Friday, July 29, 2016

The Age of Reason Revisited

"These are the times that try men's souls."

Thomas Paine, one of many patriots in America's fight for independence, wrote that famous opening sentence in The American Crisis, and it is indeed a fitting statement for our times, I believe. While I did not engage in gavel-to-gavel viewing of either political convention, from the social media comments and slanted media reporting of events in Cleveland and Philadelphia, I have come to the conclusion that the "great American experiment" is in its final throes of life.

The pundits drilled into our heads that the Republican party was fractured and its eventual presidential nominee is too much a "loose cannon, angry, unprincipled and shady businessman" who has no experience for the "top job in the land." On the other hand, it seems that the Democrats were more fractured and divided: Bernie supporters were very openly told to "get over" their beliefs and support an "untrustworthy, lying, unscrupulous" woman who has never worked outside of government in her life (even her legal career was attached to some government entity or another), but somehow has the experience for the "top job in the land."

America has drifted very far from the early years of our republic and the reasons why our ancestors embraced the noble cause of freedom, to the point that we now find ourselves at a crossroads. As over the top as this may sound, that crossroads will take us either to renewed freedom or total enslavement.

Consider: the continuation of Mr. Paine's opening paragraph describes in very simple, yet clear, language how tyranny grows in a society, and, in my opinion, like a cancer in the human body, "is not easily conquered." Once given an opening, tyranny becomes an all-consuming monster until, left unchecked, fully enslaves its this instance the United States. For some perspective we only have to look at the spread of government influence in our lives to see that our situation is dire.

Mr. Paine wrote, focusing his attention on the "tyrant" Great Britain, that she "has declared that she has a right (not only to tax) but 'to bind us in all cases whatsoever.'"  Is there not a resemblance today? Has not our federal government become the Great Britain of our age?

When our elected representatives, in the early part of the 20th century, allowed for the creation of the Federal Reserve System, with the power to tax, the nation put itself on a path to destruction. For in that one action, Americans were placed on that slippery slope to slavery. Mind you, it was not easy; even cancer has a difficult time progressing when the body itself is healthy and strong. So, with the help of a Congress that has abdicated its Constitutional authority, this tyranny -- this cancer -- has metastasized to other parts of our national body and now we find ourselves bound in just about "all cases" -- all aspects of our lives: education, housing, public welfare, health -- there does not seem to be a part of our lives that does not have the stench of this tyranny on us.

The very sad thing is that the failsafe, that antidote called the Bill of Rights which is the chemotherapy our country needs, is somehow too costly and painful for Americans to embrace. States rights? ....they have none when the Supreme Court reverses decisions on matters that are Constitutionally reserved to the states. Freedom of speech? ....well, that depends on what you say. Religious freedom? ....only (it seems) if the religious beliefs are subjugated to the will of the state. The right to keep and bear arms? ....only if you report everything to some government body to regulate.

It goes on and on, and "we the people" have an ever-diminishing voice as the cancer of tyranny, emboldened by division and class warfare, now rapidly moves to take the very breath of liberty from us.

Perhaps we as a nation have come too far from those days of our ancestors, and we have obtained too easily the freedoms previous generations of Americans fought to preserve, and therefore, as Mr. Paine says, we "esteem it too lightly." While the trendy idea would be to place blame of some sort or another as to why and how this happened, it is really in our own best interest to remove ourselves from the comfort zone of victimization and toward the active task of treating this cancer before it consumes us.

Should we as a nation truly believe in the ideals of freedom, then we must, as Mr. Paine again says, embrace that our current situation is that of our own making and that "by perseverance and fortitude we have the prospect of a glorious issue;" and freedom will yet ring again between our borders; but that, by doing nothing, "by cowardice and submission, the sad choice of variety of evils - a ravaged country -- a depopulated city -- habitations without safety, and slavery without hope" will be our lot.

I know that many will not subscribe to the picture I have painted of our current reality, but I hope some will see that my heart and affection for what was bought by the price of blood and nurtured by the dreams and ideals of our ancestors is true and pure. I can only add that at this crossroads, we can somehow find our way back, or, to conclude with Mr. Paine, we shall "look on this picture and weep over it! And if there yet remains one thoughtless wretch who believes it not, let him suffer it unlamented."

Tuesday, July 12, 2016

Watching Old Movies

Not unlike many of my friends who grew up in the 1960s and stumbled through adolsecence in the early 1970s, I earned spending money babysitting. I must have been pretty good because I found myself keeping quite busy from Friday nights through Sunday afternoons (and sometimes on week nights) managing children so that parents could get away for a few hours to enjoy a "date night," engage in community charity events or fulfill some social or business obligations.

Once the children were settled for the night, I would clean up any messes we made, then I would either work on homework or check out what was on television. Keep in mind that in the early 1970s there was nothing close to 24/7 news and sports coverage, cable with channels dedicated to food, movies, DIY programs, or reality shows which are so common now. Depending on where I was babysitting (some families had better television coverage than others), I was fortunate if my choices expanded to four channels.

One thing I could count on, though, was that Friday and Saturday nights typically aired old movies after the 10 o'clock news. I'd check in on my little charges to be sure all was right in their dream world, then I would switch on the TV, ready to be transported to wherever the film would take me.

Most of the time the movie was what my Mom used to call "a B movie" -- the ones starring the less than high profile actors and actresses of the time or the early pictures of rising stars. Fred MacMurray, Barbara Stanwyck, June Allyson, Kirk Douglas and Van Heflin, were the headliners, although every now and then I might see Rosalind Russell, Katharine Hepburn, Clark Gable, Lana Turner and Spencer Tracy. It really didn't matter too much; I was content to see a good story brought to the "screen" with great dialogue, costumes and pretty good acting. It really didn't matter what sort of movie it was: I liked comedies, dramas, historical costume extravaganzas, musicals......westerns, military, horror and sci-fi, not so much. Every now and then the television station would throw me a curve ball and I would find myself watching some movie starring Elvis Presley or one of the post-studio driven movies of the late 1950s or early 1960s. On those evenings, I always prayed that the parents would be home early.

Sometimes the parents did arrive home at their stated time and I would leave before seeing a movie to its conclusion, which was a real bummer if I was enjoying the film. Never fear, though, my mom would not go to bed until she knew I was home and it was not uncommon for me to get in the door to see her sitting in front of the TV watching the same movie I had been viewing. Rather than call it an evening, we would sit together to see the movie to its conclusion and she would recount to me where she had seen the picture in a movie theater "when she was a young thing" and what people thought of the movie at the time.

It was not often that my mom would talk to me much about her life growing up, but those moments shared watching a movie were pretty special. It is funny, now that there are channels dedicated to those "classic" films I have chances to watch them again. I can't see The Ballad of Cable Hogue or Desk Set or Love Me or Leave Me without thinking about her. She would share much about what it was like growing up during those years and when I see these old films again, I can't help but have a richer experience of those years gone by simply because I connected with her.

Now that these classics are so readily available through television and DVD, I still get to be transported to the diverse times and enjoy seeing not only old favorites but others as well. I also am enjoying that I get to see Jeannine enjoy these films. I have been amazed, but she readily enjoys old movies (newer ones as well), and if she happens to catch me folding laundry while watching a Fred Astaire and Ginger Rogers marathon, or whatever "star of the month" is showcased, she will usually watch for awhile and then suggest that when I finish folding clothes we put together some snacks and watch some more. More often though she will suggest that we go online to order the movies so that she can watch them anytime she wants. Her interest was not really in the plot details or the clothes or any of the things that film critics assess. For Jeannine, she likes the relationships she sees, especially those characters who exhibit the qualities of kindness, concern, helpfulness and love.

So for what it is worth, what started out as a means to pass time while children slept has become a lifelong interest and really a passion for me. Movies are a wonderful vehicle for entertainment, escapism and in many ways learning and understanding history. Films like Gone with the Wind, The Buccaneer, Anna and the King of Siam, or The Desert Fox, whose historical settings bring to life the events of previous times and  deepen our understanding of the people and places which cannot be gleaned by mere facts and dates alone. From the comedies, especially those starring Cary Grant, Danny Kaye or Doris Day, we are able to tap into many of the foibles and inconsistencies in human nature that we all share. Beyond all of this, though, I have a tremendous fondness for what film has done for me in connecting with others; first my mom and now Jeannine. On one level it was a way to know and understand my mom that could not have been communicated otherwise; on another, it is a way to stay engaged with Jeannine even if it costs me playing Fred Astaire to her Ginger Rogers as we recreate some dance sequence from The Barkleys of Broadway.

Thursday, July 7, 2016

To Serve and Protect

A sad and appalling incident making headlines today brought back a flood of memories for me. It seems that any news story involving some disabled person can elicit a strong response from me -- be it joy and wonder, or in this instance anger and pain.

Many may have read about Hannah Cohen, a disabled 19-year old woman who was beaten by TSA agents at the Memphis airport.  Complete details of the story and subsequent lawsuit are detailed here.

All of this brought to mind an incident we had at Portland International Airport two years ago. Jeannine, my daughter with Down syndrome, her father Tim and I were flying to Tucson: I was attending a health coach training meeting and Tim and Jeannine were tagging along to spend some time together at "a nice hotel," as Jeannine likes to say.

I have my own opinion about the current political state in which we live, but that aside, we had all our "papers" in order and proceeded to the cattle line to go through the security check point. It was all lovely as one of the TSA attendants, likely seeing we were traveling with a special needs person, approached us and invited us to go through the Pre-check line. "Wow," I thought to myself, "this should give Tim some relief that he won't have to worry about me making a scene!"

That was short-lived. Tim and I breezed through the line; then came Jeannine. She bantered with the agent, telling him that she was going to Tucson and would be staying in a nice hotel and going swimming and having a good time. What he responded I do not know, but the next thing I knew he was asking her how old she was. "Eighteen," she replied, and of course added that "I am going to be 19 next February."

He stopped her there and asked if she had any identification. She looked up, bewildered. He asked again if she had any identification. At this point I figured out what was going on and asked Jeannine if she had her identification card with her. She carries the "state issued" card with her, and just needed to have the question asked in a way she understood. She then told me she did not have her wallet with her.

Jeannine does not understand the concept of "traveling light," and when she goes anywhere, even if it is just an overnight, she will carry more clothes than she needs, more books that she will read, office supplies and photo albums. I will own this mistake; I told her that she did not need to bring everything with her on the trip and she decided she really did not need her purse or wallet. One has to have priorities, I suppose.

Anyway, the ensuing half hour was one that I do not want to have to relive. I suddenly found myself on the floor at the checkpoint, tearing my own things apart in an effort to find something that would satisfy them as to her identity. Did I have her library card? Yes, that wouldn't work because, while her name was on it, it was in her handwriting. The agent asked if we had any medication. Well yes, but it was in her checked bag.

By this time other travelers were backing up in the "Pre-Check" line, so we moved aside still trying to figure out what to do. Tim kept watching me: he was well aware of my opinion of this sort of violation of our rights, and I knew he was in fear that I would create a horrible scene. The agent made a phone call but would not tell us to whom -- I supposed it was to some next level up agent to get some direction. Seriously, this should be a no-brainer. Here is a young person with clear physical indications of developmental impairment, traveling with two adults who happened to have all the "proper papers." Couldn't there be reasonable accommodation afforded here?

The agent then approached me and Tim to let us know that they would have to take Jeannine aside and question her -- alone. My heart sank. I knew that this was going to take a very long time, as Jeannine's anxiety level increases in stressful situations. To be taken apart from her parents to go with strangers in uniforms? I knew that even if they asked straight-forward questions, she might not process them correctly and start giving answers that might not be 100% accurate. Things like her phone number (she knows several), her address (she can transpose numbers), where she was born (in a hospital and it rained hard that day).

Thankfully, this interrogation took place just a few feet from where we were standing. One agent was at a computer, another faced Jeannine to ask the questions. She was able to answer her name, birthday and how old she was. Then the agent asked her which parent she knew better, Mom or Dad. She looked toward me for clarification and the agent told me I could not help her. I just prayed that she would pick me, because of the two of us, Jeannine has more accurate information about me than Tim (she thinks Tim is 45 -- another story).

She chose her Dad and I just thought that we would end up -- all three of us -- in some FBI office being held on suspicion of something or other. What happened next was quite surprising. The agent behind the computer apparently had access to a database and funneled questions to the other agent. They asked her his birthdate (thankfully, not his age), what he did, where he worked (the specific address). She answered most of these questions without glancing our way, and apparently her answers were fine, because the next thing I knew, the agent asked that she and I go through the "special" screening process where we were wanded down, had our hands screened and Jeannine's backpack tested for I don't know what. We were dismissed with the caution that we needed to have some sort of identification for Jeannine on our return flight (duh).

By this time, our flight was getting ready to board and Tim sent me on ahead, the thought being that it was more important for me to get on the flight than either him or Jeannine. In the end we all made it; I called daughter to have her overnight Jeannine's wallet to us at the hotel in Tucson, making certain that her identification card was in it.

While I can appreciate the "efforts" our government is taking to keep us "safe and secure," in this age of "terror," somewhere along the way reason and sanity have been lost. Even though our incident with TSA did not end up with physical injuries like what happened to Hannah Cohen, I know exactly how Hannah's mother must have felt as she helplessly watched her helpless child, confused and upset, became a victim at the hands of those who are supposed to serve and protect us. It is also disturbing that at the click of a mouse, any information these agents need about us is available for use or misuse. At the end of the day, I know that in spite of Jeannine's need to be free and independent, I will just have to suck it up and continue to harass her about the things she needs to have to be a strong, independent woman (that is, her state-issued identification). I also know that when it comes to "serve and protect," we cannot and should not depend on anyone but ourselves to shield the most vulnerable in our lives.

Monday, July 4, 2016

In the Clinic at Monthy Staff Meetings

It took me a very long time to actually schedule regular staff meetings for the office. Quite frankly, when the staff was just me and a medical assistant, there was little need to have a formal time set aside to update workflows or disseminate information and address any problems that surfaced. As we added more administrative and back office support, however, there became a crying need to keep everyone on the same page as well as provide a place where general clinic workflows could be handled.

Not that I was consistent, mind you. There were years where three or four months passed between meetings. Even then, the meeting agenda seemed to focus on upcoming changes to our computers or, most often, my efforts to redirect employee behaviors in a non-confrontational manner. As we grew from a staff of two, with one provider, to a staff of four and a half supporting two and a half providers, it just became necessary to be consistent with these monthly meetings.

The first Thursday of the month is the chosen day for this monthly gathering and we try to get things started by 3 pm. We block the schedule out at 1 pm so that the providers are able to finish with any patients coming through the office, and enable all of us to work on our desktops so there is no last minute rush to finish work after the meeting concludes. In order to make the event less threatening, I decided that a light bill of fare, complete with wine might be helpful. Tim had no objection to this, and we encouraged staff to contribute whatever they might like to the meeting snacks.

Little did I know that this would throw a salvo of panic through our otherwise merry little band of coworkers. In an attempt to model the behavior, Tim and I would try to contribute healthy choices like veggies or fresh fruit, cheese, crackers or bread, along with one bottle of red wine, one bottle of white wine and a sparkling cider for those who were interested. All Thursday morning, the banter heard throughout the office swirled around who was bringing what and if someone needed to go out at lunch to pick up anything. By the time we gathered for the meeting, though, we were able to settle in and tackle the agenda.

The biggest hurdle in these meetings besides the food, that is, has been to find a way for Jeannine to be part of the discussions in a meaningful way.  As much as we have worked on her "conversation" skills, she still has a remarkable way of grabbing the floor and launching a stream-of-consciousness stand-up act that covers anything from her organizing the patient confirmation calls, to Danika taking her for a "spa day" sometime in the nebulous future, to how she is going to be getting another job somewhere else because her job at Cleary Medical is too stressful.

Thankfully we are more family than coworkers, so Danika, Andrew, Mary, Maureen and Tim patiently sit and nod as she takes over directing the meeting. At length, however, I have to intervene, at which point she rises from her seat and storms out of the meeting. Understand that our meetings are held in our patient waiting area where there is the most room for all of us to gather, and as she bolts through the door to the reception area, we can all see her running -- flailing, really -- her head tossing from side to side until she disappears to the back office.

As I regain control of the meeting, Jeannine decides that I have not been punished enough. We hear her talking to herself, mostly quoting movies and television programs that are amazingly germane to the situation. Quotes like, "You weren't invited," or "Nobody asked me...." can be heard quite clearly from the back office. It doesn't help that everyone but me starts laughing in a kind and knowing sort of way. Luckily as we are closing in on the end of the meeting, which is reserved for the "I Spied..." comments, and as the staff really look forward to going home right after the meeting, we refocus.

We instituted the "I Spied..." comments for two large reasons. In an attempt to do some team building, I thought it would be a good idea for us to place little handwritten notes in a box, each note beginning, "I spied....." and completed with whatever the person spied someone doing. "I spied Dr. Cleary cleaning an exam room," or "I spied Andrew making Mary laugh," are some of the things shared. This worked well for a time, especially if we had a new person join the staff and wanted to be sure they felt welcomed.

The second big reason we did this was for Jeannine. Many of the comments were about Jeannine helping by making copies, or printing patient paperwork, or just giving hugs and kindness on busy days. So getting to this part of the meeting always brought her back to the waiting room. Not only did she like hearing about how she was truly a part of the team, she also liked when I read her "I Spied" comments about what she sees, hears and appreciates about each of us....and she was not one to leave someone out: each of us could count on hearing about what she had "spied." The most amusing aspect is that many of her comments have nothing to do with clinic doings. Andrew can count on being told that he is "cute and funny." Danika is her "Cheeto" and when will they go out on a spa date again? Mary is "pretty" and she likes hanging out with her. Dr. Cleary is "handsome" and the greatest man. Maureen is "beautiful" and she likes sharing cookies with her. I, well I am her "beautiful Mom" and the "best cook ever."

So for what it is worth, our monthly staff meetings are much more than going through an agenda of items. It is a time for working on those things that will bring better patient care to the clinic. It is a time for us to come together in what I always hope is a relaxed environment to share ideas, concerns and updates on clinical medicine. More than that, it is fun to watch and hear staff as noon approaches, each offering to help each other get work done so that we can get to the meeting sooner and thereby perhaps leave a little ahead of clinic hours closing. Once again, though, Jeannine steals the show. She provides comic relief as she vents her frustrations with me in particular; she celebrates each of us as individuals with her sometimes out of the blue "I Spied..." comments; and she brings us all together as a team by reminding us of our unique talents and value to the clinic.