.
I believe he is bigger than boxing, but judged only as a fighter he is one of the very best. Ever.
To me, he is the GREATEST of all time.
Thursday, August 23, 2007
Is Your Child Goth?
I found this posted in another group. It is taken from a post on Christianforums.com. I am not sure if this is a parody or not--it's so sad that with some fundamentalist tracts you can't really be sure--but I am posting it, as is, along with my score--and yes, my score would suggest I am VERY GOTH!
"If your Child is a Gothic, Reform Through the Lord!
Listed below are some warning signs to indicate if your child may have gone astray from the Lord. Gothic (or goth) is a very obscure and often dangerous culture that young teenagers are prone to participating in.
The gothic culture leads young, susceptible minds into an imagined world of evil, darkness, and violence. Please seek immediate attention through counselling, prayer, and parental guidance to rid your child of Satan's temptations if five or more of the following are applicable to your child:
-Frequently wears black clothing.
-Wears band and/or rock t-shirts.
-Wears excessive black eye makeup, lipstick or nailpolish.
-Wears any odd, silver jewelry or symbols. Some of these include: reversed crosses, pentagrams, pentacles, ankhs or various other Satanic worshipping symbols.
-Shows an interest in piercings or tattoos.
-Listens to gothic or any other anti-social genres of music. (Marilyn Manson claims to be the anti-Christ, and publicly speaks against the Lord. Please discard any such albums IMMEDIATELY.)
-Associates with other people that dress, act or speak eccentrically.
-Shows a declining interest in wholesome activities, such as: the Bible, prayer, church or sports.
-Shows an increasing interest in death, vampires, magic, the occult, witchcraft or anything else that involves Satan.
-Takes drugs.
-Drinks alcohol.
-Is suicidal and/or depressed.
-Cuts, burns or partakes in any other method of self-mutilation. (This is a Satanic ritual that uses pain to detract from the light of God and His love. Please seek immediate attention for this at your local mental health center.)
-Complains of boredom.
-Sleeps too excessively or too little.
-Is excessively awake during the night.
-Dislikes sunlight or any other form of light. (This pertains to vampires promoting the idea that His light is of no use.)
-Demands an unusual amount of privacy.
-Spends large amounts of time alone.
-Requests time alone and quietness. (This is so that your child may speak to evil sprits through meditation.)
-Insists on spending time with friends while unaccompanied by an adult.
-Disregards authority figures; teachers, priests, nuns and elders are but a few examples of this.
-Misbehaves at school.
-Misbehaves at home.
-Eats goth-related foods. Count Dracula cereal is an example of this.
-Drinks blood or expresses an interest in drinking blood. (Vampires believe this is how to attain Satan. This act is very dangerous and should be stopped immediately.)
-Watches cable television or any other corrupted media sources. (Ask your local church for proper programs that your child may watch.)
-Plays videos games that contains violence or are of a role-playing nature.
-Uses the internet excessively and frequently makes time for the computer.
-Makes Satanic symbols and/or violently shakes head to music.
-Dances to music in a provocative or sexual manner.
-Expresses an interest in sex.
-Masturbates
-Is homosexual and/or bisexual.
-Pursues dangerous cult religions. Such include: Satanism, Scientology, Philosophy, Paganism, Wicca, Hinduism and Buddhism.
-Wears pins, stickers or anything else that contains these various phrases: "I'm so gothic, I'm dead", "woe is me", "I'm a goth".
-Claims to be a goth.
If five or more of these apply to your child, please intervene immediately. The gothic culture is dangerous and Satan thrives within it. If any of these problems persist, enlist your child into your local mental health center."
*************
When I took this I got 28 hits which must be something of a Satanic number; it is after all 23 plus 5. It is absolutely a danger sign if a teen-ager somewhere watches cable TV or has an interest in sex. I can certainly see that. Especially if he or she is alone. I think that probably adds three or four more clicks to the total right there.
Goth related foods? Seriously? How many four year olds in Arkansas are under a 24 hour suicide watch because of goth related foods?
Thank God I only eat Frankenberry. But I do eat it with my morning glass of blood--does a body goth, I mean good. Sorry, I was wearing black so Satan took temporary control of my laptop.
Also, where do they keep the trashed Marilyn Manson CD's; I think I already have them all but it is good to have a spare in case I get blood on it or I scratch it while self-mutilating.
As a 52 year old man (yes I am old but eccentric nonetheless) I don't really wear a lot of black eye make-up or go to school--where I would certainly misbehave if I did (am I now 28.5?) so if I get this many how likely is it that 99% of all the teen-agers in America would get a pretty good little total themselves?
Anyone know the phone number for a good local mental health center here in the Bay Area?
"If your Child is a Gothic, Reform Through the Lord!
Listed below are some warning signs to indicate if your child may have gone astray from the Lord. Gothic (or goth) is a very obscure and often dangerous culture that young teenagers are prone to participating in.
The gothic culture leads young, susceptible minds into an imagined world of evil, darkness, and violence. Please seek immediate attention through counselling, prayer, and parental guidance to rid your child of Satan's temptations if five or more of the following are applicable to your child:
-Frequently wears black clothing.
-Wears band and/or rock t-shirts.
-Wears excessive black eye makeup, lipstick or nailpolish.
-Wears any odd, silver jewelry or symbols. Some of these include: reversed crosses, pentagrams, pentacles, ankhs or various other Satanic worshipping symbols.
-Shows an interest in piercings or tattoos.
-Listens to gothic or any other anti-social genres of music. (Marilyn Manson claims to be the anti-Christ, and publicly speaks against the Lord. Please discard any such albums IMMEDIATELY.)
-Associates with other people that dress, act or speak eccentrically.
-Shows a declining interest in wholesome activities, such as: the Bible, prayer, church or sports.
-Shows an increasing interest in death, vampires, magic, the occult, witchcraft or anything else that involves Satan.
-Takes drugs.
-Drinks alcohol.
-Is suicidal and/or depressed.
-Cuts, burns or partakes in any other method of self-mutilation. (This is a Satanic ritual that uses pain to detract from the light of God and His love. Please seek immediate attention for this at your local mental health center.)
-Complains of boredom.
-Sleeps too excessively or too little.
-Is excessively awake during the night.
-Dislikes sunlight or any other form of light. (This pertains to vampires promoting the idea that His light is of no use.)
-Demands an unusual amount of privacy.
-Spends large amounts of time alone.
-Requests time alone and quietness. (This is so that your child may speak to evil sprits through meditation.)
-Insists on spending time with friends while unaccompanied by an adult.
-Disregards authority figures; teachers, priests, nuns and elders are but a few examples of this.
-Misbehaves at school.
-Misbehaves at home.
-Eats goth-related foods. Count Dracula cereal is an example of this.
-Drinks blood or expresses an interest in drinking blood. (Vampires believe this is how to attain Satan. This act is very dangerous and should be stopped immediately.)
-Watches cable television or any other corrupted media sources. (Ask your local church for proper programs that your child may watch.)
-Plays videos games that contains violence or are of a role-playing nature.
-Uses the internet excessively and frequently makes time for the computer.
-Makes Satanic symbols and/or violently shakes head to music.
-Dances to music in a provocative or sexual manner.
-Expresses an interest in sex.
-Masturbates
-Is homosexual and/or bisexual.
-Pursues dangerous cult religions. Such include: Satanism, Scientology, Philosophy, Paganism, Wicca, Hinduism and Buddhism.
-Wears pins, stickers or anything else that contains these various phrases: "I'm so gothic, I'm dead", "woe is me", "I'm a goth".
-Claims to be a goth.
If five or more of these apply to your child, please intervene immediately. The gothic culture is dangerous and Satan thrives within it. If any of these problems persist, enlist your child into your local mental health center."
*************
When I took this I got 28 hits which must be something of a Satanic number; it is after all 23 plus 5. It is absolutely a danger sign if a teen-ager somewhere watches cable TV or has an interest in sex. I can certainly see that. Especially if he or she is alone. I think that probably adds three or four more clicks to the total right there.
Goth related foods? Seriously? How many four year olds in Arkansas are under a 24 hour suicide watch because of goth related foods?
Thank God I only eat Frankenberry. But I do eat it with my morning glass of blood--does a body goth, I mean good. Sorry, I was wearing black so Satan took temporary control of my laptop.
Also, where do they keep the trashed Marilyn Manson CD's; I think I already have them all but it is good to have a spare in case I get blood on it or I scratch it while self-mutilating.
As a 52 year old man (yes I am old but eccentric nonetheless) I don't really wear a lot of black eye make-up or go to school--where I would certainly misbehave if I did (am I now 28.5?) so if I get this many how likely is it that 99% of all the teen-agers in America would get a pretty good little total themselves?
Anyone know the phone number for a good local mental health center here in the Bay Area?
A Short Primer on Number Symbolism in the Tarot
Number Symbolism: when you look at the deck you notice the 4 suits and the 22 major arcana cards and sometimes when you are starting off it may seem like a lot to deal with. One way to help learn how to read is to break down all the cards (except the court cards) in to numbers (for example 14, Temperence, is a 5 -- 1 + 4 = 5, 21 The World is a 3 -- 2 + 1 = 3) and so on.
Here is a very high level look at what the numbers "mean". Please realize this is not the be all end all here but just one way of looking at them and try to look at it as sort of a short-hand approach to tarot.
One--think of somebody pointing their index finger. They are directed, focused. Ones are about drive, vision, making things happen. Single-mindedness.
Two--a couple, a decision (this or that), yes/no, up/down, right/left, etc. Twos are either partnerships or decisions but they deal with questions of what to decide upon or who to be with.
Three--a triangle. All numbers divisible by 3 (3, 6, and 9) deal with creative ways of approaching things, in one form or another. Better or worse depending on the suit and placement.
Four--a square, a foundation. A home typically has four sides. Completion. The four of wands is often a marriage or partnership so 4's and 8's deal with laying the foundation, more conservative and traditional approaches.
Five--my least favorite number in the deck but that is just me. Five is the fingers of one hand but true balance comes from having BOTH hands. Fives often are pop quizzes and sometimes indicative of where things are out of balance in some way.
Six--a nice number, two interlocking triangles, a nice, soft creative approach. Sometimes that approach in life can be a disaster but I have a fondness for the "three numbers".
Seven--magical, the menorah, spirit fills the air.
Eight--two squares, foundation, worker bee, what can I do to make this "work"--job, 401K, keep the marriage together, etc.
Nine--high level creativity or inspiration. Luck. Also, Nines often indicate decisions that should, or need to, be made.
Ten--I can carry the burden with both hands. I can DO IT. Achievement, culmination, rewards.
With the 9 Card, luck is something of a generic concept in that it can swing both ways and I see the 9's (depending on the suit) as being often about things that don't always SEEM fully conscious, where there is sometimes a disconnect in determining causality, sort of a "how did that happen?" vibe or a "gee I just wish this would happen" vibe as well.
If 4 is laying the foundation then 8 is about either maintaining the foundation or moving in to what was created with the 4. I think the results shown by the 8 are typically more "logical" and easier to "understand" than the energy indicated by the 9's.
Anyway, a simplistic but hopefully helpful little cheat-sheet.
Here is a very high level look at what the numbers "mean". Please realize this is not the be all end all here but just one way of looking at them and try to look at it as sort of a short-hand approach to tarot.
One--think of somebody pointing their index finger. They are directed, focused. Ones are about drive, vision, making things happen. Single-mindedness.
Two--a couple, a decision (this or that), yes/no, up/down, right/left, etc. Twos are either partnerships or decisions but they deal with questions of what to decide upon or who to be with.
Three--a triangle. All numbers divisible by 3 (3, 6, and 9) deal with creative ways of approaching things, in one form or another. Better or worse depending on the suit and placement.
Four--a square, a foundation. A home typically has four sides. Completion. The four of wands is often a marriage or partnership so 4's and 8's deal with laying the foundation, more conservative and traditional approaches.
Five--my least favorite number in the deck but that is just me. Five is the fingers of one hand but true balance comes from having BOTH hands. Fives often are pop quizzes and sometimes indicative of where things are out of balance in some way.
Six--a nice number, two interlocking triangles, a nice, soft creative approach. Sometimes that approach in life can be a disaster but I have a fondness for the "three numbers".
Seven--magical, the menorah, spirit fills the air.
Eight--two squares, foundation, worker bee, what can I do to make this "work"--job, 401K, keep the marriage together, etc.
Nine--high level creativity or inspiration. Luck. Also, Nines often indicate decisions that should, or need to, be made.
Ten--I can carry the burden with both hands. I can DO IT. Achievement, culmination, rewards.
With the 9 Card, luck is something of a generic concept in that it can swing both ways and I see the 9's (depending on the suit) as being often about things that don't always SEEM fully conscious, where there is sometimes a disconnect in determining causality, sort of a "how did that happen?" vibe or a "gee I just wish this would happen" vibe as well.
If 4 is laying the foundation then 8 is about either maintaining the foundation or moving in to what was created with the 4. I think the results shown by the 8 are typically more "logical" and easier to "understand" than the energy indicated by the 9's.
Anyway, a simplistic but hopefully helpful little cheat-sheet.
Tuesday, August 14, 2007
Embracing my Inner Outlaw
They are gathered together, the captains of killing, in their dark cars, with slippery eyes and swollen fingers, staring out at the oil-stained fields of death. They want it all. They do. They expect it all. They plan to take it.
All.
And they will--unless we stand up, unless we realize that this is no different than Germany in 1933, unless we take a stand together.
As artists we must band together to let our words and images speak truth to power. As concerned citizens, people who care, we MUST take a stand so that others in this world can live in peace.
As people of color, all colors, we have to love each other and DO what is right and fair and supports the planet and ALL people, not just rich white people.
I have dropped my connection to the white boy world—no longer will I take consulting jobs, no longer will I lend my expertise to support and help corporations. My $175.00 an hour consulting jobs—GONE. My fancy Platinum American Express Card—GONE. My belief and acceptance of the “status quo”—LONG GONE.
Because if we don’t stop it now something will stop US later on. Read a history book. Take a stand. Fight the power, fight the powers that be.
All.
And they will--unless we stand up, unless we realize that this is no different than Germany in 1933, unless we take a stand together.
As artists we must band together to let our words and images speak truth to power. As concerned citizens, people who care, we MUST take a stand so that others in this world can live in peace.
As people of color, all colors, we have to love each other and DO what is right and fair and supports the planet and ALL people, not just rich white people.
I have dropped my connection to the white boy world—no longer will I take consulting jobs, no longer will I lend my expertise to support and help corporations. My $175.00 an hour consulting jobs—GONE. My fancy Platinum American Express Card—GONE. My belief and acceptance of the “status quo”—LONG GONE.
Because if we don’t stop it now something will stop US later on. Read a history book. Take a stand. Fight the power, fight the powers that be.
Saturday, August 11, 2007
Bush War Adviser Says Draft Worth a Look
A few months back I posted a bulletin saying I believed there was a very good chance that the dreaded military draft would soon be making a comeback.
There is legislation currently on the books, drafted originally by Rep. Charles Rangel in 2003 and re-introduced in January, 2007, requiring national service for all citizens between the ages of 18-42 during a time of war, with a further proviso for mandatory military service during wartime.
This was originally introduced by Rep Rangel as a form of protest but it is on the books nonetheless and, cynic that I am, I felt that the reintroduction of this bill earlier this year was entirely too convenient if the stop-loss orders and low morale wore down the existing military to a point where no other options were readily available.
Here is a link to the Library Of Congress site for the amended bill (H.R. 393): "http://thomas.loc.gov/cgi-bin/bdquery/z?d110:H.R.393:"
For a true rockin' good time for all the twenty and thirty year olds on myspace, check out this site: "http://everyoneserves.org".
I believed then, as I do now, that not only is the draft possible but that it is actually quite probable.
At the time, I might as well have written that the Easter Bunny was going to bomb Indiana and then attack the Tooth Fairy because everyone thought this idea preposterous and let me know just how stupid I was.
I guess perhaps I really am THAT stupid because I still believe it very likely that the draft will be reintroduced.
It was mandatory when I was in High School that all 18 year olds register with Selective Service. I had a draft card when I was 18 and was worried all throughout high school that my days of little boy jock bliss might one day come to a screeching and unhappy stop and that I would wake up and find my blond skirt-chasing behind standing waist-deep in a rice paddie in South Vietnam.
Thankfully, I was in the United State's last draft class: I was born in 1955, the "all-Volunteer" Army was introduced while I was a Senior in High School in 1973.
I hope this never happens but, fwiw, I am attaching the following article taken from commondreams.org: http://www.commondreams.org/archive/2007/08/11/3117/
Published on Saturday, August 11, 2007 by The Associated Press
Bush War Adviser Says Draft Worth a Look
by Richard Lardner
Frequent tours for U.S. forces in Iraq and Afghanistan have stressed the all-volunteer force and made it worth considering a return to a military draft, President Bush's new war adviser said Friday. "I think it makes sense to certainly consider it," Army Lt. Gen. Douglas Lute said in an interview with National Public Radio's "All Things Considered."0811 05
"And I can tell you, this has always been an option on the table. But ultimately, this is a policy matter between meeting the demands for the nation's security by one means or another," Lute added in his first interview since he was confirmed by the Senate in June.
President Nixon abolished the draft in 1973. Restoring it, Lute said, would be a "major policy shift" and Bush has made it clear that he doesn't think it's necessary.
The repeated deployments affect not only the troops but their families, who can influence whether a service member decides to stay in the military, Lute said.
"There's both a personal dimension of this, where this kind of stress plays out across dinner tables and in living room conversations within these families," he said. "And ultimately, the health of the all- volunteer force is going to rest on those sorts of personal family decisions."
The military conducted a draft during the Civil War and both world wars and between 1948 and 1973. The Selective Service System, re- established in 1980, maintains a registry of 18-year-old men.
Rep. Charles Rangel, D-N.Y., has called for reinstating the draft as a way to end the Iraq war.
Bush picked Lute in mid-May as a deputy national security adviser with responsibility for ensuring efforts in Iraq and Afghanistan are coordinated with policymakers in Washington. Lute, an active-duty general, was chosen after several retired generals turned down the job.
There is legislation currently on the books, drafted originally by Rep. Charles Rangel in 2003 and re-introduced in January, 2007, requiring national service for all citizens between the ages of 18-42 during a time of war, with a further proviso for mandatory military service during wartime.
This was originally introduced by Rep Rangel as a form of protest but it is on the books nonetheless and, cynic that I am, I felt that the reintroduction of this bill earlier this year was entirely too convenient if the stop-loss orders and low morale wore down the existing military to a point where no other options were readily available.
Here is a link to the Library Of Congress site for the amended bill (H.R. 393): "http://thomas.loc.gov/cgi-bin/bdquery/z?d110:H.R.393:"
For a true rockin' good time for all the twenty and thirty year olds on myspace, check out this site: "http://everyoneserves.org".
I believed then, as I do now, that not only is the draft possible but that it is actually quite probable.
At the time, I might as well have written that the Easter Bunny was going to bomb Indiana and then attack the Tooth Fairy because everyone thought this idea preposterous and let me know just how stupid I was.
I guess perhaps I really am THAT stupid because I still believe it very likely that the draft will be reintroduced.
It was mandatory when I was in High School that all 18 year olds register with Selective Service. I had a draft card when I was 18 and was worried all throughout high school that my days of little boy jock bliss might one day come to a screeching and unhappy stop and that I would wake up and find my blond skirt-chasing behind standing waist-deep in a rice paddie in South Vietnam.
Thankfully, I was in the United State's last draft class: I was born in 1955, the "all-Volunteer" Army was introduced while I was a Senior in High School in 1973.
I hope this never happens but, fwiw, I am attaching the following article taken from commondreams.org: http://www.commondreams.org/archive/2007/08/11/3117/
Published on Saturday, August 11, 2007 by The Associated Press
Bush War Adviser Says Draft Worth a Look
by Richard Lardner
Frequent tours for U.S. forces in Iraq and Afghanistan have stressed the all-volunteer force and made it worth considering a return to a military draft, President Bush's new war adviser said Friday. "I think it makes sense to certainly consider it," Army Lt. Gen. Douglas Lute said in an interview with National Public Radio's "All Things Considered."0811 05
"And I can tell you, this has always been an option on the table. But ultimately, this is a policy matter between meeting the demands for the nation's security by one means or another," Lute added in his first interview since he was confirmed by the Senate in June.
President Nixon abolished the draft in 1973. Restoring it, Lute said, would be a "major policy shift" and Bush has made it clear that he doesn't think it's necessary.
The repeated deployments affect not only the troops but their families, who can influence whether a service member decides to stay in the military, Lute said.
"There's both a personal dimension of this, where this kind of stress plays out across dinner tables and in living room conversations within these families," he said. "And ultimately, the health of the all- volunteer force is going to rest on those sorts of personal family decisions."
The military conducted a draft during the Civil War and both world wars and between 1948 and 1973. The Selective Service System, re- established in 1980, maintains a registry of 18-year-old men.
Rep. Charles Rangel, D-N.Y., has called for reinstating the draft as a way to end the Iraq war.
Bush picked Lute in mid-May as a deputy national security adviser with responsibility for ensuring efforts in Iraq and Afghanistan are coordinated with policymakers in Washington. Lute, an active-duty general, was chosen after several retired generals turned down the job.
A Liberal's Response to Conservative Rants against "Sicko"
One of the arguments made against “sicko” is that it promotes socialized medicine and is just more “liberal whining”. The hard line argument by many conservative critics is that if we go to a system like Canada’s then we will all wait in line for weeks on end and no one will ever get care and then we will all be in the fields harvesting wheat and making substandard toaster ovens in some post-Stalinist nightmare world.
Could it just be that capitalism without checks and balances is fundamentally “different” than what the US once was and the idea of regulatory, best practice oversight is not a bad thing but instead the basis upon which we can make things better?
The health care system in the US is, if not broken, then at least seriously “bent”. I remember being a kid in the 60’s when you could still go to the doctor and not have to sell the house in order to do it. It is certainly not that way any more!!
There are laws and laws should be obeyed equally by all, not just by the poor or powerless. If health care providers are outside of the written legislation then the system does not, in fact, cannot, work.
But the reason we have laws is that it has been shown that not everyone “voluntarily” takes the high noble path. Too often individuals or groups succumb to self-interests and commit deeds that “go against” what is best for the group.
That, on a simplistic level, is why we have a legal system–a codified standard of behavior with “watchers” to help confirm we adhere to those standards and “penalties” to be administered if we don’t.
Health care providers can “stretch” contractual language–your policy–to the point of breaking and that is not fair. All I am asking is that health care providers be held accountable to do what the laws say they should do. Either re-write the laws or do something to hold providers accountable for breaking them. Either or.
Sadly–That is not how it is now. And that is what needs to change.
The concept raised by many Conservatives is that government “involvement” in an issue is analogous to communism. This seems, to me, to be a very weak argument. There is government involvement in every area of our lives–checks and balances is the positive term, government interference is the negative.
Why can’t I drive 90 mph through a school district? Why do I have to have my kids vaccinated just so they can go to 3rd grade? Why do I have confine myself to just one wife; why not three or four or as many as my income will allow?
These are examples of “regulations” (instituted and “controlled” by the government) and I don’t think this is a novel concept that they exist and, hopefully, they are put into place in order to help make the “system” work “better” for the common good.
What is happening, I believe, with health care is that the “idea” of what one gets with insurance turns out to be in variance with what one often times receives. In both socialized medicine countries and the US there is a distinct stratification at work.
Whether one is excluded due to volume or due to income, in both systems there will be those who suffer and those who prosper and there are limitations to both.
If Insurance Companies and other health care providers actually provided the services they “advertise” and contractually agree to then this would just be a question of rich vs poor and a different line of argumentation would likely follow.
But the most important issue (in my opinion) is that health care providers are taking advantage of a system that allows for profit taking (by many that have nothing to do with actually providing care but instead serve only in administrative capacities) to the detriment–in many cases this is life threatening–of the people who pay for their services.
Why, if I am a manufacturer, should I put decent brakes on motorcycles if I can make them at a higher profit with sub-standard ones? Why build the house to code if the likelihood of fire seems so remote? These lines of argumentation are no different than asking “why don’t you provide a level of service that meets acceptable, agreed upon standards?”
The issue is not that Canada is better or worse. The issue is that the system in the US does not work and whether or not one implements “socialized medicine” or not is not nearly as important as making the current system better and providing a level of oversight and control that supports better service to the consumer/patient.
There are many people who feel as if the current healthcare system in America works “just fine”. I disagree. There are methodological imperatives based on both IT infrastructure and clinical processes that are out of control and most of the cost based models underlying health care are at serious odds with accepted best practice models.
Just to put things in perspective, as I do have some first hand experience with health care, on both sides of the curtain, I made about 300,000 a year (as an analyst and manager for Kaiser Permanente–a rather large health care provider and, sadly, a very poor one, as well) and my 300,000 a year salary and my fancy job and title working FOR a hospital did nothing to help me because the hospital I designed business processes and testing methodologies for allowed my child to die.
They were so cost-conscious that they did not “notice” a medical crisis and so now we have no daughter. There are other problems I have experienced with health care as well. One more example (although nothing compared to the loss of our child): I have an arthritic badly damaged shoulder, but the doctors did nothing to help me with that other than confirm that, yes, my shoulder is damaged.
Thanks for the insight. No treatment, no medication, no therapy, nothing. I should “exercise it” and “maybe” it will improve.
As a former athlete I exercise it pretty much all the time. There are horror stories galore I could recite from listening to others talk about their experiences with their health care providers but I think mine should be enough.
And, after allowing our child to die–and trust me, if this happens to you, you may re-think your position on health care–the hospital LOST critical medical records and then, later, inserted false records in their place.
We know these are false because we know EMR (electronic medical record) protocol and the “found” records do not conform to that protocol so they are obviously fakes–and please don’t even ATTEMPT to dispute this because, once again, based on my JOB, I know what these are supposed to look like and these “ain’t it”.
The issue at hand is not one of socialism versus capitalism but rather the implementation of controls and standards that are in closer adherence to standard best practice models in business–the only best practice models anyone in health care pays much attention to are cost reduction models, which is fine provided that frugality does not undercut the efficacy of the service provided.
I am not saying that we need to be Canada or have socialized medicine. What I am saying is this:
1. The health care system does not work as well as it should.
2. Somebody should do something about it. Socialized medicine is not the only answer; but there must be changes, fundamental root cause changes, in order for the health care system to be viable and, well, “healthy”.
To deny that there are “real” problems is, to me, very short-sighted thinking.
Policy always drives process–always–so if the health care providers knew they were expected to conform to a specific level of care or risk being penalized then they would figure it out and the system would change. As long as they can play fast and loose and avoid being penalized nothing will change. That is the issue.
The health care system is based on a big lie–and it is this: we will honor our bargain with you, no matter what.
But what happens is this, if it becomes problematic or expensive later, then the health care providers stop holding up their end of the deal.
When you take your wedding vows, “in sickness and health” there is no fine print that says “unless you get really sick and your illness costs a lot of money to cure.”
With an insurance company you hear the vow but don’t realize the fine print because it is a faint hollow whisper. All I am asking is that the insurance companies honor their vows, their sacred trust, with me and anyone else who signs up for their services. Would you leave your sick wife or child to fend for themselves alone? Is this fair?
SOMETHING has to happen; the status quo is no longer a viable option and if “sicko” brings awareness to this issue and initiates a dialogue and critical assessment of current state, then this, in my opinion, is a positive thing.
Could it just be that capitalism without checks and balances is fundamentally “different” than what the US once was and the idea of regulatory, best practice oversight is not a bad thing but instead the basis upon which we can make things better?
The health care system in the US is, if not broken, then at least seriously “bent”. I remember being a kid in the 60’s when you could still go to the doctor and not have to sell the house in order to do it. It is certainly not that way any more!!
There are laws and laws should be obeyed equally by all, not just by the poor or powerless. If health care providers are outside of the written legislation then the system does not, in fact, cannot, work.
But the reason we have laws is that it has been shown that not everyone “voluntarily” takes the high noble path. Too often individuals or groups succumb to self-interests and commit deeds that “go against” what is best for the group.
That, on a simplistic level, is why we have a legal system–a codified standard of behavior with “watchers” to help confirm we adhere to those standards and “penalties” to be administered if we don’t.
Health care providers can “stretch” contractual language–your policy–to the point of breaking and that is not fair. All I am asking is that health care providers be held accountable to do what the laws say they should do. Either re-write the laws or do something to hold providers accountable for breaking them. Either or.
Sadly–That is not how it is now. And that is what needs to change.
The concept raised by many Conservatives is that government “involvement” in an issue is analogous to communism. This seems, to me, to be a very weak argument. There is government involvement in every area of our lives–checks and balances is the positive term, government interference is the negative.
Why can’t I drive 90 mph through a school district? Why do I have to have my kids vaccinated just so they can go to 3rd grade? Why do I have confine myself to just one wife; why not three or four or as many as my income will allow?
These are examples of “regulations” (instituted and “controlled” by the government) and I don’t think this is a novel concept that they exist and, hopefully, they are put into place in order to help make the “system” work “better” for the common good.
What is happening, I believe, with health care is that the “idea” of what one gets with insurance turns out to be in variance with what one often times receives. In both socialized medicine countries and the US there is a distinct stratification at work.
Whether one is excluded due to volume or due to income, in both systems there will be those who suffer and those who prosper and there are limitations to both.
If Insurance Companies and other health care providers actually provided the services they “advertise” and contractually agree to then this would just be a question of rich vs poor and a different line of argumentation would likely follow.
But the most important issue (in my opinion) is that health care providers are taking advantage of a system that allows for profit taking (by many that have nothing to do with actually providing care but instead serve only in administrative capacities) to the detriment–in many cases this is life threatening–of the people who pay for their services.
Why, if I am a manufacturer, should I put decent brakes on motorcycles if I can make them at a higher profit with sub-standard ones? Why build the house to code if the likelihood of fire seems so remote? These lines of argumentation are no different than asking “why don’t you provide a level of service that meets acceptable, agreed upon standards?”
The issue is not that Canada is better or worse. The issue is that the system in the US does not work and whether or not one implements “socialized medicine” or not is not nearly as important as making the current system better and providing a level of oversight and control that supports better service to the consumer/patient.
There are many people who feel as if the current healthcare system in America works “just fine”. I disagree. There are methodological imperatives based on both IT infrastructure and clinical processes that are out of control and most of the cost based models underlying health care are at serious odds with accepted best practice models.
Just to put things in perspective, as I do have some first hand experience with health care, on both sides of the curtain, I made about 300,000 a year (as an analyst and manager for Kaiser Permanente–a rather large health care provider and, sadly, a very poor one, as well) and my 300,000 a year salary and my fancy job and title working FOR a hospital did nothing to help me because the hospital I designed business processes and testing methodologies for allowed my child to die.
They were so cost-conscious that they did not “notice” a medical crisis and so now we have no daughter. There are other problems I have experienced with health care as well. One more example (although nothing compared to the loss of our child): I have an arthritic badly damaged shoulder, but the doctors did nothing to help me with that other than confirm that, yes, my shoulder is damaged.
Thanks for the insight. No treatment, no medication, no therapy, nothing. I should “exercise it” and “maybe” it will improve.
As a former athlete I exercise it pretty much all the time. There are horror stories galore I could recite from listening to others talk about their experiences with their health care providers but I think mine should be enough.
And, after allowing our child to die–and trust me, if this happens to you, you may re-think your position on health care–the hospital LOST critical medical records and then, later, inserted false records in their place.
We know these are false because we know EMR (electronic medical record) protocol and the “found” records do not conform to that protocol so they are obviously fakes–and please don’t even ATTEMPT to dispute this because, once again, based on my JOB, I know what these are supposed to look like and these “ain’t it”.
The issue at hand is not one of socialism versus capitalism but rather the implementation of controls and standards that are in closer adherence to standard best practice models in business–the only best practice models anyone in health care pays much attention to are cost reduction models, which is fine provided that frugality does not undercut the efficacy of the service provided.
I am not saying that we need to be Canada or have socialized medicine. What I am saying is this:
1. The health care system does not work as well as it should.
2. Somebody should do something about it. Socialized medicine is not the only answer; but there must be changes, fundamental root cause changes, in order for the health care system to be viable and, well, “healthy”.
To deny that there are “real” problems is, to me, very short-sighted thinking.
Policy always drives process–always–so if the health care providers knew they were expected to conform to a specific level of care or risk being penalized then they would figure it out and the system would change. As long as they can play fast and loose and avoid being penalized nothing will change. That is the issue.
The health care system is based on a big lie–and it is this: we will honor our bargain with you, no matter what.
But what happens is this, if it becomes problematic or expensive later, then the health care providers stop holding up their end of the deal.
When you take your wedding vows, “in sickness and health” there is no fine print that says “unless you get really sick and your illness costs a lot of money to cure.”
With an insurance company you hear the vow but don’t realize the fine print because it is a faint hollow whisper. All I am asking is that the insurance companies honor their vows, their sacred trust, with me and anyone else who signs up for their services. Would you leave your sick wife or child to fend for themselves alone? Is this fair?
SOMETHING has to happen; the status quo is no longer a viable option and if “sicko” brings awareness to this issue and initiates a dialogue and critical assessment of current state, then this, in my opinion, is a positive thing.
Lehnabug
A story was published back in February on the front page of the LA Times under Dan Costello's byline outlining some of the problems underlying Kaiser Permanente's multi-billion dollar white elephant, Health Connect.
In that story I was quoted as saying that in my fairly extensive career as an IT project manager that I had never seen a project so poorly or ineffectually managed as this one—since I am the person who, literally, wrote the Disaster Recovery Plan for Enron, perhaps this is really saying something. What Dan failed to mention in his story is that the motivation for me to come forward with my concerns stemmed largely from the manner in which my daughter's stillbirth was handled and the completely ridiculous manner in which my daughter's mother had been treated both during and after her pregnancy.
My position as someone tasked with helping design business processes and providing some level of testing oversight for the project could not protect us from the bottom-line approach taken by Kaiser and the economics of death (as I learned AFTER the fact) make for a strange and, in our case, tragic bed fellow.
There is a 30% chance that induction of labor will lead to an emergency c-section and thus (the REAL problem) potentially lead to a greater expense. Fixed cost projects of any kind do not like the sound of a 30% chance of revenue loss.
But, if a woman goes beyond her due date there is an approximate 1 in 300 chance that the child may die. Also keep in mind that Beth (Lehna's mother), no matter how healthy and fit she may be, was a 40 year old woman and potentially a high-risk pregnancy due to her age. These are not particularly good odds for a parent and no parent, if presented with this scenario, would accept these odds but Beth and I are not doctors, we assumed all was well—after all this was a company that paid me a fairly handsome sum to work for them on what I knew to be one of the largest, most expensive software initiatives in history so (from my perspective) this was a cash rich organization and certainly one that would watch over our special needs—and so we were not informed of the risks associated with having the pregnancy continue so far past the due date.
I know for many of you the idea of what Beth (especially Beth) and I went through—and continue to go through each day—must be unimaginable. But, please bear with me as I attempt to share our story in a way in which, perhaps, you may get a better sense of what really happened.
So: First thing–I want you to imagine a scene. I want you to imagine a baby's fat little naked body. I want you to imagine the baby's chubby little cherub body lying on your chest like you saw in that video in the birthing class you and her mother took the month before she died in Mommy's belly.
I want you to imagine the baby now being coaxed out of her grieving morphined mother. I want you to see it, really see it. You can hear the nurses whispering, their small pleasantries and kindnesses too little too late but you are appreciative just the same. Look at the clock. You are constantly watching the clock. Pulling time forward, desperately trying to push it a few days back. You know what's coming. You brace yourself but you have no idea, really, what to expect.
To add to the torment the mother has to be induced. She is not ready, naturally, to deliver her child but the baby is already dead and she has to come out somehow. A caesarean is out—too risky. It is not worth the risk to the mother (and later, when you begin putting two and two together, the EXPENSE for the hospital). The drugs are administered (poorly) the prayers for deliverance and strength offered, the nightmare has just begun. It is 3:00 am Sunday morning.
You hold the mother's hand; you try, somehow, to make the night as peaceful and comfortable for her as you can. The mother is beautiful truly physically beautiful and she is going through something no one should EVER have to experience and you do your part to make the pain she feels now as bearable as you can and you brace yourself for the next wave of pain you know is coming.
When she starts to come out, PUSH PUSH PUSH, her little head peaking out PUSH PUSH PUSH of her mother's vagina, you die. On the spot. Your heart doesn't just break. It stops beating. It no longer beats, it simply allows blood to somehow flow from place to place to place.
The baby, as you know, is already dead, and when she is pulled free her little lifeless body covered in her protective sack, her little dark hairs plastered tight against her cold little head, your mind breaks off a bit and ropes off a little space over in the corner under the boogie man and next to the spiders and bats and creepy old Mrs. Caverly, your ninth grade English teacher, the one who called you a parasite because you didn't read "Great Expectations". The birth of this child and all the terrible pictures and sounds and smells of the night (and, of course, the following day) is something that you can never forget. It is also something that you would never WANT to forget. This day is your only day and it will have to last a long long while.
Her death and the day you spent together is a line in the sand that marks in many quite recognizable ways the end of your own life. The baby's death now becomes your death. Remember what I have said.
The baby's death is your death. You are no longer the same; you can never EVER even pretend to be the same. You might just as well be dead yourself.
Perhaps, maybe, you are.
Remember, too, what it was like the night before after you drove to the hospital and when you found out in the labor and delivery triage room that somehow your baby had died, a baby who had gone full-term through a perfect pregnancy, a baby you had expected two days earlier, when you first came to this same triage room, to hold in your arms and dance and kiss and smooch for a lifetime.
Neither Beth nor I nor our beautiful daughters Elise and Riana will ever be the same again. No settlement no apology no ANYTHING will ever make it right. After Lehna's death I stayed at Kaiser because I believed that my skills as a business analyst would help minimize the chances of this happening to other parents but the project is beyond, I believe, ever really being fixed.
Beth and I had many quite serious disagreements about my continuing role at Kaiser after Lehna's death but I believed, then, that this was the correct approach, no matter how damaging psychologically this may have been to both Beth and me. Also, it allowed me to watch, like a hawk, exactly what was happening within the project over the past year from a fairly unique vantage point.
But when Lehna's fetal heart monitor strip just magically "showed up" one day–WITHOUT a date/time stamp–THEN I changed. It was then, literally THAT DAY, on the spot, as if a bolt of lightning had been attached rather crudely to my behind, that I became ABSOLUTELY determined to (a) leave Kaiser and (b) tell "MY story".
In retrospect I am not so sure I was correct in taking this approach but I was trying, to the best of my ability under the circumstances, to salvage what had been a fairly successful career and I did not want to lose both my child AND the career I had worked so hard for so long to craft and nurture but, ultimately, Lehna's death has most likely ended my career as well. Certainly her death has tarnished the rest of my life in ways that can never be undone.
Lehna Jordann Brewer was finally delivered into the world in Walnut Creek, CA at 3:44 am on Sunday, March 5, 2006 but, officially, this child never existed even though almost every time I touched her Mommy's belly she reached out her little hands to pat me; how can anyone ever REALLY get over this?
Lehna Jordann Brewer, according to the laws of California, was never born, she never died she is, legally, nothing but she is something to us and perhaps one day her life and death may serve a higher purpose. She was and is a BEAUTIFUL BABY: our little muffinizer rascalian girl.
The idea that a stillborn child is a non-event seems logically antithetical to the concept that a "child" can be murdered in the womb. This interpretation has, to me anyway, always been problematic.
Lehna was absolutely our child. We all miss her and her death really ruined our lives in so many ways. I changed her diaper and she spit up on my shirt. How she had a poopy diaper and COULD spit up on my shirt I don't know but I have the diaper and shirt to prove it.
We have locks of her hair. More importantly in a little box wrapped in a blankie we have what is left of Lehna, a pile of ash, with no kisses or toys or happy memories, nothing but a little cardboard box.
The more time passes the more I blame Kaiser for the way in which they handled the situation and the manner in which they treated Beth. As time passes, my ideas conform more to Beth's interpretation of what happened no matter how far apart they may have been six to eight months ago.
It was the manner in which Kaiser handled–or should I say "mis-handled"–Beth's medical records that led me to change my opinion and that change has caused me an incredible amount of grief and made it difficult for me to return to the corporate "world" again.
I am attaching part of an email I wrote as the cover to a "Lessons Learned" document I submitted to Kaiser leadership last November–this is before finding out that our daughter's medical records magically re-appeared (without a name, date, or MRN number at which point I stopped really trying to help Kaiser and "gave up" any hopes of things ever working out).
Anyway, for a small taste of what my opinion of Kaiser's methodological weaknesses may be I am attaching part of the cover letter to my Lessons Learned doc, dated 11/10/2006:
{The two most common reasons for a software implementation to have "issues" are 1) data integration requirements for all existing legacy systems are problematic and systems don't "talk" to one another or 2) late in the game additional requirements and/or wishes are introduced, often times leading to a condensed time line for the creation and testing of those changes. Both will potentially impact the stability of a given system.
From an organizational change perspective, the two most common deterrents to effective change management are 1) lack of effective, overt executive sponsorship and 2) conflicting messages either in type or decree. All of these issues are evident in KPHC in some degree or another.
I still believe the major problem here is communication and the major communication problem is a lack of some measure of centralization and control of the release of information.
I disagree in principle with the manner in which we are conducting our testing; I am not referring to our team but rather the totality of entities involved in requesting, testing, and promoting code into a production environment. I realize this is not news that I disagree and I will continue to raise this as a concern as long as I believe it continues to be problematic. My analysis is attached . . .}
There are a multitude of problems within Kaiser and certainly a multitude of "potentially" serious problems (in my opinion—realize, though, that this is only my opinion).
I believe, within the context of "Best Practice" methodologies—and a Kaiser manager once told me, to my face, "F*@K your methodology" (only the impending birth of my daughter stopped me from leaving and raising a stink at the time; yes "Kaiser cares")—a VERY strong case can be made that Health Connect poses a potential risk to all Kaiser members and I believe a strong case can and perhaps should be made that some level of governmental oversight should be applied towards addressing potential risks within Health Connect.
In a nutshell, all the ways in which a software implementation could go wrong I believe went wrong (WAY wrong) with Health Connect.
But "projects" mean little when life and death is at stake and so, to cap off my narrative, I am including the email I wrote the morning after Lehna's death, informing my co-workers that I would not be coming in to work that morning. Here is the text, as I wrote it, on March 6, 2006:
{Our beautiful baby daughter, Lehna Jordann, died in utero this past weekend. Beth was induced and she gave birth to Lehna, stillborn, Sunday morning at 3:44 am. I am telling you this not to make you feel sad, because I know many of you will feel sad both for the situation and for me, but to let you know how my experience is likely to impact my short-term commitments to Kaiser.
I also know that many of you know me and have heard me as the silly joyous hopeful 51 year-old expectant father-to-be go on and on about Lehna and my hopes and dreams relative to the child and, as a result, I realize this also adds to your sadness for this situation and I truly feel your pain as you try to feel mine. Some of you have had experiences like mine, perhaps not exactly, but you know the sense of loss personally and deeply, too.
On Thursday morning, I went with Beth to the doctor for a stress test and ultrasound. The doctors told me to basically hang out, everything looked good and the possibility of the baby saying hello before the end of the day was very strong. On Thursday night, Beth thought she was in labor so we drove to Walnut Creek and went to the triage room in Labor and Delivery. We were there for a few hours. The monitors showed the baby's heart beating away but we were told that it was not time and sent home. Beth was past her due date and if Lehna didn't come on her own we were scheduled for next Wednesday, 3/8, to have Beth induced.
On Saturday Beth said she felt as if the baby wasn't moving. We assumed this was the "calm before the storm" and the baby was getting her sleep so she wouldn't be tired when her parents kept waking her up to kiss her and try on different outfits. I assumed everything was fine but we went to Walnut Creek Saturday night just to make sure and that is when we learned that Lehna had already died. The next 24 hours were crazy--Beth was admitted and induced to have labor, she had Lehna at 3:44 am and then we stayed with Lehna and looked at her and held her and loved her and tried so so hard to capture something of her to remember.
All parents think their children are beautiful and will go to Harvard and win Wimbledon and become King of Norway but please believe me when I tell you all that this child was truly beautiful. She was 7 lb 13 oz and 20 3/4 inches tall and she was even prettier than I could have imagined her--and I imagined her as being pretty special. Lehna's physical appearance only adds to our bewilderment as to how such a beautiful well-formed baby could suddenly just die.
The irony is not lost on me that my professional role as someone with some level of responsibility for planning and developing testing methodologies for a hospital should see their child die in that same hospital when all the diagnostic tools failed to uncover any problem and the doctors have no ideas as to what caused her death.
Also, I want to thank you for the lovely baby shower you gave to me last week. I apologize for not responding earlier but so much was going on Wednesday and Thursday and I talked with Gilda and I planned today to send a formal thank you which I will do later; I promise. Beth and I appreciate so much your kindness and I slept last night with one of the little blankies you gave us for Lehna and I know that she would have loved everything, too.
I can't figure out why this happened. I try and make sense of it but it is beyond me to understand. By nature I am driven so much by emotion. My professional life, though, is driven by my ability to analyze, understand, and detach. This means this, this and that lead to a probability of this, methodological dictates say this should be so and this shouldn't.
As such these modes of being and thinking are like two different engines on the same train. The analyst is a skill, pure and simple, one I can literally turn on and off light a faucet. The other half, the artistic emotional half, is not so easy, though, to turn on and off. It is because of this duality of nature that I feel that, for now, I need to stay away in order for the feeling me to have its time. I can go hard core methodology RFA Project planning etc in bursts but right now I cannot sustain that.
Give me a few days and I will be back, perhaps remotely for day or two but I will be back.
This leads to another issue which is how will you all respond to me when I do come back. I don't want you to feel as if you have to wear black in my presence and avert your eyes and shuffle away in fear my personal sorrow is contagious. It is not. When I come back I hope you will treat me just as you did before and I am hopeful, too, that I will be professional enough to keep everything in order so as not to negatively impact you or your ability to get the things done you need to. I will not be a bottleneck for testing but I will be our of pocket for today.
Thank you all for your friendship. Some of you have been friends of mine for many years and others of you I have know only a short while but still you have all been so good to me throughout my time at Kaiser. If I have left anyone off this please let them know and forgive me, too, for not personally writing to you.
Thank you for reading this for me and I will see you all very soon.
Andy
In that story I was quoted as saying that in my fairly extensive career as an IT project manager that I had never seen a project so poorly or ineffectually managed as this one—since I am the person who, literally, wrote the Disaster Recovery Plan for Enron, perhaps this is really saying something. What Dan failed to mention in his story is that the motivation for me to come forward with my concerns stemmed largely from the manner in which my daughter's stillbirth was handled and the completely ridiculous manner in which my daughter's mother had been treated both during and after her pregnancy.
My position as someone tasked with helping design business processes and providing some level of testing oversight for the project could not protect us from the bottom-line approach taken by Kaiser and the economics of death (as I learned AFTER the fact) make for a strange and, in our case, tragic bed fellow.
There is a 30% chance that induction of labor will lead to an emergency c-section and thus (the REAL problem) potentially lead to a greater expense. Fixed cost projects of any kind do not like the sound of a 30% chance of revenue loss.
But, if a woman goes beyond her due date there is an approximate 1 in 300 chance that the child may die. Also keep in mind that Beth (Lehna's mother), no matter how healthy and fit she may be, was a 40 year old woman and potentially a high-risk pregnancy due to her age. These are not particularly good odds for a parent and no parent, if presented with this scenario, would accept these odds but Beth and I are not doctors, we assumed all was well—after all this was a company that paid me a fairly handsome sum to work for them on what I knew to be one of the largest, most expensive software initiatives in history so (from my perspective) this was a cash rich organization and certainly one that would watch over our special needs—and so we were not informed of the risks associated with having the pregnancy continue so far past the due date.
I know for many of you the idea of what Beth (especially Beth) and I went through—and continue to go through each day—must be unimaginable. But, please bear with me as I attempt to share our story in a way in which, perhaps, you may get a better sense of what really happened.
So: First thing–I want you to imagine a scene. I want you to imagine a baby's fat little naked body. I want you to imagine the baby's chubby little cherub body lying on your chest like you saw in that video in the birthing class you and her mother took the month before she died in Mommy's belly.
I want you to imagine the baby now being coaxed out of her grieving morphined mother. I want you to see it, really see it. You can hear the nurses whispering, their small pleasantries and kindnesses too little too late but you are appreciative just the same. Look at the clock. You are constantly watching the clock. Pulling time forward, desperately trying to push it a few days back. You know what's coming. You brace yourself but you have no idea, really, what to expect.
To add to the torment the mother has to be induced. She is not ready, naturally, to deliver her child but the baby is already dead and she has to come out somehow. A caesarean is out—too risky. It is not worth the risk to the mother (and later, when you begin putting two and two together, the EXPENSE for the hospital). The drugs are administered (poorly) the prayers for deliverance and strength offered, the nightmare has just begun. It is 3:00 am Sunday morning.
You hold the mother's hand; you try, somehow, to make the night as peaceful and comfortable for her as you can. The mother is beautiful truly physically beautiful and she is going through something no one should EVER have to experience and you do your part to make the pain she feels now as bearable as you can and you brace yourself for the next wave of pain you know is coming.
When she starts to come out, PUSH PUSH PUSH, her little head peaking out PUSH PUSH PUSH of her mother's vagina, you die. On the spot. Your heart doesn't just break. It stops beating. It no longer beats, it simply allows blood to somehow flow from place to place to place.
The baby, as you know, is already dead, and when she is pulled free her little lifeless body covered in her protective sack, her little dark hairs plastered tight against her cold little head, your mind breaks off a bit and ropes off a little space over in the corner under the boogie man and next to the spiders and bats and creepy old Mrs. Caverly, your ninth grade English teacher, the one who called you a parasite because you didn't read "Great Expectations". The birth of this child and all the terrible pictures and sounds and smells of the night (and, of course, the following day) is something that you can never forget. It is also something that you would never WANT to forget. This day is your only day and it will have to last a long long while.
Her death and the day you spent together is a line in the sand that marks in many quite recognizable ways the end of your own life. The baby's death now becomes your death. Remember what I have said.
The baby's death is your death. You are no longer the same; you can never EVER even pretend to be the same. You might just as well be dead yourself.
Perhaps, maybe, you are.
Remember, too, what it was like the night before after you drove to the hospital and when you found out in the labor and delivery triage room that somehow your baby had died, a baby who had gone full-term through a perfect pregnancy, a baby you had expected two days earlier, when you first came to this same triage room, to hold in your arms and dance and kiss and smooch for a lifetime.
Neither Beth nor I nor our beautiful daughters Elise and Riana will ever be the same again. No settlement no apology no ANYTHING will ever make it right. After Lehna's death I stayed at Kaiser because I believed that my skills as a business analyst would help minimize the chances of this happening to other parents but the project is beyond, I believe, ever really being fixed.
Beth and I had many quite serious disagreements about my continuing role at Kaiser after Lehna's death but I believed, then, that this was the correct approach, no matter how damaging psychologically this may have been to both Beth and me. Also, it allowed me to watch, like a hawk, exactly what was happening within the project over the past year from a fairly unique vantage point.
But when Lehna's fetal heart monitor strip just magically "showed up" one day–WITHOUT a date/time stamp–THEN I changed. It was then, literally THAT DAY, on the spot, as if a bolt of lightning had been attached rather crudely to my behind, that I became ABSOLUTELY determined to (a) leave Kaiser and (b) tell "MY story".
In retrospect I am not so sure I was correct in taking this approach but I was trying, to the best of my ability under the circumstances, to salvage what had been a fairly successful career and I did not want to lose both my child AND the career I had worked so hard for so long to craft and nurture but, ultimately, Lehna's death has most likely ended my career as well. Certainly her death has tarnished the rest of my life in ways that can never be undone.
Lehna Jordann Brewer was finally delivered into the world in Walnut Creek, CA at 3:44 am on Sunday, March 5, 2006 but, officially, this child never existed even though almost every time I touched her Mommy's belly she reached out her little hands to pat me; how can anyone ever REALLY get over this?
Lehna Jordann Brewer, according to the laws of California, was never born, she never died she is, legally, nothing but she is something to us and perhaps one day her life and death may serve a higher purpose. She was and is a BEAUTIFUL BABY: our little muffinizer rascalian girl.
The idea that a stillborn child is a non-event seems logically antithetical to the concept that a "child" can be murdered in the womb. This interpretation has, to me anyway, always been problematic.
Lehna was absolutely our child. We all miss her and her death really ruined our lives in so many ways. I changed her diaper and she spit up on my shirt. How she had a poopy diaper and COULD spit up on my shirt I don't know but I have the diaper and shirt to prove it.
We have locks of her hair. More importantly in a little box wrapped in a blankie we have what is left of Lehna, a pile of ash, with no kisses or toys or happy memories, nothing but a little cardboard box.
The more time passes the more I blame Kaiser for the way in which they handled the situation and the manner in which they treated Beth. As time passes, my ideas conform more to Beth's interpretation of what happened no matter how far apart they may have been six to eight months ago.
It was the manner in which Kaiser handled–or should I say "mis-handled"–Beth's medical records that led me to change my opinion and that change has caused me an incredible amount of grief and made it difficult for me to return to the corporate "world" again.
I am attaching part of an email I wrote as the cover to a "Lessons Learned" document I submitted to Kaiser leadership last November–this is before finding out that our daughter's medical records magically re-appeared (without a name, date, or MRN number at which point I stopped really trying to help Kaiser and "gave up" any hopes of things ever working out).
Anyway, for a small taste of what my opinion of Kaiser's methodological weaknesses may be I am attaching part of the cover letter to my Lessons Learned doc, dated 11/10/2006:
{The two most common reasons for a software implementation to have "issues" are 1) data integration requirements for all existing legacy systems are problematic and systems don't "talk" to one another or 2) late in the game additional requirements and/or wishes are introduced, often times leading to a condensed time line for the creation and testing of those changes. Both will potentially impact the stability of a given system.
From an organizational change perspective, the two most common deterrents to effective change management are 1) lack of effective, overt executive sponsorship and 2) conflicting messages either in type or decree. All of these issues are evident in KPHC in some degree or another.
I still believe the major problem here is communication and the major communication problem is a lack of some measure of centralization and control of the release of information.
I disagree in principle with the manner in which we are conducting our testing; I am not referring to our team but rather the totality of entities involved in requesting, testing, and promoting code into a production environment. I realize this is not news that I disagree and I will continue to raise this as a concern as long as I believe it continues to be problematic. My analysis is attached . . .}
There are a multitude of problems within Kaiser and certainly a multitude of "potentially" serious problems (in my opinion—realize, though, that this is only my opinion).
I believe, within the context of "Best Practice" methodologies—and a Kaiser manager once told me, to my face, "F*@K your methodology" (only the impending birth of my daughter stopped me from leaving and raising a stink at the time; yes "Kaiser cares")—a VERY strong case can be made that Health Connect poses a potential risk to all Kaiser members and I believe a strong case can and perhaps should be made that some level of governmental oversight should be applied towards addressing potential risks within Health Connect.
In a nutshell, all the ways in which a software implementation could go wrong I believe went wrong (WAY wrong) with Health Connect.
But "projects" mean little when life and death is at stake and so, to cap off my narrative, I am including the email I wrote the morning after Lehna's death, informing my co-workers that I would not be coming in to work that morning. Here is the text, as I wrote it, on March 6, 2006:
{Our beautiful baby daughter, Lehna Jordann, died in utero this past weekend. Beth was induced and she gave birth to Lehna, stillborn, Sunday morning at 3:44 am. I am telling you this not to make you feel sad, because I know many of you will feel sad both for the situation and for me, but to let you know how my experience is likely to impact my short-term commitments to Kaiser.
I also know that many of you know me and have heard me as the silly joyous hopeful 51 year-old expectant father-to-be go on and on about Lehna and my hopes and dreams relative to the child and, as a result, I realize this also adds to your sadness for this situation and I truly feel your pain as you try to feel mine. Some of you have had experiences like mine, perhaps not exactly, but you know the sense of loss personally and deeply, too.
On Thursday morning, I went with Beth to the doctor for a stress test and ultrasound. The doctors told me to basically hang out, everything looked good and the possibility of the baby saying hello before the end of the day was very strong. On Thursday night, Beth thought she was in labor so we drove to Walnut Creek and went to the triage room in Labor and Delivery. We were there for a few hours. The monitors showed the baby's heart beating away but we were told that it was not time and sent home. Beth was past her due date and if Lehna didn't come on her own we were scheduled for next Wednesday, 3/8, to have Beth induced.
On Saturday Beth said she felt as if the baby wasn't moving. We assumed this was the "calm before the storm" and the baby was getting her sleep so she wouldn't be tired when her parents kept waking her up to kiss her and try on different outfits. I assumed everything was fine but we went to Walnut Creek Saturday night just to make sure and that is when we learned that Lehna had already died. The next 24 hours were crazy--Beth was admitted and induced to have labor, she had Lehna at 3:44 am and then we stayed with Lehna and looked at her and held her and loved her and tried so so hard to capture something of her to remember.
All parents think their children are beautiful and will go to Harvard and win Wimbledon and become King of Norway but please believe me when I tell you all that this child was truly beautiful. She was 7 lb 13 oz and 20 3/4 inches tall and she was even prettier than I could have imagined her--and I imagined her as being pretty special. Lehna's physical appearance only adds to our bewilderment as to how such a beautiful well-formed baby could suddenly just die.
The irony is not lost on me that my professional role as someone with some level of responsibility for planning and developing testing methodologies for a hospital should see their child die in that same hospital when all the diagnostic tools failed to uncover any problem and the doctors have no ideas as to what caused her death.
Also, I want to thank you for the lovely baby shower you gave to me last week. I apologize for not responding earlier but so much was going on Wednesday and Thursday and I talked with Gilda and I planned today to send a formal thank you which I will do later; I promise. Beth and I appreciate so much your kindness and I slept last night with one of the little blankies you gave us for Lehna and I know that she would have loved everything, too.
I can't figure out why this happened. I try and make sense of it but it is beyond me to understand. By nature I am driven so much by emotion. My professional life, though, is driven by my ability to analyze, understand, and detach. This means this, this and that lead to a probability of this, methodological dictates say this should be so and this shouldn't.
As such these modes of being and thinking are like two different engines on the same train. The analyst is a skill, pure and simple, one I can literally turn on and off light a faucet. The other half, the artistic emotional half, is not so easy, though, to turn on and off. It is because of this duality of nature that I feel that, for now, I need to stay away in order for the feeling me to have its time. I can go hard core methodology RFA Project planning etc in bursts but right now I cannot sustain that.
Give me a few days and I will be back, perhaps remotely for day or two but I will be back.
This leads to another issue which is how will you all respond to me when I do come back. I don't want you to feel as if you have to wear black in my presence and avert your eyes and shuffle away in fear my personal sorrow is contagious. It is not. When I come back I hope you will treat me just as you did before and I am hopeful, too, that I will be professional enough to keep everything in order so as not to negatively impact you or your ability to get the things done you need to. I will not be a bottleneck for testing but I will be our of pocket for today.
Thank you all for your friendship. Some of you have been friends of mine for many years and others of you I have know only a short while but still you have all been so good to me throughout my time at Kaiser. If I have left anyone off this please let them know and forgive me, too, for not personally writing to you.
Thank you for reading this for me and I will see you all very soon.
Andy
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