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Category: Personal

‘Tis the Season

‘Tis the Season

Indeed, ’tis the season to find a deal on a new car. Even I’m sniffing around to see what I might find to sate my very limited preferences to replace, or at least supplement, my current ride, the Ford Windstar I’ve had for 14 years (and which is actually 21 years young), is pushing 250,000 miles/400,000 kms, and stubbornly refuses to die.

In these parts, the commercials run on local TV are mostly for car dealers, tort lawyers, back surgeons, furniture vendors, and, of course, drogas. There is hardly a station break (of which there are lots and lots) without at least one car ad.

It’s interesting observing the different kinds of buyers each marque is aiming for through its TV advertising. For instance, Chrysler-Fiat and Nissan appear pitted in a competition to see which can appeal more to the remaining muscle-car drivers out there. You know, the kind of drivers who get their thrills driving through walls and burning rubber on the open road in a quest to see who can be first to the finish line somewhere out on the salt flats, or accumulate the maximum number of speeding tickets. Meanwhile, Chevy mostly makes use of supposed buyers in its ads, revealing in those chosen to appear the low opinion in which GM must hold its customers. Lately, though, in the spirit of the season, Chevrolet has been running its employee-discount commercials, and based on those apparently Chevy employees are vastly more intelligent and appealing than Chevy buyers. For its part, Ford also makes use of prospective buyers in its commercials but, based on the ads, Ford buyers are a great deal smarter and more likable than Chevy buyers.

Kids, you may have noticed, figure in a disproportionate number of car ads. Car manufacturers and their advertising proxies have calculated that kids help sell cars to families, and a little child exploitation is worth the bump in sales. This trend is all the more apparent in this festive holiday car-selling season.

I’m not sure to what kind of people Honda is appealing with its advertising, but I’m pretty sure I don’t want to meet them. Hyundai, on the other hand, mixes music and humor to appeal to buyers’ lighter side. Upscale Lexus, though, both in its advertising and design philosophy, seems intent on appealing to buyers who like cars so aggressively ugly it would not be unfair to characterize them as the Darth Vaders of the automotive world. Meanwhile, Kia takes on Lexus directly in its Sorento commercials, belittling the Lexus driver for not realizing he was being out-flanked by the supposedly off-road competent Kia Sorento.

Taking a different tack, Lexus competitor Infiniti focuses on the kind of nice people having fun with its cars that it’s hoping to attract, while Acura, word in the industry has it, is focusing more on mobile advertising, with a barrage of vertical images and music by Kid Ink, aimed at a younger yet upscale audience.

Among European manufacturers, Volkswagen is out there slugging, its commercials aimed at mostly younger buyers, maybe folks out buying their first new car, and looking it. At the other end of the spectrum is Mercedes-Benz, which futilely attempts to convince us that kids (speaking of unbridled child exploitation) fantasize about owning a Daimler when they grow up. I recall my childhood car cravings, and Mercedes never once figured into them, the marque more associated in my mind with stodgy old people, crooked lawyers, and wearers of mink coats. Not the kind of car most kids would aspire to driving. But at least the current breed of Mercedes commercials, unlike an earlier iteration, don’t feature cars sliding sideways and crashing through plate glass windows, apparently careering into young children dreaming of Mercedeses inside those windows.

In fact, for awhile it seemed that the only direction most cars in automotive advertising went was sideways. That unfortunate trend seems, happily, to be reaching an end, or at least tapering down. But now the latest thing is to show how a car stops by itself, or comes veering back into its lane after nearly sideswiping a passing vehicle. Or, clever trick, parallel-parks itself, positively impressing lovers and prospective relatives. Drivers, passengers, and passers-by all seem incredulous at these amazing feats of the semi-self-driving cars. Of course, one would not be faulted for wondering what drivers would have done had the car not stopped itself or corrected course. Would they have just allowed the car to plow ahead into whatever caused it to stop itself, or maybe paid a bit more attention before drifting out of a lane? Or, gasp, perhaps going to the trouble to learn how to parallel-park? Increasingly, possession of those skills seems to be too much to hope for in late 2017 on the cusp of 2018. My guess is that all these car tricks can only encourage more distracted driving, leading careless drivers to believe they can get away with texting or yakking away on the phone while behind the wheel.

Indicative of how things are going, Volvo, the Swedish car maker now owned by the Chinese after its sale by Ford, previously always focused on the safety features of its cars in its advertising. Now it looks, based on recent Volvo advertising, that the car’s self-driving features can compensate for brainless drivers who find it bothersome to pay even modest attention to their driving. And then there are the other Volvo commercials showing cars just driving in ordinary ways on ordinary roads, with the warning in small type at the bottom of the screen admonishing, “Professional driver on closed course. Do not attempt.”

And I guess that’s where we’re headed out on the road. If you don’t have a car that does everything for you, don’t attempt to drive. Or if you’re one of those drivers who actually are in control of their vehicle, maybe you shouldn’t attempt to drive, either, given all those other idiots out there whose cars have taken over for them.

Come to think of it, judging by some of the driving I see regularly, maybe it’s better to just stay home and watch car commercials, and let the admen and adwomen do the driving for you.

Happy New Year, everyone!

The View From the Shoulder

The View From the Shoulder

To point out the obvious, I survived the surgery that was the subject of my last posting, and have been in a process of slow recovery over the past three and a half weeks. The surgery – a quintuple cardiac bypass, which I didn’t even know was a thing – went well, and I’m told my recovery has been as good as could be expected. I’m grateful to my surgeon and all the others who were involved in getting me through this, as insane as it all seems to me.

Where I’m at now is a world of difference from where I was in the first few days after the surgery. There are still lots of inconveniences and things that are not yet back to normal, but at least I’m past the excruciating pain and weakness that characterized those initial days. At that time I had to wonder why I ever put myself through such mutilation and torture, and still I can’t imagine ever going through anything like that again. I had a pretty clear sense throughout the whole ordeal that I could return to normal functioning and an active life, but I realized that if all I had to look forward to was permanent disability and struggle, as others I saw around me, I’d have a pretty hard time justifying it. Even today, as far as I’ve come, I had to wonder how the mechanisms that are my heart and body could sustain all this and keep on functioning. This is a mystery I may never unravel.

In case you’re wondering about the title for this posting, as much as I’m now ambulatory and functioning at a relative level of normalcy, I still feel I’m sitting on the shoulder of the road. Other than emails and shopping lists and questions for my doctors and a couple of business-related items, this is the first piece of any sort of coherency and even marginal creativity I’ve been able to write in 26 days. And it’s admittedly pretty thin. I’m hoping in the next several days I’ll be able to write more, and then more, and I can resume more regular posting to these blogs, but I’ve found that gathering mental energy is virtually as hard as gathering physical energy. And having anything worth saying is yet a step beyond that.

Four days past the surgery I attempted to get online, and was met with the shocking reality that I had forgotten all my passwords. I still couldn’t muster the strength to have someone fetch my laptop from its bag or to hold it on me, and trying to do things on my phone reinforced the feeling of insanity of doing anything serious on a phone, even when in normal health. I had that sense before the surgery, and that disconcerting experience only confirmed it. Two days later, when I finally did get onto my laptop, I was astounded at the number of typing mistakes I made. It was like my fingers were not in direct contact with my brain and they took on twitches and strokes that defied my best attempts to control them. Not quite as disjointed as the time I tried to work on a Turkish keyboard, but close. I’m told that anesthesia can really scramble both brain and body cells, and so I’m chalking these aberrations up to that. I’m doing a lot better now with typing and other fine motor skills, and the files on my laptop helped me recover my passwords, but the process has been a continuum.

Other bodily functions – notably an astoundingly annoying throat irritation and coughing, and problems with peeing – have slowly been recovering, and while not back to what I’d characterize as normal, are hugely better than they were in the early days.

I had five and part of a sixth day in the hospital following the surgery, and then four and part of a fifth day in a rehab center, located on the same complex as the hospital, after that. At that point I got the boot, and two wonderful friends and fellow boat people came to fetch me, assist with getting food and medications, and establish me back aboard my boat, which is my home. I don’t know what I would have done without them, and I’ll be forever grateful to them. It’s two weeks today that I’ve been back aboard, and I think returning here was the best alternative. This past Tuesday my surgeon, with some persuasion, gave me back my driving privileges, and that made a huge difference in my life. And two days ago my primary physician told me I’m very impatient. I told her I know I’m a pain in the ass, but I wasn’t challenging her expertise. That’s just me. And she laughed.

I’m going to have lots more to say about the medical and healthcare situation in this country in coming weeks and months here on FJY.US and I may have some fictional things to say about it on Stoned Cherry. I’m fortunate in that I have access to Medicare and private insurance, and that made a huge difference. It shocks some people, but I really have nothing negative to say about my insurance company. And I have lots of praise for the doctors, nurses, aides (known, it appears, as Patient Care Technicians in some circles these days), therapists, and all the others who assisted and supported me through all this. That said, when there were rare failures they were pretty notable, and one thing I came to discover is that it usually is the little things, the small details, that can have the biggest impact on a patient and the patient’s experience. I’ll have more to say on this, too.

I really feel bad for writing all this self-centered drivel, but I felt some explanation of where I’ve been for the past weeks was in order, a kind of transition from the breakdown on the shoulder I went through to getting back into the traffic pattern. I’ve seen the moon and the sun since my last posting, and so day-by-day it’s time to get on with life. I promise, barring any unforeseen circumstances, this will be the last posting focusing on this whole thing, and I now can say, enough of these adventures.

I’ll be pulling off the shoulder pretty soon, so watch this space for what’s to come.

Watching the Moon Rise

Watching the Moon Rise

“Death is always on the way, but the fact that you don’t know when it will arrive seems to take away from the finiteness of life. It’s that terrible precision that we hate so much. But because we don’t know, we get to think of life as an inexhaustible well. Yet everything happens a certain number of times, and a very small number, really. How many more times will you remember a certain afternoon of your childhood, some afternoon that’s so deeply a part of your being that you can’t even conceive of your life without it? Perhaps four or five times more. Perhaps not even. How many more times will you watch the full moon rise? Perhaps twenty. And yet it all seems limitless.”

— Paul Bowles, The Sheltering Sky

That quote always stood out to me because, when you think about it, it’s so true in its own terrible precision.

I don’t mean to be depressive or to read more into Bowles’s words than what is there. It’s just that tomorrow, Wednesday in this part of the world, I’m scheduled for major surgery. As unenthusiastic as I am about it, I’m doing my best to remain positive about it, especially considering how unattractive the alternative is. And helping me move forward toward what seems inescapable at this point, I’ve lost count of the sets of encouraging words I’ve received from friends, family, clients, and acquaintances, which I do appreciate.

It is, nonetheless, the kind of thing that makes you feel your own mortality.

If I fall a bit behind on posting to this blog, now you know why that might be. Please catch up on reading back posts and the things I’ve posted up top until I am able to post something fresh. Let me and everyone know how you feel about whatever it is you feel about. And as uncomfortable as it might be, consider the finiteness of your own life. It helps put things in perspective.

Physician, Heal Thyself!

Physician, Heal Thyself!

No, this isn’t about drugs or addiction or ODing, or any of those things. It is about frustration, though. Frustration with the medical profession. Frustration in trying to create sense where sense seems not to exist. Frustration that can lead to scenes such as in the image. Fall down on the floor, tear out your hair, rend your garments sort of frustration.

To be perfectly clear, this posting is based on a personal incident – drama is more like it – playing out now with certain elements of the medical profession. To protect both the innocent and the guilty, I’m not going to name any names. Now. But if I continue to be stymied, that decision might change. Watch this space.

If you’ve read my piece on The Biggest Shell Game in the World, which you should before reading on here, you know how I feel about the so-called “healthcare system” we have in this country. You’ll also see I elaborated on some specific actions that might help ease the growth in the cost of healthcare. That posting focuses on the macro dynamic of the system. This posting focuses on the micro dynamic, the one on the doctor level.

It’s no longer a laughing matter – it never was a joke – to say that much of the medical profession is still anchored, not just in the last century, but maybe even the one before it.

When I lived in Montana some dozen years ago, my physician – an author of the reputed Helena Heart Study, so no slouch – presented himself as advanced because he took his notes on a laptop. Why that should have been considered advanced when small computers had been in fairly wide business use for a quarter century already is a good question to ask, if you’re inclined to ask questions. Now, all the doctors I go to use laptops for their notetaking and recordkeeping. Of course, it is, at last count, 2017.

The one thing my Montana doctor did that really stood out was to communicate by email. Quick, easy, asynchronous. Email. One would think this also would be pretty standard now. That’s what I thought. I mean, I run a global business and communicate with clients all over the world at close to 100% by email. So picture my surprise to be out of Montana and in a southeastern state that also shall remain nameless (besides, I often reverse the “d” and the “i” in the name, which is embarrassing) and to find that email does not play a role in typical doctor-patient communication.

Does one even have to wonder why calling a doctor’s office often leads to more frustration, lengthy stays on hold listening to dreadful “hold” music and self-serving promotions, being asked, finally when you get past the official hold, “Can you hold, please?” (Okay, at that I’m tempted to fire back, what are my options here?)

Again, how can almost any organization in 2017 function without email? It’s not only a fast and easy means of communication, but it also can be used as a system of sending health information to patients and even, if one is allowed a bit of crassness, as a marketing device. But, no, this seems to be beyond the understanding of most doctors.

Then there are those doctors’ portals. Potentially great idea, completely mutilated, misused, and just plain not used, in execution and practice. First, they’re all clunky in that clunky way that special-purpose software (like used in lawyer and, yes, doctor offices) always is. I don’t know, maybe it’s me, but I’ve had a litany of problems with the portals of several doctors and healthcare groups. Sometimes I’d have to enter a new password each time I signed in. Sometimes things I’d want to see, like reports, are there. Sometimes not. One portal doesn’t even tell me my next appointment, which would seem pretty basic. I’ve yet to be able to get a prescription refill put through based on a request posted on a portal site. And, perhaps the biggest issue I’ve encountered, often doctors’ front offices don’t mind the sites, so sending a message to the office through the portal is like throwing a quarter down a deep well. “Pathetic” is too kind a word.

Okay, despite all that, that’s not my biggest problem nor the most immediate. Oh, no. I have a far bigger gripe, which we’ll get to now. The one that concerns the Health Insurance Portabliity and Accountabillity Act – HIPAA – and how doctors not only seem not to know much about its requirements but, worse, seem to think it exists to protect them and not the patient. Which is wrong.

I had one doctor earnestly tell me that there is a $50,000 fine attached to a single HIPAA violation. Well, he was part right. Fines can range from $100 to $50,000, or $1.5 million maximum per year for ongoing violations. What puzzled me then, and which irks me now, is that the implication was that the doctor had to protect himself against violations and resultant hefty fines. The point that was completely missed, even inverted, is that denying a patient access to his or her records in whatever way the patient deems suitable seems like a more sure route to a violation than just providing what it is the patient requests, in the form or via the means requested by the patient.

Now that doctor’s office will fax me things like test results. Some will even (horror!) email them. And then there are others, like another one of my doctors, who refuses to provide records or results in any form other than by mail, or picking it up in person. Never mind the inconvenience of the latter choice, I would defy anyone to show me how snail mail is any less prone to pilferage or misdelivery than a fax or email. I even maintain an encrypted email account for highly sensitive information. But all that is irrelevant. The Department of Health and Human Services (HHS), which oversees application of HIPAA, is clear on the subject: A provider should email, fax, or accommodate alternative delivery means as requested by the patient. Look it up. It’s right there, explicitly spelled out by HHS, in the department’s HIPAA FAQs.

That’s really the key issue: Patients have a right to see and receive their own records and results, and HIPAA exists to protect them, not the doctor or other provider. So if a patient wants his or her bloody records emailed or faxed to them, HHS says the provider should accommodate that request. But you’d never know that from the patchwork of restrictions, most of which make little to no sense anyway, that one encounters when requesting one’s records.

Of course, all this assumes that a patient has signed a statement authorizing release of information to the patient and whatever third-party designees, if any, that the patient might include in the release. Now here is a suggestion – a strong one: Why not include a check-off box with a line where the patient authorizes positively (by checking the box) transmittal of records via email or fax? Easy-peasy, and takes care of any misunderstanding. And while you’re at it, how about another line with a check-off box authorizing the same thing for any third-party designees? Two lines, and you can sleep better at night knowing the patient has asked for this and HHS says you should give it to them. And it’s in writing, no less.

All this leads to the source of my current distemperous mood toward doctors and things medical. It’s been four weeks – not hours, not days, not business days, but weeks – that I have been requesting the results of an MRI from a certain specialist. I requested that the doctor or his nurse-practitioner call me before I left on an extended trip so I could at least have a sense of what the MRI revealed. I was told, well, he probably won’t call you. He likes to do things in person.

Well, I like to do things in person, too, when that works. But in this case, it wasn’t even possible to get an appointment in less than a month or more. And I was clear that I was leaving the state and needed the information before I went.

Ha. Fat chance. Four weeks have gone by, I’ve lost count of the number of times I’ve called this doctor’s office, had my primary care physician’s office call him, even the insurance company called the office when I filed a grievance with them over this. And still I can’t get either the doctor or the nurse-practitioner (which would be fine) to speak with me and discuss the test results, much less actually get those results. Now if ever there is a HIPAA violation, it would seem this is it. It will take a formal complaint to HHS, but that is imminent. I now even have my attorney on the case.

The doctor might have his procedures, but there are two parties to the transaction, the other being the patient, and in this case this patient has different procedures. And HIPAA is on his side.

It’s bad enough having to deal with doctors and tests and health issues without having to be put under further stress and duress by providers and offices that just throw more roadblocks and obstacles in the patient’s path.

All this seems very 19th Century to me. Doctors hold themselves up as miniature deities and patients are just supposed to accept whatever inconveniences, incompetence, or affronts that the doctor and doctor’s minions subject them to. And there are others besides those discussed here. Let’s just save my rant on the prescription system for some other time, ‘kay?

If you’ve encountered any of these issues in dealing with doctors, I invite you to tell everyone about it in the comments. And if you have a different and more positive story to tell, by all means post that, too, in the comments. And if you question the premises on which this piece is based, well, fire away with that, too.

Meanwhile, I’m going to fax this piece off to a few doctors I know (I have to fax them since I don’t have their email addresses) and maybe shake a few trees. Or else things will just go on as they always do. And watch this space if I decide it’s necessary to start naming names.

Physician, heal thyself!

There Goes, Here Comes, the Sun

There Goes, Here Comes, the Sun

It isn’t news to anyone that a full eclipse of the sun traversed the United States on Monday. You’d have to be ensconced in a lunar base on the dark side of the moon to have missed that. But if you got to experience the eclipse, especially in a place where totality occurred, you probably know how special this event was. And maybe you noticed how it was special in ways beyond the purely celestial.

I traveled from West Central Florida to the coast of South Carolina for the big event. This was the second full eclipse I’ve experienced, the first one being in March of 1970, at Cape Charles, Virginia. After that experience, I wasn’t going to miss a chance to be present for another one, especially one this close.

Without going into all the minute details, I wanted to stay flexible in terms of my precise destination since the weather was looking pretty iffy. As the morning of the eclipse went on, clouds were moving in from off the ocean and conditions were heading south almost by the minute. Viewing conditions along the coast were predicted to be fair to poor and, in the midst of all that, the Charleston weather radar went down, so I was pretty much on my own.The moon eats the sun

Charleston, which was on the southern edge of the zone of totality, was overcast as I passed through it, as was North Charleston, across the harbor. Following my inclination that conditions would be better on the coast north of the city, I continued up US 17, and that’s when I came across some signs pointing to a side road that led to the Cape Romain National Wildlife Refuge. Making a snap decision, I turned right there and followed that road until it ended at the refuge. Cars were parked up and down both sides of the road, so I found a place, parked, and walked in to the picnic area and boat launch site at the road’s end. Cape Romain was actually the place, virtually on the center line of the zone of totality, I had thought to view the eclipse when I first started planning this expedition.

A long concrete pier stretched out across the marsh and clumps of people were out on the pier, interspersed with some open areas. I found one of those open spots and set myself up. It was about an hour until totality.

When I arrived there were big blue breaks in the clouds, allowing the sun to shine through, but as time went on more and more clouds moved in from off the ocean. At times the clouds obscured the sun, but when they did, one could see the disk of the moon encroaching on the face of the sun. With one layer of clouds, it was too bright to see the image. With three layers, the sun was too obscured. But with two layers, it was perfect, and the moon could be seen eating the sun – as primitive peoples believed – without benefit of eclipse glasses.

Birds overheadWith about a half-hour to go, a family of four set up next to where I was. It turned out they had come from Denmark, just to see the eclipse. As more and more people arrived, and looking up and down the pier, I was thinking how many people, not just on that pier but from coast-to-coast, had come to share in this event. I was hoping we’d get a clear view, not just for myself but for others, like that family, who had never experienced a total solar eclipse before.

Minutes before the moment of totality, more clouds passed in front of the sun. Inland and to the south things were totally socked in, with lightning strikes to the west. A bank of clouds was moving in off the ocean, but a big band of blue stood between where we were and it. The wind was blowing the lower clouds quickly, and then the wind blew them past, and there was the sun, framed by two high, thin, motionless clouds, and that was when the eclipse entered totality. And our view was unobstructed for the entire duration of the eclipse, as short as it was at about two minutes and 40 seconds. Speak about making the right decision and lucking out.

If you haven’t experienced a total eclipse, you don’t know what that moment of totality Totalityis like. Even 99.99% totality is not the same as 100%. It is when the sun is completely obscured by the moon, when the sun’s corona can be seen flaring out from behind the moon, when day turns almost to night, and when earthbound creatures express their confusion by going wild, that makes a total eclipse the awesome event that it is. Even knowing that an eclipse is happening and that it’s a natural phenomenon that has a beginning and an end, it can be a disconcerting experience. It is no wonder that people over the ages spun such myths and felt such fear around eclipses.

I have to say that the first eclipse I experienced seemed more awesome, and I think it had mostly to do with the environment. At Cape Charles, I was right on tidewater, and there were flocks of birds, and it seemed the tides reversed and the birds went crazy at the moment of the eclipse. At Cape Romain, it was marshes, and the few birds that there were had passed overhead minutes before the eclipse and flew on. But as a sheer celestial event, this eclipse was as awe-inspiring as any. This eclipse, any eclipse, reminds that we’re on an object somewhere out in space, spinning around a star, out in the vastness of the universe.

Plane flying close to the sunAt that moment of totality, I think most people experiencing it for those couple of minutes might have forgotten the differences, the views, the beliefs, the expectations that separate Major cloudsus. For those couple of minutes we weren’t liberals or conservatives, Americans or Danes, dog lovers or cat lovers or none of the above. We were just humans, curious, eager, awe-inspired humans, beneath the shadow of the moon as it crossed the face of the sun. It’s too much to expect that the feeling would last much beyond the eclipse and the return of the sun from behind the moon, but it was nice while it lasted.

After the eclipse was over, it took more than four hours to get to the Interstate, with the flood of people returning to wherever they came from – the plurality of cars on my route had Florida license tags – and from there things got easier. By the next morning the eclipse seemed already to have receded into the past, a curiosity for strangers to ask about in passing.

The marsh near totalityBoth on the way to South Carolina and on the way back, things seemed to be more homogenized than they had been in years past. Chain restaurants and fast-food joints, more than ever, supplanted a lot of the local down-home places that formerly one could find with ease across the South. I finally found the kind of down-home place I had been searching for, Grannie’s Country Cookin’, on US 301 in Starke, Florida, and it was worth the wait. The Jurassic-sized slab of meatloaf and the giant flaky biscuit and the grits and mashed potatoes and gravy were what I’d expect at a place called Grannie’s, and not some pseudo chain Grannie’s. But the average age of the patrons was somewhere north of 60, so I had to wonder how long it will be until the entire country is homogenized, fast-foodified, Amazoned, Uberized, Facebookifed, plasticized, devicified, electronicuted. What will the roads, and the country, look like for the next solar eclipse to come here in seven years, in 2024?

It’s a disconcerting thought, and the roadsides, and our world, will be darker for it. And not because the sun is in eclipse.

All photos by the author.

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