Scatter my ashes here...

Scatter my ashes here...
scatter my ashes in the desert...

Friday, October 31, 2014


The other morning Dennis went out to get the paper and found this dude passed out in front of our garage.

Felix was out late, probably took SpongeBob drinking, and like the sponge that he is, he wandered off and found our house and passed out.

Felix claims he is glad that SpongeBob is no longer couch surfing at his house, so we're stuck with him for a while. Until he ends up back in Felix's custody. When he least expects it...

I feel really "off" today. Not sure if it's a delayed body hangover from doing the Rock Repeats the other day, I doubt it- or being ahead of an incoming weather front- possibly- or what. I just feel tired and not very motivated.

This morning started out rough, we found out that one of Dennis's college teammates had an emergency aneurysm repair after being rushed via helicopter to a hospital in Denver yesterday afternoon. He's my age. I don't even know all the details yet.

And just yesterday I heard about a guy I knew in junior high back in Pennsylvania who suddenly dropped dead from a heart attack, 51 years old.

For some reason those events smack you in the face. I suppose as you get older, these things happen with more frequency and hit closer to home each time. Life is short, live it now.

Wednesday, October 29, 2014

Live From The Woman Cave: False Start

Only three days into the week and I can tell I need a long rest. Monday and Tuesday were crazy jam-packed days with work and I got out for an hour run on Monday followed by a very brief half mile run with the tire.

I could feel the tire in my low back just slightly on Tuesday when I woke up, but it went away over the day. At noon I met several people from the Fort Collins Running Club at noon at the Fossil Ridge High School track. I jogged easy laps while they did 400s. I just wanted to be there and meet some of the new members of the club. I ran about 4 miles and did a short ride on the bike, mounted on the trainer, that afternoon.

Today I went up to Horsetooth Mountain park and did two Rock Repeats, something I haven't done in months. I figured it would be good to get some climbing in, all I did was hike the uphills and jogged the downhills, I know I will be sore as hell even from that, but I needed to do it.

On my way out there I ran into some old running friends I hardly ever see anymore, they were out with their dog to hike the rock once. We talked for a while before we got started and again before I went out for my second climb, they were finished with their hike.

There were deer out everywhere, on the roads and trails.

Tuesday before I went to the track I had a long conversation with an acquaintance from some of the cancer-related organizations I've been involved with in town. We had not talked much, just briefly when we ran into each other at social functions, since I left the hospital, nearly a year ago. It was a great conversation, ranged from local cancer politics to life and death existential issues to our mutual dislike of the profit-focused lack of care in health care.

It's the kind of thing that sticks with you, and when I was running on the track afterwards, I couldn't wait to get to a quiet place to process what we had talked about, it fit perfectly into a piece I'm writing now.

This week I've been working mostly from home and been spending time with the girls. Iris was waiting for her dad to come home from work in this picture.

Tonight I indulged in a seasonal beer from New Belgium, Accumulation IPA. It has a light body, a mildly citrusy hoppy taste without being overpowering, and hardly any bitterness compared to most IPAs. I like it. Okay, maybe the hard core beer connoisseurs would say it's girl beer. Girl IPA. Girls appreciate the good things, we don't have to drink tar or acid to prove ourselves.

Speaking of girls, they had an extra little treat tonight before we came out to the woman cave, while I opened my beer. They love to lie down at my feet while I work, but occasionally they'll want in or out of the cave.

The rest of the week has some walking, time on the bike, a swim or pool run, and the Tortoise and Hare 5K, a Fort Collins Running Club event which is low key and I will jog it, just to be there. I got a text from Wheaties Boy today asking me if I wanted to meet for speedwork on Friday! I said, you're dealing with a geriatric runner here, how about a beer instead? I don't think I'll be ready for speedwork of any type until 2015.

I can tell how tired I am, I can run and feel decent one day, but then the next day I feel like death. Not ready to jump back in yet, this week has been an experiment with short workouts to see how everything feels.

Definitely far from being ready to get back to anything called training. That's okay, I have enough deadlines and projects to keep me busy.

Tonight I made chicken-spinach enchiladas with a new recipe I invented, sort of. I borrowed a salsa recipe from a restaurant in Manhattan Beach that the owner gave me, and adjusted it just a little.

There is this breakfast place we go to when we're there and it is amazing, it's right next door to a very popular restaurant that people wait in line for hours to get into, but just down the hill there is this tiny café that serves the most incredible food, and they make this fresh salsa that they put at the table and I think I go there for the salsa as much as I do for the food.

The owner is from Mexico and he made this salsa from dried chiles and it has oregano and bay leaf in it, and the flavor is too good to describe, you have to eat it to understand.

I had some chicken breasts that I cooked a few days ago, ground those up in the food processor, sautéed some spinach and onions and red bell pepper, and threw it all together with some nonfat sour cream, and corn tortillas, and a little cheese. I baked it in the oven while I made the salsa.

I added some hot chicken broth to it. About 10 minutes before the enchiladas were done I took them out and poured the salsa broth over the pan of enchiladas and stuck them back in the oven. The enchiladas were mild, with almost nothing spicy, but the salsa was super hot and spicy, and it was a perfect combination.
Eventually I'll remember to post this on Bitchen Swill, but maybe I'll keep it a secret for a while. Good thing I made a big pan, we'll have leftovers tomorrow.

Iris is staring at me from outside. I think she's telling me to quit for the night and come in the house and go to bed.

She gives good advice.

Friday, October 24, 2014

Color, Sky, and Trails, Pain-Free

As we move later into the month of October, which is my favorite month, along with September and May, I am mesmerized daily by the colors and the sky.

This morning I went slightly out of town and hiked Arthur's Rock with Emma. I have not been in Lory State Park at all since we came back from Arizona, except to watch the staging area at the Quad Rock race. I always go to Horsetooth Park instead.

I forgot how much I love the trails in Lory. I used to run there all the time back in my Leadville training days but since my ankles went bad I haven't been up there.

I've been wanting to get out and do some vertical, and even though this is hardly challenging vertical it was so good to get out. The trail is rocky in a few places but not bad. I didn't have any ankle pain at all. Not even one little twist or peep!

I've been working on my hip adductors and hip strength in general, and I think it's helped. Less likely to twist my ankle and not be able to correct myself.

I kept having to stop along the way to take pictures.

I am starting to go a little stir crazy from not doing much. In a way I'm enjoying it but my body is not too happy about being so sedentary. I'm looking forward to starting the workouts. I've been pretty much of a sloth this past week. I will start something next week, at least consistently get an hour or so of something with an effort each day. I've been walking a lot but that doesn't get my heart rate up very high.

I've been busy, between webcasts, Hanginars, radio shows, tweetchats, speaking to students, the exercise support group I started, a book chapter I'm writing, a couple of guest blogposts and podcasts here and there, a magazine feature here and there, some advertising, and attending social and business gatherings, I stay busy. And of course, my clients. I love this.

I finally got my hair chopped shorter yesterday, I realized I haven't had a haircut since April! It was starting to look like a gray haired granola hippie version of myself at age 17.

Not much to report on the ranting end of things though, just a mild one today. I was happy to hear that both nurses who were exposed to Ebola are now clear and discharged from the hospital. I hope the other doctor in New York is able to recover. We have so many more problems in our health care system that need to be addressed, Ebola is a tiny problem by comparison. It's not a tiny problem in West Africa though, and they need help there.

In the U.S., hospital acquired infections (HAIs) like MRSA and C.Diff infect and kill so many more people and cost so much more. So do medical errors. Yet the people in power don't get that underfunding and understaffing lead to these problems. It is interesting to watch the reaction of the health care community and the media hype and paranoia machine, Ebola is the pornography of the day and HAIs are just boring now. Doesn't anyone remember all the hype about MRSA a few years back? Most people probably forgot what it was. It's not this month's centerfold.

Nobody ever said you have to be smart to be in health care. Just because someone is a doctor doesn't mean they can think outside any box. Sometimes the people who are supposed to be the smartest are the ones who have the most inflexible ways of thinking and functioning. I've seen a few dumb nurses, but I think I've seen a lot more dumb physicians. And even more so in administration, Dumb and Dumber, because you always have to have the VPs and alphabet soup of chief executives to prop each other up.

I am looking forward to next Wednesday because the election will be over. I am sick of the political ads and disgusted by how much money is being spent. I got these huge oversized postcards, full color, from the Colorado Democratic Party to remind me to send in my ballot. Are you kidding me? I would think if someone bothers to register with a political party these days, they are going to vote. Why spend all that money on direct mail? I already sent in my ballot.

I wasn't happy about the choices either. Don't tell me that Udall is going to do anything special. I only voted for him because I think his opponent Cory Gardner is terrifying. Needless to say the Colorado Democratic Party is not going to be getting any donations from me. We waste so much money in this country on these stupid political campaigns to elect people who don't do shit. And then we pay them even more to do nothing.

You know what scares me? Over the past couple of weeks I've been paying more attention to the mainstream media online than I usually do. I know about trolls who stalk the comment sections on most of these media sites. But I never read their comments. Until this week, because I was curious to see what people were saying about the Ebola thing and health care, to see if the real important messages were getting across to the public.

Nope. It became the same old slugfest of people who don't think because they can't form a rational thought. They can't write sentences, either. It's ignorant, hateful, racist and creepy. I hope that they just represent a small percentage of public opinion and voice because if this is mainstream thought, then we're in big trouble. We might as well forget about Ebola protection, let's have an epidemic and wipe everybody out and start over in a few million years. I am convinced that those people who troll the comment sections are not human. No hearts, no brains. Chilling.

There's color everywhere. Just this week the leaves started to fall down, I know what's coming next, gray skies, bare trees, and ice. I'll enjoy the clear streets while I can.

This, by the way, is the mother tree to our apricot trees. I took the pits from the fruit on this tree a few years ago and sprouted the seeds, and I planted 5 of them in our yard. Three of the five are doing well, two are as tall as me and another is 8 feet tall.

And the Buffaloes are enjoying the crunchy leaves.

Tuesday, October 21, 2014

The Fallout Continues...

Tonight I did a radio show on breast cancer awareness month and pinkification of October. It was fun, especially when I was scheduled for a 30 minute show and the host suddenly, a few seconds before we started, saw something that erroneously told her we were on for 60 minutes. I was fine with that, I had plenty of material and I could talk forever about these topics. We slowed everything down to stretch it out, and then suddenly, 5 minutes before the 30 minute mark, someone tapped on the door to tell her the show was only 30 minutes, so she let me get my last words in and I scrambled to say all of the important points in the last 3 minutes or so. Crazy, but fun anyway.

After the show we talked for a little while casually about health care and I mentioned my challenges in getting my business off the ground. One of the biggest assumptions I made at the beginning was about how I'd market my services. I thought doctors would be interested in what I was doing and welcome it. Well, getting to talk to a doctor face to face has only happened enough times to count on one hand, and most of those were by accident when I ran into them in town somewhere by chance, like in the grocery store.

The way I see it is, I have this great service that would be so good for their patients, but I can't even get 5 minutes of their time to talk with them about it. They just don't prioritize that, it's a different way of operating than they are used to, and now with fierce competition in town, everyone is protecting their own turf and profits. They see anything outside of what they do as competition.

The host of the radio show, who works in health care herself, told me that a doctor she knows thinks physicians are slow as snails to adopt anything new, she said on the order of 17 years (about as long as a new drug patent used to last before the generic could be marketed).

We are still being inundated with Ebola everything, and I have read some highly astute observations from people at the direct care levels of health care, physicians, nurses, infection control specialists, and techs on the state of health care in this country. Many of the things I have discussed in past blogposts with regard to patient safety and how nurses are treated in the workplace and when they raise concerns about safety issues in the workplace have surfaced in the Texas Presbyterian flap.

I also read with interest this article about how things are being handled at the Biocontainment Unit at the University of Nebraska medical center, one of the hospitals where Ebola cases are treated and they have a solid and effective plan in place for their workers to prevent transmission of the disease. If you go to page 2 they talk about breaking shifts into four hour blocks when dealing with the extreme conditions of having to work in hazmat gear, and on page four, they discuss how they pay attention to the needs of the caregivers.

Some of the things they do could be applied in general, such as allowing time for breaks, to eat and drink and use the bathroom, having behavioral specialists to help people deal with the stresses of working. If you're not in health care, you might think, what? Of course you need to take breaks and eat, drink, and go to the bathroom. If you are a nurse, you're thinking, what a novel common sense approach, and you're already googling on U of N Medical Center to see if they have any open positions on their employment site. You're thinking, hell yes I'll work with those patients in a space suit if it means I get to pee and eat every four hours!

Just think what we could accomplish if safety was our top priority. We'd have to slow down, and maybe take care of the needs of the employees who are taking care of patients. And then maybe we could have zero hospital acquired infections, and instead of thousands of medical errors they would be as rare as Ebola in the U.S.

Why is it that in health care, when we should be staffed by smart people making good decisions because we are relying on them to take good care of our health when we are sick and dependent on them, that it turns out we are at the mercy of irresponsible, detached, myopic decision-making at the highest levels of the organization which trickle down to the front line workers being abused and working under inhumane conditions?

The other thing I noticed was that under the CDC new guidelines, which they released after a bunch of health care workers (namely nurses) made A LOT OF NOISE about the inadequacy of the first few messes they sent out...the new guidelines clearly state that management and leadership (ha- see my blogpost from a few days ago) are responsible for seeing that the guidelines are implemented and followed. Read: Five Pillars of Safety and I quote:

Five Pillars of Safety

CDC reminds all employers and healthcare workers that PPE is only one aspect of infection control and providing safe care to patients with Ebola. Other aspects include five pillars of safety:
•Facility leadership has responsibility to provide resources and support for implementation of effective prevention precautions. Management should maintain a culture of worker safety in which appropriate PPE is available and correctly maintained, and workers are provided with appropriate training.
•Designated on-site Ebola site manager responsible for oversight of implementing precautions for healthcare personnel and patient safety in the healthcare facility.
•Clear, standardized procedures where facilities choose one of two options and have a back-up plan in case supplies are not available.
•Trained healthcare personnel: facilities need to ensure all healthcare providers practice numerous times to make sure they understand how to appropriately use the equipment.
•Oversight of practices are critical to ensuring that implementation protocols are done accurately, and any error in putting on or taking off PPE is identified in real-time, corrected and addressed, in case potential exposure occurred.

A culture of worker safety. Hmm. And what culture is that? It's the one that is greatly exaggerated by most corporate leadership accounts. If something interferes with the bottom line, there will be a workaround. Somehow...

And somehow...University of Nebraska seems to get it, but that safety culture needs to expand throughout the health care system in this country, and profit-centered models of health care are not going to welcome it.

Certainly that culture was nonexistent at Texas Presbyterian, where they couldn't figure out that their PPE was inadequate or spend the money to transport a patient to where someone knew how to take care of him...yet they had plenty of money to hire an expensive PR firm to tell them how to handle their image after their disastrous mistakes that repelled patients to the point where their hospital is nearly empty now.

The culture at Texas Presbyterian, the same one that has administrators telling nurses not to go to the media or they'll be fired, the same one that resulted in one nurse blowing the whistle and we know she'll never be able to go back to working for that hospital again because of the retaliation she will face. Lawyer or not, the hostility directed at her after speaking the truth will make it impossible for her to carry out her duties, as they'll be watching her every step and finding ways to harass her until they get rid of her.

This is the reality of health care, folks. And it needs to change. If you're not in health care, this is what goes on behind the scenes when you or your family member is being "taken care of". This is what the nurses endure. This is what physicians are forced to work with, administrators who are unresponsive to their needs too.

This is what I've been screaming about so passionately for a long time, and finally we have a crisis that has brought these issues directly to the surface. And a lot of organizations are going to deny that they do business this way, and defend their own practices with lawyers, PR tactics, and doing whatever they feel they can get away with. "We're not like Texas Presbyterian" will be the cry of protest. But right now, every one of these organizations is scrambling to give the impression that they are prepared and trying to minimize their expenses to protect their profit. Some are more prepared than others, but the culture is what needs to change across the board.

This is health care in the U.S. naked.

Do you care yet?

Sunset: Three Views

Time to get back to running and the good stuff.

I took a whole week off from running last week, all I did was walk the girls. My feet are in the process of getting ready to shed the blisters, soon I will be able to peel those old calluses off, but not yet. I have three toenails that are painful and I'm ready to pull them out, but they aren't ready yet. When I'm trying to get comfortable at night, every time the sheets hit those toenails, they hurt! I think after all of this I might only have four toenails left.

Last night I was driving home from a client appointment and I saw the sky and knew I had to stop at the lake to take pictures. I got Longs Peak, Horsetooth Rock and the mountains in between. I live in such a beautiful place. So lucky to have this in my backyard.

I went out for an easy 3 mile run yesterday and I felt creaky. Not ready to dive back into it. I did set my bike up on the trainer and will start that this week, and go to the pool at least once.

Tonight I am talking on a radio show, on the local public radio station, about how we can improve on breast cancer awareness efforts and about pinkification. It's a half hour show. Eventually the podcast will be available.

I'm enjoying the fall colors, which are peaking right now in town. The trees are dropping their leaves fast and soon it will be back to winterscape. We've had such mild temperatures, we've only had frost a couple of times so far. The raspberries and tomatoes continue to grow and ripen.

It's always a tough time of year for me with running, I love fall and would like to be out running long in this weather, but I need the break so badly. There are so many runs I'd like to do. I go for walks, and I can get out and hike, as I plan on doing later this week. At some point the season has to end and my body has to go into hibernation for at least a short time. Winter will be here soon enough. For now, I'll soak in the colors at a slow pace, as long as they last.

Sunday, October 19, 2014

Is Ebola the Cure?

Ebola is shouting at us, but is anyone listening?

This morning I read what perhaps makes the most sense of any of the volumes of material that have come out in the media over the past two weeks since Ebola hit our shores.

I'd like to elaborate on some of the points the author makes and add my own.

Ebola might actually be the cure, if we would just pay attention and listen to what it is telling us about how we run things in this country.

I see Ebola as an opportunity to get things back on track. Will we have the vision and leadership to do this?The way we’ve been operating for so long, my fear is, we do, but we’ve forgotten where to find it. We need to put our ears to the ground to listen.

First, we have gross misallocation of resources in this country. The huge portion of our GDP that we spend on health care is largely wasted, we’re not getting our money’s worth.

We don’t value preventative care or good health.

We have media looking to make a buck off mass hysteria. They stir the pot to the point where it bubbles over to one side or the other, parroting stupidity and spewing hate. Each side is convinced the other side has a conspiracy to destroy those with whom they disagree. Look at the trolls who follow any online article.

We have greedy, profit-centered institutions guide our health care system, looking only to make a buck off our sickness, with lip service to something called wellness.

Companies manufacture more new products every day to make us sicker, from foods to chemicals to sedentary entertainment gadgets.

Specialty-trained health care providers looking to make a buck off the few patients they hang onto when avoiding joining the big guns give advice to patients they don’t really have the expertise to provide, and the patients themselves are not health literate or able to critically think enough to know the difference.

Health care itself is dysfunctional in that there is no communication between the levels of hierarchy that have been created. Nurses, who spend the most time with patients, know the most about the patient. Physicians know how to treat the patient, but do they listen the nurses? Administrators are concerned only with protecting the bottom line of their own little turf, don’t listen to the physicians, and friction develops between the layers.

Meanwhile, the money gets funneled to duplication of efforts and waste. No one at the top of the heap listens to the muffled cries of those at the bottom, those who see reality on the ground.

We have a political system that has completely failed us through inaction and servitude only to the wealthiest entities who feed it. Only self-interest and greed guide our career politicians. There is no coordinated effort in our government to look out for the best interest of the people. Those who seek election think it’s optional to take facts and scientific evidence seriously. If it interferes with profit, who needs it?

Not only have we failed to fund public health, we’ve been failing to fund education, transportation, and other public resources. Look for more crises in these sectors in the near future.

We’ve forgotten how to communicate with respect, how to listen, how to think critically. All of the issues that Ebola has brought into sharp focus should be seen, but we don’t have any leaders who are seeing.

We’re going to face more crises of this magnitude the longer we allow our country to operate in this dysfunction. We need true leadership, an end to the greedy, profit-obsessed way of operating, and a re-focus on the needs of our greatest assets: people.

Saturday, October 18, 2014

Leadership is just another word for...

Yes. As in yes men.

One of the things you see in organizations is the habit of naming certain people as part of the LEADERSHIP. They LOVE the L word. They love to hear themselves say it.

They emphasize to everyone that THEY are the designated leadership team. That gives them privilege, they get to sit in on meetings and are privy to additional layers of company secrets that the underlings are not. They also get to escape accountability as a perk. They get to blame other people for failure, but leaders stay clean. 

The moment anyone DOES try to hold them accountable though, they hide behind the other big L: Lawyers.

Leadership has become simply another word for yes man.

What we needed in the face of the Ebola problem, as in so many other events, was a leader. Solid decisive action. We did not get that. We got buddies of the President appointed out of political favor instead.

You won't hear me criticize Obama very often. I don't usually mind when people do, though, because I don't mind other people having opinions that differ from my own, and I don't need to be right.

As long as it's not some troll spewing mindless racist hate or parroting abject stupidity, I just let it be. I have my own political views and I'm not afraid to say I tend to lean very much toward the left most of the time. But I also think it's important to remember that we are talking about public health and safety, and Ebola doesn't care if you're a Republican, Democrat, or Purple. Nurses don't refuse to take a patient based on their political affiliation. We're all human beings and we're all affected by this.

That said, I am very disappointed in Obama for this appointment of a so-called "Ebola Czar." This guy has no health care or public health experience whatsoever. He's an attorney and works with big business, and therefore has no clue about the things that frontline health care workers do or deem important.

We have a problem in this country and it's lack of true leadership. True leadership is not the fake kind taught at Harvard Business School. Look at the people in Congress, for example. They won't even act on minor issues because it's midterm election season. Where are their priorities? They certainly are not with the people of this country. They prioritize their own reelection so they can continue to prey on the well-funded palms that feed them, the ones who got their money by preying on the public.

We need to string them up by the part of their anatomy that is most sensitive to pain and say, you need to act. Quit protecting your own turf and do what we're paying you to do. Remember we are still paying them, in terms of benefits like health care and retirement, and it's out of our taxes, which we pay disproportionately more of than their rich buddies. The perks from lobbyists and guarantees of golden parachutes are much more lucrative, and as long as they keep it so, the people are screwed.

Career politicians are not leaders, just like the so-called leaders of corporations. Self-interest. Greed. Power. Those are the things that motivate these people. As long as they are safe, comfortable, and profitable, they won't do a damn thing to change.

This is what happens in corporations. I can remember working in the hospital and there would be these "leadership" meetings that always consisted of roughly half the unit staff, while the other half stayed and worked. All of the so-called leaders were in their positions due to length of time they'd been there or the fact that they were the biggest kissasses, and/or the most toxic people on the unit.

This is an aside, but I couldn't help thinking, when I saw what happened to Nina Pham, the first U.S. nurse diagnosed with Ebola in Texas, that she must have somehow drawn the short straw on assignments that day. Or maybe she volunteered for the challenge. I can remember the nasty charge nurse I had to deal with in ICU who would always give me the most distasteful assignments that she'd never give to her buddies. When I was a new nurse, I used to ask for more challenging assignments, but what usually happened was I got the patients no one else wanted. Had Ebola come to the unit I worked in, I probably would have been the one given the Ebola patient without adequate protection.

Who knows what they discussed in those meetings, I was never invited. I was one of those dangerous people who questioned things and might actually think for myself. I stayed and took care of patients while they "led" in the conference room. They never communicated to the rest of us what was discussed in those meetings. Occasionally we'd ask them to, and they'd pretend they would do it, but they never actually got around to it.

There were always a lot of leaders relative to the non-leaders. It was more of a secret club than anything. You'd have to somehow demonstrate your loyalty to the system before you could be granted admission. And just how you did that, was never made clear. There was never a book of rules, or a playbook that was shared with everyone. That's how you keep the underlings in line. People who want to do things and take action are not the ones who are valued in these organizations. It is the sheep who stay, are promoted, and kept.

Do a shitty job, keep your clique in place, and get rid of anyone who thinks critically or has ideas? Get promoted to an executive position, created just for you.

Take action on a patient safety issue? You're fired. We don't want the world to know that we really don't value patient safety, that it interferes with the bottom line.

Business schools and law schools don't produce leaders. Actually most schools don't. They provide didactic knowledge, but it's not applied to any real world situation very well, if at all. Experience and demonstrated decisive action do. That's one reason why we've always valued military service when people ran for president.

I am not sure that the military is any better of an organization but it certainly does provide opportunities to demonstrate leadership. With all the changes in the military I am not sure that it provides what it used to. But I do know that in my health care experience, I have seen the establishment frat boy culture completely diss a newcomer with military experience and common sense, when they could have learned and gained from his ideas.

The frat club of business school-educated "leaders" knows how to work the system to eliminate any common sense or true efficiency from the system. They pretend to implement systemic changes which really only serve their bottom line, and usually result in inefficiencies for the people who do the real front line work.

Some have called for an office of a National Nurse, another ball that has been dropped in our pathetic Congress. If there had been a national nurse (not to mention a Surgeon General and adequate funding) in place prior to the Ebola incident, perhaps we could have avoided this mess.

What's it gonna take? Well first, we have a midterm election coming up. You can start by voting for people who have demonstrated competent leadership. A newcomer, preferably, not an incumbent. We can make sure that anyone running for President who gets as far as the primary is thoroughly examined by the public to look for true leadership ability and experience, not a career politician.

And we need to insist, like National Nurses United has demonstrated so well, on our voices being heard, our recommendations being implemented and taken seriously, and not backing down to the fear tactics currently used in the corporate playbook that result in voices acting in the public's best interest being threatened and squelched.

The one nurse from Texas who blew the whistle and went to the media? She is a hero. She is risking her livelihood but she is protecting the public, and that's more important. She will find work, perhaps not in a corporate health care system, but someplace where she can do meaningful work.

We have got to stop allowing these business school educated, incompetent people to run our health system. We need people who know the health care landscape, who have experience, boots on the ground, and know how to take action in a crisis.

You wouldn't allow the CEO to run a code, would you? Why should they run the hospital at all?

Health care and public health are not a business. Stop running it like one.

Thursday, October 16, 2014

A Day Late...

And a dollar short...yeah, that's the understatement of the year thanks to the CDC and a few other entities who could have been on top of things.

On Wednesday I listened in on the teleconference held by National Nurses United on the topic of Ebola. I want to share some of the details of that webcast with you, because I think it's important for the public to get a picture of what is going on in health care from a health care provider's perspective, and how it could affect your health if you were to end up as a patient in a medical facility, regardless of what you come in to that facility for.

It's important to think about this, instead of listening to all the media hype, because they are great at scaring large segments of the public, and if you read the comment sections on any online news story, which I advise against, you will immediately see a list of diatribes from anti-Obama, anti-government, anti-everything psychotic rants that do nothing but finger the political party with which they disagree and blame them for this. The truth is much broader than that and it's a failure on many levels.

The fact is, you are highly unlikely to come in contact with Ebola in your usual everyday life.
But I also want you to understand the magnitude of the problem because for those very few instances where there is an actual case of Ebola, it is a problem, the way it's been dealt with so far by hospital administrators and the government. And this needs to change.

I want you to understand that if you are admitted to a hospital for kidney stones, for example, and your nurses or doctors have been caring for a patient with Ebola, and have not followed proper procedures, your health could be at risk.

That said, nurses and doctors are human beings and they work for entities known as health care organizations aka hospitals and those hospitals have certain policies and procedures that they mandate the staff to follow when interacting with patients everywhere from signing admission paperwork to ordering meals to handwashing, not to mention handling isolation patients with highly contagious and deadly diseases.

The NNU teleconference started with statements from nurses stating their hospitals were unprepared, from all over the country. There were a few statements from nurses from other countries.

There was also the story of a Florida nurse who was "suspended indefinitely" for seeking her own information directly from the CDC, because her hospital did not provide the information.

The CDC did not act fast enough when it was known that there was a case of Ebola. The health care workers did not have the training or proper protection and for 3 days took care of the patient with less than adequate protection, even though the CDC's information on their website was dated June 2013 so we already knew that Ebola was a class 4 pathogen. The virus can live for up to 7 weeks outside the human body, so the disinfection process is much more intensive and specific than for many other pathogens.

The fact that hospital acquired infections from organisms much less dangerous and virulent than Ebola are epidemic in our health care system, even according to the CDC itself, to the tune of 1.7 million per year! and chronic understaffing of health care workers- from nurses to housekeepers, results in staff who are working being more likely to be rushed, pay less attention to detail, with more mistakes made, and important things missed.

Why the CDC did not immediately arrive in Texas is not known. Why did it take 3 days before the nurses caring for the first Ebola patient had barely adequate protection? Why did the administrators at the hospital allow the nurses working with Duncan to take care of other patients? Why did they not demand a visit from authorities to give them clear and immediate direction in handling this case? There are dozens of unanswered questions from the whole incident from the time Duncan arrived at the hospital the first time.

Where are the administrators of the Texas Presbyterian Hospital now? They are silent (CYA) hiding behind their lawyers, and of course bracing for legal action. They are no doubt formulating their defenses and not 100% concerned with health care at this point. After all, as a human being, you can only do so much. Here is the statement from the nurses at that hospital.

Why did the CDC tell the second nurse that it was okay for her to get on a plane? She should not have but she did seek their guidance. And that is what they told her. Two wrongs don't make a right. She should have used her own judgment in not getting on plane, but the CDC also should not have advised her to get on plane.

The plane that carried her from Cleveland was decontaminated. How many passengers could be exposed, probably few at the early stage of the disease but we all know that planes are filthy and not cleaned between flights, so there is a huge potential safety hazard to the public which the airline industry should be addressing now. Do we actually know how Ebola is spread at different points in the disease? What is the viral load at the beginning of symptoms as opposed to when the patient is extremely ill or dead? How are the virus particles spread- through the air? Or only by direct contact as they were saying. In the teleconference one of the scientists said that she was now changing her mind about how the virus might be spread, and it's possible that it could be airborne. We just don't know for sure yet.

So many pictures have surfaced in the news of workers wearing hazmat suits to transport patients and decontaminate. So why were the nurses not given this protection? The hazmat suits are Level 4 HazMat gear which is recommended for Ebola, Marburg, and several other types of extremely contagious pathogens. A secured area is required that will contain a method of decontaminating and removing the protective suits, the hazardous waste is handled in a completely different manner than most red bag waste in hospitals, and the rooms are cleaned and disinfected in an entirely different way than even most standard isolation rooms. Transporting and disposing of the waste (through incineration) requires another detailed and meticulous process. This is far beyond what is needed for meningitis, flu, TB, and other commonly encountered diseases in the U.S.

Employees who will be involved in any part of the process, from nurses to housekeepers to facilities and waste management people, will now have to be trained in flawless execution of these procedures. That costs money and takes time.

According to National Nurses United, it's a public policy failure, a result of long term underfunding of public health. The CDC’s budget for Public Health Emergency Preparedness fell from $1.1 billion in 2006 to $698 million in 2010 to $585 million last year. From 2008 to 2013, local health departments lost 48,300 jobs to layoffs and attrition, or about 15 percent. “Those job losses absolutely eroded the capabilities that would be needed if we had to deal with Ebola,” source: The CDC's funding had been cut in half over the past 6 years. Now we have a crisis.

Off the subject, but relevant, is the fact that so many public agencies have been underfunded. Take public education, for example. Eventually those chickens will come home to roost too. If the comment sections of any of the online news outlets are any indication, people have already lost the ability to think logically and critically, they just parrot the words of politically motivated hate spew.

National Nurses United is bargaining for adequate staffing, protection, and training. The ANA (American Nurses Association) has been much quieter, have not taken a strong and vocal stance. Nurses were the ones who made noise about it while the CDC and Texas hospital administrators, and administrators of hospitals all over the country were dragging their feet. We all know that if administrators had to go see a patient with Ebola you can bet they'd have the highest quality hazmat suits ever but with the workers they try to do it on the cheap. All about the bottom line.

Nurses are concerned with care and protection for patients and workers. Nurses will save your ass. In a pinch, count on a nurse.

There is a whistleblower hotline 1-888-381-4585 to call if your hospital is not taking adequate precautions. For more information

The NNU says they will be not silenced and will not stop, will not back down to leadership or threats. Policymakers (Congress) are not helping, they need to take action. People and the public trust nurses, and for good reason. We are the ones screaming about this louder than anyone, and have acted to make changes in health care. (Except for maybe the news media, who have blown this all into a scare crisis to boost their own bottom lines.)

If you are a nurse or health care worker in a place that accepts patients from the public (urgent care, hospital, ER) and your employer has not yet come up with any sort of plan to address potential cases of Ebola and shared at least the relevant information with you, then you ought to be looking for a new job, and at the very least, blowing the whistle. There is nothing wrong with opening your mouth. You might save lives. Too many nurses have been silent about safety issues in situations far less deadly than this one. It's time to stop that submission to power and threats, and do what you know is right.

So if any heads should roll, let's start with the director of the CDC, the Texas hospital administrators, the administrators at the Florida hospital, and any other people who tried to suppress the actions of nurses who were acting in the interest of public health.

And if Congress does not act, their heads too. Election year or not, they better do something. We have a problem in this country, and it is our elected officials' addiction to power and money.

The bottom line is, there are a lot more important things than profit. If we would start valuing those things, like public health, and education, in a spirit of compassion and respect for our fellow human beings, it would go a long way toward solving so many of these crises before they even become crises.

Wednesday, October 15, 2014

Curse The Nurse: Not Gonna Fly

The chickens came home to roost. The old knee-jerk response out of the administrative playbook, blame the nurse, it's the nurse's fault, is not going to work anymore. Playing the game I call Curse the Nurse.

National Nurses United had the cojones to address the situation head on, instead of the pathetic response from the American Nurses Association. No wonder no one joins the ANA. They don't do a damn thing for nurses, they are part of the problem.

Just a few brief thoughts here as I am busy today with other things, and I want to attend the teleconference being hosted by National Nurses United about the Ebola issue.

Playing Curse the Nurse: It's a problem that happens from the lowest levels of management to the highest levels of national agencies. If you as a nurse let your manager know that there is not enough working equipment on the unit, they are likely to say, "Well, what are YOU going to do about it?" (implied: in between caring for 4 or more patients)

From a foot-dragging response to concerns about patient safety on the unit that could easily be fixed with an inexpensive solution, to passive-aggressive spying tactics and manipulation of coworkers to skew employee reviews, to playing dumb "I don't recall having that conversation", management plays this game flawlessly. They get away with it.

And as the CDC has shown us, it's a convenient tactic at any level of the health care industry. Blame the nurse for all the problems. Blame the people with little power and few resources for the missteps of those who hold all the power and all the resources.

Blame the nurse for breaching a virtually nonexistent, and at best, totally inadequate protocol. Tell other nurses, when your mistake is discovered, that they'll be fired if they say a word to the media.

Profit-mongering, covering your ass, and playing these big business games are unacceptable in healthcare. When it comes to public safety and patient safety, nurses don't operate like that. We are there for the patients first. No big executive bully is going to tell us we can't go to the media or we'll be fired. Being fired is better. Who wants to work for scumbags like that?

Provide the right equipment and training, quit screwing around and counting your beans, and take people's lives seriously.

The truth comes out. Oops.

Here is my friend Andrew Lopez on the issue.

There are additional public health issues coming to light as we discover that a second health care worker in Dallas has Ebola, and may have flown on a commercial flight with 130 other passengers. There are the issues of flying & travel, e.g. surfaces in airplanes, poor hygienic practices of staff who easily cross-contaminate the public: flight attendants, airline companies, restaurant workers, hotel housekeeping staff.

But we aren't even there yet. What I am hoping is the silver lining, in this Ebola outbreak, whether it is contained at a handful of cases or becomes something larger, is that the public will be made aware of just how dangerous a big-business profit model is to their health and safety.

I'll have more to say later.

Sunday, October 12, 2014

Feet Gone Bad: My Feet Are Delaminating!

I'm off to a good start for next year. I have now blistered under all my calluses and they will all peel off soon, and then I can start giving myself pedicures and smoothing the calluses as they build again. It's like starting over with delaminated feet! I haven't had so many problems with blisters since Badwater in 2011!

I can look at the Boulder adventure in several different ways. As a race, it was a disaster, but then, it wasn't really a race race. All my foot issues came home to roost. And choosing to run a 24 hour race on dirt and trails when I haven't run 74 miles on dirt in probably the past year, was not the brightest of ideas.

I got plenty of sleep and everything was easy going into the run, when I woke up Saturday morning and got ready to leave the house, the girls sat in the living room and just howled. I texted my neighbor later in the morning before the start to ask her to check on them, hoping they wouldn't go out in the yard and do that. Dennis was on his way back from Gunnison and planned to stop off at the reservoir to see me run for a while on his way home.

Eddie and I met at the reservoir and set up our stuff. He had a canopy from a local running store and I just had my table.

Having the canopy from the running store was probably good for Eddie because he could tell his friends where to find him. I had my table set up in front on the edge of the road.

I found the canopy to be a bit of an issue because all afternoon every time I'd stop at my table to grab my stuff for the next loop, I needed to get what I needed and get going. And every time, some Boulderite dweeb would invariably stop by and start talking to me, asking me stupid questions about the running store or people who worked there. None of them were looking for Eddie. All of Eddie's friends knew he was there and didn't need to ask.

These other people were just being dweebs. And I wasn't even under the canopy, I was just another Joe Blow runner. I needed to pay attention to what I was doing since each loop was 7 miles long and if I forgot something I'd be screwed. Annoying. So I was relieved when it got dark, it was like dweeb repellent. Boulder...

The course has nice variation, a few rolling hills, some flats, some pavement, and some singletrack trail. The trail section is known as the "Certain Death" trail.

It was a nice afternoon, it did get warm for a couple of hours but the entire day was pleasant. At one point, Eddie came across a big snake stretched across one of the trail sections. Certain Death.

At one point, the wind got strong and blew my hat off and down the embankment, there was no way I was going down there to look for it.

I felt really good and I stayed at an even pace and according to a plan that would yield 107 miles, and if all went well I might even have time to squeeze in an extra loop. I hit 50 miles in about 10 1/2 hours and felt extremely fresh, except I could feel a few hot spots on my feet. I stopped once and pulled off my socks, and lubed the spots. I didn't see a need for tape anywhere else, and I had already taped over the ball of my left foot where I got the blister in Cleveland.

Shortly after dark Dennis showed up and I sat down in my chair to check my feet again and change my socks as he held the headlamp. I had the beginning of a blister on my left big toe, but the hot spots everywhere else were still just hot spots. I lubed them again and took off.

Another two loops later, I had at least five painful hot spots, the inside of both big toes, my right heel, under my toes above the Cleveland blister, and lower down on the instep of my left foot. Dennis had already gone home and I sat there in the chair with my headlamp, eating soup and yogurt and trying to patch my feet. I popped three blisters and taped over everything, plus it looked like most of my toenails were separating from the nailbeds. What the hell was happening? Then I saw in the light of the headlamp that my hands were swollen.

Too much salt, is probably what I did. I had been peeing and felt well hydrated all day, and my hands were not swollen, but then when it got dark and cooled off, I think I continued to take in too much salt. I didn't make the adjustment for cooler weather, as I haven't been running in cooler weather yet this year.

As I finished patching everything and put on clean socks, Eddie stirred in his tent under the canopy behind me. He had been napping. He got out and said he would do a lap with me to keep going. I wanted to get out there and see if my foot surgery made a difference. We took off and after a little over a mile, I knew I didn't want to hobble the whole 7 miles. It hurt too much, even after a mile of trying to get the foot pain to go away and distract myself. So I told Eddie I was done and I turned around and headed back to the table, told the race people I was done, then packed up my table and supplies and drove home to Fort Collins. I got home at 4 am, took a shower and crawled into bed with Dennis and the girls.

I did have a blast, it was fun, I enjoyed my time out there with the other runners and it was a beautiful day and evening. It was fun running with Eddie as he was doing his first 24 hour run and he got 85 miles and was 2nd in HIS age group, and he put in a great effort out there.
For me, I got 17 hours of running listening to music and enjoying the scenery and the night sky. So I can't complain. The sunset behind the Flatirons was spectacular.

I got 10 full loops in at 7.14 miles each plus and extra 2 and a half or so after my second foot surgery, so I ran about 74 miles. And Eddie tells me I won my age group. Grrrr. I hate winning my age group when it's a pathetic performance. But that's just me being silly. This is the longest low mileage winning streak ever.

Is this what happens when you get old? A few weeks ago my eyes suddenly took a dive and after going for years without needing reading glasses, suddenly one day I couldn't even read my running watch, and my arms aren't long enough. Crap.

The other thing is that I know I have mega endurance because if every few weeks I can go and hammer out a 70 or 80 mile long run with little impact on my body other than feet gone bad with blisters, I'm okay. It's just a matter of finding the right race next year and I'll get there. Next year I will benefit from this great base.

I am taking it easy the rest of the month and not going to do anything even resembling running training until Thanksgiving. I will start getting in the pool and on the bike sometime next week.
This morning I convinced Dennis to go out and bring Starbucks home. He did, and he also brought home pup cups for the girls. A family of princesses, that's what he has to deal with.