Monthly Archives: August, 2011

Two Hours of My Life I’ll Never See Again

Susan B. Anthony Got This Dress on Sale

‘Beware of any enterprise that requires new clothes’ said Thoreau. Warily, I venture out to buy a shirt. I’m embarking on an enterprise and want to make a good impression. All my clothes are garish, vintage or beat up, and I’m not real happy about my waistline. A new shirt will look crisp and corporate, I hope.

I must truly be getting old, when the distance between Nordstrom’s and Macy’s looks like a hike. This is part of my waistline problem, but that’s for another day. A grey shirt, I think, would be nice. I hate Providence Place Mall, but surely among the ten thousand shirts hanging there I will find one I can love.

Two hours later I have seen them all and I don’t like them.

I must really be a curmudgeon. No new clothes after all, so I’ll just have to put on an attitude.

While it Lasts

It’s 10:10am, I’m cooking what was in the fridge. Everything still works, just a couple of tiny flickers in the lights. I’ve still got hot water and the basement was pretty dry last time I looked.

There’s a big branch down in my back yard but nothing was there to hit. In my neighbor’s parking lot the cars are huddled as far from the big tree as they can get. They look so pitiful and scared. My cat is oblivious to it all. ‘Brain the size of a walnut’, as my husband says. He was not kept late at work today, but will be braving the storm tonight because hospitals do not close, ever.

Home care is a different deal, we’re staying off the roads as much as possible.

I DON’T HAVE TO WORK TODAY!

It’s an ill wind blows nobody good.

Hurricane Barrier Ready for Action

Sunset at the Hot Club

That awesome piece of landscape sculpture, the Providence Hurricane Barrier, is on standby according to the ProJo. GoLocalProvidence has a post by John Ghiorse on the history and function of the hurricane barrier. John himself is a Rhode Island historical treasure, The Ghiorse Factor will be off the scale this weekend.

Men–CNN Will Scare Your Pants Off

Today’s health headline– Five Questions to Ask Before Having Penis Surgery.

An unfortunate man in Kentucky not only lost a part of himself, but also a lawsuit against the surgeon who did the cut. It sounds like the doctor had evidence that the man did really have cancer and that he followed the standard of care.

The CNN article kind of drivels about how women have all kinds of pink ribbon support, and men are on their own. Not too long ago, it was routine for a woman with a breast lump to go under anesthesia not knowing whether she would wake up with her breast amputated, or just an incision. Better treatment is the good news, high incidence of breast cancer is the bad news. I guess, all things being equal, it’s better not to have a rare disease, but the downside is that breast cancer is common and there are few women of any age who never worry about it.

It may be time for a men’s advocacy organization for better treatment of male problems. I’ve done nursing care for guys whose ‘routine’ surgery became a debilitating, miserable, long-term ordeal. CNN’s article contains a lot of good advice and is a good place to start if you want to know more about men’s health.

Trial by Media

Dominique Strauss-Kahn is free, his accuser facing an uncertain future. What started out looking like a turning point– a poor working woman seeking justice for a crime committed by one of the world’s privileged, quickly degenerated into a media circus that left no one looking good.

I care very much about the presumption of innocence. Too many people have been wrongly convicted, from the Salem hysteria, to the Scottsboro Boys, to the many prisoners exonerated after years by DNA evidence. The press can’t be expected to ignore a story that is so intensely interesting on so many levels, but the trial by media harmed both parties. Dominique Strauss-Kahn has wealth and social protection on a level that Naffisitou Diallo can never aspire to. He will never know what it’s like to face poverty or to labor in a foreign country. Ms. Diallo, even if she wins a civil suit, has suffered the greater loss. She had a hard job, but a secure one, with decent wages and benefits. She had privacy. She might have fallen prey to bad judgment and bad companions, but just as likely would have stayed under the radar. Any money left from a settlement after lawyers take their cut is unlikely to set her up in a life that is financially and socially safe. Her reputation as a quiet, hard-working woman has been destroyed. Her life, no less than Strauss-Kahn’s, has value. If her testimony is true, her attacker vandalized a woman’s life just on impulse.

I believe she was telling the truth about what happened in that hotel suite. I think that Strauss-Kahn is not a ‘womanizer’ who uses charm, but a man who won’t take ‘no’ for an answer and has become a man who has a compulsion to hurt women. But that is trial by media– not something that serves justice or the rights of the accused or the rights of victims.

William Saletan at Slate has a post called ‘Frame the Victim’ that brings up some of the troubling aspects of the DA’s office handling of the case. I think they did a lot right, took a lot of heat for it, and then caved too soon. I’m flat out and not able to take it point by point, but will post especially relevant posts like Saletan’s.

This I Believe — Public Education Needs to be Public

We are facing a bit of a “do or die” situation here in Cranston. On September 1, The Board of Regents will vote on a plan submitted by our Mayor to start a new district of schools that will be run by an out-of-state corporation called Achievement First.

Why am I concerned? Why have I partnered with other parents in Cranston to start a rally on Wednesday to oppose this plan? Well, lots of reasons. But the most important is because I believe that public education needs to be public, and this process of siphoning off funds to start large numbers of charter schools is going to hurt our public schools.

Don’t get me wrong. I am not wholesale opposed to charter schools. I considered sending our older daughter to one when we began the process of her public schooling, but chose to put my faith in the Cranston public school system instead. I am grateful for my soundness of mind when I made that decision with my husband seven years ago. Our older daughter has prospered and grown exceptionally well. The Cranston public schools had a lot to do with that.

But the situation with Achievement First is different. This is a proposal to start a whole new district of charter schools, and to eventually draw about 1800 children off of the Cranston and Providence schools. Here is what I see in the future for our local elementary school, which is a Title One school. These are the schools that the charters are likely to draw more children off of — the schools with high percentages of students living in low income households. So the first year, maybe 6 or 7 children go to the charter school from my local school. That means my principal is down about $100,000 when she goes to do her budget. The next year the total number drawn off our of elementary school is about 15. Now she is down over $200,000. As the grades increase in the charter school, more children go there. In year four, she is down about half a million. The school has had to lay off desperately needed staff and reduce programs even further. This is after we have already lost our gifted program, our music programs, and some of our athletic programs in the higher grades.

Some may call my predictions simplistic, but I call them realistic. This is what will most likely happen. Eventually, I fear that a school like the ours will be closed for lack of funding. Now we have a need for another new school because we have lost another neighborhood school. Now the charter district has a reason to expand.

This I believe is wrong. If people have issues with our schools’ unions and how much money our teachers make, let’s work on those issues. I would say we already are, as the teachers have signed a new contract in which they will get no raises. We can work on it more. If there are things that Achievement First and other charters are good at, we can integrate these things into our own schools. We do not need to waste money and time and energy setting up entirely new schools.

So if you have the time and the energy, I ask that you join me and lots of other concerned parents this coming Wednesday, August 24th, at Cranston East High School at 6 pm. We started a Facebook page to gather people together around this issue and to develop our own positive identity as a school district, and the group grew to about 175 members in 48 hours, and is continuing to grow. Please visit our Facebook page here. You can also RSVP to the event on Wednesday by visiting the event page here.

Suburbs 101

Hello friends. I’m not posting so regularly. New job and my father is needing much care and family time.

Tom Sgouros has written common sense analysis of the economics of growth that even this nurse can understand.

This article in GoLocalProvidence
explains the basics of growth, housing, immigration and population, and how it relates to both the ‘burbs and Rick Perry’s Texas Miracle.

So I’ll leave this link. Have a nice day.

Fukushima Like Chernobyl


Today’s news from Bloomberg.com
reports thyroid poisoning similar to Chernobyl…

Medical tests on children living in three towns near the crippled Fukushima Dai-Ichi nuclear plant found 45 percent of those surveyed suffered low-level thyroid radiation exposure, Japan’s government said in a statement.

While the statement didn’t comment on the source of the contamination, the announcement follows reports of radioactive material found in food after radiation leaks from the meltdown of three reactors at the Tokyo Electric Power Co. plant.

Not as bad as Chernobyl, no immediate risk. The Japanese public is increasingly frightened and angry, as authorities are shown to have minimized and covered up the extent of the disaster. Politics trumps science, there as well as here. We have hard choices to make if we are to cut our carbon emissions, but nuclear is not the way. The benefits last a few decades, the consequences are with us for thousands of years.

They Dump, We Pay

I’m on the road today, taking a break at the Liberty Elm. Not much time, but I’ve been on the intertubes late at night when I’m too tired to write, and there’s a little item from the back pages of the ProJo that caught my eye, back on July 27.

This is in my visiting nurse territory. The two elderly high-rise buildings on the end of Smith Street (you will have trouble finding because it’s off the Centredale roundabout) are built on contaminated land. Although I have not seen any three-winged geese or giant mushrooms in the little green patch alongside the parking lots, I do think it’s a shame that un-named persons left behind something as nasty as dioxin. Look up Agent Orange to learn more about how dioxin persists in the soil and water, and what it does to people.

The agency’s investigation found the highest levels of contaminants at a location along the river, just off Smith Street, where two apartment complexes are now in operation. Those complexes are Centredale Manor and Brook Village.

The site was a hub of activity for a former chemical company and a drum recycler, which polluted the area with dioxins during a period from the early 1940s to the early 1970s.

Soil at the main site contained levels of dioxins, PCBs, pesticides, metals and other pollutants that were in excess of environmental standards, according to the EPA.

Most of the contamination was in soils just below paved or capped areas; soils at deeper depths contained less pollution, according to the EPA.

Go to ProJo.com to read
and weep about the cost of the cleanup, and the pollution levels downstream from the little marsh behind the buildings. I have no idea how long that stuff persists if not remediated, but I have seen buildings come and go. A site for elderly housing today could be needed for families with children tomorrow. It would be a bright future if the grandkids could step on the grass.

This was just a little spot on the back pages of a slow news day. Citizen Pete in the comments asks why the Providence Journal doesn’t publish the names of the businesses that dumped all this stuff in the water. Good question.

And, oh yeah, I remember why I posted on this topic. Republican candidates are attacking the Environmental Protection Agency. Well, North Providence has this little remembrance from the good old days before regulation to clean up and pay for. Think of how much money we could have saved with prevention, and how careful the dumpers would have been if they had to pay for the mess.

Take This Cup and…

After about 20 years in nursing I’ve learned to take a methodical approach to certain things. Lab tests, for instance– why not test for everything all the time? That way you won’t miss anything?

It doesn’t work that way. My experience with community screening for diseases like diabetes only reinforces the principle that you need a reason to do a test. Targeted screening is good, random sometimes worse than useless. Wasteful, raising anxiety in people at low risk, missing the ones who need it and scaring people with false positives.

Before testing at all, it’s important to ask what will be done with the results. The ‘Women’s Cancer Screening Program’ for instance, swiftly learned that you don’t say to a patient–’You have a spot on your mammogram. Have a nice day.’ Nope. You have to refer uninsured women to doctors and hospitals that will provide treatment, and that takes more funding. The ‘Women’s Cancer Screening Program’ saves lives and engages many volunteers and providers to carry out their mission. It’s not as simple as free mammograms.

Testing without a good reason and plan for dealing with the results does more harm than good.

I thought of these things when I got this email from my cousin–

THANK you FLORIDA and KENTUCKY!! Florida and Kentucky are the first states that will require drug testing when applying for welfare, effective July 1st. Some people are crying this is unconstitutional. How is this unconstitutional? Its OK to drug test people who work for their money but not those who don’t (and live off the people who do)? Re-post this if you’d like to see this done in all 50 states.
I didn’t verify it but I’m all for it!!!

Well, it doesn’t exactly verify. Kentucky, according to Snopes.com, has this in the legislature, but not passed. Florida just passed a bill this year and is working out implementation

Is the welfare population especially at risk for drug abuse? Who are they, anyway?

I put ‘Rhode Island welfare’ into Google and got the site of the Rhode Island Department of Human Services. Here’s the menu bar…

Families with Children
Children with Special Needs
Adults
Adults with Disabilities
Elders
Veteran

I work with the elder population, and I doubt the benefit of testing all the grandmothers in the high rise buildings. I don’t know if the public wants to cut off benefits for veterans if they have a substance abuse problem– this would seem to call for drug treatment instead. Maybe they are thinking of adults on General Public Assistance…

Eligibility

Rhode Island residents who are between 19 and 64 years old can apply for GPA. To be eligible a person must-

have an illness, injury or medical condition that is expected to last 30 days or more and prevents a person from working
have a monthly income of $327 or less
have resources of less than $400
have only one automobile with an value of less than $4,650
cannot be eligible for other Federal assistance programs, although it is okay to receive SNAP benefits (food stamps)
cannot have a child under 18 living with the applicant
cannot be pregnant

Covered Benefits

The GPA program covers primary care doctors’ office visits/ health centers visits and most generic prescription medications.

When I worked in a primary health clinic there were people who went on public assistance to get coverage for drug treatment. SSTAR detox and drug treatment, for example, accepts Medicare and Medicaide. I can understand the frustration that someone who wrecks their health with drugs can get disability while so many pay a huge chunk of their paycheck for insurance. It is better for society to support drug treatment than to build more prisons, but until we have universal health insurance these inequalities will be a flashpoint for public anger.

Drug tests cost money. Florida’s law requires people applying for public assistance to pay out of pocket for drug tests– if they pass they are reimbursed, if they fail they lose benefits. Since mothers with children are a large percentage of people on public assistance Florida law has a procedure. From the Miami Herald…

• Parents who fail drug tests can get benefits for their children by naming a state-approved designee to collect the money. That designee must also pass a drug test.

This looks messy. It’s not that drug-using parents are okay, but this system seems thrown together and probably unfunded. Who’s going to approve the designee? What happens when there is a dispute?

There are many unanswered questions. What happens with a false positive test? What happens when a prescription drug affects the result? Who evaluates a positive in that case? Which labs will be authorized to do the tests and what will they be allowed to charge? Who guarantees the quality and accuracy of the tests? Governor Scott has a financial interest in a chain of clinics that does drug testing. Does this pass the ethics test?

One of hottest topics in Florida politics these days is Gov. Rick Scott’s plan to start randomly drug testing existing state employees. With estimates of as many as 100,000 tests a year, there would be a lot of money in it for the company that gets to do the testing.

Perhaps not surprisingly, that stirred up talk about Scott’s major investments in Solantic, an urgent-care chain that provides drug-testing services. (During the campaign, he cited its worth as $62 million, deciding to transfer the holdings to his wife’s name after he was elected.)

So, it’s okay I guess.

The new law may not pass the Constitution test. Lawsuits are pending.

A final word about mass screening. You have to look at cost vs benefit.

The most deadly addictive drugs in our country are tobacco and alcohol. They are widely used everywhere. Florida might do more public good with a stop-smoking campaign and a crackdown on drunk driving. The welfare drug test doesn’t cover drinking and smoking.

Another cost, less tangible, is the cost to human dignity. The chain email mentions drug testing ‘people who work for their money’. I don’t think we should accept the idea that our privacy is traded for our paycheck. Some jobs should screen–pilots and truck drivers, for instance. But should everyone get handed a cup, even if they sit at a desk? And there is no problem with their work performance? Does an employer have to have a reason, or is this just the new normal?

Is mass-screening people on public assistance intended to fight drug abuse, or is it a way to please the base, and make a few bucks for some clinics? Are there good options for dealing with the people who test positive, or will they drop off the welfare rolls and end up in the prisons, or in the hospitals at greater expense? Should we institute mandatory testing of politicians? They are responsible to the public, they live on our tax dollars and there is some evidence of substance abuse in that population.

I hope this idea won’t fly in Rhode Island. The best way to solve our social problems is to get our unemployment rate down, and I hope our politicians are keeping their heads clear and working on job creation.

Drug abuse is not limited to the poor, but poor people have not got much opportunity to get help. They can’t just check into the Betty Ford Center. The way to help people beat addiction is to engage them in services, not cut off aid. Too bad Florida did not first build a network of addiction treatment centers, then start a public health outreach. But that would cost money and would not be politically popular.

AND ANOTHER THING: Shockingly, there are people with mental illness and emotional distress who use drugs. Who would have imagined such a thing was possible? It’s called dual diagnosis. Some of the people I’ve worked with who had this problem were military veterans with physical and emotional wounds from war. We are just starting to recognize the damage of traumatic brain injury– the signature wound of the Iraq War. It’s not going to get easier, as long as we damage people faster than we heal them.

THE ICKY PART: Friend Kathryn suggested that our political leaders be the ones who handle the pee cups. That gave me flashbacks to a bathroom with the sink and toilets sealed off, and having to get closer to some grouchy guys than I would prefer. I did a few drug tests when I worked for a walk-in. It’s time-consuming, paperwork-intensive and stressful, because some truck driver’s job depends on the results. I handled the cups, at least I didn’t have to observe the source, as I believe some nurses are required to do. Hey, Florida nurses, thank your governor when the waiting room fills up with sick people while you maintain chain of custody on yellow cups.

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