First….fix the harm we have done.

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The opioid crisis.  It could have been predicted, after all.
Today you hear the smart young health advocates talk about setting up “pain clinics” as the “NEW” answer to the opioid crisis. You have already seen holistic wellness centers and alternative medicine practices cropping up on almost every corner.  But, let’s remember the ’70s.  When you had unlimited visits to chiropractors and physical therapists; when doctors could take their time to talk to you and treat you – when triple booking patients was not an industry best practice – but reserved for flu epidemics and such?  If you’re under 45 years old, you won’t have any idea about this – unless you are a medical history buff.  If you’re a physician you won’t even get this “old school” information taught to you in med school.  But this was before managed care – before big pharma, big health-insurance-business, big hospital-business, and big government regulation – when these things weren’t just tried here and there – they were a staple of medical care.
In the early ’80s a severe sciatica problem had me going dutifully to my chiropractor 3 times a week.  The most I did for pain outside of those visits was Tylenol and an ice blanket.  I was re-educated about how to not cross my legs at the knee, but instead at the ankle, when I sat for long periods of time; how I should get up and walk around about once an hour at work; and why carrying a heavy pocketbook and briefcase over one shoulder was no longer advisable.  I also learned about anti-inflammatory foods, and got advice on the proper exercise to do – and not to do.  It was a struggle, and it didn’t go away quickly, and there was one bout of a prescribed muscle relaxer for a few days – but, slowly, I learned the triggers and the treatments.
What would that treatment look like today?  What would the pill of choice be that I would be prescribed?  And how many would I get?  Would I get beyond 5 to 10 office visits to a chiropractor?  Would physical therapy be covered at all – and what would the wait time be to get in to see someone?  Would there be some counseling provided as to a good diet and proper exercise – and preventive techniques?
90% of pain clinics ceased to exist – yes, they were closing up shop, except for those serving the more well to do – out-of-pocket patient base. Other than that, compensation and reimbursements were drying up.  People were still in pain – and there was no miracle new drug that had been discovered.  Big-everything changed all that.  Managed-everything was faster, cheaper, and less holistic. And, today we find ourselves in an addiction and overdose epidemic of epic proportions.
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I agree with this article, by Cindy Perlen, LCSW, and posted on KevinMD.com.
Now that we are in this crisis – in 2016 – what are we talking about to deal with this opioid prescription crisis and a population increasingly in need of pain control? We’re talking about opening pain clinics, and encouraging (not paying for) people to seek alternative methods of dealing with pain – get a massage, go to an acupuncturist, utilize exercise.  Only if you really get hurt will it be paid for, and then, that treatment will also get restricted as to numbers of visits and/or costs.  We’re also talking about limiting pills doctors can give their patients.  We’re investigating doctors.  We’re criminalizing the medical system – and people who get hooked. Of course, there are real reasons to do some of that.  But in our rush to criminalize, to sanction, and to walk government right into the hallowed privacy of the doctor patient examining room, we have forgotten what got us there.  We have forgotten that we already know much about how to fix people in chronic pain.
For those who, because of their brain wiring, being prescribed opioids was the worst possible treatment. Now, they are on an addiction spiral, and we struggle to know what to do.  We have never seen a crisis like this.  Our drugs won’t take care of it.  Our prisons won’t.  Our mental hospitals won’t.  For now – it is our graveyards that are.
It is time we face this square on.  Pay for proper treatment of people in pain.  Open the pain clinics.  Pay for “alternative” care.  Re-educate the medical specialists who know so little about other ways to treat – other than pills and surgery. Stop the problem from continuing. And figure out how to clean up the mess that has been left behind.
Put the blame where it belongs.  We did this to ourselves.  I swear if you live long enough, you really do begin to see everything “old” become “new” again – functional exercise replacing use of complex equipment; simple, real foods replacing fast food grazing; custom-made anything replacing manufactured goods; “made in the USA” a better brand than the magic of manufacturing “made in China”, natural materials over plastics, organic over GMOs.  Eastern medicine looked at with new eyes, as Western medicine struggles to keep the healthy healthy, but has a pill for every ailment.
Don’t blame the doctors. Don’t blame the patients. Blame big pharma, big business, big medical-training, and big government…
Retraining and new curriculum for medical professionals. Healthcare for all might be the only answer – with a prevention and holistic focus – that’s two places to start.  Pay for proper treatment of people with pain.  Invest in prevention.  Help the addicted and the overdosing.  Sometimes it seems as though the plan is to wait until they all die away, and we can hit reset.  Sometimes it seems that we are on that road. We simply can’t do that. Nor can we fail to address that as we live longer, and are more active, people will have pain.  Intense pain.  Pain that we already know much about treating.  And we’re only offering half the treatments that are out there. Or will we only stoke the science machine to develop that next new pill?
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50 years ago it was Kitty Genovese who couldn’t breathe…

As the tragedy of the death of Eric Garner and the call for action and justice, has played out nightly with demonstrations coast to coast, and cries of “Black Matters” and “I Can’t Breathe” have entered into our cocktail chatter and business conversations, I can’t get the thought of Kitty Genovese out of my mind.

Do you remember Kitty? 

Kitty was a 28 year old woman. She worked as a waitress. One night, around 2am, she was murdered – stabbed and raped – right outside of her own apartment – by a 29 year old man who said he simply went looking for a woman to kill “because they didn’t fight back”, he later revealed. Kitty fought. She screamed. It was a loud, disruptive incident. Yet – no one called or came to help Kitty. Over 37 people later said that they were aware she was being attacked. They had heard her screaming for help.  Each person believed someone else was doing something. Calling for help. Rushing to her aid.  Yet, no one did.

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The social psychological phenomenon became known as the “bystander effect”, and, Kitty had her immortality, in the study of the “Genovese syndrome”, which continues to this day in colleges all across the country.  Literally, books have been written about Kitty – and the syndrome that bears her name.

While a student at Providence College, I studied social psychology.  I became rather fascinated by the development of group consciousness, group mentality, and “diffusion of responsibility”, and the “bystander effect”.  How could it be that one or two people would have more probability, individually, of helping someone than a group would?  How does the instinct to act become dissipated when they see themselves as members of a group?

We see this demonstrated with Kitty, yes.  We also see this on our college campuses when we talk about rape and sexual assault.  Often, the worst take place in fraternities or at parties, where society’s boundaries morph to the new society of the moment.  Where actions one person would never think about, much less act on, become the group’s behavior, and the individual becomes but one cog in the wheel that has been set in motion, with its own outlying concepts of right and wrong, its own shady sense of rules. As but one cell of the whole, the power to pull away is exponentially difficult.

The collective brain often rules.

The study of this has led to some good things.  It only took 25 years or so for CPR training groups to realize that there was a fatal flaw in step #1 – “call for help”.  How many of us were first taught to shout at the downed person, “are you all right” and then to shout out into the air or the group gathered, “call 911”!   Groups that were forever tweaking their CPR compressions, breaths, etc, heard about this, studied it and realized it was true that sometimes no one called for help – each thinking another member of this newly identified group had done so.  New instructions were written that when you called for help you should specifically select one or two people – looking at them directly and address them with a powerful order.  “You! Get help – Call 911 – now!”  What did this do?  It charged the specific person with a specific action.  The burden to do something – to move – was extremely powerful – and effective.  Some others in the group may act, too, but assuring that one person carried the full weight of that charge is now known to be crucial in a successful “chain of survival”.

How can this study – these concepts – help us better understand what happened to Eric Gardner – and offer critical retraining to our police officers?

We know his name.

Daniel Pantaleo. He is the police officer who put Eric Gardner in a fatal choke hold. But do you know who Justin Damico is? He’s one of the other officers. There were four others, too. There were also four EMTs/paramedics.  All told there were 10 “first responders” engaged with Eric that day.  And a score of others watching. The five police officers were given immunity to testify about the choke hold actions of Daniel Pantaleo.  The EMTs were suspended for their lack of lifesaving efforts at the scene, though they were later put back into duty.

Yes, Daniel Pantaleo was the officer who performed the fatal choke hold.  But there were four other officers there in that heap on top of Eric.  Did anyone say, “hey, back off a little, I think you’re killing this guy?”  Was that even a whisper? Or did the “diffusion of responsibility” have a powerful effect to have five officers believing that their actions were justified – there was no individual cry-out because there was no individual any longer – just ‘one of the five’.  Add onto this the layer of Eric being black. Add on to this the layer of poverty – all of this was happening in a poor section of the community.

What questions and answers can the study of group phenomena bring to retraining? Another group has used this information to help stop wrong side surgeries. Collective conscious thinking has been responsible for operating room errors when there was an assumption that the surgeon was cutting into the right appendage of his or her patient – even in the face of serious doubt or question.  It is a strong phenomena that makes an individual, maybe someone low on the hierarchy in the room, frozen from questioning, from saying, “wait, let’s check this again”. It is hoped that by retraining, and allowing all members of the group to have equal voice, this can change. To be effective, there must be a real promise of no repercussion, even if the person is incorrect, and all members of the group must believe that, to be so empowered.

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Did those officers, did Justin, and the four others, and David – approach Eric – with individual decisions that they were going to make this day one Eric would never forget – they were going to take this guy into custody – and if he resisted, they were going to kill him.  Right there, on the street, in front of groups of people, and while being film?

The overlay of race and poverty.

Did race – and bigotry – and fear – and poverty overlay these dynamics making the situation beyond salvation? Of course.  Exponentially so. So, yes, we need to do our cultural education and racial education, and our retraining.  We need to also restore the power of the individual to question tactics, protocols, and moments when common sense has gone haywire. Shoot to kill? Arming our police force like they were at war? Match our law enforcement to the diversity of the community? Teach individual responsibility and empowerment?

“I can’t breathe!”

There were lots of people around Eric.  Lots of people cried out.  But the most important ones who could have stopped it – the officers, themselves – didn’t hear.  They were bonded by a powerful magnet creating one new entity, made even stronger by fear. Each, by their silence to the others, reinforced the actions – the holds, the knee into the back, the smashing of Eric’s face into the cement – the fatal choke hold growing tighter and tighter.  They could no longer see with their own eyes, or hear their own thoughts – and they certainly did not the 11 cries from Eric – “I can’t breathe! – I can’t breathe! – I can’t breathe! – I can’t breathe! – I can’t breathe! – I can’t breathe! – I can’t breathe! – I can’t breathe! – I can’t breathe! – I can’t breathe! – I can’t breathe!

“We have met the ‘enemy’ and he is us.” – The Parent/Teacher Rift

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The assistant principal of the J.F. Deering Middle School in West Warwick, Subhash Chander, wrote a commentary in the Providence Journal, which ran on September 13th entitled, “Parents must do more than just buy school supplies”.  At first read, I thought – absolutely – excellent points. Well said. But then I noticed the one-sided view that this principal chose to use in addressing parents. And I could actually see a finger waving back and forth, admonishing me, the parent. I started to remember my experiences in my encounters with teachers over the years, when I would ask questions, or suggest something. That awful, tenuous, careful push-pull feel of it all.

Like a presidential rebuttal I feel compelled to respond and ask this of Ms. Chander, “what is a teacher’s responsibility”? And not to plagiarize in any way, I’ll use some of her own phrases. As an administrator are you focusing first and foremost on reinforcing with your teachers, what it takes “to be ready for the school year”?

When sentences begin with, “To parents: The least you can do is start taking an interest….” you’ve already lost the ‘we’re a team’ point.

My children are in their mid 20s now. They were educating in public schools in the Cranston school system. They went on to public university education, then beyond to advanced degrees. They have good jobs, here in RI.

No, I was never a helicopter parent. But, I was always ‘there’ – for events, concerts, parent teacher meetings, etc. I even had a strange few years on the PTO. I looked at homework assignments, provided a good dinner and study time at home, pulled back on extra curricular activities when I could see that was interfering. I did the dreaded dioramas and helped in the equally dreaded poster board presentations. I struggled to understand the new rubrics. I agreed to let my kindergartener not worry about mispronouncing words, as the new reading methods didn’t are about that (don’t ask about a 20-something’s pronunciation faux pas, to this day). I gave up on the old math of memorizing “times tables” to the new math (have you gone to a farmer’s market and watched the young people struggle to make change from a $10 when you have spent $5.71 – watch it – it’s the “new math”). That “better way” of doing math far exceeded my ability to understand and keep up at some point around middle school.

They excelled academically and are thriving as individuals. Given a poor teacher year or a year fraught with unresolved school issues, they managed to get through pretty much on their own resolve.

My visits to the schools were few. But they were almost never well received; my requests never greeted with openness and a ‘spirit of cooperation’. Teachers were unavailable, unaccommodating, wouldn’t look you in the eye, didn’t return phone calls, for the most part. Of course, there were a few outstanding gems, to be remembered for a lifetime.

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This principal writes, “To Parents: the least you can do is take an interest in your child’s education” – let me write this: “To Teachers: please take an interest in your student’s life”. Talk to them. Ask them on a daily basis what they do outside of school. Ask them what’s important to them. Don’t ever assume they have all the support they need for academic excellence. Ask them if they need extra help. In talking to your student, please let them know that you will stay in touch with mom and dad. And do it. And when you talk to the parents, do so in a friendly and inviting way – do not stop maintaining those connections, even if you find parents are very busy and may not have the time to talk to you when you can talk to them. After all, these days, it is easy to stay in touch with parents using electronic media.

Always remember that you are accountable. And that teaching effectively is your primary responsibility – and you will be reviewed on your performance. I have no doubt that you are busy and overworked and under resourced.

Think of ways to welcome parents to your classroom – establish a hotline if that works well for you. Teach your students to respect education and of course the people who teach them every day. Provide an environment in the classroom that fosters respect for all people. Show your students that you respect their parents, too. Never disparage your student’s parents, or home situation in front of your student.

As teachers it is imperative that you share your student’s educational journey not only as “the teacher”, but also as “a person”. Let your students feel that you are their best support in education. Encourage them to discuss anything with you, that they don’t need to hide the fact that they may need something they are not getting in the classroom or at home; let them know you are right there for them. Create an environment of open discussion around topics related to education. Create that environment with your students’ parents, too.

Yes, “children who are ready to learn are easiest to each.” Remember, parents who are welcomed and know what they can do to help can be your best advocates. Know that some parents will fail their children, and be ready to help support these young people as best you can; it is not their fault. Nothing could be more valuable than ensuring a promising future for your student through education. After all, this is why you chose to do this for a living.

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Here is the link to the original op ed, and it is printed in its entirety, below…

http://www.providencejournal.com/opinion/commentary/20140913-subhash-chander-parents-must-do-more-than-just-buy-school-supplies.ece

The back-to-school frenzy is over and schools have finally opened. Kids have gotten their wish lists taken care of and parents have spent or overspent their budgets in their desire to get their children ready for the new school year. The students are back to the classrooms after a gap of almost three months and teachers are ready to roll out the new academic year.

Are the children ready for the school year?

This is a question that baffles all at the end of every long nonproductive vacation. What does it precisely mean to be ready for the school year?

Because few students faced serious intellectual challenges during vacation, the teachers are going to have to design remedial course work to prepare them for the curriculum. It is every teacher’s wish that the summer vacation would be devoted to some productive academic activities. During the summer break, learning invariably takes the back seat and a sizeable chunk of the year is devoted to unproductive activities only remotely related to education. Hence many students end up losing one-fourth of a year’s worth of education. Staying stagnant and inactive for three months, a child’s brain is sure to regress.

Do the parental responsibilities end with the provision of school supplies?

Education of children is a complex matter and cannot be entrusted to specialists alone. True, teachers are entrusted with this responsibility and paid for it. But children’s education is a joint responsibility of parents and teachers. Teachers cannot fulfill this responsibility singlehandedly.

The majority of the teachers do fulfill their professional obligations to the best of their abilities, but children spend a good part of the day at home or in their communities. That is where parents have a role to play. By doing little things, parents can make a significant contribution toward the success of their children in school.

To parents: The least you can do is start taking an interest in your child’s education. It starts with talking to your children on a daily basis about whatever transpires at school every day. Never think that your children have grown up enough to handle their educational responsibilities on their own. The more involved you become in your child’s education, the more successful your child is going to be.

In talking to your child, please stress that you will stay connected with his or her teachers. No matter how unwelcome children find your visits to, or contacts with, school, do not stop maintaining those connections. These days, it is easy to stay in touch with the teachers using electronic media.

Always remember no one is more accountable for the education of your child than you as parents. You do not need to be a college graduate in order to help your child become a responsible student. All you need to remember is that education is important for all, and as parents it is your prime responsibility to continue to inculcate love of learning relentlessly.

I have no doubt that, as parents, you are busy ensuring the supply of things of daily needs and are quite hard-pressed for time. But please note that nothing could be more valuable than ensuring a more promising future for your children through education.

Thus you should establish a hotline with your child’s teachers, and help teachers feel comfortable communicating with you. Teach your children to respect education and the people who provide education to them. Respect for teachers is a cornerstone of successful education. Never disparage your child’s teachers in front of your child.

As parents, it is imperative that you share your child’s educational journey with them at a highly personal level. Let your children feel that you are their best support in education at home. Encourage them to discuss anything and everything with you as this way they will learn not to hide things from you. Create an environment of open discussion in the house around topics related to education.

Remember that children who are ready to learn are easiest to teach.

Subhash Chander is assistant principal of the J. F. Deering Middle School, in West Warwick. He is a former professor of English in India.