I had a conversation this evening at a reception, with two people involved in healthcare. We discuss whether Terri should have lived or died, but rather on the issue of “sides.” Somehow, this sad story divided people into black and white issues–taking the side of either the parents or the husband, with nothing in-between.

But really, this wasn’t about the parents or husband, or about being a red voter in a blue state or a blue voter in a red state. It wasn’t about rooting for the parents or husband, or being a liberal or conservative. Rather, it was about a woman named Theresa Schindler Schiavo, and what was really the right thing to do for her. Terri, somehow, had vanished in the media frenzy, and enveloped by the Schindler family versus Michael Schiavo.

So what did Terri really want? We will never know. What really happened to her that night she collapsed? An eating disorder, spousal abuse, or something else? That, too, we will never know.

What we do know is that many facts and circumstances are forever muddled, the stories of her marriage, wishes and desires, and the underlying conflict between her parents and husband appears as blips and sound-bytes in the press. What is the truth?

I think that died with Terri.

You can read the full gory details here, at abc.com. I won’t bore you with details that are readily available. I guess that we can be happy that as a nation, we starved a brain damaged but otherwise healthy young woman to death.

What I don’t know is that after 15 years, why couldn’t the courts just decide that should Terri become ill–and she has had a number of illnesses over the years as are common with someone who is immobile–just to let her go? Just allow her to succumb to her illness rather than removing the source of her feeding while she was healthy?

We have laws which restrict the use of embryonic stem cells, and a lot of hoopla centering around the life of a pre-embryo in a petri dish, but when it comes to full grown living and breathing people, our laws are murky and muddled.

Should Michael Schiavo, a man who is living with another woman and has had two children with her, be the sole decision maker in a life and death question? Should his testimony, made years after Terri’s initial colllapse, that she “wouldn’t want to live this way,” hold any water?

If anything, this case begs for our current laws to be re-examined and puts into the spotlight the need for a living will. We really do need to revisit what constitutes “artificial” live support vs. basic care. We need to take a look at what constitutes “allowing death to naturally occur” as opposed to actively causing it.

Medical ethics is a mess, and as our knowledge and technology keep advancing, it becomes even more so. We learn things that we may wish we never knew, because they effectively annul the knowledge that we thought we had. Take persistent vegetative state. Can anyone really tell us what it means? Do we know that these people are suffering, or that they’re on cloud 9, or that their spirit has long departed from this plane? No, the docs don’t know. Same for patients with Alzheimer’s and dementia. Are we going to decide that they too, can be starved, because their condition is not consistent with life as we know it? And what if a person leaves a living will, which states that “please stop feeding me should I develop Alzheimer’s. I do not choose to live in that manner.” Where do we take that one?

I am glad that Terri is no longer in a state of limbo. Now Michael can live happily ever after with his not-so-new new wife and kids, and the world will be a better place because we “allowed” Terri to die. Just as a footnote; Michael is such a good husband that he is commanding that Terri be cremated immediately, and denying her family the right to give her a Catholic funeral and burial. The woman is dead for God’s sake. What difference does it make if she’s cremated or buried? Terri was a Roman Catholic, and it does seem that she would have preferred a traditional burial. But then, I guess Michael will jolt his memory and suddenly recall, “I think that Terri once said she’d prefer cremation!”

Over and out.

Made it safe and sound to North Carolina. It certainly is pretty here–so woodsy. Unfortunately, they are predicting rain so that might hamper my efforts to explore, although it may keep me indoors at my conference. Then again, I would love a good old fashioned thunder/lightening storm as we don’t get much of that on the Pacific coast.

Postings are going to be lean these next few days, so it will be a reprieve from my usual ranting and raving! I was too tired last night to post anything, and I had to finish up an article and send it in. After traveling all day, and taking a peek around while it was still light out…I was too sleepy to start thinking up something interesting to blog about.

Anyway, speaking of health (and that is what I’m supposed to be doing on this blog), I am now surrounded by healthcare extraordinaire, as well as biotech and pharmaceutical companies. Duke University and the University of North Carolina are just a stone’s throw away, and the Research Triangle just a few miles down the road.

Well, now it’s off to the woods.

This morning I am off to North Carolina, for a conference. What else? Anyway, I’ve only driven though North Carolina en route to Florida, and haven’t actually stopped there or seen anything other than highway. So I am looking forward to it, as it looks absolutely beautiful in pictures.

So this will be the only post until evening, when hopefully, I will be back on line–my hotel promises high speed access.

For all of the people addicted to Coca Cola in its various incarnations, today is the day to sing “Happy Birthday.” And back in the good old days, coca was really an essentially part of the drink.

Actually, Coke did not begin its life as a carbonated beverage but rather as a patent medicine, developed by an Atlanta chemist named John Pemberton. In the late 19th century, patent medicines flourished, promising to do everything from curing liver dysfunction to growing hair on a bald male head. Pemberton created quite a collection, including Triplex Liver Pills and Globe of Flower Cough Syrup, but his most famous formula was the “Esteemed Brain Tonic and Intellectual Beverage.” This was a cure all for nervous affections, sick headache, neuralgia, hysteria, and melancholy.

His highly touted formula, which many came to enjoy immensely and become quite addicted to, contained carbonated water, cane sugar syrup, caffeine, and extracts of coca leaves and kola nuts. In other words, cocaine was a primary ingredient. The forerunner to modern day Coca Cola was unveiled on March 29, 1886. But because Pemberton was in ill health (not even his coca formula could cure him), he sold most of his business by 1888, and died soon afterwards.

Pemberton would never know how famous his little patent medicine would become. Another Atlanta pharmacist named Asa Candler bought the entire business in 1891 for $2,300. And eventually, while caffeine remained in the drink, the coca leaves were removed.

Speaking of eating disorders…eating in America is a very strange bird. According to the latest statistics from the CDC:

# In 1999–2000, an estimated 30% of U.S adults aged 20 years and older — nearly 59 million people — were obese, defined as having a body mass index (BMI) of 30 or more.

# In 1999–2000, an estimated 64% of U.S adults aged 20 years and older were either overweight or obese, defined as having a body mass index (BMI) of 25 or more.

And yet, as we grow fatter, our rabid worship of ultra-thin continues. Rather ironic, don’t you think? Fashion models are supposed to glorify perfection, even though many of them are not particularly attractive, and are basically skin and bones. But their emaciated and air brushed photos which grace the covers of fashion magazines are considered “beautiful,” while the sorry little girls making themselves puke and keep their figures at a starvation weight are considered “ill.”

Perhaps the most poignant example of this is how some magazines handle these issue. Case in point: Several years ago I was on a plane, and someone had left a popular woman’s magazine in the seat pocket. I picked it up to skim it before the plane took off (before I was able to turn on my laptop!!), and opened to an article about model Claudia Schiffer. The story was one of those humdrum pieces of nonsense about her “struggle” to keep her weight down, and how she had to drop 10 pounds when she first came over from Europe to model in the U.S. According to this article, Schiffer stands at 5 feet 11 inches and weighed 125 pounds.

I had to take a few deep breaths. I am tiny, just under 5 feet 1 inch. And I weigh 106, and I am thin. I wear a size five shoe, and my brother once commented that I have a wrist like an insect (he was trying to buy me a bracelet). But here is this woman, who stands nearly a foot taller than I am, and weighs only 19 pounds more than me. I cannot begin to imagine how hideously emaciated she must look in person, and yet, we consider this scarecrow an object of great beauty.

Now if this story wasn’t enough to churn your stomach and make you want to rush out and eat a large sized pizza, the magazine also had an article about a girl with anorexia. She was skinnier than Schiffer, no doubt about it, and she looked pretty bad. Scrawny, hair like straw, and so on. Then again, she wasn’t made up by a professional and her photo was raw, and didn’t have the imperfections air-brushed out of it as did Schiffer’s.

What irony. In the front of the magazine, the emaciated look is being glamorized and we are supposed to pat Schiffer on the back and say, “Oh you brave girl, how difficult it must have been to drop from 135 to 125. What courage! How wonderful you look with your ribs sticking out.” But in the other article, we are supposed to be revolted at the ultra-thinness, and feel sorry for this poor mentally deranged girl who equates starvation with beauty.

The only difference between Schiffer and the anorexic girl is simply a few pounds, some make-up, and a good photographer. I have no idea whether or not Schiffer suffers from any sort of eating disorder, that’s not my point. What I’m trying to say is that both are ultra-thin, only the anorexic has just taken it a little further. It’s a fine line between the two, the precarious borderline between what we consider to be beauty and what we consider to be mental depravation.

It did seem so peculiar to put these two articles into the same issue, as though they were entirely unrelated. The schizophrenia of American eating habits and concepts of health and beauty. A nation whose waistlines are bursting at the seams, and who worships women who resemble coat hangers.

If you notice, Terri Schiavo’s name is missing from the headlines. In fact, on Google news, the only “news” about her are several articles about her eating disorder. It is strange how that works, don’t you think? Someone decides, “Okay, enough with the life/death issue, let’s do eating disorders today. And sure enough, it’s the domino effect in action. There are 8 articles today reporting on the woes of eating disorders and how bulimia led to Terri Schiavo’s collapse, subsequent heart attack, and resulting brain damage.

This is old news. Her eating disorder has been highlighted before, and recently, so why the domino effect today? Do all of these papers and online news sites all get together and decide to do a blitz, or is it telepathy? Osmosis, perhaps? I guess with the court battles over, the death watch is getting a bit gruesome. She’s been without food now for 11 or 12 days, maybe more (I’ve lost track), and it does seem to be a very INAPPROPRIATE time to be bringing up an eating disorder. I mean, while this woman is slowly and intentionally being starved to death, is it really in the best taste to bring up her past eating disorder?

I am assuming she is still alive. Slowly becoming dehydrated and going into electrolyte imbalance and organ failure. I’ve said this before and I’ll say it again; why not just humanely put her out of her misery? Is a passive death somehow different from active death in this case? Is it not euthanasia to deliberately withhold food from someone who is not terminally ill and not dying?

Please, spare me the semantics. We know what happens if you don’t eat or drink. Unless you are a yogi mystic, who can survive on air and God’s love alone, then you will die. The idea that Terri Schiavo is somehow having a natural death now is just so repugnant. Would a man who shot his child in the head vs. one who deliberately starved his child to death be treated any differently in a court of law?

The kindest thing for someone to do at this point would be to give Terri a nice whopping dose of morphine and let her fall into a peaceful bliss. And die quickly. At least we can treat her with the same respect that we’d give a convicted murderer, don’t you think?

Here’s another reason to stay away from genetically modified foods–it keeps you safe from the Seed Gestapo aka Monsanto. Buying and using patented seeds can get you fined, put you in prison, or get you guillotined, if you dare cross Big Brother Monsanto and use the seeds in a way that “violates” your contract. This includes saving some of the seeds to sow for the next season, something that farmers have been doing since the dawn of time.

But if farmers do that, Monsanto loses money. They want every farmer to buy fresh seeds every season. Now, I have no idea what the contract states, but personally, I think if you’re a farmer, you have to have a few screws loose to get involved with Monsanto and their punitive contracts. And fear not, Monsanto has garnered a huge “seed police force” and will prosecute you if you violate the contract in any way, shape or form.

So, just one more reason to encourage farmers to stay clear of Monsanto and their fancy patented seeds. Buy organic veggies and fruits, which are grown using old fashioned seeds, and keeps Monsanto out of the food supply.

Here is some information on the Monsanto and their army corps of seed whackers, from the Organic Consumers Association:

Monsanto Keeps Up Attack on Seed Saving Farmers

Since the advent of farming, thousands of years ago, farmers have carefully collected seeds at harvest so as to have enough seed for the next year’s planting. Concerned that seed saving by farmers reduces their profits, seed and biotech giants like Monsanto have rammed though controversial “intellectual property laws” in numerous countries that make traditional seed saving a crime. Last year, Monsanto harassed and/or sued more than 500 U.S. farmers who saved their seeds, forcing them to pay the company over $15 million in fines, including up to 8 month long prison sentences

Another powerful earthquake in Indonesia–just what the people there need right now. Reports differ slightly, ranging from 8.2 to 8.5, but either way, it’s a strong quake. And in some ways, it sounds more powerful than the last one. The shaking lasted for two minutes, which is a very very long time for an earthquake. I know, it doesn’t sound like much to those of you who have never experienced an earthquake, but believe me, two minutes is like having a hurricane last for two weeks.

Also, the earthquake was felt as far away as Thailand and Malaysia, and actually jolted people out of bed. In comparison, the Dec. 26 one was only felt in and around Sumatra, and the resulting tsunami was a very unpleasant surprise to those having breakfast in Phuket, Thailand.

Anyway, not much is known at this point, except that it occurred very close to the spot as the one on Dec 26. No news yet of tsunamis, although I think if one was going to hit Indonesia, it would have happened by now. Tsunamis do not always occur after earthquakes, so perhaps the people will have a reprieve this time.

Stay tuned for updates…

Conspiracy and cover-up. Deliberately hidden data showing detrimental health effects. According to an article in Cnet.com, the cell phone industry is the next Big Tobacco.

Very interesting. Cell phones are an addicting habit, enjoyable, and very popular. Same as cigarettes. And no one wants to know that these habits may be detrimental to your health, least of all the companies making billions on the product.

Unfortunately, studies start to appear showing that the product might be harmful to its users–even cancer-causing. The product’s manufacturers deny the presence of any danger and even spend millions of dollars trying to discredit the research that points to problems. Then, an insider emerges, seemingly with proof that the product could be dangerous. The industry agrees to publish warning data about the product, but continues to maintain that the product itself is safe for use. Lawsuits against the product’s manufacturers are filed, but all are dismissed. Industry analysts know that any case that does succeed could start a domino effect of future lawsuits, which keeps the industry determined to maintain that the product is harmless, despite increasing evidence to the contrary.

Cnet is talking about cell phones in this instance, although the above paragraph is a dead-ringer (pardon the double pun) for tobacco. But a number of studies have resulted in disturbing results, such as increased rate of brain cancer deaths, development of tumors, and genetic damage among heavy cell phone users. One study from Europe also showed that without a doubt, radio waves from mobile phones do, damage DNA and other cells in the body.

If you’re a heavy cell phone user, this data may be something to think about. Anyway, it’s an interesting article, so read it at your own peril….

Happy Easter Sunday. It is rainy and gray in Seattle today, which I take as symbolic of the cleansing and rebirth which this day is supposed to signify. At least, that’s what it signifies to me.

But there was one thing that always baffled me about Easter–and that was why Easter and Passover very rarely coincided with one another. After learning the traditional story of the crucifixion as I was growing up, I simply could not understand how Easter could be “so early” this year (as I often heard the adults around me say when Easter appeared in March), and indeed, there was still snow on the ground as Easter Sunday rolled around–while Passover was not due for another month. This year Passover begins on April 22, nearly a month after Easter Sunday.

So according to our calendar, Jesus was crucified and rose from the dead before he ever dined at his last supper. Is something wrong with this picture? Wouldn’t it help, for the sake of clarity, to coordinate Easter and Passover to the same calendar?

My mother, or any of the other adults I questioned, seemed rather blissfully unoconcerned about this discrepancy, and completely ignorant of the methods used for determining the dates of both Passover and Easter. If we want to stick by the biblical rendition of the story, then the crucifixion and resurrection would have to immediately follow Passover. The dates would have to be coordinated, and be determined by using the same calendar. Of course, that would mean that Good Friday might fall on a Tuesday, and Easter Sunday would then be Easter Thursday.

Very Very Complicated

But as we know, that is not the case. Passover commemorates the ancient Hebrews’ exodus from Egypt. The dates are coordinated according to the Hebrew calendar, which celebrates Passover from the 14th to the 21st day of the Jewish month of Nisan, which is sometime in April.

Easter Sunday, on the other hand, is calculated as the first Sunday after the paschal full moon that occurs on or after the vernal equinox. If the full moon falls on a Sunday, then Easter will be celebrated the following Sunday. This means that the holiday can occur anywhere between March 22 and April 25. To add to the confusion, the Western Christian churches do not use the astronomically correct date for the vernal equinox, but instead, made it a fixed date–March 21. And their interpretation of the full moon is also not the astronomical full moon but the “ecclesiastical moon,” which is based on tables created by the church.

The Eastern Orthodox church uses the same basic formula, but their dates differ because they use the Julian calendar rather than the more contemporary and widely used Gregorian. In addition, the Eastern churches use the actual, astronomical full moon and the actual vernal equinox to set the date of Easter. So not only are Easter and Passover set according to different calendars, but the dates for Easter vary as well, among different sects of Christians.

But according to the Wikipedia, separating Passover from Easter was a deliberate move.

According to the Roman Catholic beliefs, their Holy Week occurs around the same time as Passover. Easter was set so as not to coincide with Passover, though it is determined by a lunisolar calendar as is Passover. The Catholic calendar is designed so that Easter nearly always falls out during the week of Passover or immediately after. The Catholics believe that Easter replaces Passover in importance, as Passover represents the death of Jesus, they believe that Easter represents the resurrection.

The Roman Christian Church developed its tradition of celebrating the resurrection, deviating from the celebration of God’s appointed Holy Day of the Passover representing the death of Jesus, early in its history. In letters exchanged between the Eastern (Greek) churches and the Roman Church as early as the second century, a dispute is laid out that is referred to as the “Quartodeciman Controversy”. The Eastern Churches believed that Christians should continue in the tradition of the Apostles of celebrating the Passover on the 14th of Nisan (also known as Abib), whereas the Roman Church had already abandoned the Passover in favor of a celebration on the following Sunday. Most Protestants follow in the Catholic tradition of celebrating Easter instead of Passover.

Images courtesy of FreeImages.co.uk

I know, that Schiavo woman again. But I thought of a rather perplexing trivia question, one that no one has sought to answer.

Terri’s feeding tube has been removed so that she can die in peace. This is being done to relieve her pain and suffering, and to end this miserable existence that she’s led for the past 15 years. The “experts” who believe that Terri is no longer a sentient being, say that she will feel no discomfort as she slowly dehydrates and dies. To them, Terri is basically a plant, a shrub, something that’s still growing but has no mind, and no ability to feel pain, love, joy, sadness, hatred or fear.

So here’s the $10 million dollar question; if Terri is unable to feel anything, then how can she be suffering in her present state? How is it that she is leading a “life of misey” if she is basically lump of flesh that continues to breathe but has negative brain activity?

Why remove her tube then? What then, is the crime of turning her over to her parents care (she is a plant, afterall, and not suffering) and allow them to try some new experimental therapies that may help her? Since the woman supposedly doesn’t know the difference, whether she’s on Mars, Jupiter, Florida or having dinner at the White House, then what is the harm?

As you can see, the experts have twisted themselves into a riddle. Terri is miserable so we must allow her the peace of death, but yet she is basically a vegetable, so she is unable to feel the misery of death by dehydration and starvation.

Well which one is it, boys and girls? Does she or doesn’t she? You can’t have it both ways. If she’s suffering in her life now, then it is illogical to assume that her death will be painless. Likewise, if she is now in a state of blissfull unawareness, to the point that total body shutdown will not even make her flinch, then why must she die?

Yes, it’s the countdown. Terri’s Schiavo’s last hours. I want to clarify that I am amazed at the media and energy which this case has generated, when our politicians and president should be focused on far more pressing issues. Perhaps it is a smokescreen against all of the planned cuts that the Bush administration has in mind? Bob Herbert, a NY Times columnist, had a great column about that a few days ago.

But what I find offensive in this instance is the “we know it all” attitude of many of the doctors making judgments about Terri. Many of the medical experts reassure the public that stopping Terri’s food and fluids will cause her absolutely no discomfort, because a person in a persistent vegetative state feel no discomfort from either dehydration or hunger.

Of course, these same medical experts used to believe that infants were incapable of experiencing pain. Many invasive and painful procedures used to be performed on infants (even surgery) without sedation or anesthesia. Does it seem possible? Well it was, and not all that long ago. I can tell stories that would make you cringe in horror. One example was a 1 year old who had brain surgery, and I had him as a patient fresh post-op. The baby was moaning, in obvious pain, but all he had was Tylenol ordered! Uh, would you like Tylenol after your head was cracked open–which is what I asked the resident who refused to give me an order for a narcotic.

It was only after I threatened to call the child’s parents that he came up to the unit and wrote me an order for morphine. Duh, the baby stopped moaning and his vital signs improved dramatically. The resident was stunned. I really didn’t think he’d be feeling pain, he told me. They’re not supposed to be able to at this age.

The NICU used to be a house of horrors for newborns, because of this attitude. Even today, babies are usually circumcised without any type of anesthetic because “they don’t feel anything.” I refused to participate in any way, shape or form in circumcisions during my last years as a nurse. Babies don’t howl because they “don’t feel anything.” I asked one doctor, who told me that very thing, how he would like it if I cut off his foreskin. Think it would feel good? He was a little stunned, then mumbled something about it being different for an adult.

Anyway, there are many changes in what was believed to be “scientifically true” over the years. Another example are tonsils, which were formerly believed to be a worthless mass of tissue in your throat. They were routinely removed from children without a second thought, much as you’d clip a toenail. Of course, then the discovery came that they play an important role in the immune system.

The doctors who preach that Terri Schiavo is not a sentient being, and therefore, does not feel pain or discomfort, really don’t have a clue. How do they really know what is going on in her mind? If you ask, they’ll bark a bunch of scientific gibberish at you, same as the docs who said infants don’t feel pain, or that women don’t need their uterus once they’re done having kids. Have you ever noticed how medical facts change from one day to the next? Have you ever noticed that there is often no concensus on many medical topics? How often, in the past two years, have you opened the newspaper and seen something to the effect of, “Mammograms are worthless…” “Mammograms save lives…” Mammograms don’t save lives…” Mammograms detect breast cancer better than a self-exam…” “A self exam is better than a mammogram…” and so on. Certainly gives you a lot of confidence in the modern medicine.

Right to die?

I cringe whenever I see things that “Terri has the right to die with dignity” or that she has a “right to die.” Is “dying with dignity” applicable when a person is not near death? It would be one thing if Terri had been in organ failure, or had a terminal disease, or was failing. Then I would say fine, withhold treatment and let her go. But she was healthy, well nourished and nowhere near death. So where does the “death with dignity” come in? Right to die? Uh, she wasn’t dying. And that is what I consider so wrong about this decision.

When it comes down to it, no one can speak for Terri. Her parents, husband doctors, lawyers, politicians–no one knows what she wants, or what she would have wanted. Her husband blabs about Terri’s wishes, but I hardly think that they sat down and discussed what she would want or not want, should she ever fall into a persistant vegetative state. I highly doubt that she said, “Michael, please don’t let them connect me to a feeding tube, and if they do, please have it pulled.”

As I posted earlier, in Europe, this case would be a no-brainer. Terri left no written directive, she did not insist on death. Therefore, feeding continues. And in our nation, you would think that since there was no firm directive from Terri, that all of us–courts, lawyers, family, etc–would err for life over death. At least, that is what civilized societies are supposed to do.

It is sad that this case has become so political, and has garnered so much attention. If we really had good laws that protected people like Terri, and that clarified this type of issue, then there would be no need for this.

A reader in the NY Times wrote a letter to the editor, and I find these two sentences especially poignant:

I relate to those who want Ms. Schiavo to live based on her family’s grief and belief that she might be helped by advances in medical science. Harder to comprehend is the passion of some who are actually eager for her death.

If anything, I hope that this case will at least polarize the need for better laws protecting those who cannot speak for themselves, and better define what exactly, is meant by artificial life support.. In my interpretation, food and fluid is basic care. And that’s all that Terri was receiving.

As they would say in the UK, this is creating quite a row. The Commons Science and Technology Committee raised the possibility that parents should be able to select the sex of their baby, when undergoing IVF. Currently, sex selection in the UK is only permitted if there are strict medical reasons, such as an inherited sex-linked disorder in the family.

“The use and destruction of embryos does raise ethical issues and there are grounds for caution,” the report concluded, but added: “On balance we find no adequate justification for prohibiting the use of sex selection for family balancing.”

The report was controversial to say the least, with many saying that this would lead to “designer babies” or that it would unbalance natural sex selection. Even the members of the committee which debated the fertility issues for a year could not come to a consensus, with five of the 11 members to refuse to sign the final recommendations.

“I was one of the more vociferous of the five MPs against,” Bob Spink, a member of the select committee, told The Scientist. “I’m against the irrational, inept liberalization that flies against the views of public opinion.”

He cited evidence obtained by the committee finding that 85% of the UK public were opposed to IVF for sex selection in the absence of other motives, such as screening for sex-linked disorders. “If we’re not going to follow public opinion, we need good, evidence-based reasons, and these are lacking here,” Spink said.

Sex selection is a thorny issue in other parts of the world, where female fetuses are aborted and live female newborns are killed. A little more pronounced and gruesome that choosing the sex of a child while still in the pre-embryo stages, but it is still sufficient to raise the ire of many people in Britain.

In India and China, where sex selection has caused a sharp imbalance between males and females in a number of regions of their respective regions, it is unlikely that sex selection would have the same effect in the UK. For one thing, not that many babies are born via in-vitro technology. For another, many couples undergoing fertility treatments are primarily concerned about being able to produce an infant, and sex is relatively unimportant in the greater scheme of things.

But nevertheless, it still raises questions and makes people uneasy. I really don’t know what I think about it. IVF is such an unnatural procedure to begin with, so is choosing the sex of the baby that much more “against the grain of nature?” After working for so many years in newborn intensive care, and having seen the worst of it, I feel that people should be happy when their newborn comes out in one piece! Arrives on time, has no birth defects, cries on cue, and can’t wait to eat. Anything beyond that, such as having a wished for boy/girl, is simply icing on the cake.

What do you all think?

There are fluff living on Mars. Check out Kaslog and you’ll see what I mean. Very cute fluff, with green whiskers and purple paws. I just know that when Eponine and Cosette see that picture, they’re going to start nagging me for their own set of purple socks.

What more can really been said about the nursing shortage? Well, not much really, except that the media frenzy just keeps on going, and basically ignoring the fact that nursing shortages in the past have never been solved. The reason? Hospitals, for the most part, are truly not interested. A prime example is my recent post about the nursing home that basically removed the right of an employee to call in sick.

Anyone working in healthcare, and I’m not talking bloated suits upstairs drinking lattes in their plushy cushy offices. You know, the ones who suck million dollar bonuses out of systems said to be teetering on bankruptcy. And these are the same institutions bleeting and farting all over the news about the “nursing shortage” and why they simply can’t make their hospital a safe place to work, or offer benefits and wages to nurses that befit the job being done. Of course, they see nothing wrong with paying some dweeb a $2 million dollar bonus because he signed a few documents and had his office refurbished with imported Italian handmade leather furniture.

Beach Baby Blues

California is a prime example of what I am talking about. The nurse:patient ratio law is workable, as Kaiser Permanente has proven. Nurses will come to work in hospitals that offer then decent pay, benefits, respect, safety, and an overall positive work environment. It can be done, the nurses will show up.

Now, a judge dashed Gov. Arnold’s plans for reversing the clock and getting rid of that pesky ratio law. Unless the California govt. appeals, the judge’s order is now final. On all medical/surgical floors, the ratio of nurse to patient is 1:5.

Many hospitals have been mismanaged, and they are trying to pawn that off on the ratio law. Quite a few more are bloated to the gills with unnecessary middle management types who know nothing about patient care, and who do nothing other than micro-manage to the point of disruption. Fire those, and use the money to hire new nurses.

Hospitals can also make better use of per diem nurses, who work only as needed, and who do not “strain the budge” for things like health insurance or pension plans. The can also initiate their own registries, and thus cut out the expensive middle man when they need temps to fill empty slots. But many nurses report that hospitals refuse to budge on those things. They won’t allow a potential hire any flexibility, so they end up with no one.

The Double M

I will agree that Medicare and Medicaid (MediCal in California) are problematic for hospitals and doctors. Reimbursements are ridiculously low, especially for Medical, and many facilities just cannot accept patients covered under those policies. It’s not being mean, it’s being realistic. Federal cutbacks to these programs simply mean that less of these patients are going to get the care they need.

Another problem in California is illegal immigrants. Yes, a political hot topic button, but a problem nevertheless. Most of them do not have insurance, they don’t receive Medical, and they show up in the ER and expect to be treated. Without paying for it. No, I am not being cruel. I’ve taken care of babies in the NICU whose parents are illegals, and the bill is just eaten by the hospital. It is a major problem when a patient runs up a million dollar bill and there is no hope of ever collecting the money.

So I agree, something needs to be done about those issues. I don’t fault hospitals for that, and while it does seem terribly cruel to refuse an admission, or for a physician to put a “No Medical” on the door, it is a matter of financial survival.

But it still doesn’t explain the attitude. Hospitals just don’t seem to understand that there will be a nursing shortage as long as working conditions remain horrendous. Maintaining the nurse:patient ratio, but firing support staff isn’t going to earn you brownie points either. Sorry, guys, but nurses are no longer martyrs in white dresses. They don’t work for ‘da master no more.

I hve received several comments from people about my posts on Anoopa Sharma, which prompted me to return to her website and see if there was anything new posted. There was a lovely comment from her uncle, and I hope he won’t mind if I repeat just one paragraph of what he wrote.

I am Very proud of my sister Anita & brother in law Dennis Sharma, for having raised such an outstanding child !! Surely the pain of seperation is felt deeper ..than merely in the Heart. It shakes one to the very Soul. GOD must Truly Love her.. to recall her so soon.

None of us have any idea why someone so young and promising, why someone who had great plans for healing the world of some of its pain–would die so soon. The idea that it was God’s love, rather than indifference, is an intriguing one. Looking at it from that aspect, then it would explain why my mean, bitter, thoroughly nasty and violent grandmother lived to be almost 100–God kept putting it off as long as he could!

Anyway, I cried when I watched the video of the broadcast from Fox Atlanta’s news station. This was a person I never met, know nothing about it, and yet the story of her short life and end brought me to tears. Especially poignant are the words of her father at the end, where he speaks of how much they will miss her, and then his voice breaks and you know that he is crying…

Last night I was waiting to use the ATM and the nice, well dressed gentleman that I was standing behind, suddenly turned his head and spit. Now I can see if he was choking, about to suffocate unless he was able to get that gob of mucus out of his throat. But no such thing. He spit and then calmly returned to retrieving his money. Before he left the ATM, he spit once again for good measure.

Thank you sir, for being so considerate, and allowing me the honor of having to step into your spit in order to get my money.

It was a windy evening, and I had the good sense not to stand directly behind him. You develop that kind of sixth sense when you live in Seattle. This is the spit capitol of the U.S. I can’t imagine that even hillbillies chewing tobacco spit more than the people do here. It is just so disgusting, and so many people just stroll through the streets spitting. There is about as much spit on the sidewalks as dog piss. And now that we’re entering into a drought and the sidewalks are nice and dry, you get to clearly observe spit globules on the pavement, every few feet.

This came to mind after writing about tuberculosis. There is TB in Seattle, and it is spread by coughing and spit. To say nothing about spreading just plain old flu and common cold germs.

If a person walked out naked, they would probably get arrested. But walking naked is a fairly harmless activity. Worst case scenario, we have to look at someone’s flabby pot belly, or their hairy crotch. Who cares? But yet, a nude person will get fined or arrested, while spitters appear to have complete immunity.

People also have to clean up after their dogs. Well maybe we should have spittle scoopers, and require spitters to wipe down the sidewalk after they’re done. If they can’t refrain from sloshing their saliva on the street, feel offended by using a tissue or hankerchief, or can’t wait until they see a trash can, then at least clean up your mess.

The list of people who have succumbed to tuberculosis reads like a who’s who of politicians, writers, artists, musicians, royalty and so on. Eleanor Roosevelt, Robert Louis Stevenson, Frederick Chopin, the entire Bronte clan, King Edward VI of England, D.H. Lawrence, Amadeo Modigliani, and Vivian Leigh (aka Scarlett O’Hara) all succumbed to the disease.

TB remains a huge problem today, complicated by the advent of multidrug resistant strains which are extremely difficult to treat and cure. And it’s still a problem in the U.S., even though we don’t hear too much about it. There were more than 16,000 cases were reported in 2000 in the U.S.

So what is this leading up to? Well, on this date in 1882, Robert Koch announced that he had discovered the bacteria responsible for causing tuberculosis. While antibiotics were still decades away, his discovery made it at least possible to accurately diagnose the disease. Koch was awarded the Nobel Prize for Physiology or Medicine in 1905.

I’m a day or two late on this, but here’s another great tidbit to enter in the annals of healthcare history. And this one is for the nurses.

Everyone probably knows the story of Florence Nightingale, and how she and her pack of mighty nurses traveled to the Crimea to tend to wounded British soldiers. As the mythology goes, it was Nightingale who was responsible for miraculously downsizing a 45% morality rate to 2%. In the revised version and accurate version of the story, it was British engineers and sanitation experts who cleaned out the clogged sewers at the hospital, thus eliminating the spread of several dread diseases such as cholera and typhoid fever. While Nightingale and her nurses certainly were an asset in providing comfort to the wounded soldiers, as well as scrubbing that filthy hole from top to bottom, they had relatively no effect on the death rate.

Okay, I’m getting off track. Back to Nightingale. In 1860, she hit upon a new fangled idea. Why not train nurses in a new and scientific way? Give them some real classroom learning about anatomy (rather shocking for proper Victorian ladies to be aware of certain body parts), science, and medical knowledge of the day, as well as practical work on the wards. Nursing training, up until this point, was rather haphazard if it existed at all, and hospitals were generally dreadful places that killed more people than they saved.

In 1860, with the blessing of her pal Queen Victoria, the first Nightingale-style school opened at St. Thomas’s Hospital in London. After doctors got over their initial fear of trained nurses ( they saw them as competition, not quite understanding that nursing was a totally different discipline), the idea spread. And it wasn’t too long that it spread across the Atlantic to Britain’s former colony.

In the halls of nursing history, it is usually assumed that Bellevue Hospital in New York hosted the first, real training program for nurses in the US. While it became the most famous one, turning out a squadron of women who went on to become leaders in nursing, it was not the first. The Woman’s Hospital of Philadelphia established a school of nursing in 1863 and was the first such school to award a diploma, on March 22, 1865. So 140 years ago, the first trained nurse in the United States received a diploma.

Harriet N. Phillips is listed as the first nurse to receive a diploma at this school, so I guess we can say that she was the first graduate nurse of this new-fangled educational system. Blockley Hospital and Pennsylvania Hospital were also used as training facilities during the early years of nursing education, and the school remained open for 101 years. University and community college based training programs began to replace hospital based ones, especially in the second half of the 20th century. The School of Nursing graduated its last class in 1964 and then closed its doors. The following year, Woman’s Hospital became part of the Hospital of the University of Pennsylvania.