Emergency Medicine Then & Now

cartwheels-sq
The author and sister Mimi, circa 1940

We were, I think, about six and eight. My sister Mimi and I came home from somewhere, hot and tired and thirsty. We leaned our bikes against the side porch and ran up to the French door – which was stuck tight, as often happened on muggy days. I gave the door a mighty wham. But I missed the wood frame I was aiming for and my hand crashed through the glass pane. I stood there saying “Oh my! Oh my!” until Mimi, who was wise beyond her years, reached through the hole, turned the knob and shoved the door open. I think I was still “Oh my!-ing” while Mimi lead me through the living room, hallway and dining room to the kitchen, splattering blood along the way. We grabbed dish towels, tied them around my arm, returned to our bikes and headed for the offices of our friend Dr. Enos Ray.

Like most small-town doctors’ offices in the 1940s, Dr. Ray’s office consisted of several rooms adjacent to his home – about 8 or 10 blocks from our house. He stitched up my wound, after listening to the story and rather cleverly asking if we had left a note of explanation for our mother. Oops, hadn’t thought of that. Mrs. Ray obligingly started calling around to see if she could find our mother before she encountered an unexplained bloody scene on coming home from somewhere Mimi and I didn’t remember. Dr. Ray probably sent our parents a bill for $5.

Scar
The scar survives

My memory of the entire  incident ends with the bike ride home, all beautifully bandaged and hoping we would see a lot of friends on the way. But the scar (now getting pretty dim amidst the blotches and mottles of seven+ decades) is a constant reminder of my days with the World’s Best Big Sister and a current reminder of the changes in healthcare over those decades.

 I was re-reminded recently. I am fond of remarking at the slightest opportunity that I still, in my golden octogenarian years, have all my original parts – give or take a few teeth. Two of those unoriginal teeth are in the form of very expensive crowns attached for the last 15 years to a far more expensive (not to mention painfully acquired) implant. Not long ago, they decided to swing slightly outward, without so much as a by-your-leave. After a moment of horror (and gratitude that this happened at breakfast with no one but a sympathetic husband at the table) I realized I could nudge them back to where they belonged. I took to chewing on the other side. I called my good friend, longtime neighbor and fine dentist Richard Leeds. He said I should make an appointment with his implant friend Dr. Chin. “You’ll really like Dr. Chin,” he said. “It’s kind of like going to see the mad scientist. But he’s the best.” So I waited until Dr.Chin returned from vacation. And indeed, despite the very proper and competent staff who welcomed me, there was something of a mad scientist to the good doctor. “Let me just peeeeeer around here,” he would say, reaching for strange radar-beam lights and x-ray machines, studying my jaw from every conceivable angle.

 Eventually, he said, “There’s good news and bad news. The bad news is that you’ll Grinprobably need an expensive new crown. The good news is that the implant is just fine so you don’t need surgery, so you don’t need me.” Whereupon he shook my hand, said it had been a pleasure, and no, there was no charge.

 Later, summoned back to Dr. Leeds’ office – and anticipating future appointments for expensive new crowns – I thanked him for sending me to the charming mad scientist. He said he had a few not-so-mad-scientist ideas of his own. Whereupon he gave me a crash course in types of crowns and types of implants now in use, and explained that he thought he could screw my errant teeth back to where they belonged. The explanation was accompanied by several rather vehement maneuvers, and followed by extensive fiddlings around, bite-checking, tooth-filing and what have you. And lo, I am back to where I started with the non-original teeth and their original compatriots. Dr. Leeds will send a bill for considerably more than $5, but probably thousands less than a new crown would have cost. I could not help remembering the days of the de riguer family doctor and family dentist.

Sadly, it should be noted here that Dr. Ray has long since gone to his rewards, and Dr. Leeds is no longer accepting new patients. But given the precarious state of healthcare in the U.S., I can only be grateful for the extraordinary emergency care (Kaiser Permanente included) this middle-class American has been blessed to receive.

Would that healthcare were such for everyone.

The Scary Danger of “Fake News” Talk

Fake news? The press is the enemy of the people? I am up to here with that.

newspapersDenigration of the press may be a way to excite some (happily minimal) percentage of Americans, but for all Americans – Democrats, Republicans, geezers, millennials and certainly everyone wanting to preserve our fragile, shared democracy – it is beyond dangerous.

I have been a newspaper/magazine writer for well over a half-century. I have made a lot of mistakes (most recently I omitted one 12-year-old from a list of grandchildren in a feature story; whew!) But I have NEVER knowingly written an untrue sentence. Anything not verifiably correct, furthermore, has been corrected by an editor. (We have now even cleaned up my act about the missing granddaughter with a follow-up story in the same newspaper.)

So, is attacking the free press just playing politics, or is it dangerous? Look at Turkey. At a conference in Budapest just three years ago I sat next to a university professor from Istanbul who said she could face arrest when she returned. “And if I were a journalist,” Demonstrations in Turkeyshe said “I’d be far more afraid.” Looking at the videos of journalists – and others – being led to trials that will most certainly lead to long sentences at best is a sobering view of where Turkey is now, under an autocrat (whom the U.S. theoretically supports.)

PBS News/Hour was recently anchored for one week by science correspondent Miles O’Brien, who has been a part of my family (it’s complicated) for more than a quarter century. I have not always agreed – familial love aside – with the personal choices this distinguished journalist has made. But I’m willing to bet he has NEVER written or spoken a knowingly false word in reporting the news. He is in a list of personal journalistic friends & heroes that include Roger Mudd, Charles McDowell, Belva Davis and a number of contemporary journalists – Michael Fitzgerald (Boston,) Caitlin Kelly (NY,) that list could go on. Not one of these news reporters ever has, or ever would, write or speak a word that was fake.

Here is what the First Amendment says:

Congress shall make no law respecting an establishment of religion, or prohibiting the free  exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.

Floyd Abrams
Floyd Abrams

Author Floyd Abrams was in San Francisco recently plugging his new book The Soul of the First Amendment. The talk, moderated by U.C.Berkeley Dean of the School of Journalism Ed Wasserman, involved reviews of cases – and they are legion – Abrams has argued, and wide-ranging talk about the freedoms guaranteed by the first amendment. But one opening remark, almost a throw-away, stuck with me. Abrams mentioned that President Trump’s comments about Mexicans, Muslims and other groups would be criminal in other democracies, citing cases in Canada and Finland that had resulted in criminal convictions for lesser remarks.

That, though, is not what most distresses this longtime reporter. I understand and appreciate the defense of free speech, even terrible speech with which I strongly disagree. (Think Westboro Baptist “Church.”) What makes my all-American heart ache is the speech that seeks to undermine our free press. If enough people can be led to distrust the press, an autocratic leader doesn’t need to bother throwing journalists in jail.

Think about it. Most reporters, commentators, broadcasters are fairly bright men and women who could make a lot more money doing something else. Do they go into the news business because of a passion to follow a story, to find the truth and set it free?

Or are they just in it for the fake?

Democracy is a fragile concept. After all these years, I hope ours doesn’t break.

Are facts dead? Say it isn’t so

“We’ve got to be nicer to each other. A little more humility; a little more good faith . . .”

facts

These were a few solutions to the condition of the country today offered recently by Author Tom Nichols, during a Commonwealth Club talk titled “Are Facts Dead?” Facts may not be hopelessly dead, but Nichols fears for their survival. (He’s talking about Facts here. Established knowledge. “Alternative facts” seem unendangered.) Nichols maintains that the proliferation of fact-slayers has a lot to do with the rise of narcissism and its corresponding I-know-more-than-you-do assumption.

Nichols, Professor of National Security Affairs at the Naval War College and a CBS TV political analyst, is most recently the author of The Death of Expertise: The Campaign Against Established Knowledge and Why It Matters. Just to reinforce the fact that he falls into the category of expert himself, he is also a five-time undefeated Jeopardy! champion.

“The attack on expertise is part of the narcissistic trend,” he says; “but it’s also because people feel things are out of control. It becomes empowering to say ‘I don’t believe you’ – ‘I don’t believe the experts.’” Nichols readily admits that experts can be wrong. People like to point out ‘expert failure,’ to say, “Well, Thalidomide. Challenger.” You will never find an issue on which everyone was 100% right, he concedes, or a person who’s never made a mistake. But the denigration of experts and widespread refusal to accept known facts is a growing threat.

Tom Nichols & Melissa Caen 5.24.17
Tom Nichols with Melissa Caen

Moderator Melissa Caen, a political and legal analyst, TV personality and no slouch with facts and expertise herself, asked about Nichols’ students, and whether the problem of expert-doubting often starts with (adult) students.

“I tell my students,” Nichols says, “’You’re here to form opinions, not to have your opinions confirmed.’ The best weapon they can have, the most important skill to develop, is critical thinking. Rigid, ideological thinkers are easy to manipulate; critical thinkers are hard to manipulate.” Nichols can wax indignant about teachers who say they learn more from their students than their students learn from them. “I tell them NO! If they’re not learning far more from you then you’re not doing your job.”

The quick acceptance of any absurdity because it’s been pronounced on a TV show or an internet site, along with the doubting of experts is in no way confined to students, though. Non-facts, “alternative facts” and outright lies are being repeated over and over again by public figures today – encouraging people of all ages to accept them as truth. And this, Nichols believes, presents a very real threat to our democracy.

The only people who can keep things on track, Nichols argues, “are the voters. Ordinary citizens.” And it will help if they let experts do their job of getting at the facts. A little critical thinking on all sides might still keep civilization afloat.being nice

Meanwhile, maybe we should also try to be nicer to each other.

Art & the Protection of Democracy

Ward show w Fran
Schumaker with the writer

Ward Schumaker and Vivienne Flesher, two San Francisco-based, nationally recognized artists whom this writer is proud to call friends, have been fighting depression – to put it mildly – since last November. It is of course political – everything’s political these days – but for Schumaker and Flesher (who are in fact married to each other,) it’s about much more than politics. It’s about  human rights, the future of the planet their 9-year-old grandson will inherit, and protection of our democracy.

I met Schumaker shortly before the closing of his latest show at San Francisco’s Jack Fischer Gallery, for a brief talk about art and activism. (Sorry if you missed the show. You can still see his work at Fischer’s Potrero Street Gallery.) Does creating art help them deal with depression, I wondered?

Ward show 1“No. It’s just hard. But it’s what we do: get up in the morning, every day, and go to work at 8 AM.” Some extraordinary examples of Schumaker’s work were assembled for the latest show – creating them took about a year and a half, not all of which time was clouded in depression. My personal favorite is a piece titled “The cloud of unknowing.” Schumaker conceived the piece as a meditation, referencing the ancient (late 14th century) work of mysticism which suggests that contemplative prayer might lead to an understanding of the nature of God.

To mitigate their depression, however, Schumaker and Flesher are doing a little more than painting. They have created an assortment of postcards, some with messages on the front and some just featuring their original artwork. After printing out a stack of cards, they also printed out the names and addresses of every member of Congress, both Senate and House. (You can do the same, by following the links.) They keep these, along with a supply of 34-cent stamps, on their breakfast table, where every morning they enjoy coffee and The New York Times. When they find someone in Congress has done something positive, they send a thank-you postcard. Others get a card expressing disapproval.

Ward show 2Postcards take a little more time than a phone call or email, but are a powerful way to make one’s voice heard. Especially if one is worried about human rights, the future of the planet one’s grandchildren will inherit, and the protection of our democracy.

Plus: this is how democracy is protected.

 

 

 

 

 

 

 

 

 

 

 

 

 

Throw-Away Culture v The Planet

Building 2.16.17
Built in late 1980s

The very lovely, 12-story building in which I have lived for four+ years – along with 90 other condo-owning geezers, sometimes more delicately referred to as “retirees” or “seniors” but let’s face it – is about to embark upon an exterior repair job that will run upwards of $3 million. Repair. Not build, or upgrade, or renovate. Repair. This building is slightly over 25 years of age. (Its owners average generally at least three times that; are WE getting $3+ million repair jobs? We wish.)

Our building exterior is a material known as EIFS, which stands for Exterior Insulation Finishing System. According to its Wikipedia page, EIFS is “a general class of non-load bearing building cladding systems that provides exterior walls with an insulated, water-resistant, finished surface in an integrated composite material system,” in case you care. I am on the Homeowners Association board of directors. For a writer whose undergraduate degree was in Art and who was born essentially without a left brain, I know more about EIFS than I ever wanted to know; I can absolutely promise you that.

EIFS is still quite commonly in use. But I think they have figured out something that early EIFS people overlooked: using paper in an exterior building material is a very bad idea. Guess what happens when the sealant shrinks and water gets in and there’s paper involved. Our EIFS people hadn’t figured that out yet.

3965 Sacramento April '17
Built in 1905

Oh, well. What’s $3 or $4 million to fix a 25-year-old building? I do have to mention that the 4-story house we sold in order to move into this lovely building was itself built in 1905. Throughout a century or so of earthquakes and California rainy seasons (about half of which time it belonged to my husband  and/or the two of us) our exterior repair ran to a few thousand dollars in repainting every six or eight years. It is hard not to mention that I grew up in Virginia, where 18th century buildings (still doing fine) dot the landscape.

No offense to the building industry, but what’s wrong with building buildings to last more than 25 years without 4’ by 8’ panels falling off (yes, two of them did, in a bad storm earlier this year) in the middle of the night?

Building damage 1
(After the storm)

This essay started out to be all about planned obsolescence. EIFS buildings perhaps are not deliberately designed to become obsolete in a decade or two; ours just happened to fall into that category. And the above just came to mind as I was starting to write. But about planned obsolescence. It has its own Wikipedia page. According to that page, it “tends to work best when a producer has at least an oligopoly” (which also has its own Wikipedia page.) It was inspired not by the building nightmare but by my recent experience with my beloved Epson printer/copier machine.

My beloved Epson WF 3520, age four years, took to printing in weird colors. After extensive cleaning of the print heads and performing other bewildering actions in the Systems menu, I persuaded it to resume printing photos (for instance) in absolutely true colors. But now it’s inserting disconcerting lines across peoples’ faces and stuff. Not good. I made a trip to the local Office Max where it was purchased four years ago to ask what else I might do to make the lines go away. The following conversation ensued:

Me: “Is there another Systems thing I can try?”

Office Max clerk (age 20-something): “Did you clean the print heads?”

Me (proudly): “Yes.”

OM: “And the nozzle?”

Me (hesitantly): “I think so.”

OM: “How long have you had it?”

Me: “About four years. I bought it here.”

OM: “Oh! That’s a pretty good run.”

Me (an aside that was totally lost on OM): “Clearly you weren’t born in 1933.”

But come on now, folks. Four years is a “pretty good run” for a $400+ machine used by a little old lady who doesn’t print out much beyond an occasional letter or a short story every now and then? God help us.

Old-time sales & service shop
The DiMele Bros repair shop in NYC

In the olden days, which are getting more olden by the day, there were places called Repair Shops. There was often one titled Mr. Fix-It. Alas, one does not repair anything much in this brave new day – one simply tosses it away and buys the latest new model. In San Francisco we do have a spot beloved by many, Phil’s Electric. (This is an unpaid plug.) If you have something electric that Phil’s can’t fix, you’ve probably worn it out over too many decades.

Things electronic, however, are another matter. You don’t wear out an iPhone 4, you discard it for the 5 and then the 6 and then the 7 and now maybe the 7S. Can you wear out a FitBit? Or an Apple Watch? Or any item gently referred to as a “device?” Nahh.Funky cellphone lady You can, without undue effort, lose them to theft, ineptitude or malfunction. In the latter case – see above re my lovely Epson – the good news is that function can actually be restored in some cases.

Having just done an internet search I find there are more than a few electronic repair places in San Francisco, so perhaps all is not lost. There’s even one near Phil’s Electric.