I remember seeing a cartoon with a two-part panel.
In the first panel, a young man who has obviously struck it rich is talking to his unkempt parents outside their tiny, falling-down shack in some hillbilly enclave. Now, he tells them with a proud smile, he can buy them the home of their dreams.
The second panel shows him returning, to be confronted with the same falling-down shack, built 100 times bigger.
There's a message in that, and the recent legal problems of Atlanta Falcons' quarterback Michael Vick provides yet another. Both speak to one of the more enduring beliefs in our society, that having lots of money automatically makes you a different (and, theoretically, better) person.
Sure, it happens. Unfortunately, though, most of the evidence is stacked to the contrary. The history of lotteries in this country is full of sad stories about people who won millions, then burned through it in short order.
Athletes provide a particular cautionary tale here in the 21st century. Many of them come from grim inner city neighborhoods or hardscrabble rural areas. Why? Because those settings toughened them, and allowed them to take their natural athletic ability up a notch. Moreover, many come to see their their future as a stark choice between athletic success or poverty.
As a football coach once told me: "The kid from the suburbs would like to make the first team. The kid from the slums has to make the first team."
Again, there are exceptions, but Vick isn't one of them. He grew up in a marginally rough section of Newport News and was defined early on by his athletic ability. He struggled academically at Virginia Tech, and has never come across as a particularly articulate or educated individual. A regular guy, in other words, who happens to possess otherworldly physical talents.
Eventually, those talents earned him multi-millions, but he's still the same person. Is he going to join one of Atlanta's elite social clubs? Is he going to suddenly start hanging around with college presidents and bankers and software savants? Probably not, because he has nothing in common with those people beyond his bank balance, and perhaps their adoration of him.
So who does he choose for friends? The guys he grew up with. Some pro athletes actually transplant their pals from the old neighborhood to wherever they happen to be performing. That's a sweet deal for members of the "entourage," and the party is usually on their old buddy who's made good.
Except that when the jock in question has roots in a rough subculture, that entourage can get out of hand. As in the case of Baltimore Ravens' linebacker Ray Lewis, who nearly spent the rest of his life behind bars after one or more of his "friends" stabbed two men to death outside a nightclub. Or Tennessee Titans' defensive back Adam "Pac Man" Jones, two years removed from West Virginia University, who caught some of the blowback when a bouncer at a Las Vegas strip club was shot and paralyzed by an entourage member.
The rest of us feast on such lurid tales. We love it when an actor or a rock star or a quarterback turns out to have feet of clay and a rap sheet.
What we should be thinking about, though, is our generally skewed perspective on money in general.
We can fantasize, as most of us do, that one day we'll win the lottery or be gifted by a forgotten rich relative or (in the case of many newspaper reporters) write the novel that will become a cash cow.
It's good to dream, but we need to realize that even if our ship does come in, we'll still be who we are. And if we're not ready to properly receive it, our good fortune is apt to fly away.
Especially if that ship turns out to be full of pirates.
Saturday, September 1, 2007
Sunday, August 12, 2007
Would you like to be President? We can help
C'mon, you know you could do a better job than the guy in the White House.
If only you could come up with the money. If only you could raise your name recognition to a national level. If only your boss would give you a couple of months off to campaign.
The coffee shops and bars and boardrooms of America are filled with people who think they could transform the Oval Office, if only they had the chance. Maybe you're one of those who stare in disbelief at their TV sets and crumple their newspapers at the breakfast table and mutter: "What are they thinking?"
So here's your chance to shine, in a very limited way. Just like God (in the person of Morgan Freeman) gave Jim Carrey the chance to be God of Buffalo in "Bruce Almighty," we at the News & Advance would like to make you President of the United States. Sort of.
Here's the deal. Between now and next January, when the primaries begin, we're offering you the opportunity to tell us how you would fix some of the things you think are wrong with this country. Or bolster what you think is right.
What would you do if you were the man or woman in charge? How would you get us out of Iraq? Or do you think we should stay there? How do you feel about the national debt? Global warming? The separation of church and state?
We'll find a panel of astute people to sort through all of your suggestions and narrow them down to five candidates. Then, we'll give each of those who make the cut the opportunity to deliver a short campaign speech that we'll post on video on our Website. We'll also publish your ideas in the newspaper. Then, we'll throw it open to a general vote of all our readers.
The finalists will not be chosen on the slant of their ideas -- we will hold no prejudice toward left, right or center suggestions. Indeed, it will be a much better election if we have an ideological range. The key will be whether your suggestions are clearly thought out and presented. Nor do you have to be an Ivy League graduate -- common sense will count just as much as an advanced degree.
So think about this, and take your time -- you've got several months. We'll also probably reward the person who's elected in some way, although that's still in the talking stages. You can e-mail us your ideas, or mail them.
If you'll notice the previous blog on this site, I've thrown out a few of the many issues you could discuss. I'm sure you have your own.
The only rules are these:
1. We want you to suggest a platform of your own, not simply criticize what's being done now. Pretend that there's a vacancy at the top, and you're starting from scratch.
2. We want you to be serious. Any suggestions like "Give everyone a million dollars" or "Legalize crime" will be chuckled at, then discarded.
3. Stick to national and international issues, not state and local.
So give it a shot. Who knows? Maybe you can even make it onto the national ballot from here.
If only you could come up with the money. If only you could raise your name recognition to a national level. If only your boss would give you a couple of months off to campaign.
The coffee shops and bars and boardrooms of America are filled with people who think they could transform the Oval Office, if only they had the chance. Maybe you're one of those who stare in disbelief at their TV sets and crumple their newspapers at the breakfast table and mutter: "What are they thinking?"
So here's your chance to shine, in a very limited way. Just like God (in the person of Morgan Freeman) gave Jim Carrey the chance to be God of Buffalo in "Bruce Almighty," we at the News & Advance would like to make you President of the United States. Sort of.
Here's the deal. Between now and next January, when the primaries begin, we're offering you the opportunity to tell us how you would fix some of the things you think are wrong with this country. Or bolster what you think is right.
What would you do if you were the man or woman in charge? How would you get us out of Iraq? Or do you think we should stay there? How do you feel about the national debt? Global warming? The separation of church and state?
We'll find a panel of astute people to sort through all of your suggestions and narrow them down to five candidates. Then, we'll give each of those who make the cut the opportunity to deliver a short campaign speech that we'll post on video on our Website. We'll also publish your ideas in the newspaper. Then, we'll throw it open to a general vote of all our readers.
The finalists will not be chosen on the slant of their ideas -- we will hold no prejudice toward left, right or center suggestions. Indeed, it will be a much better election if we have an ideological range. The key will be whether your suggestions are clearly thought out and presented. Nor do you have to be an Ivy League graduate -- common sense will count just as much as an advanced degree.
So think about this, and take your time -- you've got several months. We'll also probably reward the person who's elected in some way, although that's still in the talking stages. You can e-mail us your ideas, or mail them.
If you'll notice the previous blog on this site, I've thrown out a few of the many issues you could discuss. I'm sure you have your own.
The only rules are these:
1. We want you to suggest a platform of your own, not simply criticize what's being done now. Pretend that there's a vacancy at the top, and you're starting from scratch.
2. We want you to be serious. Any suggestions like "Give everyone a million dollars" or "Legalize crime" will be chuckled at, then discarded.
3. Stick to national and international issues, not state and local.
So give it a shot. Who knows? Maybe you can even make it onto the national ballot from here.
Some issues politicans avoid at any cost
I think we can see where this is going. The 2008 presidential election is going to be all about Iraq (with maybe Iran and Afganistan thrown in), to the exclusion of almost everything else.
Of course, a lot can happen between now and then, but chances are the same vitally important domestic issues are going to be ignored yet again.
That's probably because they are difficult, prickly head-scratchers that don't lend themselves to TV soundbites. They may, however, lend themselves to solutions, if we'd just talk about it.
It seems to me that we often squander the true value of our elections. Besides deciding (in theory, at least) who is most fit for an office, they also open the floor for debate on the pressing questions of the day. Locally, it might be whether this section of a county should have sewer service or that section should be re-zoned. Nationally, the stakes are much higher.
All too often, though, debate is not what happens. The candidates either attack each other personally, or drone on about how they'll never raise your taxes. The things that really matter are blown away by the hurricane of hot air.
So what does really matter here in America, in 2007? That's a subjective question, and your list may well differ from mine. But here's a starting point:
1. Health care. Sure, the candidates will talk about health care, but most likely in an abstract, pie-in-the-sky way that doesn't take in the realities "on the ground," as the popular saying goes.
Here's what I always wonder about: Why should it be the responsibility of the your employer to take care of your health care?
Think about it. Doing the same job, I would get one salary from the Amherst New Era Progress, another from the News & Advance, another from the New York Times. Those salaries reflect the resources each newspaper has available. In terms of my medical coverage, however, it would cost all of them essentially the same.
Put simply, this concept that business should shoulder the burden of health care is killing small companies.
So if business don't do it, who should? Maybe a coalition of some sort between government and insurance companies, throwing out a net that ultimately covers everyone. But any decision that's made has to involve doctors, hospitals and pharmacuetical companies. Instead of simply lobbying the government, these groups need to interact with it.
Of course, any improvements in the health care mess will mean ....
2. Taxes. We have the war in Iraq. We have a crisis in health care. The infrastructure is sagging (the Minnesota bridge collapse, case in point). We have an endangered Social Security system.
If you're a couple sitting at the kitchen table with your bills strewn about you, and you see red ink seeping onto the tablecloth, you're going to say: "Hey, we've got to come up with some more money from somewhere." Or, you might say: "We really need to cut down on our spending."
Americans have been convinced that we don't need to do either. Just put it on the national credit card, and we'll deal with it later. We accept financial strategies from our governments that would appall us personally.
We don't resist taxes because we're stingy -- Americans are among the most generous people on earth. The problem is, no one ever seems to equate taxes to services in any sort of direct way. Moreover, those of us in the lower and middle class brackets see the more fortunate gleefully driving Brinks trucks through gaping loopholes in the tax code on their way to the bank.
I think if a tax system were truly fair, Americans would buy into it (if not necessarily with a smile).
3. Social Security. A lot of us have a system in which our checking and savings accounts are joined at the hip. If you overdraw your checking acocunt, money is automatically drawn from savings to cover the deficit. The federal government has that, too -- the checking account is called the budget, the fallback is Social Security. They just don't tell you about it.
4. Prison/drug law reform. Again, politicians have failed us miserablly here. Besides "I'll never raise your taxes," the most popular mantra is "I'm going to be tough on crime." Common sense goes out the window. The fact is, putting someone in jail for making a poor lifestyle decision (i.e., possesing drugs) makes about as much sense as busting an overweight person in the McDonald's line, or hauling a workaholic out of his cubicle.
Sure, certain drugs are bad for you, but filling our prisons with young people who then become a drain on society doesn't seem a very good way to deal with thhat.
This is, like most of the problems we ignore, very complicated. Why not make the emphasis on getting people off drugs, thereby drying up the demand? Otherwise, we have the problem of convincing a 17-year-old with no future that even though he's making $1,500 a week, there are better alternatives. Which leads to ...
5. Jobs. Our society used to offer "meat and potatoes" employment, the kind you could get with a high school diploma and make a decent living from. Most of them were in manufacturing of some sort, and you could make a good living from them. Here in Lynchburg, you could work at the Lynchburg foundry, the shoe factory, the textile mill. Now, the choices seem to be hi-tech or fast food. Government can't solve this problem, but it's certainly something that needs to be addressed.
6. An alienated minority. We can ignore the plight (and, yes, the attitude) of the disaffected youth culture in the inner cities only at our peril -- and theirs.
Of course, a lot can happen between now and then, but chances are the same vitally important domestic issues are going to be ignored yet again.
That's probably because they are difficult, prickly head-scratchers that don't lend themselves to TV soundbites. They may, however, lend themselves to solutions, if we'd just talk about it.
It seems to me that we often squander the true value of our elections. Besides deciding (in theory, at least) who is most fit for an office, they also open the floor for debate on the pressing questions of the day. Locally, it might be whether this section of a county should have sewer service or that section should be re-zoned. Nationally, the stakes are much higher.
All too often, though, debate is not what happens. The candidates either attack each other personally, or drone on about how they'll never raise your taxes. The things that really matter are blown away by the hurricane of hot air.
So what does really matter here in America, in 2007? That's a subjective question, and your list may well differ from mine. But here's a starting point:
1. Health care. Sure, the candidates will talk about health care, but most likely in an abstract, pie-in-the-sky way that doesn't take in the realities "on the ground," as the popular saying goes.
Here's what I always wonder about: Why should it be the responsibility of the your employer to take care of your health care?
Think about it. Doing the same job, I would get one salary from the Amherst New Era Progress, another from the News & Advance, another from the New York Times. Those salaries reflect the resources each newspaper has available. In terms of my medical coverage, however, it would cost all of them essentially the same.
Put simply, this concept that business should shoulder the burden of health care is killing small companies.
So if business don't do it, who should? Maybe a coalition of some sort between government and insurance companies, throwing out a net that ultimately covers everyone. But any decision that's made has to involve doctors, hospitals and pharmacuetical companies. Instead of simply lobbying the government, these groups need to interact with it.
Of course, any improvements in the health care mess will mean ....
2. Taxes. We have the war in Iraq. We have a crisis in health care. The infrastructure is sagging (the Minnesota bridge collapse, case in point). We have an endangered Social Security system.
If you're a couple sitting at the kitchen table with your bills strewn about you, and you see red ink seeping onto the tablecloth, you're going to say: "Hey, we've got to come up with some more money from somewhere." Or, you might say: "We really need to cut down on our spending."
Americans have been convinced that we don't need to do either. Just put it on the national credit card, and we'll deal with it later. We accept financial strategies from our governments that would appall us personally.
We don't resist taxes because we're stingy -- Americans are among the most generous people on earth. The problem is, no one ever seems to equate taxes to services in any sort of direct way. Moreover, those of us in the lower and middle class brackets see the more fortunate gleefully driving Brinks trucks through gaping loopholes in the tax code on their way to the bank.
I think if a tax system were truly fair, Americans would buy into it (if not necessarily with a smile).
3. Social Security. A lot of us have a system in which our checking and savings accounts are joined at the hip. If you overdraw your checking acocunt, money is automatically drawn from savings to cover the deficit. The federal government has that, too -- the checking account is called the budget, the fallback is Social Security. They just don't tell you about it.
4. Prison/drug law reform. Again, politicians have failed us miserablly here. Besides "I'll never raise your taxes," the most popular mantra is "I'm going to be tough on crime." Common sense goes out the window. The fact is, putting someone in jail for making a poor lifestyle decision (i.e., possesing drugs) makes about as much sense as busting an overweight person in the McDonald's line, or hauling a workaholic out of his cubicle.
Sure, certain drugs are bad for you, but filling our prisons with young people who then become a drain on society doesn't seem a very good way to deal with thhat.
This is, like most of the problems we ignore, very complicated. Why not make the emphasis on getting people off drugs, thereby drying up the demand? Otherwise, we have the problem of convincing a 17-year-old with no future that even though he's making $1,500 a week, there are better alternatives. Which leads to ...
5. Jobs. Our society used to offer "meat and potatoes" employment, the kind you could get with a high school diploma and make a decent living from. Most of them were in manufacturing of some sort, and you could make a good living from them. Here in Lynchburg, you could work at the Lynchburg foundry, the shoe factory, the textile mill. Now, the choices seem to be hi-tech or fast food. Government can't solve this problem, but it's certainly something that needs to be addressed.
6. An alienated minority. We can ignore the plight (and, yes, the attitude) of the disaffected youth culture in the inner cities only at our peril -- and theirs.
Sunday, August 5, 2007
Hot pursuits and bad endings
High speed police chases. Let's talk about this a minute.
It's certainly a timely subject, because hot pursuit has killed both a chaser and a chasee in Central Virginia so far this year -- a sheriff's deputy in Campbell County, a 21-year-old driving without a license in Bedford.
And the obvious question has to be: Were these pursuits that ultimately turned tragic really necessary in the first place?
For better or worse, vehicular pursuit has become embedded in our culture -- what would an action movie be without at least one car chase? Perhaps because of that, it's something many men (and, increasingly, women) fantasize about.
In real life, though, who are the people most likely to put the pedal to the metal and try to flee the cops?
1. They could be a dangerous criminal, someone on the FBI's Most Wanted List. A rapist, a terrorist, an armed robber. They could be, but it's highly unlikely -- this is a big country, and there aren't enough dangerous criminals on the lam to go around.
2. They could be fleeing from the scene of a crime, like a bank heist. Still unlikely.
3. They could be driving a stolen car. Now, we're getting more into the neighborhood of probability.
4. They could be driving on a suspended license, or unwilling to acquire the extra points that might get their license suspended.
5. They could be drunk.
The last category is the one I find most disturbing.
Let's consider this. You've got a person the police are trying to catch because they feel he is a danger to other motorists. So what sense does it make to then force this person -- whose depth perception, vision and judgement may already be impaired -- to drive at higher and higher speeds?
That's what happened when a drunk driver slammed head-on into a car containing the Barrick family on Waterlick Road a few months back.
My position on this is that I am a fellow traveler on the public highways (the Barrick accident happened on a road I drive every day). Sure, it makes me uncomfortable to think of wasted drivers sharing those highways with me, but the thought of a wasted driver going 100 miles an hour ups the ante considerably.
When you put the worst case scenarios side-by-side, it goes something like this:
If the police let the person go, the worst case scenario is that he or she will escape to drive drunk, or on a suspended license, another day.
If the police instigate a chase, the worst case scenario is that someone dies.
There are exceptions, naturally. The police are almost obligated to pursue a fleeing robber, or a criminal believed to be a public menace. But in the case of the ordinary citizen with a less-than-ordinary driving record, chances are the in-car camera has already snapped a photo of the license plate and videotaped the fleeing car. True, it's not as exciting to go by the person's home or place of work the next day to make the arrest, but it's probably a lot safer. And innocent people don't get hurt.
Based on events such as have happened in Central Virginia this year, localities all over the U.S. have decided that routinely embarking on these 90-mph thrill rides simply isn't worth the risk.
To me, that only makes sense.
It's certainly a timely subject, because hot pursuit has killed both a chaser and a chasee in Central Virginia so far this year -- a sheriff's deputy in Campbell County, a 21-year-old driving without a license in Bedford.
And the obvious question has to be: Were these pursuits that ultimately turned tragic really necessary in the first place?
For better or worse, vehicular pursuit has become embedded in our culture -- what would an action movie be without at least one car chase? Perhaps because of that, it's something many men (and, increasingly, women) fantasize about.
In real life, though, who are the people most likely to put the pedal to the metal and try to flee the cops?
1. They could be a dangerous criminal, someone on the FBI's Most Wanted List. A rapist, a terrorist, an armed robber. They could be, but it's highly unlikely -- this is a big country, and there aren't enough dangerous criminals on the lam to go around.
2. They could be fleeing from the scene of a crime, like a bank heist. Still unlikely.
3. They could be driving a stolen car. Now, we're getting more into the neighborhood of probability.
4. They could be driving on a suspended license, or unwilling to acquire the extra points that might get their license suspended.
5. They could be drunk.
The last category is the one I find most disturbing.
Let's consider this. You've got a person the police are trying to catch because they feel he is a danger to other motorists. So what sense does it make to then force this person -- whose depth perception, vision and judgement may already be impaired -- to drive at higher and higher speeds?
That's what happened when a drunk driver slammed head-on into a car containing the Barrick family on Waterlick Road a few months back.
My position on this is that I am a fellow traveler on the public highways (the Barrick accident happened on a road I drive every day). Sure, it makes me uncomfortable to think of wasted drivers sharing those highways with me, but the thought of a wasted driver going 100 miles an hour ups the ante considerably.
When you put the worst case scenarios side-by-side, it goes something like this:
If the police let the person go, the worst case scenario is that he or she will escape to drive drunk, or on a suspended license, another day.
If the police instigate a chase, the worst case scenario is that someone dies.
There are exceptions, naturally. The police are almost obligated to pursue a fleeing robber, or a criminal believed to be a public menace. But in the case of the ordinary citizen with a less-than-ordinary driving record, chances are the in-car camera has already snapped a photo of the license plate and videotaped the fleeing car. True, it's not as exciting to go by the person's home or place of work the next day to make the arrest, but it's probably a lot safer. And innocent people don't get hurt.
Based on events such as have happened in Central Virginia this year, localities all over the U.S. have decided that routinely embarking on these 90-mph thrill rides simply isn't worth the risk.
To me, that only makes sense.
Wednesday, August 1, 2007
ER's test the patience of patients
I used to work in a hospital emergency room, although it seems like 100 years ago.
It was back in the mid-70s, in Lexington County, SC, and I imagine the same challenges we faced there are still bedeviling ER personnel today.
This was, I always tell people, the perfect preparation for a later job in journalism. The hours were uncertain, the pay wasn't great, and I had to ask personal questions of people who didn't want to answer them.
Even with all that, though, the Lexington County General Hospital ER fulfilled my No. 1 requirement of any job, that every day at work be different.
We had shootings and stabbings and car wrecks. We had close encounters with chainsaws and fire ants and fish hooks and vicious dogs (as well as vicious husbands and boyfriends). At the same time, we also had a steady flow of patients who probably shouldn't have been there.
My favorite exchange between nurse and patient at that hospital was with a man who came in for treatment of what used to be called, in polite company, a "social disease." This was duly noted on the chart that I, as the primary conduit of information, filled out and placed in the window behind me.
With this individual, "patient" was a misnomer. He became increasingly agitated as later arrivals were treated ahead of him (never mind that they had suffered heart attacks and seizures), and finally he stalked over to the nurse's window and said: "Can I please be seen by someone? I'm a very busy man."
The nurse, an older woman who had seen it all, looked at his chart and replied dryly: "Yes. I can see that."
I thought about all this when I read Cynthia Pegram's story a couple of Sundays ago about long waits for emergency room patients. At Lynchburg General, one of the busiest ER's in the state, the median time before treatment was more than three hours.
The centerpiece of this article was a cautionary tale about a woman who was referred to the ER by her doctor with a possible urinary tract infection. She and her husband first walked through the doors at 1 p.m. on a Sunday and didn't leave until 13 hours later.
Some doctors can perform open-heart surgery in a lot less time than that. Put another way, that's 13 episodes of "ER," back-to-back. And in the end, the woman was told: "Just keep taking the medication you've been taking."
The couple made a point of telling Cynthia that they had no complaints about the quality of care, or the compassion with which they were treated. But 13 hours?
Here's the problem, I think. Running a hospital emergency room is like trying to operate a fast food place and a fine-dining restaurant in the same space.
Some people are there because they'd be dead otherwise. Some are there because their doctors told them to go there. And others, with more minor complaints, are there because they don't have any other place to go.
When you try to funnel all this diverse humanity through one portal, it can get crazy. The usual rule of "First come, first served" doesn't apply when you're waiting for three stitches in the end of your finger and ambulance attendants suddenly burst through the door bearing someone who has been struck by lightning. That's what happened to the woman in Cynthia's story -- she kept being trumped by worse-case scenarios.
It seems to me, however, that there must be some logical way to deal with this. How about reserving one area of the ER for the more routine cases, and let that operate indepedently of the trauma and cardiac areas?
Moreover, isn't there some way of determining how serious something might be before that person gets to the ER? Perhaps the problem is fear of lawsuits, but couldn't some of this be handled by a nurse practitioner, even over the telephone?
Emergency room visits are never pleasant, and they're not cheap. But maybe they could at least be shorter.
It was back in the mid-70s, in Lexington County, SC, and I imagine the same challenges we faced there are still bedeviling ER personnel today.
This was, I always tell people, the perfect preparation for a later job in journalism. The hours were uncertain, the pay wasn't great, and I had to ask personal questions of people who didn't want to answer them.
Even with all that, though, the Lexington County General Hospital ER fulfilled my No. 1 requirement of any job, that every day at work be different.
We had shootings and stabbings and car wrecks. We had close encounters with chainsaws and fire ants and fish hooks and vicious dogs (as well as vicious husbands and boyfriends). At the same time, we also had a steady flow of patients who probably shouldn't have been there.
My favorite exchange between nurse and patient at that hospital was with a man who came in for treatment of what used to be called, in polite company, a "social disease." This was duly noted on the chart that I, as the primary conduit of information, filled out and placed in the window behind me.
With this individual, "patient" was a misnomer. He became increasingly agitated as later arrivals were treated ahead of him (never mind that they had suffered heart attacks and seizures), and finally he stalked over to the nurse's window and said: "Can I please be seen by someone? I'm a very busy man."
The nurse, an older woman who had seen it all, looked at his chart and replied dryly: "Yes. I can see that."
I thought about all this when I read Cynthia Pegram's story a couple of Sundays ago about long waits for emergency room patients. At Lynchburg General, one of the busiest ER's in the state, the median time before treatment was more than three hours.
The centerpiece of this article was a cautionary tale about a woman who was referred to the ER by her doctor with a possible urinary tract infection. She and her husband first walked through the doors at 1 p.m. on a Sunday and didn't leave until 13 hours later.
Some doctors can perform open-heart surgery in a lot less time than that. Put another way, that's 13 episodes of "ER," back-to-back. And in the end, the woman was told: "Just keep taking the medication you've been taking."
The couple made a point of telling Cynthia that they had no complaints about the quality of care, or the compassion with which they were treated. But 13 hours?
Here's the problem, I think. Running a hospital emergency room is like trying to operate a fast food place and a fine-dining restaurant in the same space.
Some people are there because they'd be dead otherwise. Some are there because their doctors told them to go there. And others, with more minor complaints, are there because they don't have any other place to go.
When you try to funnel all this diverse humanity through one portal, it can get crazy. The usual rule of "First come, first served" doesn't apply when you're waiting for three stitches in the end of your finger and ambulance attendants suddenly burst through the door bearing someone who has been struck by lightning. That's what happened to the woman in Cynthia's story -- she kept being trumped by worse-case scenarios.
It seems to me, however, that there must be some logical way to deal with this. How about reserving one area of the ER for the more routine cases, and let that operate indepedently of the trauma and cardiac areas?
Moreover, isn't there some way of determining how serious something might be before that person gets to the ER? Perhaps the problem is fear of lawsuits, but couldn't some of this be handled by a nurse practitioner, even over the telephone?
Emergency room visits are never pleasant, and they're not cheap. But maybe they could at least be shorter.
Tuesday, July 24, 2007
There was more to Tammy Faye than makeup
I never met Tammy Faye Bakker Messner, who died of cancer last week, but I feel as though I have.
In 1987, I made several trips down to Fort Mill, SC to cover the breakup of Jim and Tammy Bakker's PTL Club and Heritage USA amusement park and chronicle the Rev. Jerry Falwell's part in that sad saga.
Nearly 20 years later, I heard Tammy Sue Bakker, the couple's daughter, speak at the Lighthouse Church in Lynchburg.
In between, like everybody else, I was alternately outraged and amused by the flood of publicity that turned Tammy Faye in a caricature.
It was her makeup, for one thing. She wore lots of it, as everyone knows, and a popular T-shirt from the late 1980s consisted of random blobs of various colors and the words: "I ran into Tammy Faye at the mall."
She cried a lot, was another thing. She cried when she was happy, when she was sad, when she felt the rush of the spirit take her over.
Of course, a lot of people -- including state and federal law enforcement authorities -- thought that the Bakkers were crooks. I was one of them, and I've often reprised a classic pronouncement Tammy Fay once made during a healing service.
Looking out over a vast field of believers, she blurted out "Someone out there has just been healed of cancer, and they didn't even know they had it."
Now, wasn't that special?
The interesting thing to me, though, when I visited Heritage USA, was how loyal many of the Bakkers' followers remained to the couple even after the bad news hit the fan.
"Jim and Tammy would never do anything to hurt us," I remember one woman telling me.
Actually, they wound up hurting each other. Jim had a fling with a church secretary named Jessica Hahn (who was so traumatized by the experience that she went on to pose for Playboy), and the couple was eventually divorced. Tammy Faye then married Roe Messner, another PTL figure, who was later convicted of financial wrongdoing himself.
Tammy Faye was never convicted of anything, though, and the arc of her life continued -- from evangelism to pop culture icon. She appeared on several reality shows, occupied Larry King's guest chair on a number of occasions, and became a sort of latter-day Judy Garland, adopted enthusiastically by the gay community.
Even her lingering death from cancer became a public spectacle. Periodically, Tammy Faye would appear on Larry King Live to report of the progress of the disease.
So what did all this mean?
To me, Tammy Faye's career provided an object lesson in the fraility of humanity. By all accounts, she and Jim started out on the right path, only to be lured into the underbrush by the onslaught of riches that suddenly came their way.
The Bakkers showed the world that it is always more advisable to follow the message and not the messengers. In the end, though, Tammy Faye managed to fight her way through the notoriety and the silliness to emerge as a redeemed and triumphant figure.
"She's a good person," Tammy Sue Bakker said of her mom last year in her visit to Lynchburg. "She really is."
I believe her.
In 1987, I made several trips down to Fort Mill, SC to cover the breakup of Jim and Tammy Bakker's PTL Club and Heritage USA amusement park and chronicle the Rev. Jerry Falwell's part in that sad saga.
Nearly 20 years later, I heard Tammy Sue Bakker, the couple's daughter, speak at the Lighthouse Church in Lynchburg.
In between, like everybody else, I was alternately outraged and amused by the flood of publicity that turned Tammy Faye in a caricature.
It was her makeup, for one thing. She wore lots of it, as everyone knows, and a popular T-shirt from the late 1980s consisted of random blobs of various colors and the words: "I ran into Tammy Faye at the mall."
She cried a lot, was another thing. She cried when she was happy, when she was sad, when she felt the rush of the spirit take her over.
Of course, a lot of people -- including state and federal law enforcement authorities -- thought that the Bakkers were crooks. I was one of them, and I've often reprised a classic pronouncement Tammy Fay once made during a healing service.
Looking out over a vast field of believers, she blurted out "Someone out there has just been healed of cancer, and they didn't even know they had it."
Now, wasn't that special?
The interesting thing to me, though, when I visited Heritage USA, was how loyal many of the Bakkers' followers remained to the couple even after the bad news hit the fan.
"Jim and Tammy would never do anything to hurt us," I remember one woman telling me.
Actually, they wound up hurting each other. Jim had a fling with a church secretary named Jessica Hahn (who was so traumatized by the experience that she went on to pose for Playboy), and the couple was eventually divorced. Tammy Faye then married Roe Messner, another PTL figure, who was later convicted of financial wrongdoing himself.
Tammy Faye was never convicted of anything, though, and the arc of her life continued -- from evangelism to pop culture icon. She appeared on several reality shows, occupied Larry King's guest chair on a number of occasions, and became a sort of latter-day Judy Garland, adopted enthusiastically by the gay community.
Even her lingering death from cancer became a public spectacle. Periodically, Tammy Faye would appear on Larry King Live to report of the progress of the disease.
So what did all this mean?
To me, Tammy Faye's career provided an object lesson in the fraility of humanity. By all accounts, she and Jim started out on the right path, only to be lured into the underbrush by the onslaught of riches that suddenly came their way.
The Bakkers showed the world that it is always more advisable to follow the message and not the messengers. In the end, though, Tammy Faye managed to fight her way through the notoriety and the silliness to emerge as a redeemed and triumphant figure.
"She's a good person," Tammy Sue Bakker said of her mom last year in her visit to Lynchburg. "She really is."
I believe her.
Wednesday, July 18, 2007
Now, it's a federal case: Who let the dogs out?
A throwaway line in the Paul Simon song "You Can Call Me Al" goes something like this: "Get these mutts away from me -- I don't find this stuff amusing any more."
Michael Vick can certainly relate. Or, he might find an appropriate theme song in that late '90s hit by the Baha Men: "Who Let the Dogs Out?" Even if the Atlanta Falcons' quarterback isn't suspended by the league, I'll bet he hears that blasting over the PA system in every city on the road.
Vick hasn't been proven guilty of participating in (and bankrolling) illegal dogfighting, of course -- but he has been proven self-destructive, by a long series of embarrassing incidents. I'm not sure what it is about the Tidewater area, but his problems remind me a lot of Allen Iverson, the Hampton-born basketball star, who also seemed determined to hang onto his tough guy, pseudo-gangsta image even after the Philadelphia 76ers made him a multi-millionaire.
In recent years, Iverson appears to have matured. Vick, 27, may have lost his chance.
Tuesday's federal indictment against Vick and three alleged co-conspirators (including a guy named Pernell Peach) was not only damning, but grisly. At one point, it accuses Peach of electrocuting the loser in one dog fight with Vick looking on. If true, that's not going to go over well with PETA.
Perhaps the hardest of Vick's statements to believe is the one about his relatives and friends staging dog fights at the Suffolk County property the quarterback owned without his knowledge.
("Quick -- Michael's coming! Let's hide the 50 pit bulls in this closet!")
That would be like Osama bin Laden saying that he thought those Afghan terrorist training centers were really summer camps for disadvantaged kids.
Even worse, Vick repeated his blanket denial to NFL commissioner Roger Goodell in April.
Unlike the federal court system, the NFL doesn't have to try Vick with a jury of his peers. If it's determined that he's become enough of an embarassment to the league, he can be suspended. Period.
Either way, this is a huge problem for Vick's team, which has built its offense, its salary structure and its marketing plan around Vick's twinkling feet and howitzer of an arm.
Falcons' owner Arthur Blank has hung in there with Vick for several years despite the fact that the former Virginia Tech star has only rarely fulfilled his enormous promise on the field, has embarrassed him at every turn, and was openly defiant of previous coach Jim Mora. Mora's replacement, Bobby Petrino, was brought in from the University of Louisville largely because it was thought that he can both coach and control Atlanta's maverick star. Oops.
Now, the Falcons have a huge hunk of dog doo-doo on their collective shoe -- and a backup quarterback, Joey Harrington, with less than All-Pro credentials.
It couldn't be more fitting that Atlanta's training camp will open in August -- the Dog Days.
Michael Vick can certainly relate. Or, he might find an appropriate theme song in that late '90s hit by the Baha Men: "Who Let the Dogs Out?" Even if the Atlanta Falcons' quarterback isn't suspended by the league, I'll bet he hears that blasting over the PA system in every city on the road.
Vick hasn't been proven guilty of participating in (and bankrolling) illegal dogfighting, of course -- but he has been proven self-destructive, by a long series of embarrassing incidents. I'm not sure what it is about the Tidewater area, but his problems remind me a lot of Allen Iverson, the Hampton-born basketball star, who also seemed determined to hang onto his tough guy, pseudo-gangsta image even after the Philadelphia 76ers made him a multi-millionaire.
In recent years, Iverson appears to have matured. Vick, 27, may have lost his chance.
Tuesday's federal indictment against Vick and three alleged co-conspirators (including a guy named Pernell Peach) was not only damning, but grisly. At one point, it accuses Peach of electrocuting the loser in one dog fight with Vick looking on. If true, that's not going to go over well with PETA.
Perhaps the hardest of Vick's statements to believe is the one about his relatives and friends staging dog fights at the Suffolk County property the quarterback owned without his knowledge.
("Quick -- Michael's coming! Let's hide the 50 pit bulls in this closet!")
That would be like Osama bin Laden saying that he thought those Afghan terrorist training centers were really summer camps for disadvantaged kids.
Even worse, Vick repeated his blanket denial to NFL commissioner Roger Goodell in April.
Unlike the federal court system, the NFL doesn't have to try Vick with a jury of his peers. If it's determined that he's become enough of an embarassment to the league, he can be suspended. Period.
Either way, this is a huge problem for Vick's team, which has built its offense, its salary structure and its marketing plan around Vick's twinkling feet and howitzer of an arm.
Falcons' owner Arthur Blank has hung in there with Vick for several years despite the fact that the former Virginia Tech star has only rarely fulfilled his enormous promise on the field, has embarrassed him at every turn, and was openly defiant of previous coach Jim Mora. Mora's replacement, Bobby Petrino, was brought in from the University of Louisville largely because it was thought that he can both coach and control Atlanta's maverick star. Oops.
Now, the Falcons have a huge hunk of dog doo-doo on their collective shoe -- and a backup quarterback, Joey Harrington, with less than All-Pro credentials.
It couldn't be more fitting that Atlanta's training camp will open in August -- the Dog Days.
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