T-Shirts, Buttons, Songs vs. Tobacco and Addiction

Something great was supposed to happen 14 years ago.  They said it would.  We celebrated the day, the very day that would come – in the year 2000 – that the goal would be reached. 

The year was 1988.  We printed little t-shirts for 5 and 6 year olds.  They were bright yellow.  The kids looked so cute in them as they put them on and the shirts went right down to their knees, leaving little sneaker feet showing.  We had bright glossy banners and stickers, too.  Wow, did they like the stickers.  Their principals and teachers didn’t as they later found them stuck to the lockers and books and walls – sorry about that. 

Image

There were healthy snacks brought in and parents invited, too.  There was lots of press that day, the first day of school in 1988.  We picked the John F. Kennedy Elementary School in Providence for the press conference.  Mr. Kane was the principal.  I was in my 30s and I believed that if you could get these kids when they were little, then you could make it happen. You could make a difference.  I believed in that.

When they were 18 years old, in the year 2000, these bright-eyed children would graduate high school as the first “Smoke-Free” Class of 2000.  They would go forth into their adult lives living without the scourge of tobacco in their medical history, waiting like a stealth device to engage and rob them of their health and their lives, years later. Their children would be smoke-free, too.  And their grandchildren, and so on, and so on, and so on.  We were going to eliminate the use of tobacco in this country.  Nothing less.

We even had a song.  “Healthy hearts! Healthy lungs! We don’t have to stop! Because we will never start!”  We are the Smoke free class of 2000 – Two – 0h – 0h – 0hhhh!  That’s the way to go!”

Image http://youtu.be/RiTY-6KqNrY

In RI, Keisha Knight Pulliam, who played Rudy on The Cosby Show, and served as the national ambassador for the SFC2000 came to visit.  I spent the day with her taking her around in a limo to schools and programs, ending at the John Hope Settlement House with Mayor Buddy Cianci.  I still remember “Rudy” saying, “Mr. Mayor, can I call you Bud?” in her fetching way (Bud was her little boyfriend on TV). The kids went wild.  There was no doubt in my mind that these kids would get it.  They would be smoke-free as 18 year olds.  We jumped for joy and sang and cheered and passed out those t-shirts, coloring books and stickers.

Over the next few years, the hoopla faded away.  The program disappeared as a priority rather quickly, and no one talked about it anymore. Notably, since the late 70s, one national health agency has raised in excess of $750 million in schools for their health program initiatives, with events held in every state.

Image

50 years ago this year we mark the first US Surgeon General’s Report on Smoking OR Health.  The report came out in 1964 and directly tied smoking to chronic diseases – specifically heart disease and cancer – but also other health threats.  It’s estimated that the rate of highs school seniors who smoke has fallen from over 38% to 16% today.  That’s more than a 58% decline.  We also know that each day, almost 3,900 kids under 18 try their first cigarette and more than 1,000 kids become new, regular smokers.

So how did we do with our t-shirts, vim and vigor?  And how are we doing today?  We do know a lot more about behavior change and about how hard it is to break addiction to tobacco.  We’ve nearly eliminated smoking in public places (including restaurants).  Yet we see the creep in cigar and hookah bars and efforts to smoke on beaches and in public parks taking on a civil rights tone of right wing America.  We see drugstore chains beginning to cave, under the leadership of mega-CVS to make tobacco harder and harder to purchase.  We are taxing tobacco to oblivion and beyond (and are making our state budgets dependent on it, too).

What else is going on?  We are seeing sales of individual cigarettes and flavored cigarettes rise.  And now we have e-cigarettes flourishing.  If you go to an Ivy League college watch what the students are smoking – long, thin, dark brown, European cigarettes, unfiltered – they are cool, man – cool from Europe kind of cool.  Tobacco companies have taken their wares and gone oversees – travel to Paris, China or just about anywhere and the stifling waft of smoke overcomes you in restaurants, bars, and just about everywhere. 

Our campaigns now focus on adults and on photos of people with half gone faces from jaw surgery and videos of scarred and mutilated women begging us to stop.  We have very direct warnings on cigarette packages. We have tobacco cessation programs anywhere you want to find them – and Nicorette – and fake cigarettes you can hold.  I have a colleague who walks around with a half smoked cigar – he lights it up about twice a day and takes a big puff, and then stamps it out.  He has custom made shirts and cufflinks and drives a Jaguar.  With this little brown rotting cigar butt clasped between his fingers.

ImageIn this 50th year of the Surgeon General’s report (also the 50th year of recognizing February as Heart Month), I don’t hear a call for the “Smoke-free Class of 2028” from any of the health agencies. The only website of the 3 who began the original program that even speaks to smoking and children in any significant way is the American Lung Association. 

The five year olds who began as our nation’s Smoke-Free Class of 2000 are today about 31 years old.  The majority have probably taken much of the same path – gone through school, natural rebellion times, their own personal trials, wins and misses, and are probably settling in a career path, finding a mate, and thinking about having their children, if they are not already parents.  So, now, they have bright shiny faces looking up at them. 

The Secretary of HHS, Kathleen Sebelius has said that if smoking rates continue as they are now, 5.6 million children who are alive today will ultimately die prematurely from smoking.  One of every 13 children.

I ask the question but I don’t have any firm answer or even a guess – who will ask these children to be smoke-free?  It’s probably not even talked about that much in our homes as drug and alcohol an texting while driving, and HIV and other issues have taken front and center.

So, what is the tobacco industry doing to recruit its brand new members today?  You can be sure they are not giving out t-shirts, and buttons, and singing songs.

Dogs and Wolves – Reconnecting with my professor…

Dogs and Wolves.

This, above, is the blog of Dr. Elaine Chaika. Check it out!

Elaine was my professor of linguistics tens of years ago when I was a freshman at Providence College in Rhode Island.  An elective, at the time, Linguistics, soon became a weekly fascinating class for me.  This was a unique time to attend Providence College.  I was in the first full class of women.  Elaine was also a rarity in that year – one of the first female lay professors – much less a person of Jewish faith in a campus of Catholic priests and nuns.  PC was stretching and straining at the time – and all these years later it has done well for it and by it. A few incredible glitches recently, but that is a story for another day.

I lived on campus and had two roommates who were both from New Haven, CT.  We had friends on either side of us also from Connecticut.  PC drew quite a few Connecticut girls in that first year.  Sometime in January, sitting in our rooms getting ready to go out and having a few cocktails ahead of time, we all seemed to have gotten quite sick of each other, or at least noodgey with each other.

That very well may have come from living in such tight quarters.  In addition to our space issues we also had issues that came from the educating of the Dominicans on campus.  Such as, no, padres, women do not shower in one big shower room (they having just moved us into what before were male dorms).  And, no, it is unsafe to put metal bars on our picture windows on the 1st floor to protect us from boys who may have thrown caution out the window in favor of raging hormones and decided to leap in and fetch us) – because, well, dear Fathers, suppose there was a fire.  How would we get out in an emergency?

I digress.  After having a few drinks, we were picking on each other, and I was trying to play peace keeper.  Then someone said – “you know, none of us can understand anything you say – we never have”.  You blab on and on and we laugh at you because you speak so “funny”.  I couldn’t wait to bring this up in class – with Dr. Chaika.  And I did.

We talked about dialects and there being no “right and wrong” about speech.  I felt better.  But yet, I found I became acutely aware and self-conscious, as I equated sounding “funny” with sounding “dumb”.  Soon, meticulously articulated “r’s” came into my vocabulary.  And enunciation of familiar RI words became rote.

nancy - maine - 1973

I went home in the spring and had dinner with my extended family – 6/7ths of them Portuguese.  My mother said – “I don’t understand anything you are saying.  You are talking ‘funny’”.  And so it went.  I now sounded “funny” wherever I was.  I’d only hoped I didn’t also sound “dumb”!

I remembered Dr. Chaika’s easy ways, common sense approach, and I recall thinking she was truly one of the most intellectual professors I had ever had.  Not merely teaching out of textbooks, but philosophizing about life; putting lessons into context of society and history.  She was a favorite memory of a strained and odd time at this college.

37529_1551218863626_3976528_n_2

Tens of years later, Dr. Chaika is my client!  We re-met on Facebook.  She is a woman of high technology, and at our first meeting she taught me things about computers and the technology of writing using resources that are “right there, dear!” that I didn’t know. She is an author, reviewer, collector, but mostly a scholar. 79 years old wearing tight corduroys and 3 inch mules, running up and down the stairs to share things with me, with her two Maltese dogs scurrying around to catch up with her.  With Nooks and iPads and laptops scattered in every room – and her office with a four foot graphic designer-type computer screen – what a treat.

Today I am happy to share her blog.  That is the link you see, above, Dogs and Wolves.  Elaine is writing a new book about dogs and communication, perhaps to be titled, “How Dogs Civilized Humans”.  She will talk about the interconnection of dog and wolf.  And so much more.  It is my pleasure to support her in growing her social media strategy and her brand as her book grows and develops. The little ones you see, below, are Skeezix and Scamp – one hesitant and a little worrisome – the other – ok, let’s do it!  They say we all have our yin and yang inside of us…

elaine_2

If you would like to follow Elaine, she has a plethora of ways to do that:

Her blog:  http://dogsandwolves-smartoldlady.blogspot.com/

Her other blog:  http://smarthotoldlady.blogspot.com/

Her website:  http://elainechaika.com/

Her FB page:  https://www.facebook.com/AmazingDogsYoursAndMine

Her Twitter:  @OurAmazingDogs – https://twitter.com/OurAmazingDogs

Are YOU the story?

ImageIn the last few weeks of 2013, there were several stories involving the media that were not about the issues they were covering or the content they were seeking to cover.  Instead, the story became about the ‘journalist’ or media personality.  The story became lost in an inopportune use of a word or phrase, an open microphone, a misguided Tweet, or an on-air gaffe, that when judged in a short time frame decidedly came out all wrong.  And in a nano-second of social media the ‘journalist/personality’ BECAME the news.  The cause, the issue, the rich content, was lost, and all cameras turned inward on the reporter.

The traditional definition of a “journalist” is:  “a person who writes for newspapers or magazines or prepares news to be broadcast on radio or television”, while the traditional definition of a “reporter” is similar:  “a person who reports, esp. one employed to report news or conduct interviews for newspapers or broadcasts.”.  Also, a “commentator” is defined as “a person who discusses news, sports, or other topics on TV or radio”.

However, we are living in a time of citizen journalism, and definitions are changing rapidly.  We are also living in a time of incredible speed pressures on reporters, journalists, etc. to get the news out there – “social it” while you are still finishing the last line of copy, in some cases.  No time to go back and check accuracies or choice of words – do that later.  “Say it” – becomes the mantra designed to target ratings, sweeps, or simply radio phones to ring.  Or to be first.  Always, to be first. And in all of this – a question:  ‘where did the news go’?  What happened to the point of the story? 

Did the reporter – or spokesperson – say something that I refer to as “red flag words”?  We all know what those are.  Those of us who work in the field of public relations and crisis communication know it far too well.  An example:  Vice President Biden leans in to President Obama and comments on signing of a major healthcare bill.  Straight into his open mic go the words, “this is a big fucking deal”.  Healthcare got lost in a hushed rush to dissect the line, get it on ‘the news’ – and there it goes….out to the masses. (PR people the world over simply closed their eyes, in a thought of solidarity – ‘oh, Joe…’).  Another example:  The Pope recently issues a statement that talks about the importance of training men in the clergy.  And he remarks that failure to do this and make the right choices creates “little monsters”.  Really?  Can you write the lead headline? 

Using these examples as well as one recently by Melissa Harris-Perry where she made humorous remarks about a photo of Mitt Romney’s huge white family, complete with a single African-American grandchild placed on his knee, went very bad.  This reporter/commentator was raised in an interracial family – as a matter of fact, she relating to being that single black child in a large white family, herself.  In moments, moments!, the story was lost in an ever thundering query of a poorly placed racial joke.  Made by a black reporter.

ImageClick here:  http://youtu.be/fleGFsjmC_8

So, while it can be an average person who makes these gaffes, it is particularly troublesome to see the media do so.  It seems altogether out of professionalism to see the reporter not standing behind the story, but come out in front of it and become the story. 

This usually happens quite by accident, but with increasing frequency.  And what do you do when it happens?  In the world of crisis communications, most professionals abide by a “never say ‘no comment’” advice line to clients who find themselves in situations with a demand for comment from the media.  You can say nothing, but you must say something, is the way I’d prefer to advise.  But ‘no comment’ is a lightning rod.  It implies you have something to hide.  Or you doubly agree with your gaffe.  Or something worse is happening behind you.  And the media (once your friends) – and the public – dig in.  The story festers.  History, if there is history, gets dragged out, and the story reinvents itself over and over and develops, what we call “legs”. 

People, be careful of your words.  Don’t let a word become a story, or take your story and stomp on it. 

Image CLICK HERE:    http://youtu.be/VMkx2ZDJFjU 

Here is Toronto Mayor Rob Ford dancing to Bob Marley’s “One Love” – does anyone know why he was dancing?  (To celebrate jazz in Toronto, which was being recognized in congress that day).  This came after Ironically, a response Ford gave to the speaker of congress who had asked him for an apology:  Ford said, “How about, ‘I am so sorry’? Is that as good as I apologize? Or, ‘So sorry?’ Which one do you want, Madam Speaker? Like, ‘Super, super, super, super, super, super, super sorry? So sorry?’ Do you want me to dance around?”

Oh, well…..

On the eve of Obamacare…. “to our health!”

Many who know my family have followed the journey of my daughter’s sudden, inexplicable illness, and her road to recovery.  A ‘sore tummy’ turned into two emergency department visits in 10 hours, a five day hospital stay, in-patient and then out-patient testing.  More questions than answers.  More doors to open than close behind us.  Five days of constant, never-ending pain, five days of morphine drips and anti-nausea meds (to tolerate the morphine); food replaced by IV fluids.

Three days with sheets unchanged and no sponge baths or washcloths to ease her discomfort – three days with the same johnny.  No little pile of towels placed precariously on a chair or table.  I was so distracted by talking to one specialist after the other – they all started to look like each other with big question marks on their faces as they came into the room. There were the crisp white-coated fellows from Beth Israel or Brigham, I can’t remember now.  They were eager to show us they had washed ‘their’ hands – they held them up and rubbed them in front of us, like surgeons waiting to dive into their task.  Their white coats were tailored and went all the way down to their knees – designer, no doubt.  These young people were beautiful – so nicely dressed, so clean and crisp, pretty jewelry, precisely coiffed, nice shoes.

For four nights I slept on a geri chair – the newest thing, they said.  Designed for those family members who wished to spend the night at bedside.  Orange plastic with breaks in two places – one at your waist and one at your knees.  When you stretched out – trying desperately with your weight to make the chair click open like a rickety barcalounger, and stay flat so you could stretch out, it would only do so until you shifted, then the weight would push the parts together, and the chair would begin to catapult forward.  A torture chamber, better replaced by a big ol’ easy chair – they should demand their money back – I’d write testimony to help with that.

Image

On day 3, I looked up and said, “who changed your sheets?”  “What do you mean?” my daughter replied.  Mom went into action and sheets were changed, but still no new johnny or face cloth, or warm soapy water – no toothbrush and little toothpaste in the kidney shaped plastic dish. Was she that sick, I thought?

On day 3, we learned about an emergency code the patient could call on the phone – a kind nurse suggested it.  And yes, late at night, a team arrived – an administrative team.  My daughter, who is skilled in conflict resolution, ran the ‘code’ herself.  She explained what had happened and how we knew no answers, how her sheets hadn’t been changed, and for her first foray into solid food she was brought pasta with red sauce.  “What were you thinking?”  At five a.m. one morning, a phlebotomist came into the room, a dashing young man, flipped on the overhead light, went between the geri chair and the bed, flipped on the bed light, grabbed her arm and put the tourniquet on as he shouted, “good morning! I have to take your blood!” and she yelled, “go away, what are you doing – who does that to someone when they are dead asleep and sick?  What are you thinking?”  (That moment was my first ray of hope she was getting better.) And how the nurses – some of them – would lie – would tell her they were going to get the doctor, and not do that.  Would tell her that the big team was coming in from Beth Israel or Brigham, and they never did.  Five days.  And she was waiting.  Maybe the ‘experts’ would have answers.  But they never came. The emergency code team took their notes.  We wondered if some famous star had sued the hospital and this team was part of their settlement to the patients left behind.  To this day we don’t know what happened after that late night bedside meeting – because no one ever told us.

Eventually, the situation improved.  She took her first steps down the hall.  Straight from her bed, without having even sat in a chair yet.  “Oh, oh..”, I thought.  And, yes, lickity-split, she was being prepared to go home.  No answers.  Lots of medication.  IVs being pulled out.

Recovery took some time.  Just walking in the door and seeing her cat made a world of difference.  Couch all made up with sheets and pillows.  Mom by her side – where else would I have been?  And time did its miracle.

Tests followed – one by one – answers, we needed answers.  Almost none were to be found.  “Don’t look further (in literally a hushed whisper) we don’t do that today, in our ‘new’ medicine – we just treat symptoms and if they go away, wonderful. We don’t look for more.”  Really.  Almost by accident we find some fixable vitamin deficiency and it gives us something to work on, a crack in a door, and we go down that path.  And still do…  We have no diagnosis.  Just questions.  Just a somewhat uneasy feeling and a “what the heck was that all about?” nagging, nagging question.

As 2013 comes to a close, I have four days left to pay the bills that have accumulated – to get the medical tax deduction for this year.  I might as well.  I have been collecting bills, notes, forms, tests, hospital ID bracelets, etc. in this folder that is so thick it no longer closes.  Tonight I open everything, decide to sort it, which bill to pay, which one to dispute (two ED visits in 10 hours? – don’t charge me for both when she should never have been sent home…please…thank you…), and then – the big question – how much has been covered by insurance?  I take a photo.  Each pile is a different ‘vendor’, if you will.  We were in one place, but I’m counting 10 separate places to be paid.

ImageMy daughter is very smart.  She is a grad student at a Massachusetts university – one with a unionized faculty.  One that offered her a position assisting a professor (and by the way, that makes you a union employee, and by the way, you also get health insurance, and there is no charge to you for it).

Our bills will total $50,000 gross.  Or more.  The door is still open.  Massachusetts was the first state to have Romneycare.  I will be doing final calculations, but it looks like we will have less than $2,000 to absorb.  Maybe $1,000 if we can negotiate based on being an adult student with little income/assets.

I am grateful.  If this were part of the health insurance plan I paid $1,500 a month for previously, in RI, I would have been looking at a bill of $6,000, $10,000 or more.  For a five day stay.  Two CT scans?  $2,500 each.  Really.

Tonight, as I write this, the Christmas lights fill my living room.  The house is quiet.  I have poured myself a glass of wine.  Red wine.  It’s healthy, isn’t it?  My daughter is going out with friends to celebrate Christmas. And yes, I’ve asked her if she’s taking her prescription vitamin and when is her next injection….and blood work….and the path is open before us.  But finally, at this odd interlude between Christmas and New Year’s, I’ve had time to think – and ponder the thousands of stories far, far worse than ours – the stories of extended hospital stays, and cancer treatment, and open heart surgeries, and extensive rehab stays.  And I smile.  It seems like an odd reaction.  But Obamacare will save lives.  Indeed it will.  It will also do more than that.  It will open access sooner.  It will force payers to force payees to lower costs.  It will empower patients as never before.  It will not be perfect.  It will moan and groan and cry and quake as it births itself to a whole new future for us – “we, the people” of this great American nation.

“Yes…to our health!”

Image

(that’s Mom’s glass of wine)

Life on the edge of nothing…

She is 86 years old.  My aunt.  My mother’s sister.  Not many people know about her because I don’t talk about her.  Call it tradition, but in our family, someone with mental illness was ‘invisible’ – we don’t “talk about such things” – they were sent away – out of sight and out of mind.  Portuguese families who came to this country and became citizens were always afraid of something that would ‘get them into trouble’ – fear of being sent back?  Not sure.

When I entering college I decided to major in psychology.  Maybe more to understand my family’s odd behavior than to understand my aunt.  I grew up in an extended family – all on my mother’s side – along with my silent German-English father.

My aunt and I got along quite well.  We do to this day.  She has never held a real job – some “piecework” in a jewelry factory on a “foot press” for a few weeks or more at a time.  A long time ago. She made some beautiful, highly detailed crafts, wrapped them in Saran Wrap, and sold them at small boutique shops, too.  And she washed and ironed shirts for her brother, my uncle, who owned a restaurant/bar and he paid her 25 cents each to do them.  25 cents.  Looking back, that was cruel.  Almost a sick joke.  She got out the stain of grenadine meticulously – scrubbing them on an antique wash board – in steaming hot water until her hands would bleed.  She ironed every crease, and starched them perfectly.  They were set up on a small rack in a corner of the kitchen – those shocking white shirts – those perfect shirts – those 25 cent shirts.

When I was in my teens they took her away one day.  She tried to melt red candle wax in a porcelain pan on the stove, and pour the wax into molds – always the creative one.  Nearly burned the house down and freaked her right out.  Her father, my grandfather, went after her.  It was a nasty scene.  And just like in One Flew Over the Cuckoo’s Nest, they came.  The small white van – the men in white.  Really!  They wore white pants like ice cream cone servers. The pants were whiter than the straight jacket they put around her as they took her 5 foot slender shrieking body out the door sideways, held like a rolled up carpet.  Or the stogey my grandfather held between his fingers as he watched her go. One more time.  Then he played cards.  His Solitaire game.

She came back in a week.  I remember she smelled so different.  And she walked like my Walking Debby doll.  She stared at her feet and moved them one at a time.  She’d look up and smile.  They called it The Haldol Walk, the look, the s-l-o-w  m-o-t-i-o-n of it all. That scene would be repeated numerous times, each time I would be a little older, a little more removed.  Waiting for my own foot out the door.  Can I go yet? Please?

Image

In the quiet times of her mental illness, she was my best friend.  Children, especially only children, gravitate to single aunts with time on their hands, as did I.  We made pictures.  She laughed at how talented she was and how I had none of it, whatsoever.  She marveled at how the talent had not made it down the genetic chain.  (But would the mental illness?)  She taught me to crochet. With size 0 metal crochet hooks.  And we made pies together.  Peach pies.  Pies you made from scratch, dough and all.  We made lots of them, using tin pie plates and wooden rolling pins. We used my grandfather’s fishing sinkers as pie weights.  Sometimes we made apple pies.  I remember slicing slivers of butter to put on top before we closed them up for baking. And cutting little patterns in the dough with a fork.

We liked to catch kittens, she and I.  There were always strays.  We would hide them in the greenhouse at the back of the yard.  Sometimes we would feed them for weeks and weeks, and play with them until they grew and started to walk around the yard, and over to the house and, well, then they would just disappear somehow.  My aunt and I never knew where they went.  That was sad.  We waited for new kittens – they always came.

Image

She even drove a car.  A 1954 Rambler with a push button gear box on the left of the dashboard.  She wore high heels – stilettos – my favorite pair were made all of wood with beachy symbols on them and straw.  I wonder if they were like those that Annette Funicello wore in Beach Blanket Bingo – my aunt loved Annette.

The years passed.  I went to college.  I grew all the way up.  I got married and had my own children.  She was lost for many years, my aunt, not sure how she managed.  She didn’t live at her home anymore – but she was never homeless.  One day I was called from a hospital and when I went to see her it was a bad scene.  She was in restraints.  Wild, really.  Didn’t know what my name was, though she did recognize me.  She spent some time in a mental hospital, and then seemed to be really fine.  But she hated her meds.  She couldn’t draw.  She couldn’t read.  Her mouth was dry and pasty.  And she fell asleep a lot.

Years would go by.  Another call.  Local police.  She was throwing her clothes out her window and could I come.  Another hospital.  Four point restraints.  Looking a little bit like the Exorcist child now.  Age had done that.  24 hours, and meds returned her to sanity.  And then to the mental hospital.  Another 10 day hold.

Did fine.  Returned back to her apartment, but they were treating her badly there.  So I helped her apply for SSDI – the first “handout” she had ever had.  She still never had health insurance, or food stamps, or subsidized housing – or a family to help – just me – now ashamed at how little I had been there. We went to the psychiatrist and certification came pretty easy.  We managed SSDI with the help of a pro bono attorney who knew that I would be the one to pay for his services, so he said, ‘never mind’.  Today she lives in subsidized housing and she still drives.  She has food stamps, though rarely uses them.  She is quite healthy.  Vision failing a bit.  86 now.

My whole life I have tried to keep her out of ‘the system’ – the places that would send men in ice cream pants to wrap her up like a rug and take her out the door sideways.  And what unspeakable things happened to her before she would return, flat, dissolved, absent? Those men and women in pale uniforms who would tie her up in brown leather four point restraints covered with white wash cloths to guard her thin wrists and ankles. The ‘new’ psychiatric hospital that tried talk therapy, and group therapy, and she would just smirk and smile and tell them ‘you’re crazy, you know…I’m not crazy…what are you talking about…ehhh, you’re kidding me. Nooo.’  She would smile.  I would, too.  Hoping the laugh coming over me would stop.

Image

She has humor and gentleness.  Except for the time she locked me in her apartment when she was in her 50s and told me that she could kill me and I could disappear and no one would ever know what happened to me.  Hmm.  I stayed away for a long time when that happened – me, trying to talk my way out the door – she, standing in front of it – grinning.  I was a mother now – no time to go getting cut up in little pieces and taken out with the trash.

Today we shop together; I take her to the doctor’s; I take her to social security when our new system begins to question her and I talk nicely to the 20 something year old clerk who says to me, ‘she never did pay into the system, did she?’ and I just smile.  She holds her own, my aunt.  If I try to help her with all the papers she has stuffed in her purse, she swats at me – with her strong, frail hand.

She does well away from the systems, the mental health professionals who had no idea then or now about what was wrong and how to fix it.  She has eked out a life for herself.  She has done it alone, and in silence.  The silence of mental illness.  The dark rooms behind wooden doors, behind metal doors. The programs that do not work.  The system that only sought to wrap her up and throw her away.  The meds that eased her angst, but flattened her personality.

Today we house 30 people a night, I’ve read, in the emergency department of RI Hospital – because there are no beds.  A teenager who wants to kill himself resides, as an unregistered patient, at another RI hospital because there are no beds – and nurses take turns buying him McDonalds’ food because he can’t get a hospital tray – remember, he’s not admitted nor discharged.  He is not even there.

And millions were spent on a big new building at the other psychiatric hospital for – how many? – 24 beds.  24.  And they were almost at once – full.  No room left there.  We closed the IMH (Institute of Mental Health) years ago, and our mentally ill are on the streets, or maybe the lucky ones are in day programs and group homes, or living somehow marginally.  Where are the violent ones?  Where are those who at one point or another think about the unspeakable – or do it?  We read about the few.

Image

I have spent my career, for the most part, in the nonprofit world – always on the periphery of mental ‘health’, physical ‘health’.  But now I am raising my voice to tell a story – of one person, one red haired, slight, 100 pound lady who walks on her toes, who listens in the dark to her radio – who warms up food in hot water because the microwave (my gift) is a mystery.  She whispers on the phone in the closet – when we speak – because “they” are listening.  And she has one small lamp on, too, so “they” can’t see her.  She’s convinced the security cameras can see around corners and into her room.  She talks to me about current events, about how it has been 50 years since John F. Kennedy was assassinated. Imagine that?  50 years.

Each December and each April my daughters receive a birthday card with $2 or $3 or $5, cash in it.  At Christmas and Easter there are cards, too – along with this wish for them – written in flamboyant and beautiful cursive writing – “I hope you are well.  Remember, if you don’t have your health, you don’t have anything.  Love,”

Hear Me Roar! Women as Storytellers…

Story telling to impact change, right wrongs, pass bills, and be successful in advocating a position….women seem to have in innate ability to do this, perhaps because we are often in the role of advocate in our families. Be interested in your thoughts…. Have you given up your anonymity on behalf of a cause? How did that settle with you? Were you effective? Would you do it again?

My article in the November issue of the RI Small Business Journal addresses the power of story telling as a PR tactic, but goes beyond in talking about why women are particularly comfortable in doing so – who has not had the experience of facing a school administration meeting on behalf of our child, feeling strong, secure and empowered, when we may not have felt that way at any other time in our lives when going up against a system.  That probably holds for men as well as women.  You know you have begun something – the road is only open ahead of you, because the one behind you has disappeared.  Forward you go, with a loss of anonymity, with a risk, with hopefully good independent advice and due diligence, with a higher goal in mind.  Perhaps a whole new life mission.  Felt great to write this, to remember a school conference room, and my little girl – and I felt as powerful as a lion.  We won, my little girl won – well, of course she did!  I wouldn’t have settled for anything less.

http://issuu.com/gillantini/docs/volume_2_number_8_issue?e=4265616/5519952

Image

Tightly Scripted: One NP’s Experience with Retail Clinics

Tapestry Communications:

An amazing read…we have made our nurses, NPs, and docs into automatons ruled by computer programs – how often is our experience now when we go in for an office visit, watching the staff member type in with a stylus what we say, in response to prompted questions on the screen. Do they look at us? Except for having to put the laptop down to put on their gloves and examine us – we almost never meet their eyes….and if the situation doesn’t fit into the screen in front of them you see them hunt and peck for how to log it all in….changes for the better? Why are they so ruled by this process? Because that is how they are evaluated….once again, in an attempt to make things better, we have mucked it up.

Originally posted on Off the Charts:

By Karen Roush, MS, RN, FNP-C, AJN clinical managing editor

Retail health clinics (walk-in clinics that are in a retail setting such as a drugstore or discount department store)KarenRoush have become an effective mode of providing increased access to care for many people and a growing source of employment for nurse practitioners (NPs). Their place in the health care arena may take on even more significance as the Affordable Care Act (ACA) increases access to care for previously uninsured people.

I worked as an NP in a retail clinic for about six months while working on my PhD. I left because of concerns I had about the model of practice. It didn’t have to do with the fact that I had to mop the floor at closing time or collect the fees and cash out the “drawer” every night. Nor because I spent eight hours alone in a small windowless…

View original 861 more words