Once more unto the breach, dear friends, once more...

The game is truly afoot, dear friends, and with just a couple weeks until the "Health Care Summit" on February 25, I urge you dishonour not your mothers, follow your spirit and upon this charge cry 'Give us substantive health care reform!'

The breach that needs filling today is not the gap in the wall of Hafleur but the gap in health care access, cost and quality. What I'm asking you is über-simple: contact your state representatives and the media and show them your mettle. One website allows you to do both with a couple clicks and you can use the following letter as you see fit, or compose your own, to tell them just what you want them to do.

THE LINK
http://my.barackobama.com/page/content/health-care-action-center/?source=20100209_ms_launch

THE LETTER
I am writing to you as a member of [INSERT YOUR COMPANY or ORGANIZATION NAME] because today offers a special opportunity to make history through the passage of substantive and intelligent health care reform. We believe that today we have come too far to turn back and that many lives, not just elections, will be lost if we do not make changes to the way health care is accessed, paid for, regulated and researched in our country. The stakes may never have been higher.

We believe in giving the best evidenced-based medical care that money can buy, and giving it so that it helps the greatest number of people. We believe in a fair and compassionately regulated system that guarantees every member of our society a minimum level of care and services while still encouraging the best that innovation and research has to offer.

In short, we believe in the following fundamental areas of reform and we believe that a majority of rational and compassionate Americans like us would agree to their necessity:

• Prevention… we believe that an ounce of prevention is worth a pound of cure, and costs less too. We need to support and expand primary care, preventative care as well as community-based and home-based care.

• Research… providers need to be free to do what is best for the patients that they know best, but they deserve to have the best guidelines, protocols and clinical research possible to help guide them in their decisions. We support Evidenced Based Medicine which means more high quality and unbiased comparative trials and research. More longitudinal meta-anayses. More safety studies. This is a job for someone like the NIH, not drug companies or groups that have vested interests.

• Choice… people should be able to choose their doctor and should have at least several insurance plans available to them. This is not the case in many areas of the country or with many employers, which is why we advocate for public options and national exchanges where individuals and groups can shop for insurance plans in a regulated and fair market.

• Cost… there will always be a finite amount of resources. The question is how they are allocated. These decisions should not be driven by profit, but from a public health perspective of what will do the most good for the most number of people. Currently there are insurance companies telling providers what they can and cannot do, we believe these decisions would be better made by public health officials. We also need out of pocket caps for policyholders because there is no point in having insurance if you can go bankrupt when something goes wrong. Finally, we need to lift the yearly caps for insurance companies because there is also no point in getting chemotherapy for cancer only to die of a cold because you passed your yearly limit.

• Accountability… taking care of people is a serious responsibility and all aspects of the system need to be held accountable. Nevertheless, punitive malpractice suits may not be the best way to do this. We need to put an end to defensive medicine by reforming malpractice law. National oversight and regulation of hospitals, payers and providers is a better way to enforce policy, set best practices and create accountability.

• Access… the best health care in the world is all for naught if there is not adequate access to it. This means starting with giving access to the millions of uninsured, but it also means guaranteeing proper access to the basics of a healthy lifestyle: fresh fruits and vegetables, clean air and water, reproductive services, and education about age appropriate diet and exercise.

Because we hold these ideas to be vital to the very survival of our health care system, economy and moral fiber as a nation, we urge you to take action now!

We urge you to pass a substantive, intelligent and compassionate health care reform package that includes the fundamental issues described above.

Respectfully yours,
A concerned and voting citizen

Read More...

Summary only...

Ethiopia 2009--super Gobez!

Debbie and I are going to spend the holidays warming up under the African sun, or at least that's the plan. This is also my "meet the parents" trip. No pressure, but Debbie's high-school friends used to call her dad "the General". I've already met several of Debbie's aunts and cousins here in the city and I'm hoping that their preliminary reports will have helped laid the ground work for the coming encounter. Debbie has not been helping things by telling me about all the things I should watch out for in terms of etiquette, like standing up when her parents enter the room, not talking with my hands in my pockets, not licking my fingers, and how elders from the village might spit on us as a sign of respect--and this is exactly what happens to Debbie when she is getting her personal blessing after St. Gabriel's, though the man spits towards her hands that he is holding rather than on her head or face...

But let's start at the beginning, our trip really begins in the Dulles airport where we are stuck for over three 3 hours. We’ve already avoided a blizzard in New York and this delay makes a long trip seem even more punitive. It’s funny because as we were walking through the terminal we overheard a boarding announcement explaining that the airport is really busy so the flight to Cancun would be using a temporary boarding gate. We find, however, our Ethiopian Airlines flight at the far end of the terminal all alone with several empty gates around it. It’s almost as if it has been quarantined here so other flights or airlines can go about their on-time business without being affected. As these things go, there is no clear reason why we are not boarding the plane that is sitting right there. At one point they announce we are waiting for “the boarding agent to bring a document” which could mean anything or nothing, then later they claim we are delayed due to the weather. The runways are clear, however, and the flight to Cancun is long gone, so go figure. The pilots and crew do not seem phased and sit in a cluster chatting or napping in the corner. We are still in DC, but somehow we are already on African time.

Speaking of African time, Debbie has always had her own sense of tardiness. She is never late for court, but misses our fourth or fifth date because she was taking a three-hour shower. It's what I call DST (Debbie Standard Time) or what Polly Platt might call quark-chronics. Here in Ethiopia, things definitely move at their own pace. When we wake up at 3:30 pm (yeah that's right, I said it) it is actually 9:30 pm Habesha or Ethiopian time. So if you ask someone when they are coming over to fix the plumbing, for example, you may need to clarify whether you are talking about Habesha or Ferengi time--not that it means they will arrive à l'heure, of course.

One explanation for why Ethiopia has it's own clock is that because it is so close to the equator, days are generally 12 hours all year round (and nights as well), so Ethiopians got into the habit of counting the hours from sun up to sun down, which is about 6 hours different from what the folks in Greenwich would have you believe (sometimes six hours less, sometimes more). There are also 13 months in the Ethiopian calendar year and a difference of about 7 or 8 years in the date, depending on whether you arrive before or after the Ethiopian New Year in September. This embassy webpage provides a good explanation of it all and how it came about.

When you talk about Ethiopia, Western people often think of two things: famine and coffee. True besides coffee exports, the Ethiopian economy is based heavily on subsistence agriculture which makes it vulnerable to crop failure and famine, but in spite of this, or perhaps because of this, Ethiopian culture practically revolves around eating. It is considered almost insulting, for example, to go to someone’s house and not eat seconds or even thirds. I’ve learned this the hard way as Debbie’s aunt locks eyes with me and then slowly extends a finger back towards the buffet table. Blurp. The trick is to start low and go slow. Don’t put too much on your plate, eat slowly and always have something on there. Because an empty plate is apparently a sign for give me another large helping in the Horn of Africa.

The story I love the best about Debbie’s mom, who is definitely one of the kindest, sweetest women on earth, involves her passing me the bread basket one night. This was about day 8 or 10 of the trip and I have just gotten over being sick. I’m almost grateful for my flu, however, because I haven’t eaten anything for like 24-hours and my stomach is no longer feeling like a packed canon. I’m trying to reach for a small piece of bread but somehow the basket keeps moving and my hands find themselves over the biggest piece in the basket. When I finally realize what is going on, I look up to see Debbie’s mom with a huge smile on her face. So sweet.

Ethiopian food is definitely delicious, and fun to eat too! Ethiopians love meat, but they also have a lot of vegetarian options. The Ethiopian Orthodox Church prescribes fasting, eating vegetarian, twice a week as well as for extended periods around Christmas and Easter. What makes Ethiopian dining really fun is that you get to eat with your hands. The idea is to use the flat crêpe-like bread called injera to gather up a mixture of stuff without getting any on your fingers (thus the proscription against licking one's fingers).

The meat in Ethiopia is also worth mentioning. I think it has something to do with its local and non-industrialized raising and processing. Whatever it is, it’s really flavorful and delicious. This wonderful meat experience is called tibs (pronounced with a sort of retroflex ‘t’). Basically, it’s a large side of raw beef (it’s really cow or carcass still at this point) hanging behind a counter that you have the guy slice for you. They take away the kilograms that you order and return with a plate full of steaming fajita-like tibs that you can dip in spicy mustard or berberé sauce. It melts in your mouth. In fact it was so good, we went back again the next night (see the video for more tibs action).

Another unique thing about Ethiopian cuisine is the butter. When I first visited Ethiopia, my friend’s host family showed me these huge blocks of butter and explained how they got them from their hometown outside the capital and how they would store in the cupboard for months or years. That doesn’t sound good, I thought, but I was wrong, because the butter is clarified, like ghee from India, so it really doesn’t spoil because the organic fats have been removed during the clarification process.

One of my favorite Ethiopian traditions around eating is what’s called a gursha. A gursha is when you grab a bunch of tibs or wet-ever (wet or sometimes wot is another yummy dish so that’s a transliteration pun) and then feed it to your guest or loved one. It’s very sensual and very fun. Kind of like when the bride and groom feed each other the cake at the wedding, except Ethiopians do it all the time.

The final thing that has to be discussed is Ethiopian coffee. Ethiopian coffee beans are excellent (much like their Kenyan neighbors) and can be found all over the world, thanks for better or for worse to places like Starbucks. In Ethiopia, coffee is call buna and is often served as part of a ceremony that involves roasting, grinding and infusing the beans right there in front of you. As you drink it, frankincense is usually burnt giving the whole experience a magical air.

As I said before, we are a bit surprised with the weather during the trip, with bouts of rain and average temperatures below the usual 70s. Addis is at 7-8 thousand feet of altitude so one expects it to be cold at night. On several occasions, we light a fire in the living room and practice some traditional dancing--which involves a lot of shoulder action. I realize I look like a chicken on the video, but you’ll get the idea from watching the others.

Christmas is approaching and we are having some trouble finding an appropriate tree because 1) pine is not part of Ethiopia's native flora and 2) it is currently illegal to cut any trees down. This means we have to choose between a potted tree from the plant nursery--which contrary to what you might think has an incredible selection of flowers and plants, just not pine trees--or a fake one. We end up getting both, but the branches of the tree won’t hold the decorations so it will have to wait until next year. What a great idea, making it illegal to cut down trees like this. Why shouldn't everyone have a live tree for Christmas? It would be less of a fire hazard and much better for the ozone. After Christmas it could be a tradition to go out into the woods (or your backyard) and replant the tree, or you could just keep watering it until next year. Okay, I realize that the whole root thing would make it well nigh impossible to have a large tree, but maybe a few could still be cut down for municipal displays or the Rockefeller center type thing. I’m just thinking out loud here…

We are having our big Turkey and stuffing meal today, the day after Christmas. Mostly because yesterday was Friday, a fasting day. So we will be opening our gifts and celebrating today. Much like other Orthodox churches, the ceremonies here are quite long and elaborate. For the most part they are conducted in a language called Ge’ez which is an even more ancient language than Amharic and more directly related to the country’s coptic origins. Women, I am told, are not supposed to attend services if they are menstruating, and apparently when she was young ,Debbie was able to use this excuse at any old time of the month to get out of going to church and the men were none the wiser. These things do remain a mystery to most of us men, don’t they?

After Christmas we spend several days in Woliso, where Debbie's father was born. It’s about 60 km west of Addis. A small town with a church her father built in honor of his father who was a famous General under Haile Sellasie. In fact, when the Emperor was overthrown, Debbie’s family, like many in Ethiopia, had to flee the country for fear of retributions. This is why Debbie was born and raised in Rome. Her family still owns property in Woliso. The land and farmhouse go back several generations. Debbie’s uncle lives there and is turning the land into a proper farm with honey, apples, teff (the grain that is used to make injera), and of course tej which is a meady, honey-beer like drink that many households brew out back as it were. The stuff will put you down if you can keep it down, is all I’m going to say on that topic.

The 27th is Saint Gabriel’s, a big holiday in the Ethiopian Orthodox Church, and people come from kilometers around to chant and pray all night long and most of the day. The prayers are broadcast over speakers so the huge crowd that gathers around the church and that can't fit inside can participate too. It's a really beautiful moment and we don't want to leave. Several priests and the bishop, head of the local diocese, come over to the farmhouse after the ceremonies to break their fast with us. It’s a huge feast and celebration--you really have to watch the video to see what I mean. It is very interesting being in such a big crowd and being the only white person. Especially in a small town/village like Woliso, it makes you something of a spectacle--kind of like being Brad Pitt or Angelina Jolie for the day. You either get used to the staring (and sometimes pointing and touching), or you don’t. Every aspiring actor should give it a try.

There is also a village elder, who is something like 98 or 100 years old, who gives Debbie and her brother Gulu a personal blessing (this is when the spitting happens). The elder and priests mostly speak in Orominia (the local language of the Oromo region), and the translation of the blessing seems a little short compared to the length of the speech but apparently breaks down to telling Debbie and her brother that they should get married and have kids, by next year if possible!

It’s New Years now and we spend the countdown flipping between the French and Italian TV stations, both of which are airing their traditional réveillon galas. One features three 8 year-old kids covering bad Euro-pop songs and soccer highlights from several seasons back, the other decides to cut to a sponsor's logo with 30 seconds left in the countdown and spends half the time promoting the guest commentators' latest albums and tours. Thank god for the Champagne and Pandoro or I would be worried about Europe. 2010, woohoo...!

Read More...

Summary only...

Stand Up, Speak Out!

It's shocking how obedient we are sometimes. Maybe it comes from our distant evolutionary past where it paid to stay with the herd, follow the alpha male, lest a mountain lion drop out of a tree and gobble you up. If you've had the occasion to observe a 'pack' of 7th graders roaming your local subway system or mall, then you might think it's not such a distant genetic influence I'm talking about.

Maybe we should blame our kindergarten teachers for doing such a good job of socializing us, imposing all those rules that we learned to obediently follow like sit up straight, don't fidget, don't talk out of turn and most of all the teacher is always right and you have to do what they say.

In John Holt's classic book How Children Fail, he observes elementary children and classrooms with piercing clarity, reminding us how scary school, not to be confused with education, was (or is) for most of us and how so much of what passes for teaching is really anathema to our natural curiosity and affinity for learning--especially as young children. In a telling example, Holt explains how he would talk to kids and ask them questions like what do you want to be when you grow up? Another question he would always ask was who thinks they have a good imagination? When he asked this question to a preschool or kindegarten class all the children would raise their hands and often yelp or bounce around to let him know, hey yes, over here, look at me, I've got one, I've got one! In first grade, he continues, maybe 3/4 or 1/2 the class would raise their hands. And by second grade, only a handful and timid few would raise their hands. School had either killed their curiosity and imagination or made them too self-conscious and scared to admit they had any.

And that's just it, either way the ship is sort of sunk. And things don't get much better when we grow up to be big strong adults either. We mostly still fear being different, changing going against the grain, against the herd. We're sheepish that society or the person sitting across from us on the subway will point to us and say, "that's baaaaaaaaaaaad."

It's shocking really how few people will stand up and say something in the face of racist, sexist, fascist, mean or just plain stupid words and deeds. We hope that we will be different when the time comes for true heroism, running into a burning tower, hiding a fugitive Anne Frank, but we mostly don't sweat the small stuff, right? And the problem is, to paraphrase the popular self-help book, at the end of the day, or a life, it has all ended up being small stuff. Minor affronts that slowly shred the fiber of our society through the death of a thousand cuts. Of course there will always be a brave or foolhardy few, but most of us will obediently press the button when we are told even when the results are cruelly and clearly splayed out in front of us.

I'm talking, of course, about a study that was somewhat unscrupulously carried out to study man (and woman's) violent and dangerous obedience to authority. It's called the Milgram Study. Basically, researchers told recruited volunteers that they were going to partake in a study of learning and memory. Each subject was told that they had to teach a student and to punish their errors by administering increasing levels of electric shocks. The "student" was a confederate of the researchers who pretended to be a poor learner and mimicked pain and even unconsciousness as the subjects increased the levels of electric shock. An incredible (or maybe not so incredible) 63% of the subjects went as far administering shocks marked as "lethal"; some even after the "student" claimed to have heart disease.

Now we may not be the most proactive of species, in terms of standing up and speaking out about oppression, injustice and the like, but we are a repentant lot. Apparently some of the test subjects experienced serious emotional crises after being "debriefed" from the study. Yes, we love our fallen angels who sob their apologies and weakness from the pulpit of their sins. It's an interesting evolutionary trait, actually. What evolutionary advantage does remorse confer on an individual?

I suppose nothing if we don't learn from our mistakes. And as John Holt so clearly explains, we don't learn well when we are scared. We tend to just shut up, play dumb, or just go along with the group hoping nobody notices us.

So here's a plug for standing up, speaking out, being noticed and not being afraid to speak our minds. Post your comments below, or better yet, click here and tell your congressional representative!

Read More...

Summary only...

Your representative is waiting for your call

Do not give up on serious health care reform. Your senators and representatives are waiting, begging even to hear from you before Congress reconvenes. Many of their jobs may rightly depend on how they vote, so they need to know what you want them to do. I just made three calls to voice my support (particularly for saving the public plan) and it took about 5 minutes. Here is a link that will help you call and/or email (calling is better) the president, your senators and your local representatives: http://www.usa.gov/Contact/Elected.shtml

Everyone needs and deserves basic health care coverage, prevention and education. The physical, spiritual and economic health of our country depends on it.

Doctor's and patients need access to unbiased research and information comparing treatment options and pharmaceuticals. This is a job for someone like the NIH, not drug companies or insurance companies or politically appointees who have vested interests.

Drug rationing already exists so let's not fear it. Doctors and patients are told everyday by insurance companies what they can and cannot do. What we are talking about is taking the rationing out of the hands of people who have a financial incentive to order more or less tests--often doctors and hospitals in the first case and insurance companies in the latter. Whatever the system, here or in Canada, socialized, nationalized or just plain old Americanized, people with money (like you?) will always be able to afford paying for the doctor, procedure or drug that you want or believe you need, so let's not ruin it for all the people who can't afford to pay and currently get what my Dad calls "bupkiss".

Dying with dignity, in comfort and without a bankrupting ICU bill is a right that we should all be encouraged to exercise. It's very personal, but if you do not have a health care proxy, living will, DNR etc., then the hospital will be making the decisions for you--which will involve putting you on every machine and ventilator known to man whether there is any hope of recovery or not and regardless of how uncomfortable it may be. Not being able to speak or move and living in an ICU with an artificial respirator is both painful and expensive. There are times where it could save your life, but there are times where it cannot, and only prolongs it, assuming you consider that a life. These are the situations where you need a living will or health care proxy to help you have the end of life that you want. This isn't death camps, but it does involve taking some time to consider these important end of life decisions and then making them known to your family and physicians. Here is a simple website that can help you create a health care proxy or living will: http://www.doyourproxy.org/

A co-op is not a reliable alternative to a public health option. This New York Times article does a great job of describing the potential risks and benefits of co-ops: http://prescriptions.blogs.nytimes.com/2009/08/17/so-whats-a-health-insurance-coop-anyway/?ref=health

Finally...

7 Reasons We Need Health Insurance Reform Now

1. Coverage Denied to Millions: A recent national survey estimated that 12.6 million non-elderly adults – 36 percent of those who tried to purchase health insurance directly from an insurance company in the individual insurance market – were in fact discriminated against because of a pre-existing condition in the previous three years or dropped from coverage when they became seriously ill. Learn more: http://www.healthreform.gov/reports/denied_coverage/index.html

2. Less Care for More Costs: With each passing year, Americans are paying more for health care coverage. Employer-sponsored health insurance premiums have nearly doubled since 2000, a rate three times faster than wages. In 2008, the average premium for a family plan purchased through an employer was $12,680, nearly the annual earnings of a full-time minimum wage job. Americans pay more than ever for health insurance, but get less coverage. Learn more: http://www.healthreform.gov/reports/hiddencosts/index.html

3. Hard Times in the Heartland: Throughout rural America, there are nearly 50 million people who face challenges in accessing health care. The past several decades have consistently shown higher rates of poverty, mortality, uninsurance, and limited access to a primary health care provider in rural areas. With the recent economic downturn, there is potential for an increase in many of the health disparities and access concerns that are already elevated in rural communities. Learn more: http://www.healthreform.gov/reports/hardtimes

4. Small Businesses Struggle to Provide Health Coverage: Nearly one-third of the uninsured – 13 million people – are employees of firms with less than 100 workers. From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%. Much of this decline stems from small business. The percentage of small businesses offering coverage dropped from 68% to 59%, while large firms held stable at 99%. About a third of such workers in firms with fewer than 50 employees obtain insurance through a spouse. Learn more: http://www.healthreform.gov/reports/helpbottomline

5. The Tragedies are Personal: Half of all personal bankruptcies are at least partly the result of medical expenses. The typical elderly couple may have to save nearly $300,000 to pay for health costs not covered by Medicare alone. Learn more: http://www.healthreform.gov/reports/inaction

6. Diminishing Access to Care: From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%. An estimated 87 million people - one in every three Americans under the age of 65 - were uninsured at some point in 2007 and 2008. More than 80% of the uninsured are in working families. Learn more: http://www.healthreform.gov/reports/inaction/diminishing/index.html

7. The Trends are Troubling: Without reform, health care costs will continue to skyrocket unabated, putting unbearable strain on families, businesses, and state and federal government budgets. Perhaps the most visible sign of the need for health care reform is the 46 million Americans currently without health insurance - projections suggest that this number will rise to about 72 million in 2040 in the absence of reform. Learn more: http://www.WhiteHouse.gov/assets/documents/CEA_Health_Care_Report.pdf

Read More...

Summary only...

Dave Barry: a journey into my colon--and yours!

OK. You turned 50. You know you're supposed to get a colonoscopy. But you haven't. Here are your reasons:

1. You've been busy.
2. You don't have a history of cancer in your family.
3. You haven't noticed any problems.
4. You don't want a doctor to stick a tube 17,000 feet up your butt.

Let's examine these reasons one at a time. No, wait, let's not. Because you and I both know that the only real reason is No. 4. This is natural. The idea of having another human, even a medical human, becoming deeply involved in what is technically known as your 'behindular zone' gives you the creeping willies.

I know this because I am like you, except worse. I yield to nobody in the field of being a pathetic weenie medical coward. I become faint and nauseous during even very minor medical procedures, such as making an appointment by phone. It's much worse when I come into physical contact with the medical profession. More than one doctor's office has a dent in the floor caused by my forehead striking it seconds after I got a shot.

In 1997, when I turned 50, everybody told me I should get a colonoscopy. I agreed that I definitely should, but not right away. By following this policy, I reached age 55 without having had a colonoscopy. Then I did something so pathetic and embarrassing that I am frankly ashamed to tell you about it.

What happened was, a giant 40-foot replica of a human colon came to Miami Beach. Really. It's an educational exhibit called the Colossal Colon, and it was on a nationwide tour to promote awareness of colo-rectal cancer. The idea is, you crawl through the Colossal Colon, and you encounter various educational items in there, such as polyps, cancer and hemorrhoids the size of regulation volleyballs, and you go, "Whoa, I better find out if I contain any of these things," and you get a colonoscopy.

If you are as a professional humor writer, and there is a giant colon within a 200-mile radius, you are legally obligated to go see it. So I went to Miami Beach and crawled through the Colossal Colon. I wrote a column about it, making tasteless colon jokes. But I also urged everyone to get a colonoscopy. I even, when I emerged from the Colossal Colon, signed a pledge stating that I would get one. But I didn't get one. I was a fraud, a hypocrite, a liar. I was practically a member of Congress.

Five more years passed. I turned 60, and I still hadn't gotten a colonoscopy. Then, a couple of weeks ago, I got an e-mail from my brother Sam, who is 10 years younger than I am, but more mature. The email was addressed to me and my middle brother, Phil. It said:

"Dear Brothers,

"I went in for a routine colonoscopy and got the dreaded diagnosis: cancer. We're told it's early and that there is a good prognosis that they can get it all out, so, fingers crossed, knock on wood, and all that. And of course they told me to tell my siblings to get screened. I imagine you both have."

Um. Well.

First I called Sam. He was hopeful, but scared. We talked for a while, and when we hung up, I called my friend Andy Sable, a gastroenterologist, to make an appointment for a colonoscopy. A few days later, in his office, Andy showed me a color diagram of the colon, a lengthy organ that appears to go all over the place, at one point passing briefly through Minneapolis. Then Andy explained the colonoscopy procedure to me in a thorough, reassuring and patient manner. I nodded thoughtfully, but I didn't really hear anything he said, because my brain was shrieking, quote, "HE'S GOING TO STICK A TUBE 17,000 FEET UP YOUR BUTT!"

I left Andy's office with some written instructions, and a prescription for a product called 'MoviPrep,' which comes in a box large enough to hold a microwave oven. I will discuss MoviPrep in detail later; for now suffice it to say that we must never allow it to fall into the hands of America's enemies.

I spent the next several days productively sitting around being nervous. Then, on the day before my colonoscopy, I began my preparation. In accordance with my instructions, I didn't eat any solid food that day; all I had was chicken broth, which is basically water, only with less flavor. Then, in the evening, I took the MoviPrep. You mix two packets of powder together in a one-liter plastic jug, then you fill it with lukewarm water. (For those unfamiliar with the metric system, a liter is about 32 gallons.) Then you have to drink the whole jug. This takes about an hour, because MoviPrep tastes -- and here I am being kind -- like a mixture of goat spit and urinal cleanser, with just a hint of lemon.

The instructions for MoviPrep, clearly written by somebody with a great sense of humor, state that after you drink it, "a loose watery bowel movement may result." This is kind of like saying that after you jump off your roof, you may experience contact with the ground.

MoviPrep is a nuclear laxative. I don't want to be too graphic, here, but: Have you ever seen a space shuttle launch? This is pretty much the MoviPrep experience, with you as the shuttle. There are times when you wish the commode had a seat belt. You spend several hours pretty much confined to the bathroom, spurting violently. You eliminate everything. And then, when you figure you must be totally empty, you have to drink another liter of MoviPrep, at which point, as far as I can tell, your bowels travel into the future and start eliminating food that you have not even eaten yet.
After an action-packed evening, I finally got to sleep. The next morning my wife drove me to the clinic. I was very nervous. Not only was I worried about the procedure, but I had been experiencing occasional return bouts of MoviPrep spurtage. I was thinking, "What if I spurt on Andy?" How do you apologize to a friend for something like that? Flowers would not be enough.

At the clinic I had to sign many forms acknowledging that I understood and totally agreed with whatever the hell the forms said. Then they led me to a room full of other colonoscopy people, where I went inside a little curtained space and took off my clothes and put on one of those hospital garments designed by sadist perverts, the kind that, when you put it on, makes you feel even more naked than when you are actually naked.

Then a nurse named Eddie put a little needle in a vein in my left hand. Ordinarily I would have fainted, but Eddie was very good, and I was already lying down. Eddie also told me that some people put vodka in their MoviPrep. At first I was ticked off that I hadn't thought of this, but then I pondered what would happen if you got yourself too tipsy to make it to the bathroom, so you were staggering around in full Fire Hose Mode. You would have no choice but to burn your house.

When everything was ready, Eddie wheeled me into the procedure room, where Andy was waiting with a nurse and an anesthesiologist. I did not see the 17,000-foot tube, but I knew Andy had it hidden around there somewhere. I was seriously nervous at this point. Andy had me roll over on my left side, and the anesthesiologist began hooking something up to the needle in my hand. There was music playing in the room, and I realized that the song was Dancing Queen by Abba. I remarked to Andy that, of all the songs that could be playing during this particular procedure, Dancing Queen has to be the least appropriate.

"You want me to turn it up?" said Andy, from somewhere behind me.

"Ha ha," I said.

And then it was time, the moment I had been dreading for more than a decade. If you are squeamish, prepare yourself, because I am going to tell you, in explicit detail, exactly what it was like.

I have no idea. Really. I slept through it. One moment, Abba was shrieking Dancing Queen! Feel the beat from the tambourine... and the next moment, I was back in the other room, waking up in a very mellow mood. Andy was looking down at me and asking me how I felt. I felt excellent. I felt even more excellent when Andy told me that it was all over, and that my colon had passed with flying colors. I have never been prouder of an internal organ.

But my point is this: In addition to being a pathetic medical weenie, I was a complete moron. For more than a decade I avoided getting a procedure that was, essentially, nothing. There was no pain and, except for the MoviPrep, no discomfort. I was risking my life for nothing.

If my brother Sam had been as stupid as I was -- if, when he turned 50, he had ignored all the medical advice and avoided getting screened -- he still would have had cancer. He just wouldn't have known. And by the time he did know -- by the time he felt symptoms -- his situation would have been much, much more serious. But because he was a grown-up, the doctors caught the cancer early, and they operated and took it out. Sam is now recovering and eating what he describes as "really, really boring food." His prognosis is good, and everybody is optimistic, fingers crossed, knock on wood, and all that.

Which brings us to you, Mr. or Mrs. or Miss or Ms. Over-50-And-Hasn't-Had-a-Colonoscopy. Here's the deal: You either have colo-rectal cancer, or you don't. If you do, a colonoscopy will enable doctors to find it and do something about it. And if you don't have cancer, believe me, it's very reassuring to know you don't. There is no sane reason for you not to have it done.

I am so eager for you to do this that I am going to induce you with an Exclusive Limited Time Offer. If you, after reading this, get a colonoscopy, let me know by sending a self-addressed stamped envelope to Dave Barry Colonoscopy Inducement, The Miami Herald, 1 Herald Plaza, Miami, FL 33132. I will send you back a certificate, signed by me and suitable for framing if you don't mind framing a cheesy certificate, stating that you are a grown-up who got a colonoscopy. Accompanying this certificate will be a square of limited-edition custom-printed toilet paper with an image of Miss Paris Hilton on it. You may frame this also, or use it in whatever other way you deem fit.

But even if you don't want this inducement, please get a colonoscopy. If I can do it, you can do it. Don't put it off. Just do it.

Be sure to stress that you want the non-Abba version.

Colonoscopies are no joke, but these comments during the exam were quite humorous... A physician claimed that the following are actual comments made by his patients (predominately male) while he was performing their colonoscopies:

1. Take it easy, Doc. You're boldly going where no man has gone before!

2. Find Amelia Earhart yet?

3. Can you hear me NOW?

4. Are we there yet? Are we there yet? Are we there yet?

5. You know, in Arkansas , we'd now be legally married.

6. Any sign of the trapped miners, Chief?

7. You put your left hand in, you take your left hand out...

8. Hey! Now I know how a Muppet feels!

9. If your hand doesn't fit, you must quit!

10. Hey Doc, let me know if you find my dignity.

11. You used to be an executive at Enron, didn't you?

And the best one of all.
12. Could you write a note for my wife saying that my head is not up there!

Read More...

Summary only...

This I believe: Be cool to the pizza dude!

"If I have one operating philosophy about life it is this: 'Be cool to the pizza delivery dude; it's good luck.' Four principles guide the pizza dude philosophy.

Principle 1: Coolness to the pizza delivery dude is a practice in humility and forgiveness. I let him cut me off in traffic, let him safely hit the exit ramp from the left lane, let him forget to use his blinker without extending any of my digits out the window or towards my horn because there should be one moment in my harried life when a car may encroach or cut off or pass and I let it go. Sometimes when I have become so certain of my ownership of my lane, daring anyone to challenge me, the pizza dude speeds by me in his rusted Chevette. His pizza light atop his car glowing like a beacon reminds me to check myself as I flow through the world. After all, the dude is delivering pizza to young and old, families and singletons, gays and straights, blacks, whites and browns, rich and poor, vegetarians and meat lovers alike. As he journeys, I give safe passage, practice restraint, show courtesy, and contain my anger.

Principle 2: Coolness to the pizza delivery dude is a practice in empathy. Let's face it: We've all taken jobs just to have a job because some money is better than none. I've held an assortment of these jobs and was grateful for the paycheck that meant I didn't have to share my Cheerios with my cats. In the big pizza wheel of life, sometimes you're the hot bubbly cheese and sometimes you're the burnt crust. It's good to remember the fickle spinning of that wheel.

Principle 3: Coolness to the pizza delivery dude is a practice in honor and it reminds me to honor honest work. Let me tell you something about these dudes: They never took over a company and, as CEO, artificially inflated the value of the stock and cashed out their own shares, bringing the company to the brink of bankruptcy, resulting in 20,000 people losing their jobs while the CEO builds a home the size of a luxury hotel. Rather, the dudes sleep the sleep of the just.

Principle 4: Coolness to the pizza delivery dude is a practice in equality. My measurement as a human being, my worth, is the pride I take in performing my job -- any job -- and the respect with which I treat others. I am the equal of the world not because of the car I drive, the size of the TV I own, the weight I can bench press, or the calculus equations I can solve. I am the equal to all I meet because of the kindness in my heart. And it all starts here -- with the pizza delivery dude.

Tip him well, friends and brethren, for that which you bestow freely and willingly will bring you all the happy luck that a grateful universe knows how to return."
--This I Believe, by Sarah Adams

Read More...

Summary only...

5 Things You Should Know About Obama's Health Care Policy

The choice of a public health insurance plan is crucial to real health care reform. But right now, it's being smeared by conservatives and insurance-industry front groups. Don't let them swiftboat healthcare reform. I've lived and had surgery in a country with national (universal) healthcare, and it was great. Here, thanks to moveon.org, is what you really need to know:

1. Choice, choice, choice. If the public health insurance option passes, Americans will be able to choose between their current insurance and a high-quality, government-run plan similar to Medicare. If you like your current care, you can keep it. If you don't—or don't have any—you can get the public insurance plan.

2. It will be high-quality coverage with a choice of doctors. Government-run plans have a track record of innovating to improve quality, because they're not just focused on short-term profits. And if you choose the public plan, you'll still get to choose your doctor and hospital.

3. We'll all save a bunch of money. The public health insurance option won't have to spend money on things like CEO bonuses, shareholder dividends, or excessive advertising, so it'll cost a lot less. Plus, the private plans will have to lower their rates and provide better value to compete, so people who keep their current insurance will save, too.

4. It will always be there for you and your family. A for-profit insurer can close, move out of the area, or just kick you off their insurance rolls. The public health insurance option will always be available to provide you with the health security you need.

5. And it's a key part of universal health care. No longer will sick people or folks in rural communities, or low-income Americans be forced to go without coverage. The public health insurance plan will be available and accessible to everyone. And for those struggling to make ends meet, the premiums will be subsidized by the government.

Read more on "The Case for Public Plan Choice in National Health Reform," by the Institute for America's Future.

Read More...

Summary only...

The Road Less Understood

The title to this blog alludes to one of America's most well-known and most misunderstood poems. Contrary to popular belief, the poem is not a paean to counter-culture and non-conformity, to alternate lifestyles and to getting off the beaten path. Not that those are bad things. Karpe Diem, I say, and I think Robert Frost would agree with me; getting out into nature, stopping and smelling the roses and all that hippie love stuff, or jesus love stuff if you want go back to the source, is a good thing. It's just not what the poem is about, and giving the text a careful reading and lexical analysis will show you what I mean...

In the first stanza we meet the poem's protagonist, a primal projection of the young poet, the everyman, standing in a yellow wood and faced with a choice between two paths.

Two roads diverged in a yellow wood,
And sorry I could not travel both
And be one traveler, long I stood
And looked down one as far as I could
To where it bent in the undergrowth;

The first thing to note is that the traveler is already in a yellow wood. So we are already talking about a walk through the woods, not a decision to leave some urban or other lifestyle in preference for the "green" way of the backwoods.

Then took the other, as just as fair,
And having perhaps the better claim,
Because it was grassy and wanted wear;
Though as for that the passing there
Had worn them really about the same,

In this second stanza, the traveler decides to take the other path, describing it as "just as fair" and "perhaps" having a better claim because it is "grassy and wanted wear". Aha, you say. I told you so. It's all about taking the road less traveled, forging through uncharted territory, being different etc. etc. But the very next couplet belies this attempt to differentiate the two paths telling us that they were worn "really about the same".

At this point, the two paths have been described as "just as fair" and "about the same" with one of them "perhaps" having a "better claim". Not quite the rallying cry of the non-conformist that you'd expect, right? Well if you aren't convinced yet, the next stanza pretty much puts the metaphorical nail in the biodegradable coffin with the unequivocal description "equally lay".

And both that morning equally lay
In leaves no step had trodden black.
Oh, I kept the first for another day!
Yet knowing how way leads on to way,
I doubted if I should ever come back.

So far we've got a poem about a traveler standing in the woods trying to pick between to almost equally trodden paths. The traveler tries to look down the road and presumably picks the "nicer" or "better" path, but readily admits that there isn't really a discernible difference. Then the traveler sort of reluctantly chooses one, knowing that they will more than likely never go back and try the other.

At this point, the poem is starting to look a bit more nihilistic. What's the point of picking if we can't see the ends, if we can't distinguish the difference? The key comes in the final stanza, when the traveler is looking back in retrospect on their life.

I shall be telling this with a sigh
Somewhere ages and ages hence:
Two roads diverged in a wood, and I—
I took the one less traveled by,
And that has made all the difference.

We now envision the traveler in some smokey and nostalgic roadside inn, no doubt with a wooden sign hanging askew over the door and an old-fashioned "Olde" in the title. The traveler is perhaps sitting in a rocking chair by the hearth, tamping out his aromatic pipe. What we know is that he or she is addressing an unseen audience. Who are they? Perhaps fellow travelers? Perhaps a circle of knock-kneed and wide-eyed children?

And what is the traveler saying? That that one decision, that one small decision between two nearly identical paths in a yellow wood has made all the difference. Basically the traveler is attributing a great importance to a decision that at the time was almost a flip of a coin. And this is what the poem is really about, the unreliability of memory and man's helplessness in the events of life.

The traveler believes that a choice between two indistinguishable paths was a key turning point in their life. The way they remember it, that one choice made all the difference. Maybe they don't really remember how the paths were basically the same, or maybe they have an elevated opinion of their abilities and believe that even in this minutest of moments they were charging towards self-made greatness.

It kind of depends on how you read the "sigh". Is it a sigh of regret and loss or puritanical pride in a job well done? Has the traveler become a prince or a pauper in the years following that fateful frolick in the forest? We are clearly in the presence of nostalgia, but is it a nostalgia born of myopia or hubris? Is man to believe that he is the master of his fate and that decisions, even admittedly haphazard ones like the choice between following two equally trodden paths, make a difference? Or is this a lesson on the unreliability of memory and man's tendency, or perhaps need, to attribute agency and meaning to the chaos and randomness of life?

Whether you believe in pulling yourself up by your bootstraps or the inexorable wheel of fate winding out your life, the song remains the same. Frost is reminding us that each moment is precious and rarely can be saved for another day. And that as the shadows lengthen and fall upon us, we will perforce look back at the rise and fall of our days and know with certainty that our lives are precisely as they are and could be no other way. Otherwise they would not be ours to remember. We will have the choice to look back and sigh with joy or regret for the paths we chose and never chose to take, and together these will be the paths of our life lying just so, diverging in the woods of our soul. And we can be sure that the paths we trod have made all the difference, because our dusty and fading footprints are no doubt the legacy we leave behind to those who follow...

One final point about how memory diverges from life (like two roads in a wood) and how, willfully or not, this leads us to misunderstand: the Robert Frost poem is titled The Road Not Taken, not as most people will remember The Road Less Traveled. And that, to paraphrase Robert Frost, not only makes all the difference, but is exactly what he's talking about.

Read More...

Summary only...

Babies don't vote, babies don't pay

How can we be the "greatest" and "richest" country in the world when we don't guarantee basic health care to all of our citizens?

The cost of health care, in both moral and economic terms, is bankrupting our country. There is no reason why everyone shouldn't receive quality, affordable health care. A healthy workforce makes good sense, but we are really talking about caring for people, the sick--a simple mitzvah, the kind of thing your grandmother would want you to do, but taken to a national level.

But that's the easy part. It's not just who we care for, but how we care for them. Serious reforms are also necessary in how we research new drugs and treatments, and how we make choices about what procedures, particularly at the end of life, are offered to an individual.

I believe these type of complicated decisions regarding public health, preventative care and use of limited resources need to be made by scientific and non-profit oriented (i.e. non insurance and non pharmaceutical) groups like the NIH.

One of the reasons that the United States has the highest infant mortality rate in the so-called "civilized" world, that is to say compared to other places like Western Europe, Japan etc. is that babies don't vote and babies don't pay. So we spend more time and money on finding viagra and cures for social anxiety disorders. This same market logic drives research away from world wide killers like malaria or improving preventative medicine. Screening and teaching better diet and exercise to avoid diabetes just aren't as profitable as insulin.

The system will spend tens of thousands of dollars, however, to extend someone's life by a week or two. If you can call lying in an intensive care unit with failing organs and an artificial respirator down your throat as well as being extremely sedated because your body responds to the respirator as if you are drowning or suffocating as living...

This is why research and health guidelines need to be free of industrial and market bias. Health care providers and individuals need access to good information. Smart national guidelines will help doctors sort out increasingly complicated health choices (drug interactions, comparisons of generic to brand drugs, comparisons of treatment combinations). National guidelines will not tie your doctor's hands, but empower them with information rather than marketing and advertisements. It's a non-issue really, because hands are already being tied and manipulated by decisions about which procedures are reimbursed and for how much.

The next step is encouraging individuals and families to think and talk about critical care and end of life issues such as when and how much invasive care should be given, and under what circumstances. Every adult as part of their electronic and accessible health records should fill out organ donor plans, do not ressucitate orders, file health proxies etc. Schools should have a mandatory health and diet class that teaches proper hygiene, eating and exercise habits and how to become well informed participants in a national health care system.

And participation is the key. Now is the time to speak out and let your elected official know how you see the future of health care in America.

Read More...

Summary only...

4/20, cool dude!

Fire it up, ready to go. It's 4/20 and the debate to legalize the stinky stuff is sparking up across the country. You might even say that support has been growing like a weed. Should smokin' doobie be part of our new green economy?

It would seem that for more and more people the answer is yes. Economists now estimate that depenalizing dope could save the country something like $7 billion in prevention and prison and even make another $7 billion if we tax all the toking. That's a lot of dime bags, baby. And these are not half baked ideas either. We are talking about a group of 500 economists, three of whom are Nobel laureates. See what they have to say for yourself here.

Besides the potential cash to be made from hash, marijuana could be put to medical use. A bit of chronic, as it were, for pain, cancer, glaucoma, MS and more. And what about recreational reefer? Well it's the usual argument, prohibition has proven not to stop people doing it. Is it more toxic than cigarettes? More dangerous than alcohol? When's the last time you saw a bunch of guys smoke-up and then pick a fight? According to the medical journal Lancet, "The smoking of cannabis, even long-term, is not harmful to health." They go on to say that "it would be reasonable to judge cannabis less of a threat to health than alcohol or tobacco".

Okay, nobody is saying it's good for you and should replace Wheaties as the breakfast of champions (though it didn't seem to hurt Michael Phelps). It is a drug and it can cause bad things like bronchial irritation, cognitive impairment, accidents and bouts of the giggles. As such, it should be used very carefully, if at all, and only by responsible adults. Not for kids. So we shouldn't allow it to be advertised or anywhere near schools. But what about a puff for grandma who's eyes are tired after knitting? Or a toke for Mom and Dad on the weekend after mowing the lawn? Probably okay, right? So let's all lighten up a bit. It's cool, dude.

Read More...

Summary only...

Health Care for America Now

I believe health care providers need to be given support in terms of research into which drug and treatment combinations are the most effective--research that is independent of any one pharmaceutical company. They also need to be given the time and freedom to treat their patients as people and to care for them, rather than being encouraged to give unnecessary but profitable tests or race through histories and physicals. Life and death are pre-existing conditions. Health care is a basic human need and the responsibility of any "civilized" society.

Support health care reform. Speak out. Vote. http://healthcareforamericanow.org/

Read More...

Summary only...

Twittering away the hours

Ticking away the moments that make up a dull day
You twitter and waste the hours in an offhand way.
Kicking around on a piece of ground in your home town
Waiting for someone or something to show you the way...


[start message thread]
Jl: Nespee nespee nespee nespee

Kl: What's up random guy? No time?

Jl: I have new self imposed phone rules

Kl: But that don't include standards of quality?
--
Kl: About to jam with Nada Surf?

Jb: How did that end up happening?

Kl: Just lucky, I guess

Jb: Holy smokes you can say that again

Kl: Just lucky, I guess

Jb: I would expect nothing less
--
Kl: Let's stop by Hershe park on our way to Sasquatch.

Jl: Where is that?

Jb: What is Hershe park? A place or a band?

Kl: It's the sweetest place in the world.

Jb: Well who can say no to that?
--
Jb: Guess who gets to see Dr. Brian Greene lecture on the importance of science tomorrow?

Kl: Me?

Jb: Not unless you have plans to be at pierce college tomorrow. I do have an extra ticket if you decide to go though. :)

Kl: OMG, pierce through the fabric of the cosmos.

Jb: Word!
--
Dg: At your place - relaxing with a glass of wine. Have fund and don't rush or worry about me.

Kl: You always know just what to say.

[message forward]

Ko: Who's that?

Kl: My gf

Js: I'm so jealous!
--
Kl: Good times last night

Js: Indeed. Still jealous though

Ko: Haha, totally. Sorry for being the token lush.

Kl: You were token?

Ko: no.
--
Jl: Did u see the movie le haine?

Kl: Oui, La haine: ce n'est pas la chute qui compte, c'est l'atterrissage.

Jl: Arash ta mere

Kl: It's too late to lose the weight you use to need to throw around.

Jl: Sortie...
[end thread]

Tired of lying in the sunshine staying home to watch the rain.
You are young and life is long and there is time to kill today.
And then one day you find ten years have got behind you.
No one told you when to run, you missed the starting gun.

So you run and you run to catch up with the sun but it's sinking
Racing around to come up behind you again.
The sun is the same in a relative way but you're older,
Shorter of breath and one day closer to death.

Every year is getting shorter never seem to find the time.
Plans that either come to naught or half a page of scribbled lines
Hanging on in quiet desperation is the English way
The time is gone, the song is over,
Thought I'd something more to say.

Read More...

Summary only...

Tales from the 'Terp

In a few weeks I will start nurse practitioner school which will put an end to my career as freelance interpreter. "Have dictionary and unassuming JC Penney slacks and shirt, will travel," that's us. I've already taken down my website and packed away my hush puppies (you have to have white ones for nursing school), so the only thing left will be to contact the agencies and file away my resume with those from my other random and short lived careers as Safeway bag-boy, Tanglewood Island boat driver and resort hand, Park City waiter-cum-busboy, Rassias method French language drill instructor, Lycée Lakanal English assistant, financial journalist covering the MATIF (French futures market for financial instruments), Amazon.com customer service representative, .co.uk away team member, trainer and auctions marketing specialist, and finally IPAC pharmaceutical translation agency assistant. Before adding my time as a 'terp to the "been there done that" file, I thought it would be interesting to share a few memories and thoughts of just what it is like to be a French interpreter in this beautifully broken city we call Brooklyn and the Big Apple.

I started by working for a translation and language service company that was listing on Craiglist. They specialize in voice over type recordings and medical interpreting. In fact, they have an exclusive contract with the New York Public Hospitals. So besides the people in Indiana waiting next to their phone, if there is medical interpreting to be done in the city, it's through them. Nobody at the agency spoke French, or at least to me, and besides the interview the only thing they had me do was take a test in English checking my knowledge of basic, and I mean basic, medical vocabulary. Scary, right? It kind of makes sense because most interpreters speak English as their second or third language so it's more important to test their English skills. Nevertheless, being able to pass a multiple choice test in your second language does not a good medical interpreter make.

Later on, the agency made all of us pay for and take this Bridging the Gap medical interpreting course. But to be honest, taking that remedial sort of repeat everything twice and underline the rest thrice type of class and meeting the other interpreters therein only made me question more whether I had truly found my calling. Were these my people? My colleagues? This, by the way, is about the same feeling of slight repulsion and intellectual/moral elitism that turned me off commercial auditions in acting.

My first medical interpreting job, well before having spent those invaluable interpreting course hours on a somnolent Saturday afternoon discussing the interpreter as cultural advocate etc., was at the Columbia Presbyterian Women's Clinic. A black, Muslim woman from West Africa had an appointment to be fitted with a stérilet or IUD. I remember being slightly nervous as this was my first real job, and it was so bizarre because here I was with someone who was of a different gender, religion, age and culture than me. Talk about bridging the gap!

So we are in the waiting room and I'm translating her sexual and medical history intake form. How many sexual partners have you had in your lifetime? What types of birth control do you practice? Have you ever had a sexually transmitted disease? Have you ever been sexually abused? You know, that type of thing. A little different from the French we used to analyze Proust in college or order a panini in Paris. I'm thinking to myself, this woman would surely be more comfortable if we had at least one thing in common, preferably gender. The next thing I know, I'm standing on the other side of a curtain telling her to relax, and how to identify the small string attached to the end of the IUD used for retrieval should the need arise.

It often happens that while I'm doing this thing, facilitating communication, cultural brokering, bridging the gap, IUD fitting, whatever you want to call it, the doctor or lawyer or whoever will be standing there telling me what a beautiful language French is and how much they loved their recent visit to the Versailles gardens. Oui, j'aime le stérilet. Donnez-moi le stérilet, s'il vous plaît. Que c'est beau!

The medical interpreting jobs are actually my favorite. In fact, those jobs combined with volunteering at the hospital and working as a standardized patient where you pretend to be sick and medical students practice giving you a history and physical, like on Seinfeld are what convinced me that I should apply to nursing school.

After a few months of the medical interpreting, some random voice over jobs and text translations (of which the most interesting was an extremely long and boring police report from the Hague for an international terrorist case), I got on with another agency that specialized in legal interpreting and had an exclusive contract with the Department of Education. Basically, they send me to schools and for EBTs or depositions, mostly for car accident type situations but sometimes for more exotic cases, like the French lighting designer who was being sued because a spotlight fell on someone during fashion week.

As far as schools jobs, there are discipline hearings, parent teacher conferences, PTA and board meetings, and finally, school closures. Attending a nice little private school in Tacoma, Washington does not prepare you for the New York public school system. People in suits from city hall (okay the DOE, but it's the same to most of these poor parents) swoop in to assure parents that their school isn't being closed, it's being phased out. Then they run over a few statistics and aphorisms and spend the rest of the time stonewalling the parents' real concerns, questions, fears and anger.

I'm in the corner with a headset doing simultaneous interpretation for anyone with earphones who needs French. Sometimes, if there are only a few people--and I've been to meetings where there are only four parents total--I will sit just behind or next to the French speakers and do what they call whispering. This has led to some funny situations where a parent turns to me and starts asking me questions or telling me how they just want their son or daughter to have a good education. At what point do you just steamroll ahead and continue interpreting, and at what point do you give up and start trying to listen to and talk to the parent? I usually gave up (if that is the correct perspective) pretty quickly and started trying to encourage them to talk to their teachers (in what language?) about how their children were doing and what they could do to help. How do you say "the squeaky wheel gets the grease" in French? Answer: les rouspéteurs obtiennent toujours satisfaction.

Maybe this was another sign that this wasn't the perfect career for me. The interpreter is supposed to be invisible, without opinion, behind the scenes (gulp!), a mere reflection of the interlocutors and their agendas.

I am called to interpret for several school closures. The craziest is a school right in the Upper West Side, so close to Central Park West and the swanky residences thereon that you would be surprised to find a 95% Black/Latino school, where 68% of the students come from Title 1 homes, 30% don't speak English and where only 33% of students graduate in four years and about half never graduate at all. This school has more security than an Israeli airport (I can't help this one off-topic rant: why is our airport security so reactionary, slow and ineffective? Someone tried to sneak a bomb in their shoes and we all take our shoes off. Someone tried to sneak explosives in liquid and we no longer are allowed to bring water bottles or toothpaste on the plane. If someone invents explosive underwear, we will all be flying naked. All we have to do is send someone from Homeland Security to Israel for a few weeks to see what real efficient and effective airport security looks like and the problem would be solved.) Anyway, back to this public school; I am not joking or exaggerating when I tell you that the school entrance has four metal detectors, two hand held detectors, two bag scanners and about twelve DOE security guards. I don't know about education (well actually I do, because the school is closing), but as far as security goes, no child is being left behind.

I've also interpreted for several standardized tests. We are talking about little 6th graders filling in ovals about science or reading comprehension. This is another situation where I have to remind myself of maintaining a professional code of conduct. The educator in me has a hard time sitting by while little Johnny is blindly copying out sentences from the reading passage and attaching them to phrases from the question. Why? That's what our teacher told us to do. Deontology gets left behind as I watch little Fatima start blindly adding and subtracting numbers from the word problem. Are you sure you don't want me to explain what the French word moyenne (average) means again?

Another interesting job is doing an IME or Independent Medical Examination. This is when you have an injury compensation claim and the government or insurance company wants to be sure that you are really injured or not before they give you money or before they cut you off. The examiner is a doctor who is not allowed to treat you, only examine you and fill out the necessary paperwork verifying that, yes, indeed you are or are not broken. After waiting for over an hour and a half with a very nice Haitian man, our IME lasts about 3 minutes. The doctor, who does nothing but IMEs all day long, ushers us in, asks two questions, tries to get my guy to touch his toes and then vaguely swings a reflex hammer at his leg (the patient hasn't even taken his jacket off, let alone his pants), all with one hand in his pocket. Nice.

Like many aspects of welfare and social support networks, I'm sure there is a certain amount of cheating and freeloading with injury claims. No system is perfect, right? But I can tell you that the vast majority of the people in that waiting room were poor, tired, huddled masses of lower income, marginalized, powerless members of society. To add to these crimes, they have literally broken their backs at their low paying jobs and now have to fight to prove it in order to receive medical treatment and support. I really would love the people who go off on the bleeding hearts and socialists to spend a few hours in an IME or foodstamp waiting room and then decide if scrapping for a couple hundred bucks of Wellfare is really such a cushy, free-ride for lazy people. It certainly doesn't encourage dignity or independence, but that has nothing to do with the pittance people are being given. Did you know that basic SSI in New York for an individual living alone is $761 and you get less if you live with someone or make any income. Could you live on that? This is not a free ride, it's a rundown, bumpy, unsanitary slide into depression.

That's it for the fun tales of moral 'terpitude; though I have to share one more story which seems to fit with this theme of big city life. As part of preparing to go back to school, I have to renew my CPR certification. The last time I took CPR was in high-school, so I was looking forward to a professional AHA certified experience, and this one would be specifically for medical professionals. True to form, the class is a little Hobroken. Okay, that's maybe more of Jersey thing than Brooklyn, but I think it works. Although we have the dummies to practice on, we spend most of the class fast forwarding through the DVD. Periodically the instructor hits pause to make a joke about how everyone in the video seems to cardiac arrest in or near or a hospital, share a story from back in his EMT days or emphasize that we really should remember this point because it's like the first question on the test and a lot of people seem to get it wrong. A couple of times he tells us not to bother getting down out of our chairs to practice the technique on the dummies because he doesn't want to tire us out. One kid arrives late, something like half way through the class. When he asks if he can still jump in, the instructor tells him no problem. As long as he passes the test. Now my memory of the CPR class I took in high-school was that we had to take a written test as well as perform CPR on the Ressucit-Annie in front of the instructor who is holding a pump behind his back to control the doll's pulse and everything. My two-year health care provider certification is achieved after watching a 30-minute video, practicing compressions for about two minutes and then filling out a multiple choice test, for which we have been well, well warned and prepped for.

Kind of like that first test I took to become a professional medical interpreter in the New York Public Hospitals... And so la boucle est bouclée, as the French say. We've come full circle or loop de loop, in other words. From the perspective of a soon to be former freelance French interpreter in New York, 'loopy' seems like the right word to describe it all. Le mot juste, quoi.

Read More...

Summary only...

Putting the Capital in Punishment

Let's talk about one of America's most rapidly growing businesses. Maybe you've heard of it, it's a huge industrial complex and it's even recession proof. I'm not talking about health care, I'm talking about incarceration. You know, detention centers, correctional institutions, jail, lockups, the slammer. In fact, the United States leads the world in producing prisoners, with less than 5% of the world's population and nearly 25% of its inmates. According to a recent study by the PEW center, 1 in 31 adults are now behind bars, on parole or on probation. The number gets even scarier when you add the amount of people being employed by the system. And this is another sector of society that we've allowed to be privatized. Sure, we say let's outsource it; we'll laissez-faire capitalism and the almighty bottom line sort things out. The market knows best. What could go wrong, right? Let me count the ways...

Of the many things that I think are wrong with our correctional system (like the fact that it doesn't do a whole lot of correcting), the one that I'm on about today is how we have let it fall prey to privatization. Ooh, scary word, could it be even scarier than the "n" word (nationalization)?

Let's imagine what might happen when people can make a profit from prisons... Some greedy old judge high up on his bench cuts a deal with the local prison provider to act as a head hunter. He'll guarantee a certain number of convicts per day and in exchange he gets a sum of cash left under his doormat. Maybe he can even offer preferential treatment in the bidding system, or for a little extra, a sweetheart deal giving exclusive incarceration rights to his new found pen pal...

And this goes on for how long? Let's say 7 or 8 years. Okay, I didn't make this up. It already happened, and was in the New York Times. Big surprise, there were actually two greedy judges getting kickbacks, and, yes it took seven years before Mark A. Ciavarella Jr. and Michael T. Conahan got caught. Now they're both going to jail. Oh yeah, did I mention that they were railroading juveniles? Shanghai some kids to your friend's jail which is overbilling and overcharging for it's services? Nice. How much is that worth? Probably 7 years in jail. The only remaining question for me is whose facility will they be doing time in and who will be profiting from it?

Now don't get me wrong, I'm not against making a buck. I just think there are a few things that should not be based on a profit model. It's the principal of principal. Incentives work too well, "where there's a will (or money), there's a way (to get it)". There is just too much at stake sometimes to risk using them, whatever efficiencies or innovations they attract.

There should be no financial incentive to killing people, for example. This is why we shouldn't outsource our army, and why we should be real careful about how we dole out our military contracts. Another example, I'm real wary of a hospital that is deciding what's best for me based on what's best for its bottom line. And then there's education: when schools compete, what happens to the kids in the losing school? I think it's the same thing for jails. Crime shouldn't pay, neither for the criminals nor for anyone else. Otherwise it becomes a Stay Puft Marshmallow Man type situation. You remember Ghostbusters. It's the self-fulfilling prophecy. The more people are paid to make prisoners and prisons, the more they will make prisoners and prisons. Is that the kind of incentive we want for our country?

Read More...

Summary only...

What happens in Vegas...

What happens in Vegas... really should stay in Vegas. I recently went back for a second annual east-coast-west-coast reunion weekend. We had a ball, and you can see the highlight video in my blog's video box or on youtube. Drinking and gambling and stuffing your face with steaks and riding ATVs in the middle of the desert and the lights and the fake décors and breasts is fun, don't get me wrong, but there is no getting around the fact that Vegas is a crazy place and that being there as a sentient being you are sort of morally obliged to vacillate between states of extreme titillation and nausea, energy and exhaustion, winning and losing, control and addiction.

Vegas runs a Carnival atmosphere year-round, a Carnival that never leads to Lent. Or rather it's a very private form of Lent as you board your plane home and sink into a small row of seats to pray for redemption and better luck next time and a decent night's sleep in the next eight high altitude hours. Carnival has always been a reversal of rules, an important time when the poor can don masks and parade as the royal and powerful and the wealthy can do the reverse. And then everyone copulates in the streets, without regard to race, creed, color or blood alcohol level. It has traditionally, and perhaps in more spiritual and respectful forms, played an important escape valve function for many societies. It can be such a relief to blow off a little steam and not be yourself, in your skin, for a little while that we are happy to return to our problems and start daily life fresh again... even if that means being a servant to the fat guy on the hill with all the beans.

And so it is that after four days in Vegas (which is equivalent to like six days anywhere else if you count waking hours), I return home tired and happy to have gotten out alive. Yes, let me shove into a crowded subway car where everyone ignores each other and hides behind newspapers and ipods--at least they're not white-trash, wearing ridiculous clothes, staggering around and yelling things like "Who's the man? Who is the man!?!"

There is definitely something to be learned from poker. Sure some of the games are pure chance like roulette or slot machines, but playing them can be a lesson in the ups and downs, the cycles of life. Poker, particularly Hold'em, is a real interesting study in risk analysis. You can analyze the possibilities (how many cards or hands can beat mine), the people, the odds, the position on the table. People say that playing poker is all about bluffing, but that is so wrong. It's about playing the cards you are dealt, in the position you are in, with the people at your table, with the amount of money you have to the best of your ability. And that, without stretching it too much, is life. Whether you are getting a job, a house, or a date, you are going to have to do some risk taking, or at least risk assessment. Playing poker gives you some practice in assessing and taking risks. You learn not to put all your eggs in one basket, to play a strategy over time. May be you win some, may be you lose some, but hey get used to it, that's life. The one thing you can control is making the right moves that are right for you over the long haul, and you want to be in it for the long haul. It's great to splash the pot now and again for a little excitement and Shamwow! fun, but you want to be able to martial your resources so that you can stay at the table for as long as possible. It's another case of walking down the hill and... seeing some flops, my friends. So let's get stuck in there!

But I digress. Let's just say that I think you can really learn some valuable life lessons from playing some poker.

You definitely see a lot of different types of people in Vegas, but especially people who like free alcohol, bad entertainment, and the chance to win big. Maybe because of it's geographical location, there are a higher percentage of people from the midwest and maybe because they have the time and can afford to spend a little of their nest eggs, you see a fair number of older couples. Unfortunately, you don't find a lot of people displaying good taste, sensitivity, compassion or culture. This is definitely the downside of Vegas and the part that can get you a little depressed about this great land and people of ours.

The thing that really grosses me out is the excess. There is definitely this trend towards the cattle-ization or chattel-ization of people. First there are the omnipresent electric walkers, which reminds me of the movie Wall-E where everyone is overfed and overstimulated and confined to perambulating barka-loungers. Then there are the strap-on containers of alcohol. You actually see people stumbling around drunk out of their gourds, their eyes as large and glazed as any bovine with large containers of Margarita strapped and dangling from their necks like feeding troughs (I am modeling one at the top of the page--they also come in 3' Eiffel Towers!). Finally, there are the people who tether themselves to slot machines (see photo above). You get these cards on a bungee cord around your neck which automatically tally up your winnings and losings from the machines, and which cut out that whole annoying step of adding more money to the machine. To paraphrase Dean Wormer addressing the Delta house: "Tetanized, drunk and tethered to a slot machine is no way to go through life, son."

Read More...

Summary only...