July 17, 2013

Your ignorance will not save you, your denial will not change reality

 Iron Lung Ward, Rancho Los Amigos Hospital
Santayana had it right - "Those who cannot remember the past are condemned to repeat it."
 Living in a time and place where childhood illnesses are seen as mild annoyances, treated with modern medicines. Where the flu means missing a few days of work, and taking a lot of remedies to feel better. Where the possibility of your child dying is an unthinkable horror, and your worries involve threats that are statistically nearly zero like random gunmen or kidnappings.
Medicine has undergone major changes over less than one lifetime. And has radically changed life expectancy and death rates of children as well as adults. 
We have only been able to vaccinate our children against polio since the 1950s. We have only had antibiotics since the end of WWII. There are vastly more pharmaceuticals available for both minor complaints and major diseases.
Generations that have grown up with this as the status quo take it for granted, of course. It is all we have known. Unless you have listened to stories told by elders or lived in a place that does not have the luxuries we have you can't really imagine what it is like to not have that medical infrastructure.
But deciding to reject the current advances, based on discredited theories and celebrity endorsements, is irresponsible, foolish, and damages not only yourself and your children but our society as a whole. You create a reservoir for diseases that we have worked hard to eradicate because they KILLED CHILDREN. LOTS of children. They killed adults too. But children and the elderly are always hit hardest by these diseases.
It is happening now. We hadn't seen whooping cough (pertussis) in ages. Med students had to learn about it in theory because everybody was vaccinated against it and cases just didn't happen anymore.  Today we are having pertussis epidemics breaking out with depressing regularity.
So - have some numbers. I think they give a feel for the scope of the problem currently:

Anti-Vaccine Body Count

And for a less strident and more informational link:

History of Vaccines
This is a project of the College of Physicians of Philadelphia and has lots of great information in very accessible form. Not just history but also great current information.

Telling me, or your doctor, or the media, that you "don't believe" in vaccinations really means fuck-all. Your belief or lack thereof does not change reality one little iota. That applies to pretty much the rest of science as well.

July 9, 2013

Glassholes and "Citizen Journalism"


An article published in Ars Technica today about a Google Glass user referred to the individual's filming a street altercation as "citizen journalism". This individual not only filmed the sidewalk drama and all the passers-by and audience, he posted it publicly onto YouTube. Without permission of the parties being filmed, and states "99 percent" of those filmed "did not know what I was wearing." The rise in smartphones with cameras and the introduction of this newest technology is increasing the odds of each of us becoming "news" of some sort in the future.

We need to be crystal clear here. There is nothing even remotely journalistic going on in this scenario. Spouting your opinion on a blog (like this one!) is NOT journalism. Tweeting from the airport about something you saw the TSA doing? NOT journalism. Posting photos of your local riot on Facebook? Yep - NO journalism going on there either.

Journalism consists of much more than having an opinion and a platform. Journalism has a code of ethics and is crafted by people with enough professional pride to proofread their copy before they put their name on it. Most current local newspapers have completely done away with journalism, or relegated it to a couple of pages somewhere lost between the giant drop down banner ads, the local flavor blog posts and the 527 soul-crushing comments on the blurb about some local crime or politics story filed by someone who did not fact check nor proofread before hitting "send".
About that code of ethics, the Pew Research Center's Project for Excellence in Journalism has already put together a collection of links for us: Ethics Codes

You will find that there are lots of guidelines for journalists about secret recordings, verification of facts, use of multiple sources, and most importantly - accountability! Reading the ethics codes, you understand why talk radio hosts identify themselves as "entertainers". But this applies equally to all of us who use blogs and other social media to express our opinions. Social media is wonderful for providing a soap-box for everyone who wishes to hold forth on the streetcorner. But don't confuse an opinionated old crank blogging about the demise of quality journalism with an actual journalist.

And that rumbling sound? Is Edward R Murrow ...

Spinning in his Grave

July 3, 2013

Is Respect & Compassion cost-effective?

It was a physical sensation to see the announcement today that the main provision of the healthcare bill is to be delayed by two more years. Somewhere between nausea and vertigo. Granted, that is often my baseline, but seeing a hard-fought and much-compromised healthcare coverage be denied to people yet again is heartbreaking. And enraging. And frustrating beyond description.
And it got me thinking about the employment climate in this country, how employees are instructed and expected to treat customers versus how they are treated by their employers. And why the huge disconnect there seems to be ignored by all the folks selling the latest-and-greatest-new-marketing- strategy-to-increase-productivity-and-lower-costs. Why is it that you are sitting for hours at the computer doing the mandatory inservice on "Quality Customer Service", being tested on how to treat customers in a manner completely unlike the way you are treated by your employer?
Working in the medical field, I have seen a strong movement away from compassion in healthcare - both compassion towards patients and compassion towards caregivers and fellow employees. At some point we decided that compassion looked too much like paternalism or patronization, so it got thrown out with the bathwater and replaced with Autonomy and Responsibility.

[This has led us to the situation of the physician with the medical degree and years of experience telling a patient their diagnosis and possible treatment options and then asking them to decide what to do! Making them take on the responsibility of deciding on often complex treatment options in the name of "self-determination" or (heaven help us) "buy-in". This is terribly fashionable among providers, and hated by patients - they are paying for healthcare from trained providers and expect a damn sight better than they could get from a google search. Ok, exaggeration for effect, but still. Damn. Do your job.]

In all businesses, treating your employees like irresponsible criminals who are going to flake off or rob you if given half a chance tends to be a self-fulfilling prophecy. Responsible, professional adults won't stay, the folks who do are the ones who either just don't care or who see robbing you as a personal challenge. Either way, you and your customers lose.
If you treat employees like they are lying when they call in sick, like they fake injury on the job, like that death in the family was probably just a vacation, monitor their bathroom breaks, monitor their email, monitor their phone times, are more concerned with clocking in and out on the minute than the quality of work... how can you expect them to treat your customers differently?
If I tell you that I do not value you enough to provide you with medical care, but I will fire you if you call out sick too much? That the state says I don't HAVE to pay you more than minimum wage, so I won't? That our corporation does not provide childcare on-site, but we will fire you if you have to leave because of childcare issues too often?
BUT: "We strive to provide the highest service to all our valued customers and treat them with respect."
What does all this have to do with the Healthcare bill? Or are you just rambling?
Here's the thing. Our culture has become Corporate Culture. It has infused everything. Our expectations, our lifestyles, and even our healthcare. The attitudes, the philosophy, and the dehumanizing effect of being treated as just another unit, another number, another interchangeable part to be slotted in or discarded at the corporate whim.
The thing is that corporations that have tried doing it the other way, treating employees respectfully and compassionately? Wind up with happier customers. And better employee retention to boot! Funny that.