Category: Family and Friends

California/General interest/Lifestyle/Politics & Causes/seniors/USA/Women
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Pilgrims? Turkeys? None of the above. Today was just Honest Abe's good idea

by Fran Johns

Perhaps the pilgrims and the Indians did indeed sit down to a great feast and a peace pipe; there were probably plenty of wild turkeys around in the early days of the pre-U.S. But all of those things had nothing to do with the beginnings of Thanksgiving Day — you knew that, of course.

Nope. It was Abraham Lincoln’s effort to bring a little peace into the fractured country he found himself trying to lead, at a time about as fractured here as the world is, today, everywhere. Abe thought a little reverence and repentance would be a good thing. Here, in part, is what he had to say:

“But we have forgotten the gracious hand which preserved us in peace and multiplied and enriched and strengthened us, and we have vainly imagined, in the deceitfulness of our hearts, that all these blessings were produced by some superior wisdom and virtue of our own. Intoxicated with unbroken success, we have become too self sufficient to feel the necessity of redeeming and preserving grace…”

Poor Abe. If he thought he knew deceitfulness and intoxication, he should have seen what’s going on in health reform. And if he looked beyond our shores he might have sensed wider “punishment and chastisements in this world” and called for a global pause.

Whatever its origin — Lincoln’s formal establishment of the day was in 1863, but what would preschool be without pilgrims and cornucopias? — Thanksgiving Day still offers a nice time to pause.

Here in San Francisco a few hundred or so of us will be doing that at the 5th Annual Interfaith Thanksgiving Service, where we’ll have a group Ommmm, a Muslim call to prayer, a bunch of other prayers to Whomever has not given up on us all,  “with one heart and one voice” as Mr. Lincoln suggested we do. Then we’ll go home and eat stuffed turkey and watch ball games.

And a Happy Thanksgiving to all.

California/General interest/Lifestyle/Politics & Causes/seniors/USA
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God, Thanksgiving & Mother Theresa

by Fran Johns

Former San Francisco Mayor Art Agnos spoke briefly, and with holiday hilarity, this morning to several hundred Christians, Muslims, Jews, Buddhists and assorted other believers at the annual San Francisco Interfaith Thanksgiving Breakfast — “the biggest crowd I ever addressed at seven in the morning.” The event highlighted some of the work the SFIC does in the city: an annual winter shelter for homeless men, a citywide disaster preparedness program, a variety of ongoing efforts to promote understanding, cooperation and general interfaith goodwill. Agnos told a tale of encountering Mother Theresa which is condensed and paraphrased below as a Thanksgiving present from this space.

Coming home one Sunday night during his tenure, the mayor got a message (this was in the late 1980s, pre-cellphones) from his wife saying Mother Theresa was at their door. (“What should I do?” “Let her in.”)  When he walked into the living room, sure enough, there was the diminutive nun in her blue and white habit, seated on the Agnos’ sofa with another nun on each side. She wanted the mayor, she explained, to secure a particular piece of property for her good works. It was after 9 PM.

“I’ll get right on it, first thing in the morning,” Mayor Agnos said.

“No,” said the tiny nun in her quiet voice. “God’s work does not wait until morning.”

The property in question was in an area of town into which few ventured after dark. When that factor was mentioned as cause for caution, however, Mother Theresa would have none of it. “God,” she said in her still-quiet voice, “will protect us.”

So the mayor, the three nuns, the mayor’s wife (who wasn’t about to miss this experience) and a police bodyguard Mayor Agnos invited along just in case God wasn’t paying attention, climbed into a police car and drove to the building in question. Working their way through a fence which had long before been erected around the property, they walked around the back to find a small group of homeless men gathered around a fire. It was not only getting later all the time, it was mid-winter.

“Oh,” the men said in unison, “it’s Mother Theresa.” She blessed them. Then the mayor asked if the building did indeed belong to the city. “Well, yes,” they said, “but we’ve been living here for several years and nobody’s bothered us.” So the mayor assured the nun that he would get to work on her request first thing in the morning.

She was not finished. Next, she wanted to see about another piece of property, this one necessitating a trip to San Francisco General, the City/County hospital of last resort for citizens in need. By now it was getting on towards midnight.

At that hour at San Francisco General, Mayor Agnos explained, most of the people on site are the cleaning crews and base-level helpers — all of whom immediately recognized Mother Theresa. “When we got ready to leave,” said Agnos, “it was like a football huddle. Everybody in the area gathered around this tiny nun you couldn’t even see in the middle of the crowd.”

“When you die and go to heaven,” said Mother Theresa to her fellow laborers, “you will meet God. And God will bless you for your good work.”

“So,” concluded the Mayor as he opened his arms to indicate those around the room, “when you die and go to heaven, you will meet God. And he or she, whomever, will bless you for your good work.”

Makes you thankful to be in the presence of so many people doing good work.

California/General interest/Health/Politics & Causes/seniors/USA/Women
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Doctors making house calls? An old idea whose new time has come

by Fran Johns

Could house calls make a comeback? It’s already happening. The University of California at San Francisco, for one success-story example, started the UCSF-Mt. Zion Housecalls Program in 1999 with a philanthropic gift. Its original goal was to teach medical students about home care, but with the exploding need for primary care for homebound elders it has evolved into filling that need throughout San Francisco — while still teaching the new generation about house calls.

In an article in the San Francisco Chronicle, staff writer Victoria Colliver details some of the many advantages that such programs have.

June Hagosian’s brain tumor has made it difficult for the 77-year-old San Francisco woman to leave her house in recent years, keeping her mostly confined to her bed.

For someone like Hagosian whose medical needs require frequent doctor visits, that would usually pose a problem. But because of a program run by UCSF, the doctor comes to her. She has had to leave her bright yellow home in the Richmond District to go to the hospital just three times in the past seven years.

“This program has been so wonderful,” Hagosian said during a recent home visit with her physician, Rebecca Conant, director of UCSF’s Housecalls Program. “I wish everyone could have it.”

Conant, who had just 15 patients when she took over the program in 2001, is one of five part-time UCSF physicians who spend all their clinical time outside the office, traveling from home to home visiting frail and elderly patients. Housecalls currently serves nearly 100 San Francisco residents and has an eight-month waiting list.The Housecalls physicians visit patients whose conditions make it so hard for them to go to the doctor’s office that they might otherwise put off seeking medical care. By then, they would be so sick they would need an ambulance and end up in a hospital emergency room. The program takes patients regardless of whether they have insurance or an ability to pay, which separates it from private practices that offer home visits as a convenience but at an added cost.

UCSF’s 10-year-old Housecalls Program is an old idea that has gained new traction. Both the House and Senate versions of the health reform bills contain proposals to examine whether home-based care improves the health of chronically ill patients and saves the government money by reducing hospitalizations and ER visits.”There’s no question there is both a medical need and substantial cost savings to the Medicare program,” said Constance Row, executive director of the American Academy of Home Care Physicians.

The Department of Veterans Affairs’ Home-Based Primary Care program, which has been operating for more than two decades, has showed a 24 percent reduction in costs for those patients, and some studies suggest savings as high as 40 percent, Row said.

UCSF’s Housecalls Programs operates on an annual budget of $300,000, almost all of which is devoted to physician salaries. That’s an average cost of $3,000 per patient, which does not include the cost of hospital care when needed. Medicare spends a national average of $46,412 per patient over the last two years of life, when patients typically have several chronic illnesses, according to researchers from the Dartmouth Institute for Health Policy and Clinical Practice.

But new technology – the ability to X-ray patients using portable machines, conduct blood tests and provide other services using mobile devices – allows doctors to offer a much higher level of care in the comfort of the patient’s home.

Conant, an associate clinical professor at UCSF, said she uses mobile devices to aid in her patient care, but she finds home visits offer other advantages like allowing her to see patients’ physical environments, meet their caregivers and better understand what kind of care they need.

“Not only does that improve medical care, but it’s based in reality,” she said.

The UCSF program is not the only home-based primary care program in the Bay Area. Kaiser Permanente, for example, serves some 370 members in San Francisco as part of its 13-year-old Community Care Program, which is handled by physicians, nurse practitioners and social workers.

Reinstituting and reinforcing in-home care, considering the significantly improved care for patients and the reduced cost to the taxpayer, would seem a no-brainer. But brains are losing out to politics a lot these days.

via UCSF program shows house calls’ time returning.

California/Education/General interest/Health/Lifestyle/Money/seniors/USA
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On learning at 30… or 40… or…

by Fran Johns

True/Slant contributor Gina Welch, on turning 30 just now, posted a fine list of 20 things she learned in her twenties, at the precise moment when I’d been musing about the passage of time myself. A somewhat more elderly muse, that is, since mine was prompted by the realization that day before yesterday marked the 85th anniversary of my parents’ marriage. In case that doesn’t sound elderly enough, my parents were both born in 1897, whew.

So in response to Gina’s wisdom here are six things I learned in my sixties (which are way past, at that.) It was terribly hard not to plagiarize, especially Gina’s Listen to your mother, even if it’s only to her long-departed voice in your head, or Wallow not, advice that improves exponentially with age.

1 – Get up early in the morning. It’s way more fun when you aren’t doing it because the baby’s crying, the school bus is waiting or the boss is calling… but just because the To-Do list actually contains stuff you want to do. Plus, days have fewer hours in them.

2 – Go back to school. Classmates a generation or two younger can be wise beyond your years. After a lifetime of writing for newspapers and magazines (you remember print journalism?) I joined the Class of ’00 at the University of San Francisco to pick up an MFA in short fiction. Who knew? If you run into anyone ready to publish my short story collection, let me know. A few of them have actually seen the light of publication, but I’m going to publish The Marshallville Stories in full if I live long enough… or perhaps if I learn enough in my 70s.

3 – Medicare is good. Imagine not having to freak out at every bodily suggestion that fatal expenses could be right around the corner. Imagine everybody having that unfreakable experience. How about we pass health reform?

4 – Listen to your daughter. She can probably teach you a LOT about changing mores, gender identities, adventure travel and how to see the world. Not to mention low fashion, hair styling, organic food and living well.

5 – Listen to your granddaughter. She can definitely teach you about computer programs, digital photography, what 18-year-old college art students are doing, and teenage music. You can close your ears when the teenage music part comes.

6 – Count your blessings. Seriously. If you’re still able to get up in the morning and remember how to count, this is good exercise. And if you count forwards and then repeat the same numbers backward you have exercised your brain, which is increasingly important. At a certain point in life it is tempting to reflect on the world when nobody locked their doors and you dashed onto airplanes just as they were pulling up the steps. And people apologized if they inadvertently used the D-word in front of your mother (there’s her voice again in my head…) So it’s okay to count nostalgic blessings, too; just don’t forget about par courses or contemporary chamber music or sunsets over the Pacific or that grandson who speaks Mandarin and Spanish at 17…

Thanks, Gina. Happy Birthday.

General interest/Health/seniors/USA/Women
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New Cancer Guidelines: One Good Message

by Fran Johns

News about changing guidelines for cervical and breast cancer screening have some women cheering, a lot of women fuming, and most women feeling confused. Or betrayed, or mistreated or worse.

There is one universal message in it all: every woman has to be her own advocate.

For most of us, that is no big deal. We’ve known for a long time that no two of us (and surely no four collections of breast tissue or no two histories of sexual activity) are alike, and most of us have gotten used to asking a lot of questions. It’s unfortunate that so many changes have been announced at almost the same time, and especially that the issue has become politicized.

New York Times health writer Denise Grady summed up the latest developments, and the issues that have caused confusion and anger in a November 20 article:

New guidelines for cervical cancer screening say women should delay their first Pap test until age 21, and be screened less often than recommended in the past.

The advice, from the American College of Obstetricians and Gynecologists, is meant to decrease unnecessary testing and potentially harmful treatment, particularly in teenagers and young women. The group’s previous guidelines had recommended yearly testing for young women, starting within three years of their first sexual intercourse, but no later than age 21.

Arriving on the heels of hotly disputed guidelines calling for less use of mammography, the new recommendations might seem like part of a larger plan to slash cancer screening for women. But the timing was coincidental, said Dr. Cheryl B. Iglesia, the chairwoman of a panel in the obstetricians’ group that developed the Pap smear guidelines. The group updates its advice regularly based on new medical information, and Dr. Iglesia said the latest recommendations had been in the works for several years, “long before the Obama health plan came into existence.”

She called the timing crazy, uncanny and “an unfortunate perfect storm,” adding, “There’s no political agenda with regard to these recommendations.”

Dr. Iglesia said the argument for changing Pap screening was more compelling than that for cutting back on mammography — which the obstetricians’ group has staunchly opposed — because there is more potential for harm from the overuse of Pap tests. The reason is that young women are especially prone to develop abnormalities in the cervix that appear to be precancerous, but that will go away if left alone. But when Pap tests find the growths, doctors often remove them, with procedures that can injure the cervix and lead to problems later when a woman becomes pregnant, including premature birth and an increased risk of needing a Caesarean.

Still, the new recommendations for Pap tests are likely to feed a political debate in Washington over health care overhaul proposals. The mammogram advice led some Republicans to predict that such recommendations would lead to rationing.

It boils down to this: every woman will need to pay close attention to her own health care. That is bad news for the less educated, the less aggressive, and those with less access to care, and not particularly good news for many older women who grew up with “The doctor knows best” excuse for not paying attention.But it’s good news for those of us, particularly older women, who have questioned what sometimes seemed too-frequent testing and screening.

Asking questions just got more respectable.

Guidelines Push Back Age for Cervical Cancer Tests – NYTimes.com.

General interest/Health/Money/seniors/USA
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Facing Up to Dental Terrors

by Fran Johns

The only thing worse than toothache/jaw pain, to be cruelly specific, is toothache/jaw pain without insurance. Most of us are without such insurance. It has not even been on the radar of health reform advocates, which is just as well — if you add dental terrorism to abortion and public options we won’t see reform for another few decades.

Nevertheless, tooth reform, euphemistically referred to as full mouth restoration in some circles, is ahead for increasing numbers of Americans sooner or later. It comes down roughly to a choice between fixing the mouth or buying a yacht, but if your jaw aches, you forgo the yacht.

New York Times health writer Jane Brody traced the new path of dental repair journeys in a thoughtful article yesterday, explaining her own costly route from tooth decay to bridges to implants, and throwing out an estimate of approximately $3,500 to $4,000 per tooth for the now-preferred latter. Multiply this by at least three or four times if you have other issues, which most of us do once things start going south in the mouth, needing attention. That would be gum problems, repair to surrounding teeth or necessary attention to bone.

I write with authority. Some years ago, facing all of the above, I visited an assortment of dentists with an assortment of solutions that frequently had me in tears when contemplating the time, details (one would have had screws in my jawbone which I would tighten every few days for months as it rebuilt itself) and costs. Like Brody, I grew up before the days of fluoridated water and have had more repair work since childhood than the Bay Bridge. It was a mess in there.

Finally my husband, whose best wives have been born in 1933 but with bad teeth, said, “Just do it all. Don’t be going patch-patch-patch; do it all.” I proceeded to choose the most sympathetic and understandable (most of them were, except for the screws-in-the-jaw guy) dental professionals, assembled a team and went to work. Or rather, I scrinched my eyes shut while they went to work. Some 18 months and $40,000 later we were free at last.

(Out of this experience, during which I was doing a great deal of entertaining just to keep us happy and sane, came one of my finer unpublished books, Cooking for the Dentally Impaired: Recipes and Menu Suggestions for the Impaired and Unimpaired in Difficult Times. I think it’s a book whose time has come; my agent disagrees.)

Brody’s article is a must-read for anyone stewing over this issue. The following are abbreviated tips for anyone with teeth and plans to keep them:

1 – Consider early-decision. The sooner things like gum surgery, crowns, implants-v-bridges or bone issues are dealt with, the likelier all can be made well and kept that way.

2 – Get second opinions. You may even choose the screw-in-the-jaw route, but there are many different procedures and it is good to find one suited to your temperament and bank account.

3 – Ask questions. I asked so many that I was fired by one team; a polite letter said they did not believe they should take my case. It’s just as well. Those I wound up with answered my questions and seemed happy to do so.

4 – Ask for references. Brody suggests this, and I agree. Because I already knew several people who had been patients of the dentists with whom I eventually invested all that time and money, talking with them about their experiences helped keep me from any surprises.

5 – Talk finances. Several friends of mine have had major dental expenses that were far outside their budget, but worked out payment schedules with their dentists so that necessary work could be done sooner rather than later.

Meanwhile: floss.

Family and Friends/sisters
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Sisters and Heroes

by Fran Johns

When Red Room, my good Authors site (surf on over) invited everyone to blog about heroes this week I couldn’t resist posting the eulogy I wrote for my sister Mimi a few months ago. And can’t resist morphing it over here too, so herewith:

Mimi was my hero. Beginning with the day she stood down the Alpha kid in our Ashland VA gang. We were about 6 and 8 at the time. Beverly Ann Brooks kept the gang under control by placing her hands on her hips when she didn’t get her way, and declaring, “Well, I QUIT.” I was totally in awe of Beverly Ann. But one day when everyone wanted to do one thing and Beverly Ann wanted to do another and pulled that on us, my sister Mimi drew herself up to her full several feet, put her own hands on her hips and said, “Well, quit then, Beverly Ann.” I still draw on that moment for strength in times of distress.

So we grew up, with Mimi rather graciously sharing the power she acquired that day. And then we went off to Randolph-Macon Woman’s College, where Mimi regularly bailed me out when I overspent my budget – this was a time when bailouts involved several trillion dollars less than today, but they were still critical in my life. At her senior piano recital I was a nervous wreck, she was cool as a cucumber, the recital was flawless, and I remember being so proud I could hardly contain myself.

After I graduated, Mimi and my college roommate Pat and I got an apartment in downtown Richmond where we set the town on fire. Literally. One of us, who will remain nameless, left the sun lamp on late one night and we woke up to an inferno. Pat and I immediately took off – we did get the other apartment dwellers up and out, but to be truthful we were interested in our own hides. Mimi calmly sat down by the phone and called the fire department, while she took the curlers out of her hair.The neighborhood gathered in the middle of the street, watching the firemen toss our furniture over the balcony.It was 28 degrees.Pat and I nearly froze until somebody got us coats; Mimi was fully clothed with her hair combed.Those of you who knew our mother will appreciate that when she learned of her children’s brush with death her first response was, “Oh, dahling. Any lady would have stopped to put on a bathrobe.” I don’t think Mimi was interested in being a lady, she just thought ahead.

Eventually I went south to Atlanta and Mimi went northwest to Michigan. She immediately learned that southern drawl equated to dumb girl, so she sped up her vocabulary to a point at which I could barely understand her.So I talked her into moving to Atlanta, where she began a long and very distinguished teaching career.

Mimi was pursued by the sharpest and best-looking men across four states and the District of Columbia. But when she met Tom I think she recognized the person with whom she could spend nearly 50 years and never be bored. Leslie was the light of her mother’s life from the day she was born. There is, though, one issue that should probably be brought into the open here. When our kids were in high school, Leslie – along with hundreds of other teenagers – was caught up in a movement led by a Christian youth minister who will also remain nameless, since he may still be out leading movements and helping kids grow up like Leslie and we should all be grateful. But he was some distance to the theological right of many of us, and it drove Mimi nuts. Finally one day I said, “You know, Meem, given all the things we have to worry about with our children these days, I’d pick ‘too religious’ every time.” So maybe I was her hero at that point.

Mimi’s health became fragile over the past decade, and she didn’t do fragile very well. She did piano, alto, organ, accordion, Spanish, tennis, bridge, dinner parties – or declaiming on her incomparable grandchildren – she did all that fine. I am proud of her refusal to do fragile any more. I do know that heroes are masculine and I should’ve said heroine. But in the good old gender neutral a Hero is omniscient.I’m of that old school, and I’m also from woo-woo California and so I believe Mimi is now here, and omniscient, and she is still my hero.

Healthcare/seniors
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Celebrations, changes and challenges

by Fran Johns

The quietude of this space of late is in direct proportion to the activity, at long last!, over at my new blog on True/Slant.com. Boomers and Beyond (you’re invited to visit) looks at issues of concern to seniors and, increasingly also to their boomer children. Health and healthcare, housing, fitness, economic survival, liesure & recreation. We’re open to suggestion. True/Slant is a still-developing all-journalists news aggregate site I think will continue to grow stronger and more useful. With the necessary little www preceding it, trueslant.com/franjohns will take you to my page.

In the meantime, I hope to keep an occasional post over here at the Celebration site. It’s a joy to have a spot in cyberspace on which to ponder anything that might seem worth pondering; it’s even more joyful to get paid (!) for it.

Hope you’ll surf over to True/Slant whenever you can. Hope I’ll still find time to post, here, things that seem too far-out or too quirky to toss up on a serious news site. Over here on Celebrations, I still need to get to the meringue cookie issue.

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