Maternal Mortality Rates – Texas – A Developing Nation

October 18th, 2016 by Nick Jacobs No comments »


A recent study done by the University of Maryland revealed some stunning statistics around maternal mortality (mother’s dying) in the United States.  In the United Kingdom there are approximately 8.2 deaths per 100,000.  Canada is at 6.6 deaths per 100,000 and Italy is the lowest at 3.9. If you’re wondering where the United States fits it, we average 16.7 deaths per 100,000. (Maybe you should go to Italy to have a baby.)

Not included in that number for the United States are suicides due to Post-Partum Depression which would drive those numbers up about 5 percent more. Of the 181 nations included in this data, the United States ranks 39th. These numbers put us in a negative category below almost every other industrialized nation.  It also puts America nearly at its highest rate of these types of deaths in the last 25 years.  An article in the Washington Post stated that, “A woman giving birth in America is now more likely to die than a woman giving birth in China.” The United States is in a very unique group of only eight other countries in the world where these death rates are climbing

 In 1987 the death rate in America was only about 7.2 per 100,000, and now we have more than doubled that number. The analytics involved in sorting through this data seem to point toward several areas of concern including: more mothers with diabetes, more overweight mothers, drug abuse, the impact of the H1N1 virus on pregnancies, women having children later in life, and a myriad of other qualitative indicators. 

This, however, is not the most shocking statistic for the United States. If you look at a State by State comparison, Texas has seen a doubling in maternal deaths between 2011 to 2012, 23.8 deaths per 100,000.  These numbers come from the health data study led by Dr. Marian MacDorman at the University of Maryland.   

Other disturbing Texas factors seem to fall into some very religious and politically loaded categories.  As most of you are aware, Texas voted to defund Planned Parenthood which has resulted in the closing of numerous centers, limiting access to healthcare to many women.

The controversy over Planned Parenthood revolves around abortions, but Planned Parenthood provides 2.7million men and women annually with birth control, cancer screenings, STI testing and treatment, and well-woman exams. Abortions represented only 3 percent of its services. Then in 2012, the federal government discontinued Medicaid funding of the Women’s Health Program. That meant that Texas had to make up those lost funds. Consequently, the number of women served dropped significantly between 2011 and 2013.  These changes resulted in a significant lack of access to healthcare.

The second disturbing Texas factor is that, if you are a person of color, there is a greater chance that you could experience maternal mortality.

This was not intended to be racially charged or a pro-life or pro-choice column. It was, however, intended to demonstrate what was referred to in the Iraq war as collateral damage. What happens when religious based political decisions are made that disrupt care for nearly 50% of those individuals needing that care if those changes are not being addressed elsewhere? 

The Jeff Daniels speech from the HBO series Newsroom has to make us stop and think about where we are and where we’re going as a divided country: “We’re seventh in literacy, twenty-seventh in math, twenty-second in science, forty-ninth in life expectancy, 178th in infant mortality, third in median household income, number four in labor force, and number four in exports. We lead the world in only a few categories: number of incarcerated citizens per capita, . . . and defense spending, where we spend more than the next twenty-six countries combined, twenty-five of whom are allies.”

But I guess we could always be worse. The number of maternal deaths per 100,000 in Afghanistan, is 1575.



Birds and Deer – The Back Story (Just for fun)

September 1st, 2016 by Nick Jacobs No comments »

It always amazed me when I actually participated in the making of anything artistic like a play, a concert, or even a television commercial. You never really knew what went into the production; how many takes, how long, or how stressful it was unless or until you actually lived it. The first record that I ever played for took literally hundreds of takes, and when it was all put together and mastered, it sounded fantastic, but getting to that point was, well, it was very stressful.  

This past weekend I had an opportunity to uncover one of those incredible experiences that only the participants were aware of with an old friend, and, believe me when I tell you that the laughter could be heard from Hidden Valley to the UPMC building in Pittsburgh. The names and participants in this story will be changed to protect the innocent, and the statute of limitations has been up for nearly thirty years, but I’m not taking any chances.

Back in the mid-1980’s, I was the President of a convention and visitor’s bureau, the Laurel Highlands, and each year we lobbied to have a major advertisement made that would feature that area of the State for one of our primary tourism seasons: winter skiing, spring festivals, summer fun, or fall foliage. After several years of this petitioning, we won, and the ad that was produced was absolutely beautiful.  

That ad was a deer standing in a meadow when miraculously, one leaf on a nearby tree turns a bright autumn color. The deer notices and acknowledges this by lifting his head and looking toward the tree. Just then the entire tree turns colors, and a flock of doves fly out of the tree as the narrator invites the potential tourists to visit fall foliage in Pennsylvania. It was a striking, memorable ad that I remember vividly to this day.

Now the back story. In order to get a deer that would look on cue, they had to hire an animal trainer, and the only actor deer in the United States was from Hollywood. Booking a deer on a flight from Hollywood to the East Coast was no small accomplishment because it was a deer.   So, they had to disguise it and rename it a “deer dog” in order to get past the regulatiors.  

The deer landed at Dulles airport around midnight, and a company was engaged to ship this deer to Western PA for his acting gig. Well, as fate would have it, the deer transporting truck broke down in Hagerstown, and the only truck that was available for deer shipping was from a circus. Remember, this was supposed to be a subtle thing. Can you imagine if the media had become aware that a Los Angeles based deer was being shipped to Pennsylvania for a commercial? Well, the only truck that was available was a clown truck, a circus truck, and the deer arrived at its destination in a clown truck with a clown nose, and balloons plastered all over the sides and front of the vehicle.

The next phase of the commercial was slated to have hundreds of birds fly out of the tree. So, the producers suspended bags of doves all through the tree and placed giant fans under the tree. When the fans were turned on, the bags were supposed to blow upward encouraging the birds to fly away, but something went horribly wrong, and not unlike the turkey drop scene from WKRP in Cincinnati, a few of the birds fell down instead of up, directly into the fans. Needless to say the SPCA would not have been happy as bird parts and feathers flew everywhere.

The end product, though was amazing, and the good news was the commercial for Pennsylvania filled the State with “leaf peepers” from Washington D.C., Ohio, Michigan, and even Canada. No one knew the back story. Including me.


The Drug Conundrum

August 10th, 2016 by Nick Jacobs No comments »

“DEA arrests doctors in largest-ever crackdown on illegal Rx drugs.” Headlines like
this feed apprehension and concern throughout the legitimate medical professions in the
United States because it’s true and it’s happening. “Operation Pilluted,” is just one program
that has officially been shifted into high gear by both state and federal officials.
Every day we’re hearing more disturbing facts about prescription drug misuse. According
to the Centers for Disease Control, more people are dying from accidental drug overdoses than those who are killed in automobile accidents. In 2013, 44,000 people lost their
lives from drug overdoses and about 40,000 died in automobile accidents. (Forty percent of these deaths came from driving while impaired, which demonstrates even more collateral damage.)
What’s causing this startling increase? Improper use of Hydrocodone, Oxycodone,
Morphine, Methadone and Xanax are a few of the leading causes. The DEA raids are primarily concentrating on those unscrupulous individuals and pill mills dealing in illegal drug prescriptions. These people are profiting from the misery of others. Overdoses from prescription drugs have more than tripled between 1999 and 2010.
Another attention-grabbing statistic that the researchers uncovered was that the majority
of people who misused prescription drugs obtained them at no cost from friends
or family. Interestingly, chronic abusers received only about one-third or 27 percent of their drugs from physicians. This is where the conundrum comes into play. If you’ve
worked your entire life to become a doctor; four years of undergraduate school, medical
school, a residency, and possibly a fellowship, the last thing a physician needs would be to
have their license revoked and their ability to earn a living removed from them because
of these prescription problems and mistakes. But it’s sometimes very difficult for physicians to know when their patients are being truthful.
There have been plenty of calls to change what is occurring in the U.S. health system
including better education for the medical professions and the recent implementation of
stricter guidelines implemented by the Centers for Disease Control and Prevention.
Beside abuse of the controlled drugs taken by the patients, diversion is another
issue of concern. I’ve had physicians tell me that in order to continue to get their pain
medication, patients continue to complain about their pain, and that same medication is
distributed to relatives or on the street.
“We are not the police, but we have an ethical standard to maintain and a social commitment to protect the patient and the public,” commented Dr. Yi Yan Hong, a practicing pain specialist who has worked in Johnstown for more than 15 years. Dr. Hong believes that the blight of drug abuse and the recent overdoses of heroin are destroying the community and the region. Heroin, which is an illegal narcotic, is becoming cheaper and more abundant as a major drug of choice.
The recent tragic passing of Prince serves to remind us that, without proper treatment
targeted to their needs, patients with a chronic pain condition are at risk of drug
addiction and possible death. It was suggested a physician may have unknowingly contributed to Prince’s death by prescribing strong pain killers to the singer for his hip condition without knowing the extent of his secret opiate addiction.
Dr. Hong is an advocate for utilizing drug screening technology as a part of the modern
pain management regimen in order to monitor possible aberrant behaviors. It’s imperative
that physicians in high drug use geographic areas begin to regularly protect themselves
by testing patients on a regular basis. If testing shows possible drug abuse issues, better communication is needed in order to continue to provide safe and effective treatment.
Unfortunately, no one knows the answers to best tackle all these issues, but I do believe
that a better coordinated effort among the professionals, additional drug testing, and a multidisciplinary approach can help in handling this difficult problem.


Pod Cast Mass Solutions PART II

August 4th, 2016 by Nick Jacobs 1 comment »


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WHAT’S THE BIG IDEA? Nick’s Big Idea ties to the quote often attributed to John Wesley: “Do all the good you can. By all the means you can. In all the ways you can. In all the places you can. At all the times you can. To all the people you can. As long as ever you can.” His work in regional healthcare speaks to this.

Nick turned Windber Medical Center into a Planetree Facility. He stresses that you’re not creating what people will like. You’re creating what people will love.


Pod Cast – 1/2 of Nick’s Life’s Story

August 3rd, 2016 by Nick Jacobs 1 comment »


Trump or Clinton

July 30th, 2016 by Nick Jacobs No comments »

Lots of people have made up their minds about the candidate that they are going to select come November.  Well, sometimes, the only way to calm down my 20-month-old grandson is to play a video featuring a dozen versions of the children’s song, “The Wheels on the Bus.”

Truthfully, between the conventions and ongoing international carnage, we need to make sure that we check the lug nuts on the wheels of our own buses before we make our final decisions. Consequently, the topic that I would like to pursue here is hopefulness, and the art and science of rational thinking.

I’m not going to write about Dallas, Baton Rouge, Paris, Brussels, Nice, Munich, Orlando, or Minnesota. I have no desire to readdress the wars in Syrian or Afghanistan.  There will be no playing of the blame game on either party because, from my perspective, the wheels of both parties’ buses have been off more than once in this campaign. It’s been disagreeable, disgusting, and disconcerting.

My theme here is about something that one of my college professors spent an entire semester professing.  We, as human beings, are no longer being taught to actually think anymore.  Let me clarify this a little.  We are not given the tools or the classes in rational, scientific method analytics to allow us to make sense of life. We spend our days consuming Pablum.

For the vast majority of us, the primary extent of our day-to-day existence is based almost purely on emotions.  Logic hardly ever enters the equation. We are stimulus-response creatures that are mostly driven by the amygdala in our brain, and that almost always leads us into places that are not good for anyone.

We tend to focus on the mundane, the negative, the petty, the hideous, and the horrible, and that little thumb-sized amygdala gleefully sends fear, hatred, anger and paranoia throughout our brains. We mentally manipulate ourselves every day.

Much of the trouble that we are experiencing is coming from a worldwide lack of education. That, and our continued wars over whose God is better, contribute to producing a lack of rational hope. We end up living in a “whack a mole” continuum of crisis, anger, worry and warfare.

Don’t get me wrong, I’m not just pushing IQ here, I’m talking about EQ (emotional intelligence) as well. We all know very smart people who have the emotional capacity of a third-grade schoolyard bully, and some not-so-smart folks who have beautiful insights into the meaning of life.

As a capitalistic society, we tend to elevate and sometimes worship people who have worked their way to the top of the food chain.  Even through many have done it through ruthless exploitation, their wealth seems to elevate them to a God-like status of perceived genius among the masses.

When we look at the Bronze Age, the era where today’s terrorists live emotionally and intellectually, we can easily see how stupid mankind is capable of being. So, the question becomes “How do we protect ourselves from stupid?”

The anger that we see in today’s culture may be well deserved, but the solutions are not simply one person solutions. Unwinding corrupt practices can only occur if we can get to the root of the WIFM equation (What’s in it for me?) It requires finding out who the puppeteer is, and what indeed is in it for him?

If this seemed slanted toward one candidate or the other, I apologize. It is my sincere desire to encourage all of us to try to make a positive difference in our own and other peoples’ lives.   I’m just asking that we think about it and not vote with our amygdala. I’m hoping that our better selves take a few minutes to really contemplate the words that are being thrown around because some of them are deadly.


Scared of Being Scared

July 7th, 2016 by Nick Jacobs No comments »

Several members of my family are not fond of snakes. Let me clarify by saying that several members of my family are terrified of snakes. If a snake is within a mile of them, they completely fall apart. They make distress sounds reminiscent of scenes from “The Texas Chainsaw Massacre.”

Although they realize that this anxiety is over the top, they are still frozen in trembling, irrational panic over something that, for the most part, can’t hurt them.

Of course I’m not talking about killer snakes. They frighten me, too, and I certainly understand the fear of something that could end your life prematurely. It’s the other brand of snakes, black and garter, or garden, or gardener snakes.

These critters are good for balancing nature, and they eat deer ticks, or almost any other living thing that they are capable of consuming: slugs, earthworms, leeches, lizards, amphibians (including frog eggs), ants, crickets, rodents and minnows.

When I Googled phobia, I found nearly 500 phobias listed. For example, we’ve all heard of fear of spiders, Arachnophobia, and some members of my immediate family are concerned with heights, but how about Acerophobia, the fear of sourness?

That one took me back to some of my middle school teachers who had very sour dispositions. “Francis, did you finish your report on Medieval European Confrontations?” “No, ma’am, not yet,” I’d reply. “Well, if you don’t finish it by tomorrow, you will never graduate from middle school, never get out of high school, and you will be a failure for your entire life,” she’d say. Boom. Acerophobia.

During the past several years, I’ve developed another disquieting concern, Aeronausiphobia – the fear of vomiting secondary to airsickness. That one evolved from a flight in a private plane. As we flew through the clouds, I sat in the back of my then chairman’s beautiful airplane throwing up things that I’d eaten in first grade. This wasn’t a short run sickness either. It went on for hours. As we landed, he came through the cabin to exit, looked at me and said, “Fly home commercial.”

A former business acquaintance once told me that one of the primary reasons that prisons are built in rural areas is that the vast majority of the prisoners are from urban areas, and that they suffer from Agrizoophobia – the fear of wild animals. It seemed funny to me that these hardened gang bangers were terrified of being confronted by an angry opossum or a rabid squirrel, but, hey, I’m afraid of barfing in a plane.

Several of us have developed a new phobia, Anglophobia – fear of England. After the Brexit vote, it became clear that some of the things that encouraged 52 percent of British citizens to vote to exit the European Union may also be driving the elections in the United States. If there’s one thing that we older folks have learned, it’s to be afraid. Be very afraid.

Recently, one of my children decided to raise chickens. The rooster is a very aggressive attack animal, and from that perspective, at least a few of the kids have developed Alektorophobia – the fear of chickens, or at least the fear of one big chicken.

We had a dog once that developed Arachibutyrophobia – the fear of peanut butter sticking to the roof of the mouth. My Italian grandmother had Astrapophobia, the fear of thunder and lightning. She’d make me sit on the cellar steps with her and pray the rosary during storms.

I’ve personally understood Automatonophobia – fear of ventriloquist’s dummies, but only because I’ve known so many of them personally. In my case they were actually human dummies, and clearly someone with their hand in their back (or somewhere) was making their mouths move. Actually, that phobia might better have fit under the category of Proctophobia, the fear of buttheads.

My very favorite phobia, however, is Phobophobia – fear of phobias. I’m sooo scared of being scared.


Breast Cancer Research, Meditation, and Social Support

June 30th, 2016 by Nick Jacobs No comments »

Because I’m not a scientist, I’m always concerned when I attempt to describe scientific terms in my articles and speeches that scientists all over the world will wrap their heads in sterile bandages in order to keep their brains from exploding. As a trained musician, it’s probably similar to my watching some famous actor who doesn’t know the basics of directing an orchestra pretending to direct by waving their arms in bizarre circles.(Actually, Richard Dreyfuss, did a great job in “Mr. Holland’s Opus,” but he was one of the only stars who seemed to bother to learn to actually conduct.)

Well, today’s scientific word is telomere. My first exposure to this term was back in 2007 when Dr. Dean Ornish began quizzing one of the scientists atthe Chan Soon-Shiong Institute for Molecular Medicine in Windber (then the Windber Research Institute). He talked to him about telomeres and their potential relationship to heart disease. In 2009, scientists from UCSF, Johns Hopkins, and Harvard shared the Nobel Prize for their findings in telomere research. In 2013, Dr. Ornish and his colleagues at the Preventive Medicine Research Institute and the University of California San Francisco published an article in The Lancet, the British Journal of Medicine, that discussed their findings. “Comprehensive lifestyle changes may increase the length of telomeres which can be an indication of biological age over time.” (ht tps:// news/2013/09/108886/lifestylechanges-may-lengthen-telomeres-measure-cell-aging) Stay with me, please!

Telomeres are found at the ends of human chromosomes and are described by Dr. Ornish as similar to the plastic ends of shoe laces that keep those shoe laces from unraveling. Similarly, the telomeres help to keep our DNA and chromosomes from unraveling. As our telomeres get shorter, our lives tend to get shorter. “So what?” you may be asking.

Well, here’s whereIstart looking like Jimmy Stewart in “The Glenn Miller Story,” waving my arms all over the place. The bottom line is that researchers have found that telomeres may very well contribute to a kind of anti-aging and lengthening of our lives. They’re not exactly the Fountain of Youth, but they certainly seem to be heading us toward that water source.

Simply put, if we can lengthen our telomeres, we can potentially extend our existence here on Earth. Why am I writing about this? Well, a few columns ago I wrote about Tranquility Gardens located immediately off Rockwood Lane in Upper Yoder Township, and a few days later, a friend sent me a news story from the Alberta Health Services from 2014 outlining the fact that, for the first time, researchers have shown that practicing mindfulness meditation or being involved in a support group has a positive physical impact at the cellular level in breast cancer survivors.

What is that positive physical impact you might ask? The article from the University of Calgary went on to explain that the group working out of Alberta Health Services’ Tom Baker Cancer Centre and the University of Calgary Department of Oncology has demonstrated that telomeres maintain their length in breast cancer survivors who practice meditation or are involved in support groups, while these same telomeres shorten in a comparison group without any intervention.

In other words, if you meditate, you may lengthen your life. With this in mind, think about those meditation gardens. No, you don’t have to go to a garden to meditate; you can meditate anywhere. But why not take advantage of the rippling brooks, the beautiful flowers, the butterflies, and labyrinth? Why not at least try to lengthen your own telomeres. You don’t have to wait until you’re sick to attempt to help yourself.

Diet, exercise, stress management, and group support is not rocket science. Anyone can learn to conduct a march, and anyone can learn to meditate, to do a little self-healing, self-nurturing, and selfcare. It’s just over the river and through the woods.


Self-discovery, Spiritual growth

June 15th, 2016 by Nick Jacobs No comments »

I’ve known Steve Purich for a decade and a half, but I never really knew him until last Friday afternoon. Steve’s Father, an Orthodox priest, was forced to flee the Eastern Block in the mid-40s when the Communists took over. Consequently, Steve and his sister spent the next 12 years living first in tiny shacks and finally in a one-bedroom house that was home to about a dozen other family members. Every one of these kids ended up as successful professionals: physicians, attorneys, dentists, and business people. And that’s where this story begins.

Steve, too, was a successful businessman who, although Johnstown-based, was an international traveler. As it turns out, he was a student of world philosophies and ideologies, too. During his travels, he became exceptionally curious about ruins and, more importantly, their back stories. He wanted to know what worked in each civilization. He was inquisitive about the beliefs that helped these societies forge their way through each level of intellectual development and growth. This journey led him to create Tranquility Gardens.

It’s a retreat center unlike any other: a center for self-discovery, spiritual growth, and character building that, once experienced, provides a very clear message. That message is HOPE–hope for mankind and hope for the future.

In order to visualize this special place, just think of a location where there are butterfly and dragonfly habitats, a labyrinth, meandering walking trails filled with both authentic and replicated ruins from ancient civilizations, and a collection of life-altering learning and educational opportunities all tucked into nearly 10 acres of beauty, boulders, and bountiful Nature. And that’s just the beginning.

You’ll also find the philosophies and beliefs of many of the greatest thinkers in world history presented to you in succinct carvings on understated stone tablets or on breathtaking, multi-colored mosaics in various meditation areas. The street to this hidden yet very public treasure requires you to turn left off Rockwood Lane in Upper Yoder Township onto a short gravel and dirt road. Returning to pavement you’ll see the water running freely through the streams filling small reflecting ponds and creating little waterfalls. Less than 100 yards away are inexplicably large rock formations to be appreciated in their magnificent splendor.

Now, add a glimpse into the similarities subtly displayed among the practices and beliefs of people from all cultures–India, Asia, the Roman Empire, Africa, Western Europe, the United States, the Middle East, the Native Americans–and you quickly see unifying threads of sanity spoken by all civilizations that have helped us survive to date.

You will see that it’s a non-violent, education-based journey into peaceful places to explore the words of Socrates, Martin Luther King, Aristotle, Confucius, and a myriad of other brilliant people who said things like, “Enlightenment, happiness, peace, and beauty come from within.” It’s not a message of narcissism, but one of strength through knowledge, through perseverance, through education, and through practices of mind-calming and focus.

Steve doesn’t restrict access to his personal garden because he truly wants to donate it to an organization that “gets it,” an organization that will embrace the transformational opportunities presented to each person who walks these grounds. I’m anxious to see who actually does get it because it’s difficult to be recognized as a genius in your home area, but Steve is a genius who has planted plenty of those proverbial diamonds in his own backyard.

When you wrap all of this in a rags to riches story that ends in extreme generosity and caring for the future of mankind, it’s critical to realize that Steve’s primary messages at this self-constructed slice of Pennsylvania paradise is simple … if I did it, so can you.


What a WEEK! It’s All About Customer Service

June 9th, 2016 by Nick Jacobs 1 comment »

What a week and a half it’s been. My family and I have been subjected to a level of callousness that seems to be more the norm than the exception now. While preparing for a business trip to Seattle, my son and I attempted to find an alternate flight that did not take nine hours and fly us through storms in Texas. He reached an agent who abruptly told us there were no good alternatives, and if we did take a flight that would save us a few minutes, it would cost us an additional combined $778. We are both top tier frequent fliers. He’s logged the most flights and I’m not far behind, but that just didn’t matter. My son hung up, looked at me and said, “Customer service?” No legroom, no arm room, and little butt room in middle seats, between two fat guys. I had an unbelievable urge to move the entire trip.

The trip home was a lot worse. We sat for 50 minutes past our designated departure time with no access to restrooms and no explanations as to why life had been placed on hold. Mechanical difficulties?

That departure interruption put us practically in the eye of a major tornado heading from Iowa to Chicago. We flew in circles for another hour. We had been seat bound for an equivalent flight to Istanbul, Turkey. When we finally landed, we were told that our next flight, the last flight to Pittsburgh, had been cancelled.

As we deplaned, we were given a pink slip and told that we would get a deal on a room if, in fact, there were any rooms left anywhere. No one answered that number, ever, and the airline service lines looked like admission queues to the Beyoncé concert. Because it was 11:30 p.m., and we had to be back at the airport at  5a.m., and the TSA lines were averaging three hours, it made no sense to leave, sleep for a few hours, and return to stand in line. So, we sat on hard seats under sunshine bright artificial lights with arbitrary TSA announcements from the overhead speakers blaring all night long.

Then over the holiday weekend we were all scheduled to take a family boat ride. The weather was predicted to be 70 percent good, and all of the weather apps showed clear skies ahead. We checked with the appropriate authorities too, and then headed out onto the Ohio River. Five minutes later with six children and five adults on board, we were in the middle of “The Perfect Storm.” There was violent lightning, blinding rain, floating trees, and high waves rocking us like a cork in a bathtub. So much for dependable weather predicting from the authorities.

In a parallel world, another family member was placed in that circle of medical care hell that I wrote about in my book, “Taking the Hell Out of Healthcare,” where a week and a half of waiting for a diagnosis turned into an eternity. When the definitive, long-awaited appointment arrived, the receptionist said, “Your appointment was earlier today, and we can’t take you now.” There was no explanation, no apology, no excuses, no flexibility, and no attempt to ease any of the stress caused from waiting for what might have been a life-defining diagnosis. (Things eventually turned out okay.)

Too big to fail? Too dumb to care? Too insensitive to at least make an attempt to be helpful? Too arrogant to explain? Too stressed to realize that their jobs were directly tied to our collective experiences?

This seems to be the norm in a service-reliant country that is no longer service-oriented. These inconveniences may seem minuscule, and as my old business partner used to say, “No one died today,” but once we stop delivering service, we will be replaced with E-Z Passes, ATMs and automated everything as we sit at home and cry in our too-big-to-fail tasteless beer.

We’re people who need people . . . or not?

Where’s my driverless Google cab?