Continued vigilance needed in Bahraini health workers’ case
David M. Keepnews, PhD, JD, RN, FAAN
David M. Keepnews, PhD, JD, RN, FAAN
CHMP's Health in Film & New Media
[caption id="attachment_10328" align="alignleft" width="164"] Andy Rooney[/caption] On Sunday
[caption id="attachment_2811" align="alignleft" width="300"] Photo by Darren
[caption id="attachment_10335" align="alignleft" width="250"] Source: www.world-countries.net[/caption] Dorothy Gillan
This post was written by Jennifer De
This post was written by CHMP Senior Fellow Steve Gorelick who is Professor in the Department of Film and Media Studies at Hunter College of the City University of New York.
Author’s Note: When I first shared this childhood reminiscence of illness and death with Diana and Barbara, they asked the perfect question. How does this connect to health policy? Then, with the kind of wisdom they seem to have in unusual abundance, they made a suggestion that I found absolutely persuasive.
Our very personal episodes of disease and death seem to occupy some of the most prominent and conspicuous places in our life narratives. When they occur in childhood, they can take center stage and touch the very core of how we ultimately see ourselves as human beings. Small, sensory memories – perhaps the smell of alcohol used in an emergency room to clean a wound – can loom for years and continue to define our memory of ourselves at a specific time and place.
What I now see is just what an extraordinary problem this presents to anyone hoping to influence public health attitudes and policy. The messages we deem so important to public well-being –related to nutrition, fitness, timely immunizations, PSA tests, mammograms, pre-natal care and all the rest — have to do infinitely more than simply make sense and be supported by evidence.
They must penetrate nothing less than the most basic and profound narratives of how we see ourselves and our place in the world. Even the simple decision to get a flu shot must joust with a host of memories of injections past, of unwelcome side-effects, and high-profile news stories of vaccines that may have been ineffective and even dangerous. Suddenly a simple decision competes with a lifetime of experiences. Not so simple.
What follows, then, are some of the experiences that still define who I am and how I remember and imagine “the land of the sick.”
I have been trying to think of a way to tell you a story.
Travels in the Land of the Sick
And at some point, I remembered a wonderful essay written almost 25 years ago by Paul Cowan. (“In the Land of the Sick,” The Village Voice, May 17, 1988). Paul, a wise man who was much too young when he died of leukemia, envisioned illness as a destination, a land of exotic customs and practices inhabited by the sick. The rest of us, he warned, were simply the “not yet sick,” travelers on an unpredictable yet inevitably bumpy and painful road.
This is the world I have been navigating, as son and as son-in-law, as companion and as final witness.
It started last spring in the midst of a perfect storm of seriously ill parents, friends of parents, and the not unexpected, yet still shattering, death of the 10-year-old daughter of close friends. That her ten years were spent on a neurological and septic tightrope with a constant risk of potentially fatal infection didn’t even slightly lessen the pain of her loss.
What a strange trip to a strange land, traveling from one wrenching scene to another, from one city of the aging to another, from the slow suffocation that is chronic pulmonary disease to the encroaching dementia of Alzheimer’s Disease; from kidney failure to virulent and unforgiving pneumonia. And overshadowing it all has been the larger human drama of watching this far-flung cast stripped of all the self-deception that had long enabled them to imagine that they might never have to book passage. Yet there they were, well on their way, and no stories they could tell, no folktales or myths, could shield them from a slow-motion collision with their own fragility.
What I didn’t expect was that their collision would become mine.
Last May, standing at corner of Rowland and Lark Ellen Avenue in West Covina, California, I found myself surveying Rowland elementary school, a typical 1950s building in which I had attended kindergarten, third, fourth, and fifth grades. Instantly familiar were the two separate kindergarten classrooms at one end of the long block that, in 1950s style, had been walled off from the rest of the school. And despite my struggle to stay an outsider amidst the failing kidneys and diseased lungs, I realized that, despite my “Wonder Years” fantasy, West Covina had been a place in which I too had once briefly been a traveler among the sick.
I stared across the street at the swings and noticed that they were in precisely the same place they had been on an overcast day in 1956, when my class of five and six-year-olds stood in line for polio vaccinations. I can’t recall the faces of the other kids, but the memory of all the mothers, lined up and looking on with anxious and relieved expressions — is vivid. I knew virtually nothing about the scourge that was polio, but I did know that my friend and classmate Robin Miele would not be receiving the vaccine because of the polio that had already withered one of his legs and one of his arms.
I wasn’t exactly thrilled to recall the pain of the injection, the anxious faces of the hovering mothers, and Robin’s grotesquely shaped leg. For years, I had fought the idea that illness could define this idyllic place. This was where I had lived the moments that had been securely stored in files marked “hope and energy,” “teasing and flirting” and “stirrings of desire.” But some memories are annoyingly insistent, and with hardly a thought I wandered down Rowland Avenue, away from my elementary school, in the direction of our small house on Hartley Street a half mile away.
I remembered. My mom and dad chose a doozy for our inaugural journey in the land of the sick.
[caption id="attachment_10341" align="alignleft" width="300"] Michele Bachmann[/caption] I never
A platform for poetry, health care policy,
Tonight, Thursday, September 15 at 11:00 PM
Tracy Smith is a correspondent for "CBS
William M. Silberg, is a strategic publishing
[caption id="attachment_10351" align="alignleft" width="100"] Source: Pan American
This is a repost of Gary Schwitzer's
Instead of phys ed being viewed like
[caption id="attachment_10356" align="alignleft" width="300"] Source: Pan American
Guest blogger Jonathan Bentley, RN, spends one half of his work-week as a case manager at a rural free clinic and the other half as a care coordinator in a local hospital. He also serves on the governing board of The Canary Coalition, a grassroots clean air advocacy group. Living abroad for several years in Japan and Latin America provided him with direct knowledge of healthcare systems in other countries and a strong desire to contribute to positive change back in the United States. His publications include a chapter in the sixth edition of Policy and Politics in Nursing and Health Care. He lives in the Smoky Mountain region of North Carolina with his wife and daughter.
Bentley writes about his interview with T. R. REID, a journalist known for his coverage of global affairs for The Washington Post, his books and documentary films, and his light-hearted commentaries on National Public Radio. At the Washington Post, he covered Congress and four presidential campaigns. He served as the paper’s bureau chief in Tokyo and in London. Reid has written and hosted documentary films for National Geographic TV, for PBS, and for the A&E network. He is a regular commentator on National Public Radio’s “Morning Edition.” His latest book, The Healing of America, quickly became a national best-seller. Reid was the on-air correspondent for two PBS Frontline documentaries based on that abook.
I first learned of T.R. Reid when I saw his PBS Frontline documentary, Sick Around the World, which outlined the healthcare systems of five other industrialized democracies
and contrasted them with our system in the U.S. Years later I had the opportunity to meet him at an award event for the Japan America Society of Colorado. After agreeing to do an interview, he shared insights gained from his experiences living abroad and researching healthcare systems around the world.
JB: Your most recent book, The Healing of America, has been a huge success. What new projects are you working on in relation to healthcare policy?
TR: I’m making a new PBS documentary film, tentatively titled Saving Lives–and Saving Money. We are constantly told that the cost of health care is out of control. In fact, there are already organizations
providing high quality care at a reasonable cost right here in the USA. Our film looks at what they’re doing, and how others could learn from them. Medicare insures about 46 million people in the U.S., so why don’t they require all providers to use the same systems? In some U.S. counties, Medicare pays $15k per person per year on average; in other counties, the average cost is $5k per person. And the low-cost communities have results that are just as good.
How do they do it? And why don’t Medicare and the big private insurers demand equal standards? This is going to be a PBS documentary, and it should be broadcast in 2011. The filming is done, and now it’s being edited. I’ve also been doing a lot of speeches about how other rich countries manage to cover everyone and spend half as much as we do in the U.S.
JB: This seems to be a continuation of issues you covered in The Healing of America.
TR: Yes. For that book and for the Frontline documentary Sick Around the World, I went around the world looking at how other rich countries cover healthcare. And then people began to tell me, “You can also find high quality care at reasonable cost in many parts of the U.S.” We’ve found that this is true. In fact, we thought initially that in our one-hour film we could cover low-cost communities and then look at some of the high-cost venues. But there were so many good examples that we didn’t have time to cover the bad ones. At the end, we ask, “why don’t big (insurers) require everyone to be efficient?” Is it politics? I think the answer is that high-cost systems have local congressmen who protect them.
The documentary shows there are a lot of different models that provide high value. There’s the Mayo Clinic model, with hundreds of doctors working for one organization. But we also we looked at a town with 88 independent practices, each with 3 to 4 doctors. There are lots of different models that work.
JB: The Affordable Care Act seems to focus largely on extending coverage and reforming the insurance industry while placing relatively little emphasis on improving care delivery. What do you think needs to be changed in terms of how medical services are actually provided in our country?
A platform for poetry, health care policy,
Senior Fellow Liz Seegert, MA is a
[caption id="attachment_10366" align="alignleft" width="250"] Whoopi Goldberg[/caption] In 2002,