Prejudices

February 1st, 2017 by Nick Jacobs No comments »

When I was a little boy, I remember hearing a loud explosion, looking out my window and seeing a cross burning in front of the Catholic church. My mom, a daughter of the American Revolution whose relatives had been senators and military officers, and my dad, a first generation Italian born to immigrant parents, both told me not to be afraid. They told me it was just people who liked to party on Friday nights. (By setting off dynamite and burning crosses?)

By the time I was a teenager, the terrorism toward Catholics had reached a new peak as the first Catholic was elected president and the United States traditionalists said that the Pope would literally take over running Washington. Obviously, that didn’t happen, and, in fact, John F. Kennedy became one of the most beloved presidents to serve our country. (Of course, he was also assassinated.)

As an adult, I once asked my mother if she ever knew anyone who was in the Ku Klux Klan, and she very casually said, “Only my dad when he was young.”

Growing up It was not unusual to hear derogatory remarks about the Italians, Irish, Jews, and African Americans. Interestingly, however, that bigotry had not been a major part of my high school experience. I honestly believe that was because most of the African Americans, Irish, Slovaks, and Italians were working in the coal mines, and if you were a bigot in a coal mine, the only thing your working partner had to do to get you killed was to walk away from impending danger without letting you know.

It was not until I began teaching that I saw total and complete, blatant prejudice. It was devastating and disgusting. In fact, it was not only among the students but also from some of the teachers toward the students. Consequently, I began to treat my non-white students from the Philippines, China, African American, or LGBT very special.

I was their guy, and it was easy for me because, as a musician, I didn’t see differentiators and didn’t care. All I wanted to know was how they played their instrument.

My liberal approach to these minority kids became so obvious to them that one of my gifted African American students came into my office one day and said, “Mr. Jacobs, I need to tell you something.” To which I responded, “Sure, Alicia.” She went on to say that her friends designated her to tell me to stop treating the minority kids so differently. She said, “Mr. Jacobs, we just want to be treated the same as everyone else.” That girl was 13 years old, but she taught me a lesson that has lasted for my entire life.

As the president of a research institute with brilliant scientists from all over the world, and as a student at one of the most diverse schools in America, Carnegie Mellon, I saw first-hand that intelligence, ability, and more importantly work ethic, drive, and ambition was not limited to only one race.

The only thing one has to do is watch some of the reality TV shows to see messed up people, and that’s not race based. There are gifted, kind, and not so kind people of all races.

That statement “of all races” is really where the problem begins. There truly is only one race, the human race, and liking people because of skin pigmentation, hair texture, eye shapes, or any other differentiator is a nonstarter for any of us, but hatred is definitely taught.

Some of the absolutely most beautiful people in this world are amalgams of all races, colors, and creeds. So, if you’re a hater, look in the mirror and try to determine what it is you hate. It may be looking back at you.

As Albert Einstein that famous Jewish scientist said, “What a sad era when it’s easier to smash an atom than a prejudice.”

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It’s Okay. I’m over it now.

January 24th, 2017 by Nick Jacobs No comments »

In the last three years, I’ve had a flu shot every year, two types of pneumonia shots, a shot for Hepatitis C, one for shingles, and another one for Tetanus and whooping cough, but none of them stop me from becoming disease-ridden with the dreaded flu at least once a season. For the past eight years, I’ve been blaming it on flying in airplanes filled with recirculated coughs and sneezes, but all of my work in the past three weeks has not been in the sky.

OK, I do work in hospitals, those capricious breeding grounds for hundreds of unusual infections, but I’m pretty careful when I’m in those places.

It is always intense. In fact, the intensity of this condition hasn’t changed much in 30 years. The only thing I can figure out is that my childhood allergic asthma attacks, or playing professional trumpet in smoke-filled clubs for 20 years have resulted in some type of permanent damage to my lungs. When even the littlest cold attacks my immune system, it takes every white blood cell that I can muster from my entire body to keep those sniffles from blossoming into full-blown pneumonia. (I’ve had pneumonia about six or seven times, too.)

It was about 10 years ago when a radiologist friend said to me, “Hey, Nick, do you remember breaking your ribs because they’ve definitely been broken.” Did I remember breaking my ribs? The answer to that had to have been, no, but do I remember coughing so much, so hard, so loudly, and so forcefully that the chandelier started to swing? Do I remember the dog hiding in the other room? Do I remember being banned to a Lazy Boy recliner in the basement as my sit-up bed? Yes. I do remember those things very well.

It always starts out the same. There’s a little tickle in my throat that makes me sound like Barry White or some ripped guy with washboard abs at the other end of 1-900 phone number. (Not that I would know how someone like that sounds.) But I do know how Barry White sounds, and he drives the ladies crazy. Then, by the next morning the sneezes, continuous nose dripping, and mild coughing begin. By about 7:30 p.m. that night, I’m fully immersed in humidifiers, neti pots, flannel jammy pants, gallons of fluid, Tylenol, cough drops and cough medicine, tissues, and soft animal pillows to hold against my chest to ease the pain caused as I try not to crack more ribs.

Sometimes I cough so hard it seems like losing consciousness would be a blessing, but it’s only a cold.

In my work in healthcare, it always amazes me that we can do proteomic analytics to determine what proteins are spreading cancer or heart disease. We can look at individual microbes to ascertain what’s happening with our microbiome and digestion. We can look at the 300 genes that control the metabolism of our medications so that we take the right drugs, but we can’t figure out the common cold or flu.

How many times have we heard, “The Centers for Disease Control did not guess correctly on the strain of flu this year for your flu shots?” Good luck with that. I heard this morning that 400 stray cats have been quarantined in a warehouse in New York City because they have a new version of the swine flu. I’m sure I do as well. Too bad I’m allergic to cats, or I’d go hang out there, too. Here kitty kitty kitty.

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Integrative Medicine is Becoming More Popular

January 10th, 2017 by Nick Jacobs 2 comments »

According to a recent article published by the American Hospital Association, Integrative Medicine is becoming more popular in the healthcare industry, and the major force behind this movement is primarily coming from the patients themselves.

Integrative care programs, such as acupuncture, energy medicine, and tai chi, have garnered increased acceptance among the general public, and an increasing number of hospitals and health systems are adding these integrative therapies to their menu of options.  The AHA confirms that the primary reason for this increase is actually due to individual patient demand.

Massage, music, humor, and pet therapy along with mindfulness, yoga, and acupuncture are all being more widely accepted because clinicians are incorporating these therapies into their traditional Western Medicine practices in a coordinated way.

According to the AHA, comprehensive outpatient centers specializing in Integrative Medicine operate at a high cost, and, for the most part, do not have adequate reimbursements.  Consequently, many of these centers are still dependent upon donations.

It’s been my experience that, depending on the health system’s size, location, and other factors such as economic well-being, they offer either comprehensive outpatient integrative centers or integrative services in inpatient settings. Either way, the providers have to deal with reimbursement challenges for these programs.

It is customary for many Insurers to cover acupuncture and in many states, they also provide reimbursements for massage therapy. But the primary source of payment in Integrative Medicine is still from the patients who are asked to pay for them out of pocket. In some cases, like at Highlands Hospital, in the inpatient setting, the services are offered to the patients without any charges.

Because the various treatment modalities offered in integrative medicine are still not taught in traditional medical schools, there are physicians who continue to be skeptical about their use, but the amazing results that can emanate from these programs are becoming more and more widely accepted and acknowledged.

One reason for the acceptance of these programs is the increasing number of evidence-based scientific papers that are being submitted to and accepted by traditional medical journals each year. There have been over 19,000 papers submitted on the effectiveness of acupuncture alone.

The other reason for more widespread acceptance is the now recognized positive patient outcomes. In my experience as a hospital CEO, we have seen integrative therapies shorten the patient’s length of stay and reduce the need for pain medication while improving the patient’s overall care experience.

Dr. Angela LaSalle, director of integrative services at Parkview Health System in Fort Wayne, Indiana, Dr. Kelly Warshel, director of palliative care services at the Chan Soon Shiong Medical Center at Windber, Dr. Leonard Wisneski, Chairman of the Integrative Health Policy Consortium, and Dr. Mimi Guarneri, President of the Academy of Integrative Health and Medicine are just a few of the physicians with whom I have worked to create “healing environments,” for patients.

This type of total care is integral to the overall quality of the patient experience. We have seen time and time again where Reiki, music, and mindfulness practices can decrease patient’s anxiety, and with less anxiety, the immune system has a greater opportunity to work properly.

In my experience, when we compared such benchmarks as lengths of stay, pain medication use, or patient satisfaction for patients who received integrative therapies as compared to those who did not the patients almost unanimously reported a decrease in both, pain and anxiety.

As we look for ways to decrease the use of drugs and become more active in our own health and wellness efforts, it is apparent that integrative care practitioners who combine traditional medicine with the integrative therapies are providing extremely meaningful care to their patients.

I remember hearing a prominent integrative physician state the following, “Acupuncture may not work for every patient in every situation, but the great news is it can’t hurt you.  Even if it’s done incorrectly, it releases endorphins.”

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Contemplating the advantages to healthy living

January 3rd, 2017 by Nick Jacobs No comments »

One of my first experiences back in 1992 as the new chief communications officer of a major health system was arranging for our organization to have a presence in a local health fair.

The group that arranged this event had to fill a hall that was roughly the size of afootball field. Consequently, there were some rather creative participants.

When I stopped in to see how our booth looked, I noticed an exhibitor’s booth about 20 yards away with a waiting line that extended to the front of the building.

At our booth we were giving away stress balls and ballpoint pens that looked like hypodermic needles. I wondered what they were giving away that would draw that much attention?

As I made my way over to their display, I saw that it was not a health booth, it was a booth representing a cemetery. They were selling cemetery plots. (OK, that seemed a little strange for a health fair.) The catch, however, was not the Astro turf plot on display; it was the hand-out. They were distributing T-shirts that read, “Eat right, exercise, lower your stress, and you’re still gonna die!”

In the spirit of mortality recognition, I came across a recent report from the Center for Disease Control that elaborated on some changes in the estimated number of potentially preventable deaths from the five leading causes of death here in the United States. These changes occurred between 2010 and 2014.

Number one on the list was cancer deaths. According to this chart, cancer deaths decreased by 25 percent which seems pretty encouraging. Especially when you consider that most probably 75 percent of those deaths were caused by some type of environmental contaminant being absorbed by our bodies.

The next area of decrease might have come from all of the public service announcements, improvements in blood pressure medications, and reduction in salt intake in prepared foods.

Regardless, something must be working here, too because stroke deaths have decreased by 11 percent.

A not-so-impressive change, but a change none-the-less also occurred in heart disease-related deaths which have decreased by 4 percent.

The only two increases in these top five were deaths from chronic lower respiratory disease (such as asthma, bronchitis, and emphysema) which increased 1 percent, and deaths resulting from unintentional injuries where there was a 23 percent increase.

Let’s take a closer look at this statistic.

If 28,000 people died of drug overdoses, and if over 33,000 were killed in automobile accidents, and firearms killed more than 32,000 people, what percentage of those deaths were unintentional?

Considering the fact that 2.6 million people die each year in the United States and 50 percent of those deaths come from cancer, heart, and strokes, we have to go back to my original T-shirt statement: “Eat right, exercise, manage your stress, and you’re still gonna die.” But the question becomes, “Can you die older and healthier by acting smarter?”

In Japan, Switzerland, Singapore, Australia, Spain, Iceland, Italy, Israel, and Sweden, people live on average four years longer than we do. They live at least three years longer than us in another 20 countries. These statistics place the United States as 31st in life span internationally, but we spend more on medical care in this country by far than any other country in the world.

Could it be that 78 million of us are overweight? Or maybe it’s because nearly one-third of our population, about 900,000 people, are either diabetic or pre-diabetic?

Forty-two million of us still smoke and more than 30,000 of us shoot each other to death? It may also be because we eat too much red meat and never ever exercise?

I’m not the answer guy, but I sure have plenty of ideas about this. Eat right, exercise, lower your stress, and you’re gonna live a lot longer and a lot healthier until you get your T-shirt.

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Memories of a new puppy and Pet Therapy

December 14th, 2016 by Nick Jacobs 1 comment »

It was a brisk, early, spring, weekend morning and Joanna, then a 16-year-old, now mother of four, said that we needed a transition dog. Tessie, our part-golden, part-black lab, part-border collie was getting long in the tooth, and it was our custom to always bring a replacement puppy into the house when the older dog was beginning to head toward the rainbow bridge.

So, at Jo’s insistence, we drove to a dog pound about 23 miles away. When we got there, it was closed, but she kept pushing hard for a new puppy.

We then headed for another sanctuary for abandoned dogs, a no kill shelter. That shelter was about 31 miles in the other direction. We arrived right before closing time and were directed to a room that was filled with a half dozen beautiful, little, white puppies.

The puppy that jumped the highest and yipped the most was not our choice. It was instead it’s little brother, the most loving and cuddly of the brood. The volunteer said that he was probably part sheep dog and part poodle, but we really didn’t care what he was because he was adorable.

We paid our fee, packed him up, jumped into the car and headed home to our older dog Tessie for what would become months of mothering, teaching and unconditional love and patience. Jo named him Brody, and it fit him perfectly.

Tessie taught him how and when to go to he bathroom and, she taught him to be terrified of thunder, to bark at the meter readers, to play with the cats as if they were his very best friends, and to beg from me at the table. While Brody reminded Tessie how to play, he became her adopted puppy.

One evening, a newly roasted turkey was placed on the stove to cool. While working on my computer, I heard some noise in the kitchen. The next thing I heard was puppy feet on the steps and then a thump, puppy feet and a thump, puppy feet and a thump. Then Brody, the puppy appeared at my chair, his belly was completely distended, and he smelled of turkey breath. He and Tessie had eaten the entire thing. Kind of like the Butkus dogs on “A Christmas Story.”

Well, Brody grew to be the best dog and best friend ever. In fact, when my mother visited, she would hold complete conversations with him as if he was a human being.

In her obituary I wrote that “She often scolded her sons for not talking enough to their animals.” Somehow the Pittsburgh newspaper accidentally changed that line to “She often scalded her sons for not talking enough to their animals.” Only those who knew my mom could have ever appreciated the absurdity of that printed mistake. So, when people said they were sorry and scanned my body for burn scars, I knew why.

It was about six years after he joined us that I went on a heart healthy diet that excluded all meat, and, since I was the only sucker in the family who would sneak him table scraps, he had to follow my diet. He became a vegetarian dog. In fact, with some of the new fat free products and make believe meats, I always made it a rulethat if Brody wouldn’t eat it, I wouldn’t eat it either. That diet extended both of our lives.

After Brody died my life became doggy less, and I’ve never gotten over that disconnect, but with my schedule and all of the traveling that I do, it would not be fair to either the dog or to me.

So, I always spend considerable petting time with my daughter’s dog, Chipper, and believe me when I tell you that when I’m around, he is completely spoiled in every way because I’m just a dog kinda guy.

And in Tessie’s memory I added pet therapy at the hospital while I was a CEO, and I’m still convinced that those dogs provided as much healing as many of the drugs.

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The End of the World as We KNOW IT

November 30th, 2016 by Nick Jacobs No comments »

When you think of it, every day is the end of the world as we know it because everything, and I do mean everything, changes.

There is an old myth that every cell in our body dies and is replaced within a seven- to 10-year period. Some of that is true. For example, of our 50 to 75 trillion cells, each one has its own lifespan, but there’s no clock ticking off seven or 10 years. Some die within days, but some take weeks or months. White blood cells, for example, live for more than a year while our skin cells only make it for two or three weeks. The only cells that typically last a lifetime are brain cells, but there are plenty of those know-it-alls that get damaged when we drink too much.

Nevertheless, things change all the time, and the good news is that we human beings have been very adaptable to most changes. Yes, of course, cockroaches are better at survival than us, but we’re still here. And when it comes to the number of already extinct species, that’s a pretty big deal.

The predominant question that we have now is what is going to change dramatically enough to impact us as human beings? Will it be the extra 3 billion people who will be joining us on Earth over the next decade or so? If they have a standard of living like we do here in America, it would take four more Earths just to meet their consumption wants and needs.

Will it be global warming, aka climate change? There’s a new documentary out by Leonardo DiCaprio titled “Before the Flood” that hits this problem square on. Even if you’re convinced that man doesn’t have anything directly to do with it, it’s happening. The temperature has reached a point now where we’re getting mega-storms, giant tornadoes, Category 4 and 5 hurricanes, tsunamis, floods, droughts and melting ice caps, and we haven’t really scratched the surface of where things are heading.

If you’re trying to breathe in the Carolinas right now or you want to take a very long shower in San Diego or make it to your storm cellar in time to avoid joining Dorothy in Oz when the tornado hits in the Midwest, it’s a little more frightening.

What else is changing? Clearly the politics of our country have changed, and if you’re African-American or Muslim, or an immigrant from almost anywhere, things probably feel a little less safe. It’s also more intimidating for the LGBT community, for women seeking medical attention and for those individuals who are not fully employed orwho have minimum wage jobs. Truthfully, except for the things we’re seeing on television every day, that fear is pretty much based on previous negative personal experiences or campaign rhetoric.

We might also have a sense of uneasiness when it comes to the 12 million insured who might not continue to be insured in the future or the 10,000 of us who are going on Social Security and Medicare every day. But for now that is all just apprehension of the unknown.

Finally, there is some trepidation when it comes to wars that are currently covering most of the Middle East and terrorists who are sneaking into Western countries.

Bottom line? Everything, and I do mean everything, is changing in lots of ways. Consequently, we can either get used to it, adapt to it, embrace it and recognize it, or we can hide under the table and pray that it will pass over us.

I, for one, am hoping that some very smart people address the majority of the issues listed above in ways that are better for the entire gang. Either way, we have to find some way to begin to listen to each other, to try to work together and to find common ground or only the roaches will be left.

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Obamacare

November 4th, 2016 by Nick Jacobs 1 comment »

Almost every small business owner with whom I have come in contact over the past few months has expressed deep disdain about the same thing, Obamacare.  They say things like, “Obamacare is keeping me from expanding, from growing my business, and from making any money.” What went wrong? Why did this effort to do so right end up going so wrong for the small business owner?

Dr. Donald Berwick, one of the primary architects of the Act, had a long history of working for the people.  It was my honor to meet Dr. Berwick while he was the President and CEO of the Institute for Healthcare Improvement, a not-for-profit organization dedicated to utilizing evidence-based medicine and research to improve the quality, safety and cost of healthcare. He is a genuine, caring physician who has dedicated his life to attempting to fix the most expensive, and in some ways least effective, healthcare system in the world.Before you get upset about the last statement, let me explain that we are great at what I call train wreck medicine. There is no country in the world that is better at dealing with major traumas, heart attacks, neonatal births, brain surgeries and the like. Where we fall down is in the area of population health. We do not emphasize wellness and prevention. That is one reason why nearly one-third of the United States is either diabetic or pre-diabetic.

In 2010, Barack Obama appointed Dr. Berwick to serve as the head of the Centers for Medicare and Medicaid Services. The ACA had three main objectives: expand access to health insurance, protect patients against capricious activities by insurance companies, and reduce costs. The State of Massachusetts under their Republican Governor Mitt Romney, had introduced a health insurance program that was a compromise between a single payer, socialized medicine-type program and a managed care, insurance-company-based program. The Obama administration believed this compromise would result in two distinct opportunities: 1. The Republicans would support it. 2. The insurance and pharmaceutical companies would not attempt to block passage of the program.

On December 2, 2011, Dr. Berwick resigned because of substantial Republican opposition to his appointment and his probable inability to be confirmed by the Senate. As of 2015, twenty-two states are locked into the politics of opposition, states that primarily have Republican governors who have rejected Obamacare.  This political decision has left millions of their own people uninsured.

The only way this program will work is similar to the manner in which car insurance works. Here’s the formula. Everyone has to have car insurance to drive. The majority of accidents are, however, caused by younger drivers. Consequently, older drivers are subsidizing the costs of those accidents. In Obamacare, the reverse is true.  If there aren’t enough younger people in the Obamacare program, the risk pool will not be large enough to sustain the program and the costs will continue to escalate.

Because twenty-two states didn’t participate, and the Supreme Court ruled to allow states to reject Medicaid for their poorest (roughly 7 percent of the population or 5.9 million people), the anti-Obamacare states (red states and some swing states) are able to deny health insurance to their constituents and thereby make the law seem very unfavorable.  Add to that the health insurance companies that are now dropping out of the program because the pool is not big enough.

What’s good about it?  Insurance companies can’t keep you from getting insurance because of a preexisting condition. Your children can stay on the family policy until they are 26, and millions of people who never had insurance can now get insurance. The bad news is that it needs more work and co-operation to get it right. And that is one reason why Obamacare is struggling and why costs are skyrocketing. Because of redistricting over the past thirty years, politicians don’t have to work together anymore. And that is sick.

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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.

 

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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.

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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.

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