Influenza alert!

My small clinic has only been open again with our wonderful Megan Bailey, PAC, for a month, but we’ve already seen two people with influenza. And that is seeing less then ten people daily.

Please get your influenza shot. Yes, it doesn’t cover all of the strains, but most years it covers 80%. And initially Washington was seeing influenza B but now it’s influenza A and that has better coverage.

Remember that the vaccine takes up to two weeks to provide immunity. Consider wearing a mask if you have to go on an airplane — our second patient with influenza had gotten off an airplane that day. If you get a cold within one or weeks of getting the influenza vaccine, that is not caused by the vaccine. You are still at risk for influenza as well, especially the first two weeks.

If you have influenza, stay home and try not to expose other people. If you have frail or elderly or sick family, or very young children in the family, make sure that you get to the doctor early and see if prophylactic treatment is needed for household members who are exposed. If you are in the doctor’s office with any upper respiratory symptoms, put on a mask. That way you will not infect and potentially kill other patients.

Here is the CDC weekly influenza surveillance map:

You can watch it change color as the influenza crosses the country from east to west.

Please take care and Happy New Year!

The picture is the Solstice sunrise outside my house…

A Dose of Reality


This just in! According to the Center for Disease Control and Prevention Influenza levels in the U.S. have hit “epidemic” levels and are continuing to rise! So much for the Ebola frenzy and media scare from earlier this year even though Fox News still has their Ebola map and timeline updating live on their website with 19,570 cases worldwide. However, They even have an influenza outbreak map up now for the United States…it’s basically just a map of the U.S. colored completely red…because the flu, unlike Ebola, is everywhere! And can affect anywhere from 5 to 20% of the total U.S. population…annually!

Already this year the proportion of deaths reported in 122 American cities from flu and pneumonia so far has surpassed the typical level for late December at 6.8 percent which is the “epidemic threshold” set by the federal health agency. That means that 6.8% of all those who…

View original post 197 more words

Weathering emotions

Just before Christmas, I was describing the present I had gotten for a friend’s son.

“Wait,” she said, “I’m not sure he’ll like that. I want him to be happy.”


Oh, I thought. I reassured her, “I think that he will like this a lot.” and he did.

But… I don’t want my children to be happy.


No, wait. Let’s play with the idea.

Say that your goal is for your child to be happy. You want them to be happy, as much of the time as possible.

Your child will pick up on what you want. Your child wants to interact. Your child loves you. So your child will try to make you happy. Even when they aren’t happy. Then you are in a vicious circle, with you wanting your child to be happy and your child valiantly attempting to be happy or at least act happy whenever you are around until finally they hit the teen years (or possibly age 3) and scream at you, “Go away and leave me alone!” Then they will be sullen and guarded and only show up when they want food, transportation and money.

My goal is NOT for my children to be happy.

Are adults happy all the time? Well, don’t be silly. Of course not.

So why do we want children to be happy all the time?

I want my children to be able to handle the full spectrum of emotions. Happy, sad, grumpy, confused, brave, scared, apathetic, all of them. I want them to be able to name each one and tolerate it. Because my children will be adults and they have to be able to handle all of those emotions. I strongly suspect that they will encounter each and every one….

How do I model this? I tell them how I am feeling AND they don’t have to fix me. My sister died in 2012. I was very sad. I cried a LOT. Sometimes I would be sitting in the kitchen crying and my daughter would wander through the room and stop and hug me. She is not a natural hugger but she knows that I am and that I find it very comforting. She wouldn’t cry with me. She had her own emotions.

I came home from work once and said that I was furious and hurt. Ok, more than once. But once I described a meeting which turned out to have me on the agenda. The other five people knew that and I didn’t. I felt jumped and attacked. It hurt.

My son said, “Five against one?”

“Yes,” I said.

“Then they didn’t have enough people, did they?” He grinned at me and I felt much better. Still mad and hurt, but he was so funny. We went out for pizza because I didn’t want to cook.

Our US Constitution includes the pursuit of happiness. We are free to pursue it all we want. But I don’t ever think we will catch it. We will and we should still have times when we are sad or afraid or feel confused or hurt. I would go to work and tell my nurse, “I am in a really bad mood because something in my family is a mess. My mood is not about anything at work.” She would nod and then through the day I would cheer up, because I had to think about work.

Emotions are like the weather. We don’t control them. My mother died fourteen years ago. I see an ornament on the tree that reminds me of her and I feel sad and miss her. Next morning I change from writing Christmas cards to writing Valentines and I am using a stamp set and stickers and it reminds me of her and I think it’s funny. I am happy then remembering her. Let the emotions come in like the weather: name them, acknowledge them, don’t try to control them, let other people know you are in a storm, accept help, and let them pass. And let your children have their full range of emotions as well.

The photo is me and my younger sister, in 1965.

Voice lesson

The picture is my father in 2009. We went sailing on his friend Paul’s boat. My father loved to sail and loved to sing. He taught me to sing from when I was tiny….

I had five voice lessons in the spring. The teacher is a woman who comes into town to see her mother, from New York. When she comes, she teaches many of the best soloists in town, including people I’ve taken lessons from. One of our soprano soloists gave her my name.

She started by asking my singing history. I explained that my family had sung folk songs since I was tiny and that I’d been in a chorus for the last 14 years. That my father had been in the chorus and that he had recently died. We are working on the Faure Requiem and the Rutter Requiem. Our director asked me to work on the Pie Jesu in the latter and I was having trouble with the high notes. She asked about my father’s voice. I said that he was a very fine bass, who had died from cigarretes. In the last few years he couldn’t sustain, but his entrances kept the bass section on track.

She took me through the lesson. There were five things that she had me work on. It was hard to keep them all in my head at once, since they were all a change.

1. To breathe in so that the back of my throat felt cold, like the feeling you get in icy air. This opens it.

2. To think of the breath as circling along my jaw when I sustained a note or phrase. This made the notes feel alive and stay alive. Richer.

3. As I went into the passagio, to think of the sound going out the top of my head and then directly out through the back of my skull.

4. On the very high notes, to press down more with my lower ribs in my back. This increases support.

5. To open my mouth dropping my jaw, but keeping it narrow. This changes the quality of the vowels tremendously.

The lesson was so helpful that I scheduled a second one two days later and had the sense to tape it. I can practice it with my tape. She will come back within a year and I hope that I’ve improved in all five.

first published on everything2 April 2014

Painting Angels II

Painting Angels II

After my mother died, I wrote a poem called Painting Angels. It was about my kids’ comments about her death, but also about her being an artist. I wondered whether she was painting the sky or sunsets or clouds. She loved watercolors.

I was driving to the Boiler Room yesterday and came to the hill going down to Water Street and the sunrise was glorious. The leading edge of the front caught fire and there were yellow and orange and pink streaks up into the clouds.

I think my mother and my sister helped paint that sky. I stopped and took photos with my phone until I got too cold and the sun was up.

Thank you, mom. It was a beautiful show in the sky. I lost my mother in 2000, my only sister in 2012 and my father in 2013. I feel that the show has been blessed, and that getting my mother’s artwork out of storage fourteen years after her death and showing it is the right thing to do.

The Mother Daughter Show II

Over the last two days, I hung the Mother Daughter Show II, at the Boiler Room in Port Townsend, Washington. It will be up for the month of December.

This time it is the joint work my mother and I did in the 1980s. She did etchings to go with nine of my poems. The tenth poem was written for an etching she had already done. I asked my mother if she would do this project with me and she replied, “Only if the poems rhyme. None of that free verse stuff.”

I worked on the poems, I think with my mother’s etching style in mind. She used a zinc plate, with a tar solution on it. She would do a drawing in the tar, usually with a dental tool. The plate was placed in acid, which would etch where the tar had been scraped away. She would etch the plate multiple times, which gave different depths to the etched lines.

When the plate was finished, she would remove the tar and run an artist’s proof. She would heat the plate on a metal hot plate. She would ink it and then gently wipe the ink off until there was a very thin layer on the unetched parts of the plate. This had to be done delicately, so that the ink was not wiped out of the etching lines. She would place the plate on the press, place a piece of wet paper gently over the plate, lower the thick pile of wool pads over the paper and run the press. After the plate had gone through, the paper was peeled up and there was an etching, with the edges of the plate pressed into the paper.

Sometimes she was not satisfied and would return to the tar and change the etching. Sometimes she ran multiple proofs until she had the color right. Then she would run an edition. The print and poems are editions of fifty. Each etching is signed and numbered: 1/50, 2/50, 3/50, and so forth. We had the poems printed first, on a lead type press, and then my mother ran the etchings. We had a show in the late 1980s in Alexandria, Virginia.

My mother died in 2000. My father died in 2013. My mother was a prolific artist, so trying to deal with the estate felt insane. I put the art in a storage unit. When I had The Mother Daughter Show in July, it felt like a remembrance of my mother. And anyhow, I have to do something with the art in that storage unit, don’t I?

I find the etchings easier to show and sell then the watercolors. I want to clutch each watercolor, but eventually I will start to let go of them. I have the etching plates, too, because my mother said she was terrible at finishing editions. I have the box of poems printed on the lead press and the guides for running the edition. I do not have the press. My sister took it to California and it disappeared. That is ok, because there are presses in Port Townsend. There is a big art community, which is part of why my parents moved to this area in 1996. Art, music, gardens and boats.

My mother did many small fantasy etchings, flying elephants, fairies, a mermaid, a merman. The poems I sent her were almost all about animals. I wrote Eating Water Hyacinths and my mother did a charming etching of two manatees. She looked in various books to see what manatees looked like and then drew them. I wrote a blue crab poem and we bought a live crab. I photographed her drawing the crab, which was skittering around unhappily on the dining room floor. I enjoyed the constraint of rhymes. It made it easier to write the poems, though I am not sure why.

I have six of the series hanging in the show. I don’t currently have the other four framed. The Gallery Walk is this Saturday. I hope that people will come and perhaps we will sell one. We are also going to show the Panda Minimum, outside. The Panda Minimum is a mountain bike camping trailer, a bit like a teardrop trailer, designed and built by a local friend. We will have it outside the Boiler Room. I’ve already told the friend that I think the Panda will steal all the thunder and the art on the wall will be ignored, but ah, well. I have a third show scheduled, for June and July, at another venue. It is easier to do shows of my mother’s artwork than my own, because I think she was so good.

Also published on everything2 today.

The Boiler Room:

Donate to the Boiler Room! Or come to the auction, also tomorrow!

Say yes

In the improv tryout
for Lark in the Park
Joey said

Say “yes” to everything

He said

It is easier to say “no”
But then the improv ends

He made us try
Saying “no” to everthing

Each skit was a fight

He made us try
Saying “yes” to everything


We bloomed

And is that it?
All the Beloved wants?

He said that you learn
To say things
Without a question
With a hint
With an idea
With a suggestion
And the other actor responds

I’ve noticed
People don’t respond well
When I say
Don’t do that

I have to learn
To lead
Without leading
To suggest
To let them choose
To change their path
It doesn’t work
To drive them
Another idea

Say “yes” to everything

Is that what the Beloved wants?

I say “yes”

published on everything2 August 2009

Fraud in medicine: Diabetic supplies

There is a subtle ongoing fraud in diabetic supplies for diabetic patients and especially medicare patients.

The fraud is in the paperwork. An order form will arrive for me to sign for Mr. Smith. I read the fine print and it says that all of the supplies on the form will be renewed for Mr. Smith, unless something is crossed out. It lists six supplies: lancets to draw blood, strips for the glucose machine, a new glucometer, a new lancet machine and control solution to check that the machine is working correctly.

This is all good and necessary, right? Maybe.

I call Mr. Smith and say, “What do you need?”

“I just need lancets,” says Mr. Smith. “That’s what I asked the company to refill.” He is wondering why I called, because he only asked for lancets.

I cross everything out but the lancets: because that is where the fraud lies. Mr. Smith only renewed his prescription for the lancets, but the medical supply company knows exactly what interval medicare and the other insurances will pay for all of the supplies. They want me to sign a blanket order and then they will send Mr. Smith a new glucometer every time medicare allows, whether he wants and needs it or not. So if you have visited a parent or family member and wondered why they have a closet or a drawer full of some medical equipment, that is why. The doctor did not read the fine print and signed a blanket order and the patient is getting more equipment than they need or want. This is waste and it costs us all money.

Another fraud in diabetic supplies is in getting the first glucometer. I was taught to send the patient to the [diabetic educator] where they would get a “free” glucometer. However, now I tell them to check their local pharmacy instead. The “free” glucometers have the most expensive strips and lancets, and diabetics are supposed to check blood sugar at least once a day. If the strip costs one dollar, that adds up. The pharmacy often has a house brand where the strips and lancets are less expensive. I give the patient the choice. Most of them choose the house brand.

One diabetic equipment company got a hold of one of my patients and wouldn’t let go. They sent paperwork to me saying that they needed every note back to the date that I had prescribed his equipment and copies of his blood sugar records. I wrote them a letter, saying, “I am sending the notes, but I don’t photo copy the patient’s blood sugar records. You are being unreasonable. My notes contain the records I made about his blood sugars.” The company is in Florida and the patient is in Washington. The company kept demanding the notes, all the way back to the first visit, every two months. After we sent them twice, we sent a letter saying, “We already sent those twice. We’re not doing it again.” They continued to fax renewals. I talked to the patient. He wanted them gone too, because they kept calling him and wanting to send him more supplies. I called them. They did not desist. I sent them a letter and tried calling medicare fraud. The medicare fraud department said, “Call the company.” Now we just shred anything they send us, including the threatening notes saying that medicare will be after me.

The diabetic supplies aren’t terribly expensive, but when there are millions of diabetic people, this adds up. Also, most physicians are so busy that they sign papers without reading all that fine print and don’t have time to check what the patient really needs. And the companies are targeting the frail, sick and elderly, though many diabetics are otherwise healthy. I think it is a shameful scam to have a person call a company and say “I need more lancets,” and then to try to send them more of everything. Isn’t that illegal? It should be, to fill prescriptions that have not been renewed. I am tired of seeing more and more clearly how our United States medical system is a system to make money any way possible, and morals don’t matter, and it has nothing to do with people’s health.
29.1 million diabetics in the US
21.0 million diabetics diagnosed in the US

published on everything2 on November 26, 2014 and on Sermo today