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 No 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 No 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!”


Baby Think

May 29th, 2015 by Nick Jacobs No comments »

What do babies understand and how do they think? In a 2011 TED talk that I recently watched by Dr. Alison Gopnik, she hypothesized that broccoli may be the secret to finding out just how babies think.

The study leaders gave the 15 and 18 month old babies a bowl of raw broccoli and a bowl of goldfish crackers. When the adults study coordinators pretended to love the broccoli and then asked the babies for food, the result was somewhat amazing, and this is where the fun comes into this equation.

The 15 month old babies handed out only the goldfish crackers because they just couldn’t believe that anyone would actually like that broccoli. They stared in disbelief when the adults made a positive fuss over the broccoli and had clearly decided that everyone loves goldfish crackers.  

The 18 month old babies might have had trouble comprehending why anyone actually liked the raw broccoli, but if the adult pretended to like it, that’s exactly the food that the baby would give them. If, on the other hand, the adult made a positive fuss over the goldfish crackers, the babies responded accordingly. They gave the adults whichever food they pretended to like.

This experiment demonstrated that the older babies had actually figured out that, not only did people like different things, but also that, if they wanted to please these adults, they should give them what they loved. Just thinking about the sophistication of that decision making should make your adult heads spin just a little becuase I’ve known several adults who have not progressed that far in their thinking.

The question is how do babies learn so much in such a short amount of time? It turns out that there is a direct relationship between how long a childhood any particular member of any species has that is directly related to how big their brains are. For example, as Dr. Gopnik pointed out, crows are very smart while chickens are not. Baby crows depend on their mothers to feed them for up to two years while baby chickens are usually independent within a couple of months. Dr Gopnik’s talk indicated that this may be the reason why crows are incredibly smart and chickens “end up in the soup pot.”

Some animals are great at doing only one thing while others are phenomenal at multi-tasking. Because human beings have bigger brains in relation to their bodies than any other species, we’re smarter, we can learn more, but we’re much more dependent as children than any other species.

The way that evolution seems to have solved this problem is that we have a lot of baby time to do our research and development. Babies’ brains seem to be the most powerful scientific computers in this world. Babies are actually making complicated theoretical decisions based on the scientific method using conditional probability measures on a routine basis.

As it turns out, four year olds are much better at finding unlikely answers to questions than adults might be. When children experiment we call it “getting into everything,” but when you ask a kid to explain something, they actually employ scientific hypothesis.  

While adults usually decide that something is relevant and then typically focus on only that element, babies and children find answers through their open mindedness.   They can take in lots of information from lots of locations at once. This demonstrates exceptional neuroplasticity.   (Which is why creative people may be more childlike in their thinking as well.)

Dr. Gopnik ended by saying that coffee mimics the effect of a baby’s way of thinking.   “Being a baby is like falling in love in Paris for the first time after having three double espressos,” but she went on to say that this type of living might also contribute to waking up and crying at three in the morning!


Memorial Day and the Girls

May 25th, 2015 by Nick Jacobs No comments »

My son and his wife were leaving for her best friend’s wedding.  This gala weeklong event was to be held on some island in the Caribbean. The funny part about that is that, when I was his age, a wedding on an island might have been Neville Island by a Gulf Oil storage tank, not the Grand Caiman Islands.  And the trip there would have been in a used Chevy.

Because I was designated as the babysitter du jour, I picked up the Pittsburgh girls to take them to Johnstown, to hang with their cousins.  It would be another city cousins meet country cousins for Memorial Day week-end event. They would go from their comfortable, pet less, Pittsburgh home with its 3D television, American Girl dolls, and comfortable fenced in backyard to their cousins’ home, the Ponderosa.  There they would play on a trampoline, a swing set, and ten wooded acres of magnificent trails and craziness with two giant dogs and a dozen other little kids.  Oh, yes, and they would swim in the new pool and eat all of their favorite picnic foods while waiting to see the fireworks.

The first thing that we had to do, though, was to go shopping at their local Target department store. I bought a masculine looking gardener’s kneeling pad (no pretty flowers or goofy butterflies), a bucket, a manly trowel, a dirt digger-handheld little rake kind of thing, and some man-sized gardening gloves, a.k.a., Macho Gardening!

When you live in a city condo without even a balcony, gardening tools are not a necessity.  My current collection of condo tools consists of two screwdrivers (one of each kind), a crescent wrench, a roll of duct tape, pliers, and a hammer. In fact, when my grandson asked me about my tool box, I told him that it was very small and black.  He raised his brows in consternation until I reached in my back pocket and showed him my wallet.

Anyway, back to the tool purchase.  When we got to the checkout counter, I felt tangible sticker shock.  These four little, stupid things cost over $50, and the real tragedy of this purchase is that they would not be used again until next Memorial Day.  The $50 did not represent the entire purchase, though, because, while we were there, we had to buy Shopkins, TicTacs, bubble gum, and an outfit for baby, Pete.  “Buy this one, Poppa, how cute.  He’ll look so cute in this one,” they both cried out as we swept through the baby department.

Why the bucket and tools?  You see, the girls were going to learn about planting flowers on their great and great great grandparent’s and their twin great uncle’s graves for Memorial Day.  The youngest and baddest had already asked me three times if we could skip the working, planting, digging dirt part and just get right to her cousins, but with their other great uncle still hospitalized, it had been my pledge to him to get this obligatory task done before Monday.

We drove the 60 minutes to the first graveyard, and I had to explain that we were not going to dig up my mother and father and that yes, my dad had been buried in a blue suit. He hated blue. Then, at my grandparents’ grave site, I had to explain why there was a tombstone right beside theirs covered in Steeler’s logos. (The guy must have been a dedicated fan.)   Finally, at my twin brothers’ grave, things went very well, very fast and we were done for the day.

As we drove by the house that was my childhood home and headed off to the mountains where we made a promised Blizzard stop at Dairy Queen, I tried to explain the day one more time.  Maybe someday they’ll understand what this trip was really about, and maybe I will, too.


I’ve Seen Fire, and I’ve Seen Rain

May 17th, 2015 by Nick Jacobs No comments »

I’ve flown over the Sahara, visited Italy, France, Germany, Spain, England, Nigeria, Bosnia, Serbia, the Netherlands, Greece, Turkey, Corsica, Malta, Mexico, Aruba, Canada. Hawaii, Alaska, and thirty eight other States.

I’ve danced until I dropped, I’ve been operated on seven times, have been in love a few times in my life and was only ever in one fist fight at age 11, and it ended in a draw.

I’ve been robbed of tens of thousands of dollars at least three times by unarmed men in suits that I trusted. I’ve almost been fired at least three times that I knew about, quit once, and retired once. (Hated retirement.)

I’ve ridden up the side of a mountain on the back of a mule, eaten Afghan food with my fingers, been chased by a goose, had arguments with generals, spent an evening with a Prince and Princess, eaten alligator meat, and chocolate covered ants, but not on the same day.

I’ve had pretty good food in some darn good restaurants, owned a few dozen cars, held both of my parents in my arms as they took their last breath and have literally lost my heart to my kids and grandkids.

I’ve had too much to drink a few times but never used recreational drugs, and love a cold beer on a hot day.

I’ve survived a violent automobile accident without serious injury, have had dozens of close calls, hit three deer, a garbage can and the pillars in my parking garage twice. In college I’ve smoked cigarettes, a pipe, and as a young teacher chewed snuff once and side chew but stopped immediately after I threw up both times.

I’ve seen and heard some of the best jazz and rock musicians who ever lived and even played backup trumpet for a few of them. I’ve directed bands, orchestras, jazz bands, combos, and even musicals.

I’ve lived. I’ve laughed, and I’ve loved. I’ve also cried, and I’ve mourned.

I’ve seen fire, and I’ve seen rain . . . James Taylor.

I’ve been employed in over a dozen jobs: railroader, glass factory worker, store clerk, and not so handyman, choir director, music teacher, trumpet instructor, arts manager, tourism executive, hospital administrator, research institute executive, healthcare consultant, and throughout all of that, I still feel like I haven’t even begun to scratch the surface of living yet.

I’ve never jumped out of an airplane, never scratched a lion’s belly, never skied the Alps, have never seen the Pyramids or the Taj Mahal, and haven’t visited Norway, Brazil, Argentina, Russia, China, Antarctic, South Africa, Granada, Tahiti, Australia, Peru, or New Zealand.

I’ve never seen the Himalayas, don’t know anyone named Sven, and only saw St. Petersburg on the Travel Channel.

I’ve never drank mare’s milk or eaten mule cheese. I’ve never been to Mardi Gras or the Fantasy Fest in Key West. I’ve never seen Maui, Vancouver, or Tahiti, and I’m not really sure where St Barth is in the Caribbean.

As the future comes more into focus, I must admit that, although I’m not a rich guy, there are plenty of rich guy things on my bucket list and my bucket is getting closer to that proverbial kicking tee every year.

Yes, like everyone else my age, I have some physical challenges that could eventually be problematic, as in fatal, but right now I’m still ambulatory and inquisitive, interested and attentive.

The reality that I’m facing though isn’t one of additional personal stimulation through self-indulgence.

Rather, it is how many people can I help in how many ways before I’m no longer effective? So, the conundrum of “To see or not to see.” is not really my challenge.

My challenge is “To do and how long to keep doing it.” It’s my burden, but it’s also my legacy, and my personal reward.

Darn you, mom!



Abraham Flexner – Good News – Bad News – New News

April 14th, 2015 by Nick Jacobs 1 comment »

Having spent nearly thirty years as a non-clinical, healthcare insider, the treasure trove of knowledge that I’ve accumulated has been both fascinating and frustrating.  It is very clear that the overall goal of those individuals who have chosen health care as a career path have done so with one very real goal in mind, to help their fellow man.  What is also clear to me is that there is no absolute singular pathway to that end.

When exploring the history of Western medicine, we see numerous influences:  the discovery of antibiotics, the progression of military medicine, hand washing, vaccines, and attention to drug interactions.  But there has been one other major milestone that has had a key influence on modern medicine that is not as well-known.   This was a report by Abraham Flexner produced in 1910 on “Medical Education in the United States and Canada” (The Flexner Report) for the Carnegie Foundation.

When Flexner did his research for this extensive report, traditional medicine was being challenged by several competing modalities, including: homeopathy, chiropractic medicine, naturopathy, and osteopathic medicine. Flexner noticeably mistrusted the scientific validity of all forms of medicine other than that based on pure scientific research.

As a result of his personal beliefs he endorsed only the scientifically based practices of medicine.  Any other medicine that did not promote the use of scientifically documented treatments to avoid or cure disease and illness was assumed to be synonymous with trickery and deception. Medical schools that offered training in other world health modalities were required to drop these courses or fail to receive their accreditation and financial backing. Eventually all of the schools either conformed to the Report or ceased to exist.

The complete irony of the Flexner Report was that, in spite of its faults and blemishes, it accomplished some incredible things for which we should all give thanks.  The quacks were driven from the profession, the curriculum became standardized, and the quality of physicians rose as the standards for admission became more stringent.

On the other side of that proverbial coin, virtually every other type of care that had been practiced internationally for hundreds and even thousands of years was eliminated from medicine in the United States and Canada. ( As an aside he also recommended negative admission standards toward African Americans and women.)

It has been my very unique and distinct pleasure to first be an observer, then a participant, and now an advocate for several of those evidence based modalities that were thrown out with the proverbial bath water all those many years ago.  We now know from definitive, scientific research that many of these banished treatments are not only effective, they are also amazing supplements to or work exceedingly well when integrated with standard Western Medicine and they are now evidence based as well.   Energy medicine, acupuncture, chiropractic, traditional Chinese medicine, homeopathy, and osteopathy all have a role to play in the healing arts.

In my writing and speaking engagements over the years, I’ve often referred to a poem by Samuel Walter Foss entitled The Calf Path in which he describes a journey made by a primeval calf that resulted in a path that a dog, a bell-wether sheep, and eventually men on horseback followed until it was turned into a road that bent and curved and bent again, but was blindly followed by all of those who ventured on it.  This path that was made some 200 years before and was never re-examined.   We’ve all traveled those roads.

Well, the work of Abraham Flexner created a calf path that we still follow today.  Yes, it helped to get us to a destination, but now we are so locked into the heal to the pill mentality, that we have become complacent in our exploration of wellness and prevention.

Diet, exercise, stress management, group support, unconditional love, and a dozen other things can help keep us well.  Open your minds, and open your hearts.