2 rr's missing 3rd R

Our United States current Democratic Party administration of President Barack Obama and Vice President Joe Biden learned with the rest of our citizenry last week who their primary opposition’s vice presidential candidate would be.

Given that this man has been a very visible U.S. Senator from Wisconsin, actively involved in offering very controversial budget proposals in the past year or more, I am constantly amazed when I keep hearing news reports that many in the general population have never heard of him.  I find this more than just troubling, since I am always interested in knowing what government leaders are doing, or not doing, on my behalf.

When I think of  what this nation, people in every little town and on every farm have endured during the days of Wall Street and the banking world’s upheaval – the challenges we continue to face – how could people not be aware of or concerned about individuals such as him who are potentially instrumental in formulating plans they claim are needed to extricate us from this maze?

During the approximately 11 weeks remaining until our November election, we have the opportunity to thoroughly acquaint ourselves and others with as much as we can learn about these candidates, their beliefs, past actions, and plans that will significantly affect our lives and that of our children, grandchildren, future generations.  

A most succinct fact presentation of pertinent issues with information about these  candidates has been provided at Ronni Bennett’s “Time Goes By” yesterday and the previous day (8/14 and 13.)  

Whatever ones views about how to resolve our nation’s budget crisis, or if one has no view yet, I strongly urge you to read and give serious consideration to the facts she presents about Social Security solvency, Medicare’s and Medicaid’s healthcare dismantling.  The radical surgery proposed for these programs may not only be unnecessary but if done, and this was a true medical procedure, could be considered malpractice.  

Following is a slightly edited comment I was motivated to leave at TGB on those subjects.   

There can be little doubt about the goals of Republican Party Presidential Candidate Mitt Romney, now that he’s selected Paul Ryan as his Vice Presidential running mate I concluded independently before reading here (TGB.)   [Romney has since been trying to distance himself from Ryan’s positions to keep from losing support.] 

Clearly the 2 rr’s (Romney and Ryan) every effort is directed toward channeling citizen monies to those wonderful financiers on Wall St. who did so much to bring us the Great Recession. The financiers and bankers are doing fine, but the same cannot be said for too many Americans.

I think it's incredibly naive to think this nation would have recovered much better under an administration run by the 2 rr's, or would now with what they propose.

I agree with an approach of gradually reducing this nation's debt and not at the wholesale expense of reducing/eliminating support for those whose life experiences have necessitated their needing assistance as the 2 rr's budget would impose.
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I believe there is value in offering individuals a hand up to get back on their feet when circumstances have created such a need. After reading one comment, [possibly from a troll] I do have to wonder why anyone would assume their children and grandchildren would sit around and not work just because assistance was available to others in need?

I, too, recall family members stories that old folks feared going to the poor house before the creation of Social Security as a safety net.   They knew of those who despite  lives of hard work, had unexpected health, accident, or business upsets that destroyed their financial base leaving them destitute.

I know of individuals who suffered such life setbacks.  They would likely have ended in a poor house had it not been for the safety net of social security and/or disability with Medicaid insurance coverage.  Incredibly to me was that they continued to support  the political party and candidates who were the very ones persistently trying  to undermine those safety net programs.  Those  beneficiaries were intelligent reasonable people in other ways, though locked into their ideology, but were blind to life's realities -- their own reality, right in front of them. 

Were they living today they would probably vote for the 2 rr's who I think of as capable of readin' and 'riting but lacking a 3rd R in 'rithmetics higher functions -- those that combine mathematical complexities with practical reasoning through rational thought. 

I see nothing that the 2 rr's propose that hastens the creation of jobs and begins to return to prosperity a decimated middle class in this nation.

I believe the 2 rr’s will try to privatize portions of Social Security  -- this would be a disaster as we should have learned from the recent financial markets collapse.  

I do see the 2 rr’s power play $$$ grab to consolidate control of our government into the hands of the uppermost  % of the wealthiest citizens and corporations – however unintentionally, or intentionally.

We must ask ourselves if this is the American Dream we want to leave our children, grandchildren and future generations?

Communication Challenges

Locked-In Syndrome

"Diving Bell and the Butterfly"
Movie Theater Release - 11/30/07

Health Care System Weaknesses


Imagine what life would be like if we were unable to talk, make sounds, gesture with our hands, but we hear, see and understand people. We know what is happening to us, perceive circumstances and activities around us. Basically, we're just "locked-in" our mind, without voice, presumed to be unable to communicate and maybe thought of as a mental vegetable.

This sudden circumstance presents the communication challenge which has faced a New Jersey, U.S.A. husband and father, Steve Chiappa, since 2001
and a New Zealand Rugby player, Nick Chisholm, since 2000.

The National Institute of Neurological Disorders and Stroke
describes this Locked-in Syndrome as "...a rare neurological disorder characterized by complete paralysis of voluntary muscles in all parts of the body except for those that control eye movement. It may result from traumatic brain injury, diseases of the circulatory system, diseases that destroy the myelin sheath surrounding nerve cells, or medication overdose. Individuals with locked-in syndrome are conscious and can think and reason, but are unable to speak or move. The disorder leaves individuals completely mute and paralyzed. Communication may be possible with blinking eye movements..."

You can refer to The Association for Locked-In Syndrome - French which is written in English, too, for additional information.
This locked-in syndrome is also the focus of a book I read shortly after publication years ago. It's written by a man who actually lived the experience which he describes in The Diving Bell and the Butterfly, also known as "Le Scaphandre et le Papillon."

The years since my reading, I've followed the evolution of the book to film. Finally this true story is scheduled to be released into motion picture theaters November 30, 2007.

I experience trepidation about viewing any movie based on a book I view as exceptionally unique in writing and content as I do this one. All too often there is little resemblance between the book and film. I hope this film's translation depicts the author's experience realistically, effectively describes the arduous, tedious acquisition of his communication skills, though he was unable to speak or gesture, and conveys the narrative power of his words.

Australia's Radio National host Robyn Williams, a science journalist, on his broadcast transcript of "ockham's razor"
says "'The Diving Bell and the Butterfly' must be one of the most extraordinary books ever written - if written is the right word. Jean-Dominique Bauby was trapped in his paralysed body - the diving bell - in which his mind flew like a butterfly. He was locked in." (Italics and bold print added)

From the book cover:
"In 1995, Jean-Dominique Bauby was the editor-in-chief of French Elle, the father of two young childen, a 44-year-old man known and loved for his wit, his style, and his impassioned approach to life. By the end of the year he was also the victim of a rare kind of stroke to the brainstem. After 20 days in a coma, Bauby awoke into a body which had all but stopped working: only his left eye functioned, allowing him to see and, by blinking it, to make clear that his mind was unimpaired. Almost miraculously, he was soon able to express himself in the richest detail: dictating a word at a time, blinking to select each letter as the alphabet was recited to him slowly, over and over again. In the same way, he was able eventually to compose this extraordinary book.

"By turns wistful, mischievous, angry, and witty, Bauby bears witness to his determination to live as fully in his mind as he had been able to do in his body. He explains the joy, and deep sadness, of seeing his children and of hearing his aged father's voice on the phone. In magical sequences, he imagines traveling to other places and times and of lying next to the woman he loves. Fed only intravenously, he imagines preparing and tasting the full flavor of delectable dishes. Again and again he returns to an "inexhaustible reservoir of sensations," keeping in touch with himself and the life around him.

"Jean-Dominique Bauby died two days after the French publication of The Diving Bell and the Butterfly. This book is a lasting testament to his life."

An extract of the book is provided with this link.

Assoc. Prof. Roger Rees, Director, Institute for the Study of Learning Difficulties, Flinders University of South Australia, Adelaide is quoted in the Robyn Williams broadcast transcript noted above, reading this excerpt from Bauby's writing:

"I am fading away, slowly, but surely. Like the sailor who watches his home shore gradually disappear, I watch my past recede. My own life still burns within me, but more of it is reduced to the ashes of memory. Since taking up life in my cocoon, I have made two brief trips to the world of Paris medicine to hear the verdict pronounced on me from medical heights. I shed a few tears as we passed the corner cafe where I used to drop in for a bite. I can weep discreetly, yet the professionals think my eye is watering."

Rees also asks a question we might ask: how many people are there in hospital beds who receive no stimulation, are not recognized as individuals with intact minds, who might still be able to contribute if only their talents were recognized?

Here is a link to an extensive account of then 23 year old New Zealand rugby player, Nick Chisholm's experience in 2000 with locked-in syndrome. His journey, living with the syndrome is described in much more detail along with ethical issues involved.

Steve Chiappa describes on his web site being able to fight his way back into the communicating world having been given a Locked-In Syndrome diagnosis, due largely to the efforts of his family as he reports on his web site.

This New Jersey, U.S.A. husband and father of four grown children has written that at 52 years of age "On Christmas eve 2001 {I} received an early Christmas present, a severe brainstem stroke which left me with a condition known as Locked In Syndrome. At first I was completely unresponsive and unable to breathe on my own." He continues by describing becoming more alert, but he experienced a lack of recognition and acceptance by medical staff that a mentally functioning person resided in his body. What a nightmare of frustration that must have presented him as it would anyone.

Steve Chiappa states the reason for starting his web site is to provide information and hope for those who have received the locked-in syndrome diagnosis he received. Perhaps family, friends and loved ones searching the Internet for information will find him. He provides an email address for contact.

He also says:

"We often think that we are living in a society that provides the best, most advanced medical care available. Get ready for some pretty grim realities.

"Our healthcare system is ill-equipped to handle anything that requires long term treatment."

I know this to be all too true for individuals experiencing any of the large spectrum of communication problems and/or also cognitive deficits. Rehabilitation therapy services in all disciplines have been and continue to be reduced in our U.S. health care system. Most people are unaware of this situation until such time as they personally need the service(s) or have a friend or loved one who does.

Changes in our present health care system, or formulation of a new system, will require careful monitoring of any plan devised to insure further cuts are not surreptitiously incorporated in the final draft. Then there's the fine print that slides by unnoticed by most, as happened with Medicare Part B services some years ago.

Each of three therapy disciplines (Physical, Occupational, Speech) was intended to have a funding cap. The cap itself presents another whole issue relative to long term care needs of some. However, the final adopted criteria with the new limits deviated from the intended funding for each of the three disciplines to have separate caps. Instead, a shared cap between two of them was interpreted (Physical and Speech Therapy.) Efforts to correct this error and inequity have since been repeatedly rejected by legislators.

The fact of this disregard of original intent confirms to me that any health care system plan adopted, better be written carefully and exactly as intended before passage, as the likelihood of corrective adjustment afterword may be quite remote. Such fine print also needs to include the requirement for timely delivery of all medical services, as I have written about previously.

Assessment by a certified Speech-Language Pathologist is highly recommended for any infant, child or adult at any age for whom there is a communication problem, including those who have a locked-in syndrome diagnosis. In the U.S.A. contact the American Speech-Language-Hearing Association (ASHA) for referral to an ASHA certified professional. Solely in the interest of disclosure I should acknowledge this is my profession. All opinions and views expressed here are personal and my own.

Following are the links repeated from above:

Accounts of Individuals Living With Locked-In Syndrome
Steve Chiappa, New Jersey, U.S.A. Husband and Father
http://locked-in-syndrome.com/index.html

Nick Chisholm, New Zealand Rugby Player
http://www.bmj.com/cgi/content/full/331/7508/94

Book:
"The Diving Bell and the Butterfly" Amazon.com
http://www.amazon.com/Diving-Bell-Butterfly-Memoir-Death/dp/0375701214

Movie Theater Release 11/30/07
Web site: http://www.thedivingbellandthebutterfly-themovie.com/

Association for Locked-In Syndrome - French (also in English)
http://alis-asso.fr/ewb_pages/e/eng_alis.php

Elle Magazine
http://en.wikipedia.org/wiki/ELLE
http://www.elle.com/magazine/

Healthcare for All

with Timely Service Delivery

Veterans Care Idea


(This note added after post was published: Thanks to Nancy for providing this link to Kevin Ferris' 11/10/07 Philadelphia Inquirer article titled "A son's pain leads a father to call for help for the VA" documenting the idea source below. This article very effectively describes what too many of our veterans experience in their efforts to seek needed care.)


My Veterans Day post elicited some interesting comments deserving of further thought. Here are some matters which have been on my mind for some time.

A comment from Nancy from Pennsylvania (blog not known, or she may not have one) noted:

"Some of our young men and women are waiting months for appointments at the VA hospitals around the country. While they wait, they often suffer."

This "waiting" is a critical issue for me, as is the "suffer" from the delay. This is true not just for our veterans, but for all our current health care services, and for whatever system we may adopt in the future. Timely delivery of medical services is vital to optimize recovery and minimize deterioration.

Veterans definitely require timely deliver of medical care. Also, any consideration we give to modifying our current health care system, and certainly all plans for a national health care system, must ensure timely delivery of services, whether or not the ailment is life threatening.

My information gathering for several recent years about universal health care systems in other countries (Great Britain, Canada) is on a first person anecdotal level -- from young to elder adults. The one consistent criticism with their systems is with the care delay in many non-life threatening situations. The reports are of long waits "a year or more" for medical care/service for what is considered "elective surgery" i.e. joint, hip replacement surgery and many other non-cosmetic services that can seriously deteriorate with time from a bad situation to worse or more. A few months ago one individual I met reported, in reference to undue service delays, "...not just one year, but two!" This young woman added, "I should know, because I work for the NHS." (National Healthcare System in Great Britain)

I am not writing this in opposition to adopting a national healthcare system in the USA. The lack of healthcare for too many people in this country is a blight on our nation, sad commentary on our society, and heart-breakingly tragic for those parents, children, families, friends, neighbors, others, when they have need. I know of several individuals, in their midlife years, who are only a step away from losing their home, being forced into bankruptcy, should a medical problem require hospitalization and surgeries. The job they hold to pay what insurance they currently can afford would possibly be lost. Or, they might not even be able to perform their previous work if they are able to return following recovery.

I simply want to clearly define at least one of the features I consider essential to any healthcare system we adopt in this country -- timely delivery of services and not just for life-threatening medical problems. I wonder what features are considered vital by others?

Incidentally, (and this is hardly an incidental matter since I'm in this group,) those with what they believe currently to be good insurance coverage and medical service from their doctors, (my primary coverage is Medicare supported by a private supplemental plan,) would be well-advised to recognize we are not immune from possible less desirable health care changes in the years ahead as rising health care costs continue unabated.

I have read numerous reliably documented reports that an increasing number of physicians are refusing to accept Medicare insurance-covered patients. In fact, I have reason to believe I experienced this denial in one instance when I had to seek a specialist a few months ago. I was accepted at another specialist's office, but never saw him, only his nurse practitioner.

The question might be, to what extent does the fact that Medicare reimbursement rates for physicians are being decreased influence these physician actions? The rate decrease is noted in this American Medical Association's Patients Action Network report.

The issues I've mentioned here are only a few threads extracted from the healthcare coverage cloak in which we all want to wrap ourselves, so that we each can have the care we desire and deserve in this wealthy nation of ours. We certainly do need to continue to dialogue about these topics and others which readers might suggest.

One of those threads, Nancy mentioned in her comment, was a possible way to ensure our veterans receive the healthcare to which they are entitled. Here's what she wrote:

"A local activist here in Pennsylvania has a suggestion that he hopes will be put into action in relief of these veterans.

"His plan is for every Doctor in the country to "Adopt" a veteran to take care of. Just think, the young man or woman who needs help would be treated locally by a Doctor who would have a sincere interest in him/her.No long waits for appointments with a hassled Doctor at the VA who has hundreds of others to take care of at the same time. The local Doctor would become a friend, healer and champion of the vet who needs him .

"What do you think? Would it work?"

My response, Nancy, is anything is possible, but probable is another question. I'm not a Doctor, so I will not presume to surmise what the medical profession's reaction to this idea might be. I believe the local activist would be wise to consult with some doctors as to the viability of such an undertaking, to understand the pros and cons of the matter, if the activist has not already done so. If this idea has any realistic expectation of being adopted, I would think the local activist's best chance for successful implementation will be by obtaining the physicians' support. If the activist gains a Doctor(s) support, then perhaps the plan could be undertaken on a small scale. The idea seems simple and workable enough on the surface, but I think the layers in making it function are more complex.

I would certainly welcome others ideas on Nancy's question and on other healthcare issues, whether or not mentioned here.