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Category: Social Commentary

‘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!

Stop the Madness

Stop the Madness

I don’t mean to sound like a curmudgeon, since I’m not, really, but there are some things that just need to be said about how things clearly are headed in this technological world we inhabit.

News of interactive appliances, self-driving cars, bots and algorithms that determine what gets fed to us over the Internet has gotten to be pretty much old hat. Those things would be enough to give us pause, but no, nothing is about to stop there, it seems.

It’s bad enough that we have to fear our washing machine or refrigerator turning us in for some transgression, or feeding our habits to an advertising program that will just try to sell us more stuff we probably don’t need. And if I can’t open the door of the fridge to see how much milk or eggs or cream cheese is left, someone really needs to put me out of my misery, and soon. But things have already reached that stage.

There is a way of looking at things that seems to have gotten lost in the quest to come up with the next technological advance. It’s pretty simple, really: Just because it’s possible to do something doesn’t mean it’s a good idea to do it. That’s where we’re at, maybe already well past it, and the lesson seems to be lost on those who are planning our “brave” new world of technological wonders. It’s time to stop the madness, though I’m not encouraged by what I see and hear about almost on a daily basis now.

Take cars, for example. Now there’s a subject. Some of us actually don’t want our car making decisions for us. Cars that stop on their own, keep us from wandering into the next lane, open and close their own doors, and which park themselves already go further than some of us, those who were taught to drive properly and enjoy being in charge of the process of guiding a machine down the road, want. Now we’re looking at cars, and even trucks, that drive themselves. They’re already out there, sharing the roads with us. But apparently that is not enough for those who think up these things. The next step – I am not making this up – are cars that will carry on a conversation with us while they drive us around.

Am I some sort of raving radical when I say I don’t really want to have a conversation with my car? I don’t even like riding in taxis since I’d rather not converse with the driver. How much less will I want to speak with a machine? Just guessing here, but I’d say a lot. A really lot. A lot a lot. What could my car even have to say that would interest me? At least with cab drivers I can learn about other cultures and the kinds of things that brought them here. I really don’t need to hear from my car how things were in Korea or Mexico or Canada or wherever before they came here, or how they’re running hot and they just don’t feel up to par these days. And suppose their hearing or grasp of the language isn’t so good? One can only imagine the misunderstandings that might ensue.

Now we’re hearing about pills that send out little signals so that our doctors can spy on us and see whether we’re taking the bloody things as they’ve instructed. I can’t get my doctors on the phone or even send them an email, but now they’re going to be listening in on what’s going on inside my stomach? Sorry, I don’t think so. The manufacturers of these spybot pills say they’re perfectly safe. Well, I’m less concerned about that then I am about what other purposes they might be put to, like programming our refrigerators not to let us touch the bacon or the ice cream that dwells within them. Or someone hacking into those interactive pills to find out more about us, things our insurance company or Russian scammers might want to know.

We’ve become so hungry to consume that having packages delivered to our doorstep isn’t enough anymore. Now Amazon is offering “in home” delivery – literally, their delivery people will come inside our home to drop off our latest gizmo. But do I want strangers coming into my home? Hell, no. It’s bad enough they know where I live. I certainly don’t want them crossing the threshold and coming inside. And I don’t care if some hidden camera or Alexa, Amazon’s other way of getting into our house and life – and two more things I don’t want in my home — is there to observe them.

Increasingly bots and algorithms determine what we read, what ads are fed us, what vids pop up on our computer screens. Google thinks its algorithms are so smart they can tell where we are and feed us local ads. Ha, Google. FYI, I don’t live in Chicago, nowhere within a thousand miles of it, even if my ISP is located there, so you can stop sending me all those ads for vendors in the Windy City. We’re still a long way from when these things will be fool-proof, if ever, but meanwhile they’ve been unleashed on us. For instance, now we read that with the YouTube Kids application – Google owns YouTube, too, if you didn’t know – the algorithms are feeding the little darlings cartoons in which the characters drink bleach, appear as gore-covered zombies, or get it on with other characters. With parents increasingly substituting screens for actual parenting, who couldn’t see this coming? Nothing like a bot to handle the babysitting, right?

When I was a kid, my dad would take me outside on cold nights to look through a telescope at the moon and the planets. I wonder how many parents and kids do that today, and I’d be willing to wager that the only way most kids today see celestial bodies, if at all, is on a screen.

More and more we’re seeing machines and electronics and robots taking over ever-more things that used to be the province of people, of actual human beings, to do. We’re told that many manufacturing jobs will never come back because technology and robots have replaced the workers that used to be in them. And while the machines, for all their faults, get smarter and smarter, it seems people are getting dumber and dumber, with no end in sight for either trend.

There has been a question on my mind for a very long time, long before the popular future vision began to become a reality. And that is, if machines and technology can do all this stuff, what will people do? Or more precisely, what will people do to earn a living to pay for all these luxuries, all these gadgets, all these robots and technological advances? The vision of the future was a place where people could live lives of total leisure, never having to lift a finger. It seems that’s what the people developing these technologies have in mind, but is anyone thinking about the economics and the politics of it all?

I can just imagine sitting at home drinking mint juleps, prepared by Alexa, and watching on a screen as my self-driving car heads out on a scenic road that I get to enjoy vicariously from my living room. Drones are dropping off packages I’ve ordered online and bots carry them inside, while my robot vacuum cleaner does the den and my refrigerator orders up restocks of the bananas and hot dogs. My imaginary kids are playing video games and learning about life from cartoons, and all the while ads and click-bait stories about celebrities pop up on screens all over the house.

If that’s my life, who is paying for it? I can easily see a society – we’re almost there now — where a permanent underclass is forced to support the more privileged among us. Proles who support members of the Inner and Outer Party (thank you, George Orwell, for painting such a vivid picture of this notional future in the perhaps prophetic Nineteen Eighty-Four, the year in the title maybe just four decades early).

At one time we used to worry about big corporations taking on too much power and controlling our lives too much. Yet, these new corporations of technology have become bigger, more powerful, and with more influence on our lives than any ITT, GM, IBM, or AT&T of the past. Somehow we’ve come to see the Googles and Apples and Microsofts of the world as benign, looking after our well being and making our lives better and easier, and not as the profit-making, market-share-grabbing machines that they are. Maybe a comparison could be drawn with the Omni Consumer Products (OCP) corporation of 1987’s RoboCop film.

I also have to wonder what politics all this will lead to, with the political order mirroring and supporting the economic one. Already we’ve become polarized and divided almost as never before, and I can only see this trend growing as our societal dialogue becomes increasingly fractured, splintered, and Balkanized, with each individual picking and choosing what version of reality he or she prefers. And with the decline of the national dialogue and the dumbing-down of the population, it will become easier and easier for Big Brother (who also comes to us from Nineteen Eighty-Four) to simply manipulate and control a society whose creature comforts and diet of electronic pap fed them will take precedence over more traditional political values, like dissent and the freedoms of speech and association.

Already otherwise intelligent people appear to have a hard time writing anything that exceeds 140 (or 280, for the truly verbose) characters, and what at one time would be intelligent correspondence and debate has been reduced to gibberish, repetition, and name-slinging. A large proportion of the population sees the world through the medium of a phone, and the quality of their communication reflects this.

I’m not going to claim that technology is inherently bad – after all, I’m writing this on a laptop computer, and the thought of doing so on a typewriter is a chilling one – but we need to think about how far things can be carried before the beneficial becomes detrimental. Like I said near the outset, just because it’s possible to do something doesn’t mean it should be done.

It’s time to stop the madness.

The New Normal

The New Normal

The New Normal.” That phrase, already becoming hackneyed through use, pretty much tells it like it is.

Whether in New York or Nice or London or Barcelona, terrorists’ use of vehicles to mow down innocent people has become part of that “new normal.” Why bother with hijacking or blowing up an airliner when one can rent a truck, penetrate low-security areas, and make one’s twisted point with the blood and broken bones and murder of innocent people? With this approach, every low-level fanatic or miscreant worldwide becomes a tool for ISIS or other such groups to spread their message of terror.

Sad, but I believe accurate, to say, what happened in New York on Hallowe’en afternoon when Uzbeki émigré Sayfullo Saipov used a rented truck to career down a bike and pedestrian lane to take the lives of eight innocent people and injure at least another 15 embodies this “new normal.” And while it isn’t the first, by no means will it be the last time we see such an attack. What’s more, the ease and economy of mounting attacks of this nature makes everyone who ventures outside or who takes part in enjoying group activities or just taking a walk on a nice day a potential target.

It has been reported that ISIS put out the word through its social-media channels encouraging its adherents worldwide to mark Hallowe’en by doing exactly what Saipov did. Probably the only remarkable thing is that there weren’t other such attacks to mark the day and provide ISIS with more of the impact it seeks. But that should not offer any solace or encouragement. There is every reason to believe that there will be more vehicular and other low-level attacks and they will, in fact, figure into this “new normal.”

Other than personal vigilance and being acutely aware of one’s surroundings, there isn’t a huge amount anyone really can do to protect against attacks of this nature. It’s hard to tread a path somewhere between being blithely unaware and persistent paranoia. Somewhat akin to awareness of the potential for criminal activity in any public place or on any public conveyance, staying on what I would term “Condition Yellow” – being attuned to what’s going on around oneself and being prepared to react quickly to a perceived threat – should probably become the base condition for any of us when out and about.

In terms of public safety, a better response demands keen and focused policing. It’s now known that the authorities were aware of Saipov, who figured into various security investigations that were under way. Why Saipov’s plans were not uncovered and why he was not picked-up before he could carry out his heinous attack remains to be seen. Whether we’ll ever know the answer to this question also remains to be seen. We see shades of the Boston Marathon bombers, Tamarlan and Dzhokhar Tsarnaev, who also were in the FBI’s radar. The FBI even had been warned about the Chechen brothers by the dreaded Russians, but the FBI failed to take the pair into custody in advance of their murderous 2013 attack that killed three people and injured hundreds of others.

Failures in intelligence gathering and failures to act on intelligence leads are serious and have real-world consequences. Boston and New York and many of the other terrorist attacks that have taken place here and abroad where it later came out that the terrorists were on officials’ radar demonstrate the truth of this.

One thing that has come under scrutiny as a result of the Hallowe’en bombing is what is known as the Diversity Visa Program (DVP), better known as the Visa Lottery Program. Saipov had been admitted to the U.S. in 2010 under this program. While it might be a stretch to say that were it not for the DVP the New York attack – or at least others like it – would not have happened, it is a program that demands scrutiny.

As a consular officer in 1990 when DVP was first introduced, the “brain child” – to speak euphemistically – of the U.S. Congress, I and other consular officers with whom I worked were appalled by the program. Not only did it offer one more way for foreign nationals to skirt the normal strictures of our immigration law, it took the value of immigration to the U.S. and debased it, making it a matter of simple luck. Neither skills nor specific qualifications nor even family relations played any role in being selected for a DVP visa. All it took was being a citizen of what was deemed to be an “under-represented” country and having a post card with one’s name on it picked at random. Winning a visa under the DVP was the same as winning any other lottery.

Now, 27 years later, the only substantive change to the DVP is that the numbers of visas allowed have increased from 20,000 to close to 50,000. While the initial rationalization for DVP was to benefit Irish would-be immigrants, 48,000 of whom were legalized in the first three years of the program, the mix of DVP immigrants today is strongly tilted toward Asia, Africa, the Middle East, and Eastern Europe. I can’t help but ask why the most diverse country on earth needs to resort to a lottery to further that diversity?

While admission of would-be terrorists can’t be any more directly attributed to DVP than to any other U.S. immigration category, it’s pretty clear it was the source for Saipov being in the country in the first place. It’s also pretty clear that Saipov, described by people who knew and worked with him as a disgruntled truck driver with a poor driving record, lacks any of the higher-level skills that the country needs and which DPV fails to address. If, as a matter of policy, the country wants to open up immigration to other than simply family members of those already here and to encourage merit-based immigration, the answer is not a visa lottery but rather a points-based immigration system, much like Canada, Australia, New Zealand, and other countries have. To see why, be sure to read my posting on Pointing Immigration in the Right Direction.

Regardless what happens with the DVP, it’s clear that we’ve moved into the era of a “new normal” where terrorism is concerned. So be alert, stay on Condition Yellow when in public, and let’s hope those whose responsibility it is to track and apprehend those who would do us harm do a better job than they have in cases like Saipov and the Tsarnaev brothers.

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!

The Hurricane Next Time

The Hurricane Next Time

Another week, another hurricane. There was Harvey. And then Irma. Jose is heading north. Maria has worked its devastation. Hurricane Season being what it is, the storms line up across the Atlantic and the Pacific. Whatever the next time is, there will be a next time. And another hurricane.

I’m back aboard my boat after evacuating to Destin in the Florida Panhandle to get out of the way of Irma. Part of my excuse for the delay in posting to this blog. Irma, it turned out, was accommodating and jogged northeast just before it hit the Tampa Bay area. Good news for me and my neighbors. Bad news, very bad news, for people in the interior of the state and further to the northeast. Storms create winners, and losers. Mostly losers.

Ask the people of Houston and elsewhere in Southeast Texas. Ask the people of the Florida Keys, or Southwest Florida, and lots of other places in the state. Ask the people of Barbuda and St. Thomas, of Sint Maarten and Saint-Martin and Puerto Rico. And before them, ask the people of the Philippines, of Mississippi and Louisiana, of Mexico and Honduras and South Carolina and New Jersey and even New Hampshire and numerous other places.

Hurricanes aren’t picky and they don’t discriminate. They’re equal opportunity destroyers and, given enough time, they spread their devastation around. Of course, the planet would have worse problems were it not for the big storms that redistribute the earth’s heat energy, but try telling that to someone who can’t get out of their house without a boat, or no longer has a house at all, or who has no water, food, or electricity. Or lost a loved one. It’s a tough sell.

I’ve been around hurricanes almost my whole life, in their projected path several times but, if you ignore passing through two of them during one sea transit of the North Atlantic as a kid, I’ve never been in the middle of one. I guess that’s my hurricane karma. But I’ve seen the aftermath of them, spent weeks that turned into months that turned into years living with the after effects of Katrina, and I’ve had a chance to observe both close-up and at a distance the preparations for their arrival and dealing with what they leave behind.

It’s those two elements – advance preparations and dealing with hurricane aftermaths – that I want to focus on here. Some of what I have to say is based on observation of those two things in several storms, and some is based on a plan I developed while living with the protracted recovery from Katrina.

Based on the events of recent weeks, at least in the U.S., I think some lessons have been learned. Some are partly learned. But we still have a continuing learning curve to go up and more work to be done.

The debacle that was the overland evacuation in Texas from the approach of Hurricane Rita in 2005 taught us some things about evacuations. Rita, the Atlantic’s fourth most intense hurricane ever recorded, the most intense storm ever seen in the Gulf of Mexico, and coming just three week’s after Hurricane Katrina’s onslaught, prompted fears the storm would devastate the Texas Coast. This led to an uncoordinated series of evacuations that poured between 2.5 million and 3.7 million people onto the state’s highways, leading to total gridlock. While the concept of contraflow, to reverse all inbound lanes on the Interstates to outbound, was already known, the order to implement it came too late and it took more than eight hours to make the change-over. Of the seven people in the U.S. who died directly as a result of Rita, only one was in Texas. But an estimated 113 people died in the botched Texas evacuation, including 23 nursing home residents who were killed when the charter bus they were on caught fire on the Interstate.

In advance of Hurricane Harvey this year, Houston Mayor Sylvester Turner decided not to issue any evacuation order for the city. Not mandatory, not voluntary. Turner, looking back at Rita, reasoned that you can’t put 6.5 million people on the highways without creating mayhem. But virtually the entire city wound up inundated, with many left homeless, or stranded in flood-damaged houses from record rainfall. Some were electrocuted when, for reasons that are not apparent, the power was not cut off as a precaution as is normally done. It seemed the city was far from prepared for the storm to come.

As for evacuations, the answer, of course, is not to evacuate an entire city the size of Houston, the nation’s fourth largest, but to evacuate the most vulnerable areas. To provide local shelters. To move some people in buses and not everyone in private vehicles. And to do the necessary to avoid ancillary deaths, to the extent possible. It wasn’t a mystery that Houston was going to be pummeled with massive rainfall. The path and potential of the storm was known, as was Houston’s topography and propensity to flood. And yet, there was no evacuation order.

Contrast that response with the response of Florida Gov. Rick Scott and state, county, and local officials in Florida. With Irma on its way and a high likelihood it would hit the state in some place or other, Scott went on what was almost a personal campaign to get people to evacuate the most vulnerable areas, and made it as easy as possible for them to do so. Tolls were removed from the state’s toll roads – they are about to be reinstated at this writing – hotels were ordered to accept pets, the Florida National Guard was partially mobilized, and state troopers were used to escort fuel trucks.

The first priority was evacuating the Florida Keys, which are tethered at the bottom of the state by 90 miles of the Overseas Highway, the sole land access to the Keys. Other areas deemed most vulnerable, the low areas of Southeast and Southwest Florida, were the next priority. And then other vulnerable areas came after that. Scott’s campaign launched a week before Irma’s arrival, and kept up throughout the storm and in its aftermath, and continues even well after the storm. Florida’s evacuation was not perfect – there were serious fuel outages, long delays at times on the state’s Interstates and other highways, and Irma’s vagaries wound up unexpectedly sparing some areas while hitting others, hard – but overall it went pretty well, given the enormous number of people affected.

Not everyone followed the evac. orders, and authorities said they would not arrest anyone for not complying. While a major reason for an evacuation is so first responders don’t have to risk their lives searching for stragglers in trouble, authorities also said that after a certain point no one should count on a rescue. Whatever the factors involved – in part, at least, the euphoria and excessive confidence that pervades many Keys residents – those who stayed behind in the islands came to find out the devastation a Category 4 hurricane can bring. It’s not yet known what the death toll is in the state as teams go through the destroyed housing of the Keys looking for survivors and casualties.

Of the points where preparations for the storm failed, perhaps the most telling and disturbing was the lack of back-up plans, power, and action by some nursing homes, both in Texas and Florida. The incident that has gotten the most attention was a nursing home in Hollywood, Fla., where so far 14 elderly residents have died. With a hospital just across the street, it’s hard not to assign negligence to the managers and owners of this facility. The state has opened an investigation and alleged criminal negligence, but meanwhile the horse – 14 of them so far – has left the proverbial barn and can’t be brought back.

A spokesperson for the nursing home association said that nursing homes are not required to have generators, only a back-up power supply. Whatever the hell that means. From my perspective, based on what happened in these and other storms and the personal experience of my own mother when she was alive, there is entirely too little oversight of nursing homes and assisted-living facilities. This paucity of oversight applies in other times, too, not just when there are storms. But certainly things need to be beefed-up to deal with natural disasters. Every nursing home and assisted-living facility should be required to have an emergency action plan (EAP), which should be reviewed by regulators, and also to conduct drills practicing the EAP, to the extent practical. There also has to be more attention paid to those “back-up power supplies” and sufficient generation capability should be required to not just keep the lights on, but also run the air conditioning in hot areas and heat in cold ones.

As I mentioned, I lived on the Mississippi Gulf Coast through most of the recovery from Katrina. The very slow pace of recovery in both Mississippi and Louisiana was a source of frequent frustration to me, but it was a true bane to those who had to suffer through it. In some cases, people have never recovered. Burdened with too much bureaucracy and red tape and some truly bone-headed decisions, FEMA proved to be largely inefficient and, for many, ineffective in its response. In the end, someone calculated that for all the money spent on FEMA and other agency responses, the government could have built a new house and put two new cars in the driveway for each affected family. That is a scandal of the first order.

What I have seen, and experience has borne out, is that a multi-pronged approach is needed to respond to any natural disaster of this magnitude. In the plan I previously developed, this approach would be more forward looking than backward looking. At the head of the effort would be a disaster council combining federal government agencies, non-profit relief organizations, faith-based groups (which often provide a major portion of recovery efforts), and the profit sector. All these groups have a stake, and a contribution to make, both in preparing for natural disasters and in recovery. And this applies not just to hurricanes, but to other natural disasters, such as tornadoes, earthquakes, and major fires.

Similar councils should be established at the state level in the most affected states, with coordination between the state and national councils. And under my plan, Congress and state governments should consider establishing a disaster fund into which both public and private funds would be deposited in advance of disasters, not leaving things to allocations after the fact, which often come too late to deal with the worst immediate effects of a major storm or other disaster. This approach makes the response both prospective – looking ahead to future disasters – and retrospective – looking back in the aftermath of those that have already occurred. The cost will be there in any event, but by having funds already allocated they can be assigned quicker and will offer the most and most efficient benefit to those affected.

We tend to avoid thinking about what might happen tomorrow, even less about paying for it. But just as our learning curve in preparation and recovery has continued to go up with each major storm, I see this as a logical next step in our approach to dealing with hurricanes and other natural disasters, which are not just going to go away.