Speaking on this at AIHM Conference San Diego on October 24th

August 28th, 2015 by Nick Jacobs No comments »


We’ve all heard the expression that we are products of our environment, but that doesn’t really explain our decisions in life. For example, the first decade of my youth was spent in poverty. It was not Appalachian, dirt floor, poverty because we lived in my grandmother’s house, but it was powdered milk, government cheese, patches on my clothes poverty.   Then my dad got a job that literally thrust us into the middle class overnight. Some kids who were raised poor want to help their fellow man. Others want to show everyone that they are superior.   Who does which and why?

After teaching for nearly a decade in City Schools where children from low socio-economic backgrounds, were the rule, I became sensitized to their problems and lack of privilege. My last two years of teaching, however, were spent in a school where the average family income was much higher. The problems were still there, but in different packages. Some of those kids, both rich and poor, have made it big and have dedicated their lives to helping others. Which ones were they and why?

When I went to Europe for the first time, I experienced a different philosophy that fascinated me. It was a form of humanism. As a population they were taking care of each other.

That opinion was reinforced during my first trip to Toronto. There were no people living on the streets in Toronto. The both the ill and the mentally ill were being cared for, and, most importantly, there seemed to be much less violence, a type of peace in the form of mutual respect.

In the mid-2000’s, I made a trip to Africa. In one of the largest oil producing countries in the world, I saw poverty that was incomprehensible. It was clear that the only thing that was trickling down to the masses there was sadness, sorrow, and early death.

When I began working in the Netherlands a few years later, the vast majority of the people were middle class. Beggars were not visible on the streets, and a few years later, at the height of the world economic collapse, a trip to Spain reinforced this. With a 26% unemployment rate, I saw only three beggars in a major city.

It was at that time that the Affordable Care Act was being discussed, and my hopes began to rise.   Finally, we would prioritize wellness and prevention and behavioral health with parity for all other forms of health. We would take care of our fellow man in some way other than imprisonment. We would not have one of the highest infant mortality rates in the world, and we would begin to care for each other in a way that would be three times less expensive than our last two wars.

We would find the money that would allow us to take care of our fellow man and things would begin to get better; less obesity, less diabetes, less domestic terrorism from mentally ill, young white men. We would help those people who needed help the most.

The Accountable Care Organization, a result of the Affordable Care Act, seemed to be one way to finally shift the resources from a Sickness to a Wellness and Prevention based venue. We would be reimbursed for quality not quantity.   We would convert from a case by case sickness to a root-cause humane oriented, wellness based system.

Then it struck me that our medical profession has not been trained to function in this system, and as long as the rewards for sickness were greater than those for wellness, making that change would be incredibly difficult. So, I’ve spent the last seven years investing my energy in a philosophy that embraces evidence based, world medicine. It’s my dream that we can integrate world health modalities for wellness and prevention, and save our country from economic ruin while protecting our future generations from premature death.



The Windber Journey

August 16th, 2015 by Nick Jacobs 1 comment »

As a Vice President at Mercy Hospital, the Chief Communications Officer at Conemaugh (now Duke Lifepoint) and finally a CEO at Windber Medical Center, I became a frontline recipient of the knowledge needed to help change our system from sick care to wellness and prevention care.  The problem was that we had directed all of our country’s resources to sickness.   It became increasingly apparent that if we didn’t create massive changes in the system, the Baby Boomers would bankrupt the country and create a generation of children that would not live as long or be even as healthy as their parents.

Four critical stepping stones that appeared along my journey.

  1. As a 27 year old band director, I had personally experienced integrative medicine as a patient and saw the incredible value that those modalities could provide to patients.
  2. Another fortuitous event that occurred along my journey was that I was interviewed for a CEO position at Boys Town National Research Hospital. I was shocked and amazed when the former president of Boys Town, Father Val Peters, a Jesuit priest, introduced me to the concept of having a genome center as part of the hospital. This was in 1992, about a decade before the mapping of the genome.
  3. When I arrived as CEO of Windber Medical Center, I was informed by a former employee that because they had mastered a surgical technique that was unique, Windber surgeons had performed thyroid surgeries on several luminaries back in the 50s and 60s. It showed me that anyone would travel for the appropriate care.
  4. This last step came when Congressman John Murtha took an interest in our work, and he gave us an opportunity to become involved with the healthcare within the Department of Defense.

It was the confluence of those opportunities and ideas that merged in my mind, and when we received financial support for breast cancer research though the Congressman, Dr. Craig Shriver appeared on our campus and said to me, “What do you want to do here?”

The next stream of words flowed freely out of my mouth, “I want to create the genome center for the Department of Defense for Breast Cancer.”  His response was, “If you’re going to do genetics, we might as well do proteomics as well.”  To which I said, “We might as well because I’m not sure what either one of them are.  I’ll be the administrator you can be physician and principal investigator.”  And our partnership began.

When I asked him how we would get PhD’s to come to Windber, Pennsylvania, he smiled and said, “Let me help you work on that.”  When the first PhDs arrived I asked them why they had not won the Nobel Prize. Interestingly enough, they had a list of reasons that identified some of the dysfunctionality of basic science.

It was Dr. Richard Somiari who understood and embraced our vision for the Windber Research Institute.   As a musician I told him that I wanted to have ensembles of scientists, not divas and he and his wife, Dr. Stella Somiari, had told me that we also wanted tissue collected in a manner that would produce the finest results.

They also said that we needed to collect patient demographic information in a way that would give the scientist the needed information to do their work.  This resulted in Col. Shriver creating a 40 page protocol on how to collect tissue, and then he, Richard, and Dr. Hai Hu created a 500 question survey of demographic information to be collected from each donor.

This tissue repository, managed by Dr. Stella Somiari and managed by Jim Bombatch with over 60,000 donated breast tissue ended up being used as one of the resource centers for mapping the human breast cancer genome, and with an 84% acceptance rate, nearly triple the acceptance rate of the other major medical organizations that were involved, Windber was rated by the National Cancer Institute as the only platinum quality tissue repository in the United States.

Finally, we decided to create one central data repository to hold all of the collected information.

Fifteen years later, Tom Kurtz, CEO of both the Research Institute and Medical Center made one phone call which captured the imagination of Dr. Patrick Soon Shiong that has led to a remarkable partnership, the first of many that will launch Windber and the Johnstown area into one of the top ranking centers of excellence and cancer care in United States and the world.

Congratulations, Tom and the Board members who embraced this opportunity and to Dr. Soon Shiong for your amazing vision.  I love it when a plan comes together, and I couldn’t be more proud of my friends and former colleagues.


Ambassador Rich Verma . . . Doing What He Does Best – Excelling

July 31st, 2015 by Nick Jacobs No comments »

Dear Friends:

Just six months ago, President Obama came to Delhi as the Chief Guest for India’s Republic Day celebrations, and 10 years ago this month, the United States and India launched our historic cooperation on civil nuclear technology.  Over this decade, our relationship with India has soared.  Our partnership is broader and deeper than it has ever been before.  We are working on over 80 initiatives coming out of the President’s visit, and we’ve launched or reinvigorated over 30 working groups since Prime Minister Modi visited Washington last September.

In light of this historic cooperation, I am providing you with further background on the growth of the relationship between our countries.  I recently co-wrote an op-ed with my friend, Arun Singh, the Indian Ambassador to the United States, explaining how India and the United States, working together, will be a powerful force for peace and prosperity in the 21st Century, available here: http://www.huffingtonpost.com/arun-k-singh-/india-and-the-us-partnering_b_7814248.html

Our Embassy team also prepared a short video blog documenting our last six months of progress and activities here in India.  It’s been a busy time, as you can see here: https://www.youtube.com/watch?v=E1ziTGySLsc

If you want to know our stance on a wide range of issues, from climate change to defense cooperation to commercial matters, you can find a collection of speeches and remarks on our Embassy website: http://newdelhi.usembassy.gov/speeches_and_remarks.html

Finally, my Embassy team and I have reflected on this decade of growth since we launched our negotiations for the landmark U.S.-India civil nuclear agreement, and we collected some facts and figures that might help put in perspective how far the United States and India have come.  I would like to share a few of these highlights and illustrative facts and figures:  


  • S. investments in India have grown significantly – from a total of $7.7 billion in 2004 to $28 billion today.  Over the past few years, India has become the fourth fastest growing source of foreign direct investment into the United States.
  • Two-way trade has nearly tripled from $36 billion in 2005 to $104 billion in 2014, as we work towards $500 billion in trade.
  • Today, there are over 500 U.S. companies active in India, while the number of Indian companies operating in the United States has increased from roughly 85 companies in 2005 to over 200 companies today.
  • Travel for tourism, business, and education has skyrocketed:  We have seen a 152% increase in overall visa applications for Indians wishing to travel to the U.S. from 398,931 in fiscal year 2005 to 1,007,811 since this fiscal year started in October 2014.  Visa applications for Indian students have seen the strongest increase, of 202% (30,513 in FY 2005 to 92,156 in FY 2015).  U.S. visitors to India have nearly doubled from 611,165 visitors in 2005 to 1,123,444 in 2015.

Defense Cooperation:

  • Ten years ago, the United States and India barely conducted any defense trade.  Over the last few years, the United States has signed approximately $10 billion in defense sales to India. Our defense cooperation has helped promote India’s role as a security provider in the Indian Ocean region with direct benefit to third countries. For example, the Indian Air Force used C-130s and C-17 aircraft to evacuate Indian and third country nationals from Yemen and speed relief supplies to Nepal after a devastating earthquake.
  • S. and Indian businesses have partnered on the co-development of defense equipment, establishing a base from which to launch new Defense Technology and Trade Initiative (DTTI) co-development and co-production efforts in the future and expand the Indian defense industrial base.
  • The complexity of military exercises has increased in the last 10 years.  The annual bilateral training exercise ‘Yudh Abhyas’ has grown from a squad and platoon-level exercise to a company/battalion-level maneuver exercise, including a brigade-level computer simulation exercise where the U.S. and Indian Armies operate together.  This year, the U.S.-India naval exercise ‘Malabar’ will welcome the Japan Maritime Self Defense Force for the second consecutive year, along with other countries.


  • In 2015, India-U.S. bilateral agricultural and food trade is on track to quintuple in value compared to 2005, exceeding $6 billion.  Due in part to sustained USDA Cooperator marketing activities and USDA programs, U.S. agricultural exports to India are poised to achieve a new record high in 2015.
  • Since 2005 USDA has sponsored 112 Indian agricultural researchers under the Borlaug Fellowship Program, and 79 fellows under the Cochran Fellowship Program.  These figures include 21 participants in the two programs for 2015.


  • Indian students account for the second-largest group of foreign students in the United States, with approximately 102,673 students studying in the United States in 2013-14. At the same time, a growing number of Americans are choosing to study abroad in India, with over 4,000 students in India during academic year 2012-13. These students advance innovation and research in our universities and in their communities when they return home.

Fulbright Exchanges:

  • The Fulbright-Nehru program has nearly tripled in size since 2009, when the program became truly binational with joint funding for exchanges, with approximately 300 Indian and U.S. students and scholars now participating annually.  Since 1950, the United States-India Education Foundation (USIEF) has awarded approximately 9,962 Fulbright grants in a full range of academic disciplines.  USIEF has also administered 8,634 other awards, including the U.S. Department of Education’s Fulbright-Hays and the East-West Center grants, for a total of over 18,500 awards in the last 65 years.


  • Since 1993, the U.S. Center for Disease Control (CDC) has assigned experts to World Health Organization’s (WHO) regional and country offices in India to support surveillance of vaccine-preventable diseases.  Through this active collaboration, in 2014, India was certified as polio-free and the CDC continues to work with Indian researchers to strengthen the national immunization program and accelerate control of measles and rubella.
  • In 2012, the CDC, through their Global Disease Detection India Center, located at India’s National Centre for Disease Control, helped establish the India Epidemic Intelligence Service program (EIS) – a post graduate field training program modeled after the US EIS – which will help promote public health and support the necessary health workforce to prevent, detect, and respond to infectious disease threats.
  • India is the second largest exporter of pharmaceuticals to the United States.  In FY 2014, India held a 13% share of the total 64,170 imported lines of pharmaceuticals.


  • Cooperation on space science has soared to new levels – from collaboration on projects that measure aspects of Earth’s oceans and global precipitation, to recent success on a mission to Mars, to working jointly on a satellite project that will help scientists understand climate change and natural disasters.  Our scientists and space organizations continue to look for new areas on which to collaborate.

You can follow us online through these sites:

Facebook:  https://www.facebook.com/India.usembassy

Embassy and Ambassador Twitter handles:  @USAndIndia and @USAmbIndia

YouTube:  http://www.youtube.com/user/USEmbassyNewDelhi

Instagram:  https://instagram.com/usembassynewdelhi/

Website:  http://newdelhi.usembassy.gov/

Thank you and best wishes,




Richard R. Verma

US Ambassador





The Furry Convention 2015

July 11th, 2015 by Nick Jacobs No comments »

The Anthropomorphic Convention is this weekend in Pittsburgh. Athrocon began in 1997 and is now the largest Furry Convention in the world. Over 5500 Furrys will attend the 2015 Conference at the Pittsburgh Convention. The Anthropomorphic organization is a not for profit corporation dedicated to holding this fun conference each year.  In the nonprofit spirit, Athrocon has raised more than $200,000 for charities since 1997. 

Included in the ranks of participants are professional sports mascots, animators, cartoonist, puppeteers, artists, illustrators, and writers as well as those who simply think that it would be great if animals could walk or talk like we do.  I wanted to know more about the people behind the masks.  My first interview was with John Cole, a.k.a., KP, a famous character and conference organizer. 

John, originally from Texas, is now living in Orlando, Florida where he says that he, “Works to live, and does not live to work.”  KP is a peasant guy with a very welcoming personality.  His real job is in the insurance industry, but his passion is as a puppeteer who performs as a sheep dog.  He volunteers his time with an organization that works with the Make a Wish Foundation in the Orlando area.  It’s an amusement park and nonprofit organization called Give Kids the World which operates in Kissimmee near the other parks.  It operates on 74 acres where children with life threatening illnesses are treated to a free weeklong vacation. KP described it as a place where children can live out their fantasy story. 

He proceeded to tell me all about Jeremiah, a little boy who kept running up to the stage to try to touch KP’s costume.  Finally, when it was his turn, KP asked the little boy why he was grabbing at him.  As it turned out, Jeremiah was blind and wanted to know what the performing animals were.  KP explained he was a large sheepdog with glasses on, and Jeremiah was confused. Why would a dog wear glasses? KP went on to explain that he was Elton John Dog and he was wearing glasses to be cool.  He also explained that there was a ferret and a fox on the stage with him. 

At the end of their skit, KP felt really bad because Jeremiah had come to the show and not known what animals were performing.  So, they decided to make a music video for him. They sent the video to his home, and in the video they said, “Now Jeremiah go to the box that came with the video and take out the glasses because these are the very same glasses that the sheepdog was wearing, and they are cool. Then KP said, “Have your mom go to the box and take out the fur.  It’s the very same fur that you were feeling behind my ear.”  “Finally,” he said, “Get the little stone from the box.” This stone is a Magic Wishing Stone. It can make our dreams come true.” “Oh, and Jeremiah, we want you to make our dreams come true, too. We want you to get better.”

He teared up a little as he told me this last part.  A year later, Jeremiah came back to the park, ran up to the stage and said, “I’ve got something to tell you. I’m cancer free.”  That’s what makes KP tick. 

In his spare time, KP also works with children with Progeria disease, the aging disease in kids.

Then I met Ned, the amazing musician, a graduate of Berkeley College of Music.  Ned, a costumed bear named Rhubarb, and a master of his trade. I could go on and on, but . . . the convention is open to the public and because it is a Cartoon animal convention, it’s fun for the kids.  There’s even a Furry Jazz Concert on Saturday. Mark it in your calendar for next year! 


July 3rd

July 6th, 2015 by Nick Jacobs No comments »

It was July 3rd, an almost National Holiday, and my job that afternoon was to watch, hang out, and play with the six, seven, and eight year old girls before taking them on a boat ride that evening.   They arrived at my building at precisely 1PM, and the entertainment began.  After greeting Ron, the doorman, the two youngest cousins had a passionate discussion over who would get to push which buttons on the elevator to get to my condo.

Once the button pushing pecking order had been established, the chaos began in earnest. There was, of course, the struggle over who would insert the door key, then over who would get to ring the doorbell at least six times, and finally, who would turn and twist that key and turn the doorknob.

Once inside the condo, there was additional chaos as they discussed (for three seconds) who would get to explore the powder room and the bathroom first. They did their thing, grabbed a handful of dark chocolate, Hershey Kisses from my candy jar, and we returned to the elevator for our journey to lunch.

As we walked up the street, I thought it might be fun for them to visit the University bookstore which was only a block away.   Unfortunately, I think they were a few years too early to completely appreciate this grown-up experience. The seven -year-old ran immediately to a clothing rack, and she picked out a cute, pink T-shirt with the school logo on it.  Then she asked me how to pronounce what it said.  When I told her that it said Duquesne.  In a very loud and bellicose voice she declared, “I don’t want to wear anything with that word on cause I don’t know what it means!”

After looking at every single kid book in the store and examining every $44 Vera Bradley IPhone case, we decided that their purchase would be journals. Each girl would get a fancy notebook.  We went to the fancy notebook section of the store where the two oldest cousins selected exactly the same book. That particular selection was made because these books had secret compartments in the back. The youngest one selected hers because she liked the colors on the cover.

We then decided they should go downstairs to the office supply section and each get a pen.  This time all selections were made based on color, after which we proceeded to checkout.  As we left the bookstore, they ran to a table outside, opened their journals and begin writing.  That’s when the youngest one realized that she had purchased, not a journal, but a calendar.  She sure as heck didn’t want a calendar. So we went inside and exchanged it for a notebook.  Then she noticed that she had purchased a highlighter, but since she doesn’t write very much, it really didn’t seem to matter.

We walked another block down the street to a TGI Friday’s.   The youngest girl made a bathroom stop, then another bathroom stop, and after that, another one.  This time, though, she lingered for a long time, and we all began to worry a little, but neither of the other two girls were interested in checking on her because she had previously announced what her bathroom intentions were. This caused her cousin and sister to be fearful that they would be exposed to a potentially hazardous assault on their olfactory senses.

It was at that point that I went to the ladies room door and yelled for her to come out. She exited with a big smile on her face.  I asked her two questions, “Did you do what you said? And did you wash your hands?” She laughed and replied, “Yes, Poppa, yes, I did both, but do you know why I was in there for so long?

I was in there because I was dancin!”

Ah, the simple pleasures of youth.


Beverly Hills

June 27th, 2015 by Nick Jacobs No comments »

June 18th to the 27th meant trips to San Francisco, Los Angeles, Pittsburgh, Johnstown, New York, Naples, Atlanta, and Pittsburgh again.  These trips provided an entirely new meaning to Thunder in the Valley.  In fact, Thunder in the Skies would have been more descriptive.  As my work life brought me back in the saddle again, I discovered what flying the unfriendly, storm laden, bumpy, lightning filled skies of these good ole United States meant.

This type of travel gives me plenty of time to deliberate.  It gives me time to think about having life and not having it.  It accentuates life’s edginess in airborne storms, rocky take-offs and landings, and navigating through tropical downpours and blinding sand storms.  (Okay, it was a taxi ride from LAX to Beverly Hill, but there was a little dust blowing around out there.)

I’ve been working in Beverly Hills since January. It may seem strange for a former musician, arts organization, and tourism director, hospital administrator and research institute guy to be working in Beverly Hills, but I am.  It sure beats some of the other places where I’ve worked over the years. (I’m not naming any names.)

To top it off, I get to hang out in the Barbra Streisand pavilion, have lunch beside Sharon Stone, and stay at a really nice French hotel.  (Seriously, they speak French there and have the greatest pastries you can ever imagine.) It is like a cultural trip to some foreign land.

There are Maserati’s, Alfa Remeo’s, and Bentleys parked everywhere. The lawns are perfectly manicured, brown but manicured. The homes are, well, they are less than humble, and the police are, just like the ones in Beverly Hills Cop, very polite.

I’ve seen movie stars and, I’m sure I’m seeing future movie stars everywhere.  Here’s the really fun part of it all.  The people that I’m working with in Beverly Hills are great.  They are really nice and kind, and hardworking. Several of them are the children of immigrants from places like the Philippines, Mexico, and from China, and that makes it even more enjoyable.

What’s my reason for writing this?  It’s not to brag because I’m still me.  I still put my slacks on one leg at a time and still like to have a cold one with my buddies.  I’m not a Beverly Hills, Nigeria, or even a Bosnia kinda guy, but then again, maybe I am because I really liked the people in all of those places.

Oh sure, it’s sad to see all of the twenty something men and women trying to compete, to be in the IN crowd.  It’s sad to see so much wealth wasted in a world where people are starving.  But let’s just ignore the opulence and narcissism for now and focus on the fact that the folks who work there are really nice.  Of course they could be completely immersed in their own self-worth, but they aren’t.  They could be ego maniacs, but they aren’t that either.  They’re reasonable, and they’re not status seekers.  They’re just good people.

Maybe that’s the key.  There aren’t many places where they could work that would be more prestigious, and I’m sure they’re being paid fairly. But in return for that they’re contributing significantly to making it a great place.  So, possibly, they’re so nice because they have nothing to prove.  It’s like those Nobel Prize winners that I’ve met.  They’re not snobs or pompous academics.  Maybe it’s because they have a better view from the top, and it just makes them humble.

Whatever the reason, it’s clear to me that, of all the places I’ve worked over the past several years, I can honestly tell you that Beverly Hills is one of my favorite places.  It’s not the Hills.  It’s not even Beverly.  It’s the people who have gotten my attention.  Now that’s a culture I’d love to spread.



What is Population Health?

June 17th, 2015 by Nick Jacobs 1 comment »

“Population health:” what does it mean? The term is being newly used in the health space, but what it actually means depends on whom you ask. Population health impacts health care costs, outcomes, and systems management, and not all health administrators’ priorities are created equal. The term was defined by David Kindig and Greg Stoddart in 2003 as “the health outcome of a group of individuals, including the distribution of such outcomes within the group.”

MHA@GW, the online master of health administration at the Milken Institute School of Public Health at the George Washington University, asked health care professionals to provide their definition of population health to start a conversation about the many ways people define it. They found that, while some health care leaders closely maintained Kindig and Stoddart’s original definition, many others focused on different indicators of population health and successful healthcare management, such as costs, accountability, and more. Read “What is Population Health?” to learn about how a variety of different professionals define the term and what population health means for care in the future. I encourage readers to add their own definitions in the comments below.


Moving Along

June 16th, 2015 by Nick Jacobs 2 comments »

As a high school graduate, there was always the knowledge that there would be class reunions; time to reminisce and to catch up with old friends.  Some of us skipped the 5th reunion because it was just too close to graduation.  Then the tenth came and went as did the next few.

The 25th class reunion was quite an event.  It was a time to see how we all had done.  We were in our early 40’s, many of us had kids in their teens, and were working at jobs that, for some, had never been in our original flight plans.  Some key people had stopped coming because they believed themselves to be too successful.  Others just didn’t want to be reminded of their youth.

It was ten years later when Mother Nature’s aging genes started kicking in and not only did some of us begin to look like grandparents, some had already been grandparents for more than a decade. The other big thing that had begun to happen was the introduction of health challenges.  This topic comes under the category of “Reality bites.”

By the 40th high school reunion, it was evident who had made it in life, but this reunion played more like the script from the play, “The Same Time Next Year” because the “Made it” category could be measured in two very different dynamics; those who had financially made it and those who had emotionally made it.

As it turned out, several of my classmates literally did not have a pot to  . . . well you know the rest of that saying, but they were happy.  They were emotionally stable, had raised great families, and were living the dream.  Others, on the other hand, had burned through multiple marriages, had kids in trouble, and were miserably wealthy.

I’ll have to admit that there were a few who were really well off and really happy.  They had managed to grab onto a star while still keeping their feet firmly on the ground.  Some of those uber-successful classmates were not the ones who might have been predicted in high school, but they had found their way to the top legitimately.   (As far as I know, there were no mobsters.)

Obviously the number of friends who had moved onto the Rainbow Bridge or Neverland continued to rise each decade, so that by the 40th Reunion, Mr. Reeper had taken his toll on our already small class of a little more than 100 students. (Reality Bites Even Harder.)

As we continued to move through the decades, some of us held tightly onto the notion that we were still those 18 year old kids who had made up that original graduating class.  Of course, the love handles, grey, thinning hair, and bifocals betrayed us a little, but the personalities were the same.  Some of our classmates had aged gracefully.  Others had not.  But we mostly yakked young, and embraced our continued hipness.  (Is that still a functional word?)

This year, however, is officially a year that cannot be evaded, marginalized, or thrust under the legendary rug. This is the ultimate reunion year, the year that ends the singular reunion parties and pushes us into the all-encompassing ongoing geezer reunions.

This year is the 50th anniversary of our high school graduation. The Class of 1965 will have our last and final solo reunion before we are sucked up into that proverbial “everyone who is still alive reunion” where 85 year olds eat for free, that unending get-together prior to that big reunion in the sky.

I’d like to really get into the weeds with old friends at this event, and I’d like to find out what their lives were really like these past five decades. Of course it’s hard to accomplish all of that during the early bird special at the Fire Hall.

Happy 50th to the Class of 1965!


My Brother and ME

June 9th, 2015 by Nick Jacobs 10 comments »

I wrote this in March . . . and just added the ending.

Yes, he took my binky and threw it away because he thought I was too old to still have a binky. (Okay, he was right, I was pushing thirty six months at the time.) That memory is seared in my mind like a symbol burned into a calf’s butt by a red hot branding iron, but I hold no grudge.

Yes, he also took my favorite hat and tossed it into my grandmother’s outhouse, another truly devastating experience. And yes, he hid behind trees and doors and jumped out to scare me so often that, to this day, I walk defensively at night everywhere I go.

As a frequent bed wetting little kid, however, I often got even with him in our jointly owned double bed.

We have shared 12 years of our youth together and 56 more years of our adulthood. He’s Charlie, my only sibling,my brother, my friend, my touchstone, cheerleader, and translator.

We often have shared memories of vacations long gone, traditional jointly spent holidays, big Italian meals with our bigger than life Italian family, joint summer allergic asthma attacks before inhalers were invented when only shots of adrenaline provided the only relief.

We shared hanging wildly onto the bumper of our dad’s car while riding our sleds over bumpy, snow covered roads at what felt like supersonic speeds. We played army in the wash house and back yard. We had a real Nazi helmet, real enlisted man’s hat, a gas mask, telescopes, and half a dozen other war relics given to us by our WW ll veteran uncles.

We used green encased walnuts that dropped from our two black walnut trees as hand grenades as we pulled the stems- grenade pins off with our teeth and threw those hard green nuts mercilessly at each other from our natural fox holes. We had one Red Ryder air rifle that was built to shoot corks. We ran out of corks and usually filled the barrel with mud and grass by jamming it into the ground.

We had fake plastic bayonets and a plastic German Lugar squirt gun, but the most memorable part of our play was the CENTRAL COMMAND. My brother and older cousin, Jack, had set up a half dozen make believe and real adult and kid-sized radios, walkie talkies, and Morse code transmitters. Our main headquarters was on the ground floor, but the secret room, hidden by a trap door, was the second floor where a large plank window could be opened for shooting and fighting off aggressors with more fake hand grenades.

Because of our six year age difference, my brother left me behind for college just as I was entering puberty, and the next half dozen years were hit and miss as we’d see each other for holidays, summer vacation and occasional weddings, funerals, and Baptisms. (He reminded me that, while he was in college, I often sent him $5 bills from my $7.35 weekly profits from my paper route.)

His first real car was a fully loaded, mint green VW with a sun roof, white wall tires, and a white knob on his manual shift stick. He let me use it for a few weeks while he traveled that summer. What a great ride that was.

A few years later he bought a gold Pontiac Firebird, a hot car for a 20’s something brother and his college age sibling in which to tool around. Ironically, at 27 and 21, we both got married that same year, and I remember helping him move to Maryland, then a few years later he moved to Colorado, and finally back to Pittsburgh.

Overall, we’ve had a relatively uneventful, peaceful existence as we have dealt with the waves of life that jointly washed over us. We’ve said our goodbyes to our grandparents, parents, aunts, uncles, cousins and friends. We’ve welcomed children, grandchildren, new cousins, and new friends.

Through his amazing efforts, we’ve discovered ITALY, and our Italian cousins there and in Ohio and Florida. We’ve celebrated new holidays and rolled with all of the punches that life has thrown, but last night, at his bedside, I prepared to say goodbye as a rapid response team with crash carts and drugs had swarmed around him. He was unresponsive and had stopped breathing. After they performed their magic, he pulled through, was transferred to the ICU, and our story goes on to another day.


BUT AFTER TWO MORE MONTHS OF HOSPITALIZED STRUGGLE, about 168 days after he became ill in December, he left us, surrounded by our love in his home at 4:30 pm on Sunday afternoon, and my heart is broken.

Thanks to all of you for your support, your love, your assistance, and your positive comments to him, to his family, and to mine. He made this world better every day in every way. He was a VERY GOOD MAN.

I will always love you, my brother.


“Expert Panel Backs a Drug to Increase Women’s Sex Drive.”

June 5th, 2015 by Nick Jacobs No comments »

The New York Times breaking news headline last night was “Expert Panel Backs a Drug to Increase Women’s Sex Drive.” The new drug, flibanserin, is only intended to impact the 7% of premenopausal women who have a diminished interest in sexual activity.

In the spirit of full disclosure, several thoughts crossed my somewhat already tortured mind regarding this announcement, but most of those considerations were either politically incorrect or simply the work of an unyielding libido typically found in the brain of a 14 year old boy.  The only difference is that this boy happens to be trapped in an old dude’s body.

The advisory committee voted 18 to 6 in favor of this little pink pill manufactured by Sprout Pharmaceutical. (Maybe not so coincidentally, my thesaurus provided the words bud, new growth, young branch or leaf as the synonym for sprout?) 

Those individuals who were opposed to approving this drug may have been members of the Shaker religion, a religion so steeped in celibacy practices that the result was a thinning of its membership.  The collateral damage of that practice or lack of practice almost put them out of business. 

The other thought that I had about the no votes was that they may have been married to or living with old fat guys who frequently skipped showers, had beer bellies the size of the famous mound in Moundsville, West Virginia, and embraced the release of methane as an Olympic sport.

Conversely, the folks who voted positively did so with the caveat that this pharmaceutical product could only go to market if several side effect risks factors could be ameliorated.  These risks were not delineated in the breaking news headline, but if they were typical of some other sexually related drugs, they might include things like the loss of a significant other through the chance of developing roving eye syndrome.  

The suggested time for consumption of said little pink pill was immediately prior to bedtime.  Once again, this suggestion may relate to the fact that handsome, six pack bellied meter readers, and FED Ex, UPS, or USPS personnel in form fitting blue, brown, or grey shorts don’t typically stop by at that time of the evening, thus removing one of the potential side effects. (This concept gives a whole new meaning to the advertising question “What can Brown do for you?”)

It was very interesting to me that, unlike Cialis, Viagra, or other male oriented sexual dysfunction drugs which are potentially useful to probably 98% of men over 55 (or at least for every man working in the adult film industry), flibanserin is only directed toward 7% of the female population.

I’m sure we’ve all known someone who falls into that 7% category, but, unless they were our personal roommate, were the topic of discussion from an overindulged buddy at a Friday night poker outing, or were written up in People Magazine, we just haven’t known who they are and why they are part of that mystical group.

One of my fondest memories relating to this general subject area occurred during a speech that I made at a senior citizen conference in San Diego regarding wellness, fitness and the lifestyle facility that we had just built at our hospital.  The speaker before me gave an elaborate description of how it was determined that Viagra had more than the one single use for which it was originally developed, to control high blood pressure.  After the drug trials were over, none of the participants involved returned any of the sample drugs, a sure sign of the unexplored multiple benefits.    

At the end of the speaker’s description of this discovery of renewed manhood by the participants, one of the attendees, a little, elderly lady in the back of the room stood up and yelled into the microphone, “The heck with Viagra. I want a pill that will make my husband dance!”