Saturday, September 29, 2007

Communication Skills



One great thing about my friends Anne & Jeff Kayser is that they keep me up-to-date on communication skills. They are experts at difficult communications, having learned from experience with their autistic son Thomas. Tom is a sweet boy and David and I enjoyed spending time with him and his parents last night at dinner. He communicates so much better than he used to, and is delightful to be around. He tells jokes! And his jokes are funny!

Anne and I are in SpiritFish, a group of writers who get together about once a month to share our writings and encourage each other to hone our craft. One of the members shared a YouTube video with us yesterday that Anne & I watched together. You can see it here. It's about a person who is autistic describing their language processes. Judge for yourself.

But what I found even more delightful was an email exchange between Julia (who is at Stanford) and her little brother Tom.

From: Julia
Sent: Wednesday, September 26, 2007 6:19 PM
To: Anne Kayser
Subject: For Tom

Hi, Tom! How are you doing? How is school? Is running on the cross country team fun?I miss you. Today I missed you so much that I hummed Leroy Anderson's "Bugler's Holiday!" What track number is that?

LEIFO EATS WORMS!

I love you! I'll see you on the computer again on Sunday night at five o-clock.~Julia

To which Tom replied:

Dear Julia

Leroy Anderson's Buglers Holiday is track number 13

Mommy's corvax! How are you doing? Do you get sunscreen on the dogs ears ?

I'm running with Matt. Do you miss Julia? I love you Julia. Do dogs get sunburned? November 22 we fly to Florida ! dogs don't get sunburned that's silly! Are you telling jokes!
Julia will be home for Thanksgiving. I like turkey!

Love Tom

I wish any of my four brothers communicated this nicely with me and, at the very least, told me that they loved me.

Tuesday, September 25, 2007

Julia at Stanford



My dear friend Julia Kayser, who was a little baby girl not long ago, just started college at Stanford in Palo Alto, or "tall stick" as she tells me that translates. As you can see in her picture she sent, she has come down with an infectious disease which has destroyed her normally beautiful skin. It's too bad she's not having a good time at school. My prayers go out to her that the antibiotic starts working real soon.


Just a few days ago, when Anne & Jeff dropped her off, and before the rash, she seemed happy with her new roommate, especially when I promised to send the sauerkraut that John Stevenson's neighbor in Tenino made and canned sometime in the 20th century, and which I still have sitting in a corner of my basement gathering dust. Wait! I've got to send the sauerkraut soon! It must have antibiotic properties in it that will clear that skin rash up right away!

Deep Water, Sea Disaster


Last Sunday night David and I visited Cinema 21, a local avant garde movie theater in NW Portland, to see the British documentary Deep Water. This is the disturbing story of an around-the-world single-handed yacht race back in 1967-1968. A single-handed yacht race means that one person pilots one yacht around the world. It takes a little less than a year to do this, and is quite a grueling adventure that only the most responsible, experienced yachtspeople should undertake.

Deep Water is the true story of an occasional weekend British sailor who takes up this cause because he is in desperate financial straits and thinks he can win for the money. As anyone knows who has been to sea in a yacht, there are always problems, either with your boat, the rigging, the food, or with your physical body and/or soul.

As I've always heard: there are two kinds of people in the world. People with the boat dream, and people without the boat dream. Don't head out to sea unless you have an insatiable boat dream. Otherwise, it ain't worth it.

I simply wouldn't do it unless I had absolutely no other choice. The romance of it all wears off pretty fast when the first big swell comes by and washes over you, rocking and rolling the boat underneath you mercilessly. Landlubbers like me need as firm a terra firma as we can get.

Friday, September 21, 2007

The Doctor Is In, If You're Under 40

As many of you know, I work in health policy. I know a lot about the practice of medicine in this country. So this story that hit the blogosphere today struck my fancy: A young doctor in NYC has set up a virtual practice, limiting his patients to the under 40 crowd. He doesn't see people over 40 because they could be *big gulp* actually sick. He charges people with insurance less money than he does people with cash (and they say medical schools don't teach doctors how to make money). Hospitals and clinics aren't "his thing." To get a better idea of this plastic, fantastic doctor, see interview below.

I sincerely hope he is flooded with hypochondriacal phone calls from 20-somethings with major mental illness. Is that mean of me?

How did you get the idea to do this?

Well, I’m not a typical doctor. I get along fine with other physicians, but I didn’t enjoy the hospital or clinic environment. I’m a photographer as well. I shoot for Men’s Journal and stuff like that.

Are there any special hurdles to running your practice this way?

No, not really. You have to have your New York State license. The e-visits are more for things like acne, allergies and follow-up labs. Things that aren’t life-threatening. There’s no way in hell I would prescribed narcotics online. It’s a kind of telemedicine. People have traditionally used it for access [for care in rural areas]. I’m looking at it as a way to practice convenient medicine.
Is your service cash only?

If somebody has insurance, I’ll charge them less and provide them with receipts. You can get cheaper care. But you can’t get it immediately, nor will you get care where people will help you spend your money wisely. I’ve spent the the last two or three months calling physicians associated with the best hospitals in New York City and getting their prices. I called one radiologist and found he’d do a chest X-ray for $75 and another would charge, say, $300. For cash-paying patients the prices are all over the place. I’ll make referrals based on quality and price.
What’s your online process for taking a patient?

I have a few questions that I ask whenever patients contact me. Name, age, that sort of thing. If they’re over 40, I’m not going to see them. The disease profile changes after that. If you’re under 40 you have the same disease profile as an older child, adolescent or young person that I saw during my preventive medicine and pediatrics training. I’m not going to deal with people who have old-people diseases.

How many patients do you think you’ll take on?

I want to keep this small. About a 1,000 patients. It fails in its mission if it’s a large corporate thing.

Without an office, how will you pull this off?

I run this entire thing off my iPhone and a laptop. I can access any patient records from my iPhone. Patients can make an appointment on my website and it’ll text me and I’ll go see them. This is, to me, what’s missing from medicine: personalized attentiveness. Going to someone’s home allows you to get to know them ridiculously well.

Monday, September 10, 2007

Astronomy, Science, The Proving of Theories



Back in 1919 a famed British astronomer, knighted for his deeds, embarked upon a journey to prove Einstein's Theory of Relativity.

Sir Arthur Stanley Eddington took two teams of scientists to spots on the equator to measure the bending of light from stars during a solar eclipse. This would prove Einstein's theory of relativity, that asserts that gravity is the result of a distortion of space-time by massive objects. Even light cannot ignore this rule of space, so the theory predicts that light rays from distant stars should bend slightly as they skim past the Sun. When blotted out during a total solar eclipse, the bending should be visible, or so thought Eddington.


At the time his conclusions were published, it was a major news story around the globe. According to Wikipedia, when asked by a reporter whether he was one of only three people in the world who understood relativity theory, he quipped "Who's the third?"

His measurements proved Einstein's theory correct: but ever after, people have spent time dismissing his "proof" and claiming that Eddington wanted Einstein to be correct (for several reasons, including political ones) and therefore over-interpreted his findings to come to the conclusion that he wanted.

Today, researchers have found that Eddington is, indeed, correct and that he did not bend his data to find the conclusion that he wanted. Which goes to show, science is not infallible and we all must learn and re-learn the same lessons again. While he was alive, however, his theories were constantly being challenged and he was discredited in a couple of different ways. He died in 1944 in Cambridge, England.

This week's story in Nature vindicates an honorable man. You see, Sir Arthur Eddington wasn't just a British astrophysicist from another era, he was also a cousin to my husband's grandmother (Minnie Shout Wilmott). Eddington met once with David's mother, Mary Wilmott, at Cornell where they walked the Gorges together. David reports that his mother always told him that he was a fascinating man, a Quaker, and a deeply ethical human being. It means a lot to David to see this week's story vindicating his distant cousin's work.


And now we know where David got the astrophysicist gene from!

Saturday, September 8, 2007

Oregon's Feeling about Hanford

It is quite sad, and telling, that the only active opposition to the US Department of Energy dumping more hazardous nuclear waste at Hanford seems to come from Oregon, those downstream from the project. Senator Wyden is up on the issue, and his statement, reprinted below, captures the feelings of those in Oregon who face disaster should Hanford's nonsense and foolishness get out of control.

Statement of Senator Ron Wyden
Opposing the Department of Energy’s Plans to Increase
Radioactive Waste Disposal at Hanford Nuclear Reservation
Troutdale, Oregon
August 27, 2007

The Hanford Nuclear Reservation is already one of the most polluted places on the planet. It currently stores more high-level nuclear waste than any other site in the United States and it is not safely managing all the nuclear waste it already has on-site today. And now, the Department of Energy (DOE) proposes to use Hanford as a national nuclear waste dump. The bottom line is the Energy Department should not be adding more waste to Hanford when it isn’t safely handling the waste it already has on-site.

The Energy Department and its contractors have a long history of mismanagement and failures to protect public health and safety at Hanford over the past twenty years. A report by the contractor responsible for the Hanford tank farms, which store 53 million gallons of highly radioactive and toxic wastes, indicates that removal of all these wastes just from the aging and leaking single shell tanks would not be completed until the year 2032. And even that far off date was based on an invalid assumption that the treatment plant to vitrify these wastes would begin operating in 2014. With recent problems and delays, the waste treatment plant won’t start operating until 2019 at the earliest. Hanford is decades away from dealing with the waste it already has on-site. Sending more waste to Hanford will mean more delay of the cleanup and more danger to workers at the site and the one million people who live downstream.

Just last month, Hanford had a spill of high-level nuclear waste while retrieving it from the single shell tanks that endangered workers at the site. I have requested that the Defense Nuclear Facilities Safety Board, an independent DOE safety oversight agency, investigate this spill as well as the entire single shell retrieval program.

Given the long history of mismanagement of waste cleanup at Hanford, the Energy Department’s proposal to bring more waste to Hanford is essentially a proposal to turn Hanford and the Northwest into a national sacrifice zone.

According to news reports, DOE is now planning to dispose of an additional amount radioactive waste at Hanford that is equal to the contamination estimated from the Chernobyl nuclear reactor meltdown, or about three-quarters of the radiation contained in 177 leak-prone underground tanks already located at Hanford.

The waste under discussion at today’s hearing is the most radioactive in the low-level category. Federal officials concede that some of it is as radioactive as high-level waste, which includes spent nuclear fuel. The inventory is also likely to contain "transuranic waste," often contaminated with plutonium and likely to remain radioactive for thousands of years.

As many of you know, I have long been concerned about the DOE’s history of unkept promises to clean-up Hanford. I say, enough is enough. It’s time to address the current problems and not add additional risks and dangers by adding huge volumes of additional nuclear wastes to Hanford. Over some 45 years, Hanford produced some 74 tons of plutonium, first to make nuclear weapons and later as part of its continued operation of the N-Reactor despite the fact that it was no longer needed. The results are well known to all. Some 1,600 identified waste sites. Some 53 million gallons of high-level waste stored in 177 underground storage tanks. Sixty-seven of those 177 tanks are suspected to have leaked that waste into the soil. The list goes on.

What is amazing to me is that DOE has now been trying to clean up the nuclear waste and environmental contamination for half as long as the site was actually in operation – more than 20 years – with no end in sight. We are now coming up on the 20th anniversary of the signing of the Tri-Party Agreement between DOE, the State of Washington, and the U.S. Environmental Protection Agency that was supposed to set specific, enforceable milestones for the clean-up. Instead, we’re miles away from meeting those cleanup goals.

In March of this year, the U.S. Environmental Protection Agency issued a fine of more than $1 million for the failure of DOE’s contractor to properly manage the existing low-level nuclear waste disposal facility – the Environmental Restoration Disposal Facility. This fine shows that DOE is not properly managing the low-level nuclear waste it already has on site. How can the Department be seriously considering sending more of the same waste to Hanford?

The situation with Hanford’s high-level nuclear waste is even more troubling. The high-level waste vitrification plant was supposed to be completed and in operation by 2011 according to the Tri-Party Agreement. It is now being delayed another eight years and construction won’t be completed until 2019 at a cost that has more than doubled – from $5.8 billion estimated in 2003 to this year’s estimate of $12.3 billion. And the plan still leaves no solution for more than half of the so-called low-activity waste that is supposed to be removed from the tanks and which also has to be vitrified. There’s still no plan for dealing with the waste that has leaked out of the tanks. There’s still no plan for dealing with strontium and cesium capsules that have been retrieved from all over the country from another failed DOE program to spin gold out of nuclear waste.

In March 2006, I requested that the Inspector General conduct an investigation into the safety of the waste vitrification plant after a former employee of Bechtel National, Inc – the U.S. Department of Energy’s principle contractor for the Hanford Nuclear Waste Treatment Plant Project – raised concerns about his former employer’s use of unproven and flawed control systems.

Last May, in response to my request, the DOE Inspector General issued report which stated that the control system intended for use at Hanford, “does not meet the stringent procedures, plans specifications, or work practices associated with nuclear quality standards.” I subsequently wrote to Energy Secretary Bodman asking what the Energy Department planned to do to address the Inspector General’s findings. I have yet to receive a substantive response from Secretary Bodman. This hardly inspires confidence in DOE’s ability to safely process the high-level tank wastes any time soon.

My point here is a simple one. DOE has not fulfilled its obligation to clean up Hanford. It’s not clear when it will. But now, DOE is proposing to bring more waste to Hanford – this time in the form of waste from commercial nuclear power plants, medical wastes and other nuclear processing facilities.

Hanford should have less nuclear waste, not more. It should be cleaned up, not dumped upon. So, today, I am putting myself on the record as being fiercely opposed to DOE’s plans to dump more waste at Hanford and I will do everything in my power to fight to keep it from happening.

3:10 to Yuma

David and I had a night at the St John's Cinema & Pub for dinner and a show. It's a great place to see a movie because you can order pizza and a drink for a reasonable price and sit and eat it while you're watching your movie.

3:10 to Yuma is an excellent, excellent movie. I couldn't believe my eyes, truly. This was made in Hollywood? Has Hollywood come to its senses about the value of a good story, interesting character development and smart dialog?




The answer seems to be 'yes.'

Russell Crowe (Wade) is a truly creepy and brilliant outlaw intent on making a livin' the violent way, along with his sickly devoted psychopathic gang. Ben Foster (Charlie) plays a sociopathic side-kick of Wade's intent on garnering Wade's release from the iron grip of the law, or at least the railroad law intent on having him hanged for thieving. Christian Bale (Evans) is astounding as the quiet, beaten-down one-legged Civil War veteran/rancher tempted by much-needed funds to do what he shouldn't get involved with in the first place.

It's probably a better idea not to read the short story by Elmore Leonard before you see the movie. David had read the story; I had not. I liked the movie a lot; David was disappointed. I caution those seeing it: there's a lot of ways to tell a story. Movie-making and book-writing can be two different experiences, but each is valuable in its own way.

Kudos to the director, James Mangold, who also directed "Walk the Line" (the story of Johnny Cash and June Carter Cash).

Roger Ebert (Chicago Sun-Times) gives it a thumbs up and says of James Mangold:

"To remake "3:10 to Yuma" seems an odd choice after such other modern films
as "Girl, Interrupted," but the movie itself proves he had a good reason for choosing
it. In hard times, Americans have often turned to the Western to reset their
compasses. In very hard times, it takes a very good Western. Attend well to Ben
Wade's last words in this movie, and who he says them to, and why."


http://view.break.com/315989 - Watch more free videos

Tree Planting - November 14, 2009 - Omaha Street Parkway