Doctor Eclectic

Doctor Eclectic
Doctor Eclectic

Sunday, December 28, 2014

Uber

When I passed this year’s Christmas letter to Mary for editing, she called attention to my including Uber in the letter.  “Who or what is Uber?” she asked.  As someone who reads two newspapers a day, I was surprised she had missed the news about the San Francisco company, which is now in 53 countries and literally hundreds of cities.

It’s placement in the annual letter came because my granddaughter and her boyfriend are both driving for Uber.  It made and still makes business news in the WSJ, my paper of choice.  In fact there were three articles within the last week”: one about a French challenge to their operations, another about background checks in San Francisco and New York City, and a third, very interesting one on how Uber has become the soccer mom” transport for middle-school kids.

Together they provide an interesting story about this emerging company that has attracted more than $46 Billion in venture capital, and in a very short period of time: five years, in fact.

In 2010 Travis Kalanick and Garrett Camp installed their friend Ryan Graves as CEO of what they called UberBlack, choosing the name because at the time they envisioned using the black limousines in the city as their sole means of transport.  There were several reasons why this seemed a good business model.  For one, the black cars were under-utilized.  My first-hand experience is that San Francisco is a tough city in which to catch a cab.  Unless you are at a major hotel, even a call from the concierge is likely to result in an extended wait.  The limos, which often depend on hotel personnel to suggest them as an alternative to taxis, tend to wait in queue or roam, looking for someone looking at their watch. 

I have used one to travel about six blocks and, since they have no meter, paid an agreed-upon price to reach my destination.  The non-meter agreed upon-fee model is one of the things that distinguishes Uber from taxis.  Another is a concept borrowed from the toll-roads and online shopping: PayPal or credit card on record; both making transactions cashless for the consumer.

The limos also had something that worked in their favor: they were considered non-competitive by the taxi companies, since they were already handling an overflow population, often with trips to the airport.  They also satisfied whatever regulatory requirements the city had, such as background checks, bonding, and liability.

When their success exceeded their demand, Uber looked to expand by increasing its fleet.  This resulted in several policy changes: standards had to be set for drivers and cars, there needed to be a payment system for drivers and, probably the most important, recruitment of cars and drivers, many of whom had never driven commercially before.

What has developed, at least in the United States and Canada are these: drivers must speak English and have an unblemished, current driver’s license, cars must seat five or more passengers (including the driver) and be less than ten years old.  Insurance while “on the move” is provided by Uber and drivers agree to certain company policies, such as avoiding direct airport access for pickup or delivery, and no transporting unaccompanied children under the age of sixteen.  Other than through complaints or accidents, enforcement of these policies is difficult to assess.

The major change in moving from UberBlack to UberX was increased interest and concern from both the taxi industry and City and State regulators.  In fact, if you get to other countries: such as France and India, entire countries are showing concern.  Uber’s reaction has been high-powered legal action, defending the company on the grounds that it is not a transportation business, but an internet application industry.  It will be interesting as to how that plays out.

If Uber loses, it won’t be because of satisfaction.  Customers love it, and are willing to make concessions, such as walking a block to or from our local airport to use the service or, as the WSJ article mentions, turning a blind-eye to the under sixteen policy.  The drivers seem to love it also.  The flexible hours, including choosing what hours the driver wants to work seems popular.  One of the early San Francisco drivers, who drives as a full time job averages about $25 an hour and has immediate access to those funds.  He has limited liability, although some automobile insurances question whether the Uber policy lessens their liability.  There are probably some tax advantages for those who itemize, but I am sure that is a gray area.  And, in a policy borrowed from Tupperware and Mary Kay, there is a $500 bonus for referring a driver who commits to three month’s availability.

Drivers have very few restrictions.  Fares are set by Uber and vary depending on vehicle and demand, so customer controversies are with the company rather than the driver.  Drivers also avoid the major concerns of taxi drivers: company charges for required credit card use, mandatory hours and location, long waits in airport queues, mandatory GPS systems and the unevenness of the field now that Uber and Lyft have entered the market.

With the end of the year hovering about, I think I have received more solicitation letters than Christmas cards.  In my next post I’ll question why and how that happened.  I hope you will join me.

Tuesday, December 16, 2014

Annual Reviews

Like most service personnel who joined when I did, I found my life achievements, rightly or wrongly, described in the Annual Review, titled the Fitness Report.  For twenty-five of the Twenty-six years I served, I lived in fear of what effect a negative comment might have on my life.  I also carefully tried to chart a career path that would lead to Command and favorable assignments, and I was told those assignments came from favorable Reports.

Unlikely!

Although I never had an assignment I didn’t like, the only one I asked for and received was Post-graduate school at Bethesda.  At the end, when I was offered a staggered assignment that would eventually (maybe) gain me a major command, I began to feel about Fitness Reports like a longtime friend expressed when we were on our first ship.  He was playing poker and was interrupted twice by his Senior Chief who opined that he was needed by his men, an invitation he declined.  Finally, the Senior Chief said, “this may affect your Fitness Report.” To which he answered, “The only way a Fitness Report could hurt me now is if it were rolled into a tight point and stuck in my eye.”

This actually turned out not to be quite correct.  He was discharged some 1500 miles from his home and had to pay to get home out of his own pocket, including paying for shipment of his personal possessions.

Through my career I saw a change in the method used to evaluate and be evaluated.  Gradually there crept in some goal-setting, with accountability. Metrics replaced vagaries, and job definition became clearer.

About that time I found myself closing Hunters Point NSY and having only a First Class Petty Officer to assist and be evaluated.  Shortly into the interview I realized that what was important to me for him to do was not what he thought important.  If I wanted him to clear my hurdles I would have to make his expected goals clearer.  That knowledge served me well in the rest of my Navy career and through my 20 years in the corporate world.

Several recent occurrences precipitated my writing on this subject.  For one, I asked my oldest son who is in sales, whether he would receive an annual review.  The answer was essentially, no.  Instead they are assigned target sales goals at the first of the year, with little interactivity in how they are set, tied to a bonus.  There may be adjustments, and even changes in territory throughout the year, but little of what I would recognize as goal setting and accountability exists in the traditional sense.

My younger son had an evaluation recently, but again it was less traditional and more in line of a demonstration of application of principles, and understanding school goals.

So, if traditional reviews are a thing of the past, what has replaced them?

An article in a recent WSJ titled “Are You Happy in Your Job? Bosses Push Weekly Surveys” may offer a clue. Some companies are finding that anonymous motivation may result in more productivity, greater commitment, and general higher morale.  Several times during the work day or work week, a brief three or four question survey will appear on the worker’s screen.  Questions such as, “What was your major accomplishment this week?”, or “Do your managers appreciate you?” or even, “What embarrassed you as you were growing up?” offer clues as to how management may improve work assignments across the board.  If nothing else, this may move HR persons into a more empathetic and less risk-avoidance position.

We’ll have to wait and see.  In the meantime, as a pretty-much retired person, I hold a Staff Meeting with my support personnel as I shave in the morning and I can modify my goals so I am always on target.
I realized as I composed my annual Christmas letter, that I had more knowledge of Uber than Mary, and possibly more than the people to whom I send cards.  So, in my next Post I will catch you up on what I know of Uber and why it presents an enigma in our developing society.  I hope you will join me.

Friday, December 5, 2014

Handicap Placard

Hip Replacement
Almost forty years before I had my hip replaced last year, my mother underwent a similar operation.  This is not all that unusual as I was told we do 400,000 a year in the U.S., a fact that some believe is more likely to bankrupt Medicare than Congress's raiding the funding.Not discounting the tremendous changes in experience, surgical techniques, and materials, we did share some similar experiences.

We both had pre-surgical episodes with wheelchair assistance needs.  We both had genetic and familial tendencies towards joint problems, and at least one more.

We both received a post-surgical handicap placard.

I can’t remember if my mother’s was red or blue, because she continued to have problems and eventually had a knee replaced as well, so the placard I remember was a blue one.  My post-surgical placard was red, with an expiration date of four months.  I presume the rationale was that if I were still undergoing formal therapy after four months they would allow me an extension and if I weren’t, then I should be walking as part of my long-term recovery.

Neither Mary nor I are great walkers.  Me, because I was a thirty year runner and still proudly wear the gold runner around my neck that I gave myself for running 10,000 miles.  When I could no longer rum, and realized that the activity was probably aggravating my hip problem, I found it painful both physically and emotionally to walk.  Mary, because she says the house we live in, with its thirty-four steps from the bottom of our entrance to the top floor where her study is, constitutes her exercise program.  Since she weighs essentially the same as when I married her more than fifty years ago, who am I to argue?

My defense of that position is a little weaker, not only because my study is eight steps short of hers, but also because she visits the washing machine, dryer, and garage refrigerator more often than I do.  However, I do go more regularly to my car, parked in that same garage than she does, so I’m not totally fooling myself.

red (portable) placard
My surgical recovery was fantastic and my mobility a year post-op received compliments from the PA, but I had two of the worst bouts of gout that I ever had while recovering .  I now take medication and even subscribe to a daily cherry juice regime as my daughter-in-law suggests for me and her father, but I still have times when taking the first step is a major accomplishment and pain is a common visitor.

So, when my four months ran out I sought out my Primary Care Physician and got a six-month extension

As the ninth month of recovery came closer. I caught hints that Mary found our ease in finding a parking place comfortable and asked my PCP for another extension.  . I joked that I was afraid if I did not, Mary would find a way to cripple me in my sleep. He said, “Why don’t you get a blue one like everyone else?”

And I realized he was right!  Everyone seemed to have a blue placard, even at church, where they have eight spots on the main door level.  I now park in one of the two at the lower level, where the Rectory is, and climb the 8 steps to enter the church.

It has always seemed strange to me that the handicap parking spots at church fill up every week so quickly.  Wouldn’t you think some of those handicapped would be cured after a time?

When my mother passed away, one of my sons inherited her car and, as I passed it on, I thought about whether I inherited her placard.  Of course the answer was no, but I wondered why, since I had her hip replacement in the box with her ashes and transported that to Arlington where she joined my father, why couldn’t I have parked in handicap at the cemetery?

I hope you will join me for my next Post.  I’ll share with you some changes I have observed in the Annual Evaluation process since I retired.

Saturday, November 29, 2014

Mike Nichols

As I read some of the commentary following the recent demise of Mike Nichols, I was struck with two somewhat related facts: the wide variety of his prolific, productive life, spanning more than fifty years and how many of his projects were meaningful in Mary’s and my lives.  I also learned a few things about him that I had not previously known.

That when he arrived in this country at age seven, he only knew two English sentences: “I do not speak English” and “Please, do not kiss me.”  I also learned that he lost his hair at age four from side effects of a Whooping Cough vaccine and consequently wore wigs until he died at age 83.

His first real success came when he founded the Compass Players and teamed up with Elaine May. The improv group, which included a group of young comedians including Shelley Berman, eventually morphed into The Second City, which basically staffed Saturday Night Live when Lorne Michaels started it in 1971.  Our first contact with Nichols was the debut record he and May did and I still have the original vinyl.  When I was searching for images for this Post I found that my record is available on Amazon for $60. I couldn’t sell it because The Dentist routine remains a favorite.

Although he won awards for film, TV, and a Grammy for records made with Elaine May, he greatest love and passion was for the theater.  The first play he directed won him a Tony.  It was Neil Simon’s Barefoot in the Park.  Coincidently that was the first play I was cast in as a principle, playing Victor Velasco, the rather strange neighbor.  Of course my production was not on Broadway, but rather a group of local players who performed on a school stage.

The last play Nichols directed was last year, Betrayal, which opened to mixed reviews and quickly closed.  The play before that though won another Tony.  It was a brilliantly cast Death of a Salesman, which played a limited run because of cast project conflicts. Phillip Seymour Hoffman and two other actors were nominated for Tony Awards, as was the stage and lighting Director.

Although his most famous film was The Graduate the one he directed the year before got him that job.  It was Who’s Afraid of Virginia Wolfe? adapted from a play he was familiar with because he once was cast as the lead played in the film by Richard Burton.  One can only imagine how Nichols directed Burton, particularly at that time in Burton's career.  Nichol's Direction earned him an Oscar nomination, which would be repeated the next year.

He had a reputation as a strong, committed director.  The story is told of his directing Walter Matthau in the The Odd Couple that eventually would play 964 performances on Broadway and spawn a television series, a movie and a revival in 1988 with two females as the couple.  Presumably, Matthau at one point said, “You’re emasculating me.  Give me back my balls!”  To which Nichols replied, “Certainly.  Props!”  He won a directorial Tony for Spamalot, a production Mary and I saw when on our annual NYC visit for the Greater New York Dental Meeting.

Mary and I saw The Graduate and the music from the film is played regularly at dinner.  Nichols is all over the film with choices of the music and the artists who penned the score, the cast, which catapulted a young Dustin Hoffman to stardom, to the cinematography, which remains unique in its composition.  Hoffman remains in awe of Nichols for the opportunity to be in the film.  Perhaps Nichols felt a kindred spirit, remembering his attempt to break into theater in New York at about the same age by studying Method Acting.  In any event Nichols earned another Oscar.

About the only project we did not follow closely was the television Miniseries that won him one of his two Emmys: Angels in America.  As Netflix is now allowing stream-watching, I may revisit the project.

It is not surprising that, being one of a few select persons who have won an Oscar, a Tony, an Emmy and a Grammy, he would be honored for life achievement. Two of these that I recently watched in YouTube were the AFI Award, with a great tribute by Elaine May, and the KennedyCenter Award with about a 25-minute show featuring many of the actors and performers who felt his genius.

Genius may in fact be the operative word.  He was, after all, a second cousin, on his mother’s side, some ways removed, to Albert Einstein.

In my next Post, I will share with you how I have joined the legions who have a handicap placard.  You might find it interesting.

Monday, November 24, 2014

Clocks

Natrional Watch and Clock Museum
When we last set our clocks back, NPR did an interview with the curator of the National Watch and Clock Museum in Columbia, Pennsylvania.  The gist of the feature was how did they manage to set all their clocks, who did it, and how long did it take?  While I never learned the answer to those questions, I did find the concept interesting enough to reflect on clocks in my home and life, as well as to do a little research into the National Watch and Clock Museum, its counterpart, the American Clock and Watch Museum in Bristol, Ct. and the demised Clock Museum in Rockford, IL.

I also learned a new word: horology, the study of clocks and timepieces.

In a previous Post I covered the process of Daylight Savings, its history and arguments pro and con.  I also covered how I had been celebrating DST even after I retired from the corporate world.  The highlight of my celebration came about three years before I retired from WellPoint when my staff, numbering then about 16, surprised me by decorating my cubicle the Monday after the change, with posters, banners, celebratory cards and such.  Pictures from that day are still among my favorites.

I noticed this year that in another feature, Scott Simon was suggesting worthwhile things to do with the extra hour we gained.  That was also my pattern when I celebrated the occasion.  It was easier to suggest the Fall back, but the Spring forward gave an opportunity to give up all your bad habits in the one minute before you lost the hour.

I did an inventory of the timepieces I have in my house:  thirty-seven, counting both cars and the cordless telephones.  Some of these are quite interesting.  Others are more mundane.

The five bedroom alarm clocks would fall into that latter concept with one exception: the Bose that was a Christmas present from Leonard Shaffer to the Officers of WellPoint.  It has a gradually increasing radio wakeup and dual alarms, both features Mary and I have come to appreciate.

The four computers, the iPad and the two cell phones all have time functions but since they require no maintenance, I rarely use them for tracking time.  Similarly, the three TVs use as clocks is generally discounted.

 I have two mantel clocks that are my favorite, for different reasons.  One sits on a shelf of my wall unit and keeps remarkably accurate time, considering it is likely more than two-hundred years old.  I inherited it from my Mother, when she and my father moved from Iowa to California.  They in turn, inherited it from my grandmother shortly after they married in 1927  It once fell from a mantel and was declared terminal, until I got the works operational and a Navy friend repaired the casing.  About fifteen years ago I made friends with a retired clock man, who I met in a theater production.  Michael is now in his mid-nineties and as recently as a few months ago, while reminding me that he has built 12 grandfather clocks, was able to get one of my clocks working correctly again. 

That would be a clock I inherited from my mother and gifted to my younger son. So he could learn to tell Ship’s time.  It rings bells from 1 to 8 for the Watch Shifts every four hours.  I have another Ship’s Clock in my study and find it’s sound comforting if I wake in the night.  The mantle clock mentioned above chimes the Westminster chimes every fifteen minutes, a sound I tune out unless I am listening for it.  I wind it once a week and it rarely needs setting.

I have another mantel clock that has a world time function.  That comes in handy when we are following Wimbledon.  It and several others are electric.  When IO was commuting the 100+ miles for WellPoint, I had a residence in Westlake Village and missed my Westminster chimes so much that Mary bought a battery clock for the condo.  Tim now has that clock too, as it was sitting in our guest room and never had the chime turned on.

I also have a functioning gold-filled Gruen pocket watch on display.  Since it needs winding daily, I no longer set it, but I did today and find that, while it still runs, it loses about ten minutes an hour.  I think it must have belonged to my grandfather since its inscription is to the employees of a Stock firm in 1923.  I have another pocket watch in a safe deposit box from another grandfather who worked the railroad.  I have another mantel clock also in my loft.  It was made electric and doesn’t make an interesting noise so it is of little interest.

The only other clock I have is a wall clock I got for Mary for when she doing laundry.  It is in the garage with the washing machine and dryer.

As time marches on, I’ll end this here with the truism that even a stopped watch is correct twice a day.

In my next Post I will reflect on the recent death of mike Nichols, who Mary and I felt was a friend even though we never met him.  I hope you will join me.

Thursday, November 13, 2014

Thermometers

Through a weird set of circumstances I have found myself with twelve physician appointments in the last ten weeks.  At each and every one there was an initial pattern of treatment:

1.      Review my insurance information

2.      Measure my weight

3.      Measure my temperature

4.       Measure my blood pressure

What seemed strange to me was that all of these physicians are linked into some sort of group practice and further strange they all purport that they have a shared electronic record.  A fifth piec e of information that was requested by each of the eight different practitioners was a copy of the medications I take.  I have a three page written copy, which breaks out the individual medications and dosages of any multiple vitamins or supplements.  Some of these requests came within 24 hours of each other.

This experience, plus all the news regarding quarantine of suspected Ebola patients got me thinking of how thermometers have evolved over my lifetime.

I can’t remember much about thermometers until after the end of WWII, when my father returned from the Pacific and we returned back to Mason City, Iowa where he had left his dental practice.  Thermometers at that time were based on expansion of a material by heat and, depending on the portal they used to evaluate, had a small or medium-sized bulb of mercury, a material I used to use to make dimes shiny when I visited my father's dental office.

Once I was old enough to safely hold one under my tongue I was trusted to use the smaller bulb variety.  I may still have had a twenty year-old sample in my medicine cabinet when, the environmental agencies declared all of these were hazardous and should discarded for safer models.

Add caption
Thermometers are nothing new.  The Greeks and Egyptians had some method of measuring temperatures, more for scientific reasons than for health, and Galileo built a model that measures ambient air effectively and accurately.  I have a Galileo thermometer on my mantle, more as a work of art than a utilitarian piece.

I also have two combination barometer-thermometer devises, one mounted on a wheel as a parallel piece to a chiming Ship’s Clock and the other a remnant from when our rented house in Virginia was kept at a frigid 66 degrees to save on heating costs..  I have an indoor-outdoor model that tells me when to open our California home and an outdoor one to see if the combination one is accurate.

Contact Thermometer
All of these thermometers, and those presently in my medicine cabinet depend on liquid expansion as a measuring mechanism.  But there is new technology.  Some current models depend on contact with the skin to digitally read the temperature.  More than one of the offices I visited use that model.  One would guess it would have appeal to practices that treat small children.  IO find it ironic that my mother used a similar technique by feeling my forehead, presumably with about the same degree of accuracy.

And there is a model that uses measurement of infra-red waves.  This is the one you see screening West African travelers, since it keeps a safe distance from the person you are testing.
Infra-red Thermometer

I am unsure what model is suggested for monitoring exposed medical staff and contact persons twice a day for the twenty-one day incubation period.

Treatment of what one does to a patient with an elevated temperature varies greatly.  Aspirin was the only thing we had when I was growing up.  Now there must be a dozen drugs in use.  The movies (before they were called film) had a scene where Jane Russell lay next to the fevered cowboy, presumable transferring some of his heat to her.  My older son, with a temperature of 103° was advised by our flight surgeon that we should bathe him in ice water and if the fever didn’t break on half an hour should take him to the emergency room with the windows down to let in the cold Rhode Island air.  His suggestion to hold him out said window was ignored by Mary.

One of the more interesting things I learned in my medical training is that a fever is not a bad thing until it gets too high.  It provides a better opportunity to incubate antibodies and is nature’s natural reaction to a problem in our system.

Possibly inspired by my mention of my thermometers, and possibly because we recently set our clocks back, I thin k my next Post will be on clocks and how the ones I have, came into my life.  I hope you will join me.

Monday, November 3, 2014

Half of Click and Clack Dies

Tom Magliozzi died today from a long bout with Alzheimer's.  That prompted me to repost  what I wrote almost exactly two years ago.  I hope you will enjoy it.
I am Chairman of the American Institute of Wine and Food for Orange County, California.  As such I am in contact with National Officers and Chapter Chairs and others working with this group in their efforts to provide funds for Scholarships in the Food and Wine industry and Days of Taste; the program that brings good food knowledge to Title 1 fourth and fifth graders.  The other day I received such a call and, knowing it required my undivided attention I excused myself to turn off the radio.

“Radio!  You still listen to the radio?” asked an incredulous Daniel: chef, entrepreneur, and culinary school contributor from South Miami Beach.  I confessed my addiction to NPR, which Daniel admitted he listens to on Sirius XM as it streams from his car’s 12 speaker system.  When we finished our conversation I began to reflect of what part radio has played in my life.

Click and Clack
A fitting topic as this month marks the end of one of radio’s most popular shows, Car Talk.

The show had humble beginnings.  Tom Magliozzi was encouraged by his younger brother Ray to appear on a local radio station as part of a panel of local (Boston) mechanics to answer listeners’ questions.  No one else showed up, but Tom’s easy manner and breadth of knowledge impressed the show’s host enough to invite him back the next week with Ray.

After ten years of weekly appearances, for the most part unpaid, the Brothers were picked up by NPR as a commercial project.  The show is by any measure a success, with 3.3 million weekly listeners on 660 stations, according to NPR spokeswoman Anna Christopher, making it NPR’s top-rated weekend program.  NPR intends to continue broadcasting repeat shows for the foreseeable future.

This is somewhat ironic in that during the twenty-five year evolution of the show, an ongoing feature is blending some past shows with the current one in a seamless and unaccredited manner. Other features of note include who has called in for advice; for example several celebrities, including John Grunsfeld, who called in from the Space Shuttle.  In fact NASA has called more than once, including one session where an anonymous caller was asking about problems surrounding a car kit, which eventually was identified as the Mars Rovers.

For many years I listened to one or more of the 660 stations broadcasting Car Talk and thoroughly enjoyed the humor and caller involvement.  There is something about a blonde trying to mimic the engine sounds of her 1998 Volvo as it goes through its gears that is unique.

Even before Click and Clack my generation had a love affair with radio.  When my wife Mary would come home from school she would listen to The Lone Ranger before going out to play “Hide and Seek” or ‘I’ll Draw the Frying Pan”. We grew up to follow the Masked Man into television, film and even personal appearances.  The voice and one of the most famous of those appearing belonged to Brace Beemer, a six-foot five personality who actually could ride and shoot, but whose greatest claim to fame was his deep voice which announced at the start of each show, “Hi-Yo Silver — A fiery horse with the speed of light, a cloud of dust and a hearty Hi-Yo Silver … the Lone Ranger!”

There are many who have memories of the personal appearances.  The most popular of which is on You Tube as Jay Thomas’ memory of the Masked Man on the David Letterman Show.

Another classic from the Golden Age of Radio was The Shadow, which as I remember it was one of the Sunday Evening's must-hear.  There are few of us around anymore who “Know what evil lurks in the hearts of men”. I also remember the tremendous variety of the radio shows: the drama of the Lux Radio Hour, the humor of Burns and Allen, Jack Benny and so many others, the suspense of the Serials, and the mystery and terror of the creaking door from Inner Sanctum or Orson Welles War of the Worlds adaptation, whose anniversary we celebrate this month.  And of course there were the educational elements of Let's Pretend.

As my friend reminds me, we still can have those shows, streaming to us as we commute, but it isn’t quite the same as hunkering down, close to the radio, often as a family, sharing the experience.  I can’t help but feel we may have lost something, especially now that Click and Clack are leaving us.  What do you think?

Next Wednesday I will be sharing a little about my book, Harnessing a Heritage and offering contact with some interesting fellow authors who blog.  Please

Thursday, October 30, 2014

Graphic Novels

I’m reading a book with the unusual title of Kill My Mother.  What attracted me and inclined me to buy the book was the fact that it was written and illustrated by Jules Feiffer, a cartoonist and author whose work I have followed for more than fifty years, when his cartoons began running in Playboy magazine.  The second attraction was that it was labelled a “Graphic Novel”, a medium with which I was totally unfamiliar.

It turns out that Mr. Feiffer, who is now 85 years old has been very busy in the interval between my Playboy days and my most recent purchase.

He has written two novels, a successful memoir and several children’s books.  He has written several plays, including Little Murders, which was made into a film.  Mike Nichols adapted one of his unproduced plays as the film Carnal Knowledge, and Feiffer, introduced to Hollywood, then scripted Robert Altman’s Popeye, which starred the recently departed Robin Williams.  His more than forty years of cartoons from the Village Voice have gone through several iterations of print.

Not bad for a guy who started out in the business writing balloons for The Spirit.

That beginning, and the influence of its creator,Will Eisner set him on a course of crafting slightly off-center cartoons.  They, in turn opened doors to theater, film, teaching positions and a lifetime of drawing original cartoons.

The Graphic Novel would seem a natural progression because it is, after all, a hardback comic book.  There is significant character development, a serious plot, and his signature art work, all of which cause me to nibble away at it rather than to devour the entire book in one sitting.  The characters are stereotypes: the rebellious daughter, the young widow, who hides her brains and bravado from the Mike Hammer-type, hard-drinking private eye she hopes will find her husband’s killer.  There is even a Mysterious Woman.  I have yet to find out how she fits into the story.  It is my first Graphic Novel, but I may look at the genre again.

I would have plenty to choose from!

Blackmark
The origin is given to a “picture novel” published in 1950, titled “It Rhymes With Lust” but the next serious contribution didn’t come until 1968, when a Balloon-narrative novel called His Name is…Savage, with a character looking remarkably like Lee Marvin, hit the stands.  Purists would argue that the true original Graphic Novel was Gil Kane and Archie Goodwin's Blackmark, which came out in 1971, building on the popularity of Dungeons and Dragons.

Comics as a medium were changing and I can remember making good use of the Classic Comics edition of Tale of Two Cities.  It helped my eighth-grade son get through his English assignment.  And DC Comics was modernizing the comic book landscape leading to todays fixation with the Action Heroes we see on the screen.

Perhaps those films were what caused Feiffer to come out with this book.  We have a generation that seems to want ever more action and violence with their stories.  Not that they are unique.  I grew up with television and film with Superman, the Green Hornet, Batman, and Wonder Woman.  When one goes back, one wonders if we would have won WWII without them.

At the time I bought Feiffer’s book, I also bought the 14th book in the Captain Underpants series.  I originally thought it also might be a graphic novel but, although heavily illustrated, it is just a children’s book.  I have been searching for why it is so controversial, without much success.  In fact the vocabulary is probably at 11th or 12th-grade level, and I would think it might encourage young readers to read, something neither of my grandsons seem to find interesting.

There is much talk about Ebola in the news, including monitoring by twice-daily temperature checks.  In my next post, I’ll track some of the changes in thermometers in my lifetime.  You may find the “what and whys” of the changes interesting.  I hope you will join me.

Wednesday, October 22, 2014

Destination Weddings

The recent passing of Oscar de la Renta brought to mind the slightly less recent, but equally as publicized wedding of George Clooney, twice named Hollywood’s Most Eligible Bachelor.  This was primarily because Amal Alamuddin, the bride, surprised most pundits, who suspected she would choose the same designer as Kate Winslet, by choosing de la Renta to design her gown.

A second reason for remembering the wedding and choosing the topic for this Post was that Mary’s Book Club, which met a week or so after the wedding seemed to spend as much time talking about the wedding as they did about the book.  It got me thinking about the subject of Destination weddings, those where the wedding site is neither the home of the bride or groom, and a select number of guests are either transported to the destination or, more likely in the case of the Clooney-Alamuddin ceremony, pay their own way to the occasion

There seems little doubt that the 150 celebrity guests were treated well once they got to Venice.  A fleet of water-taxis picked them up from the Resort, which Clooney had booked for the entire group, and transported them to the wedding site.  In the evening, and presumably during the day they were invited to help consume the 150 cases of Premium Tequila, that Clooney brought in on his private jet.  Seeming no concerns were expressed about bringing liquids on board.

Dancing went on all night with three top bands from the U.S. providing music.

A civil ceremony the next day allowed for some photographs, since the wedding and reception were closed events. Even guests were asked to leave their cell phones outside. Apparently right to the official pictures were sold by the couple for one-million dollars, which they donated to charity.

Which charity was not specified, but one can guess that with Clooney’s leanings toward the oppressed and Amal’s career as a Human Rights lawyer and her Lebanese heritage, it likely had something to do with the under-privileged in Africa, he mid-east, or maybe Cambodia where she recently won a Civil Rights case.

My first and only invitation to a Destination Wedding was in 2002, when nephew Matt Green invited our family to Key West where he and Teala, would tie the knot.  Since they met on an airplane, finding the trip compatible while occupying adjacent seats, neutral territory for the service seemed fitting.  We guests enjoyed the fact that we could be tourists as well as onlookers or participants, especially pleasing.  At the time there were several celebrity Destination Weddings, one from Hollywood, where the guests travelled to London on what was virtually a chartered Virgin Airlines flight.

 Most recent celebrity weddings, discounting the British Royals, are more private affairs.  The Brad Pitt/Angelina Jolie recent marriage being a case in point.  Justin Timberlake and Jessica Biel being another.

The Clooney wedding purportedly cost $13 million, which must be some sort of record, again excepting the Royals.  There is speculation on where all the money came from.  Certainly George could afford it, but the best guess is a more traditional source:  the bride’s parents.  Maybe it was a sort of dowery.

Reverting back to de la Renta, I was surprised that among his accolades were episodes of Sex and the City where Carrie finds out a beau calls him Oscar.  “Oscar…You can call him Oscar?” she asks?  The character (Mikhail Baryshnikov) eventually gifts her with an Oscar de la Renta dress.  Really! Well Oscar gifted her.!

In my next Post I will share with you my discovery of a new genre in books:  Adult Graphic Novels.  I think you’ll find it interesting.  Please join me.

Wednesday, October 15, 2014

Mark Twain

Mark Twain - age 36
Recently I watched a two part series on Mark Twain, or perhaps it was a one-part series I watched over two nights.  In any event, I was certainly entertained and, in that most precious of watching Public television gifts, I was also educated.

My previous exposure to Samuel Clemons, following the obligatory adolescent reading of Adventures of Huckleberry Finn and its companion [piece Tom Sawyer was following a forty-plus year career of Hal Holbrook, who Mary and I were privileged to see on two occasions, almost twenty years apart.  His An Evening with Mark Twain provided me with several quotes, some of which I still find a way to bring into conversation: e.g., “Man is God’s greatest creation.  I wonder who decided that?”  His long-term distrust of the Congress and government in general seems almost too prophetic in this time of do-nothing division between the parties.  And comments from a man uttered more than 100 years ago are timelier than many made on Fox News.

I learned several things from the show, including the extreme highs, lows and highs of his financial life.  He was one of seven children, fewer than half of whom would live to adulthood.  Although his father was an attorney and a judge, the family lived a modest life, partially because his father died when Samuel was eleven.  Twain made great claims about when he was born, playing up the fact that he arrived on the tail of Haley’s Comet and believing he would leave the next time it made its appearance: a fact that proved to be true.

While we think of him as essentially a writer, his career was much more varied, beginning as an apprentice for a newspaper as a typesetter at the age of twelve.  By fifteen he was writing articles for his brother’s paper and in his late teens had worked on papers in New York, Philadelphia and St. Louis, while advancing his education with nightly trips to the library.  His writing took him west ending up in Virginia City where he tried his hand unsuccessfully at mining.  One of the quotes used by Holbrook in his show was Twain’s initial impression of Virginia City, a town with, “One church and thirty saloons.  Not the kind of place for a Christian gentleman, and I did not remain one for long.”

His time in the West provided the background for the story of the Celebrated Jumping Frog of Calaveras Count, which became a popular and profitable story.  This caught the attention of The Sacramento Union and started what would become a lifetime career of travelling and writing about his travels.  When he eventually hits the lecture circuit, the stories of his travels provided the structure of the entertaining presentations.

I had previously thought he enjoyed the lecture circuit and was surprised to find out that, had he not been forced to declare bankruptcy, owing what today would be more than $8 million, and had he not made a personal commitment to repay all his creditors, even though legally not obligated to do so, he would not have provided the persona that Hal Holbrook has carried through the years

Another fact from the PBS presentation that surprised me was his devotion to his wife of 34 years and to their daughters, seeing to their welfare and comfort through his hard, financial times.  The home he had built for them in Hartford remains as a museum to this day.

In my next Post I will discuss the concept of Destination Weddings and how George Clooney raised the bar.  I hope you will be interested in what I have to say.

Monday, September 29, 2014

Scribes

The Electronic Health Record
I have been following the development of the Electronic Health Record (EHR) for at least ten years and, although it is scheduled for an implementation date of 2015, it appears to me that there are several reasons to expect another delay.  This is especially true in the implementation of the dental component, which is of great interest to me.
 
Part of the reason for lack of progress is the pure complexity of integrating the various electronic services that have been cobbled together to satisfy very specific needs, defined by specialty, compensation, and broad, disparate delivery models.  This has resulted in a lack of a standard platform for data interchange.  There appears to be some recent progress in the process.  In dental Henry Schein has seized market share with their Practice Management software, Dentrix®, And in Medical a product called Epic® is dominant with their software for groups from small group practices to major hospitals.
And there are some obvious forward steps that are likely to improve healthcare delivery, while controlling healthcare costs.  I dental there is the implementation of what have been called “reason codes” of diagnostic codes embedded in the ICD-10 series of medical codes.  These will allow for development of Best Practices in dentistry by allowing Outcome analysis.  The likely result of such analysis will be a redistribution of healthcare dollars spent on dental services to increase preventive services and decrease cosmetic and unnecessary services, such as crowns on asymptomatic molar “cracked” teeth.
In medicine the trend seems to be a shift from paying for specific services to paying for health improvement.  The developing model is sometimes referred to as an Accountable Care Organization or ACO, a model that has save literally millions of dollars in Medicare costs since its adoption by CMS several years ago. 
One of the more intriguing developments of the HER is the arrival of an entirely new employment opportunity in the health field, which is the subject of this Post:  Scribes.
Medieval Scribe
The term is of ancient origin, at least as far back as the rise of the Egyptian civilization, where people educated in hieroglyphics and later the cuneiform alphabet, found themselves marketable to those less fortunate but wealthier.  Later, in medieval times, those who were literate were called upon to write books, specifically The Bible, until the advent of the printing press.  The story is that one scribe from that time, encouraged the Abbot to go to the original document instead of copying the copies.  The Abbot returned from his research dismayed that the word originally was “celebrate” and not “celibate”; a lesson in the value of editing.
Physicians have dictated their chart notes for years, partially because their handwriting was unreadable to other physicians.  What has changed, with the advent of the HER is that everything must now be electronically transmissible.  Even with voice recognition, the process is innately redundant.  Solution? Have an entry level Scribe shadow the physician and capture the conversation with the patient.  There are security concerns, and technological restraints, but these are being worked out.
A recent WSJ article discussed the blossoming opportunity for the field.  In 2010 there were 700 employees.  That number doubled by 2013 and is expected to peak at some 30,000 in the next few years.  Cost doesn’t seem to be a problem, since the physician’s time is a mitigating factor.  Training may be another issue.  I could find no standardized program, but I find that my granddaughter, which is studying to be a Court Stenographer, may have inadvertently found her future career.
I wish her the best.
PBS recently did a two-piece on Mark Twain.  In my next Post I will share how Mark Twain has intersected through my life and why his history is worth another look.  Please join me.