Archive for April, 2012

What is Real and What is NOT? The Truth, or Maybe NOT . . .

April 30th, 2012

Sixty two years ago, George Orwell wrote the novel, 1984.   He described a society controlled by government where the individual had no privacy, no real freedom, and was literally put into the equivalent of a drug induced state by the pabulum of mass media television.  It was an intimidating forecast.   But now the question; how much dumber can television get with shows like:  “My Big Fat, Obnoxious Boyfriend,” “Real Housewives of  Wherever,” and “Temptation Island?” 

It was Marshall McLuhan, the Canadian educator, philosopher and academician who came up with terms like, “the global village, “medium is the message,” and the concept of the “World Wide Web” almost thirty years before Al Gore said he invented it.  Marshall described the fact that the mass media was quickly taking over our ability to think independently as we rushed into the realities of Orwell’s  Big Brother.  He explained that we would be once again living in a world of tribal drums, total interdependence and superimposed terror as opposed to thought and feelings from rational analysis.  Can you say, “Weapons of Mass Destruction?” 

The World Wide Web has placed us in a type of tribal unity for which none of us were prepared.  Why do you think tattoos are more in now than any time before 1500 B.C.?  Piercings and tattoos make you “part of the tribe.”  Hey, the majority of presidential candidate debate issues revolved around turning the clock back to the 1950’s, no web. 

It appears that, because of this tribal unity, many very obvious changes have become accepted by our current culture.  For example, according to columnist Rex Huppke, the fact that someone of any political party can say something that is completely false and stand by it makes facts meaningless and thus, dead. He goes on to theorize that, rumor and innuendo along with emphatic assertion are also part of this new communications standard. 

Dartmouth political scientist, Brendan Nyhan professes that, “In journalism, in health and education, we tend to take the attitude that more information is better, and so there’s been an assumption that if we put the correct information out there, the facts will prevail.”Nyhan says that, “Unfortunately, that’s not always true.”   Facts don’t seem to matter, and those who expose bogus facts are often more highly criticized than the person who misrepresented the truth in the first place.

We all know that the spin can change the view on any subject matter.  In many cases, it’s the quality and persuasiveness of the argument, not the facts which becomes the issue.   If you are on the right side of the spin, or if enough information can be put out there, the mass audience will be distracted from the facts, and confusion will reign supreme. 

Fact:  The United States has one of the highest infant mortality rates in the industrialized

Fact: Legislation has recently been proposed to take away additional funding for prenatal care. 

Fact:  The United States has fallen to “average” in international education scores and our State austerity measures include the laying off of teachers. 

Fact:  The incarceration rate in the United States of America is the highest in the world with only five percent of the world’s population, one-quarter of the world’s inmates are incarcerated in the United States. 

Fact:  Average annual cost per student for a public school education $8500; average annual cost per prisoner, $23,000. 

See, many of you will not know if you should believe these facts.  Some of you will fact check them.  Others will say, so what?   Some of you will look for my prejudices regarding this list, or you may be overwhelmed and say, “I can’t change any of this anyway.”  Most, however, will not bother to read this far. 

Twitter has become the new novelette and everything is a sound bite.   As Jimmy Kimmel said, “What’s back and white and read all over? Nothing anymore.”


Temporary Insanity

April 2nd, 2012

When Clayton Osbon, the pilot of that Jet Blue plane lost it a few weeks ago, the entire world stepped back and asked what was wrong?  Did the weight loss shakes that he sold somehow impact his neurons?  Was he so sleep deprived that he became in-congruent?  What made him snap?  Everyone described him as a rock solid, non-controversial human being, and all of his neighbors, friends and family were shocked by his actions.  

Interestingly, while listening to a talking head about the soldier, Staff Sergeant Robert Bales, who was accused of killing 17 Afghan citizens, the commentator indicated that, sleep deprivation and stress can turn any human being into a moral moron. “Your decisions become so clouded and incongruent that anything becomes possible,” he said.

As a hospital CEO, one of my saddest physician practice memories occurred when one of our top docs began speaking in incomprehensible sentences and acting erratically.   The result was an agreed upon early retirement after which he came back to his full, normal functional capacity.  In a casual conversation with him months later, he believed that he had embraced a personal diagnosis.  You see, he had been working, taking calls, and visiting patients late into the night and was back on the floors by 5 AM every morning.  He attributed his incoherent activities to his sleep deprivation.

Now to a very disconcerting Pittsburgh meltdown; last week a highly respected, top CEO in this area cracked and was arrested for fighting with the husband of his mistress.  His listed salary was about $4,000,000, but more importantly, he was working to lead his organization in a new direction that could literally be a prime example of what may be possible in the new health care arena of these United States. 

Dr. Ken Melani was leading the way in the creation of an Accountable Care Organization that would cover all aspects of healthcare from cradle to grave.  His path was truly one of great risk, amazing strength, and deep understanding of the new Healthcare Reform legislation. It meant taking on the UPMC juggernaut while preserving choice in healthcare in the Pittsburgh region.  It also meant managing numerous very strong personalities who either agreed, disagreed, or thought they could do whatever was to be done in a better way than their leader. 

 Literally at stake were millions and millions of dollars and a $1.2B debt was also knocked into the risk portfolio because of Dr. Melani’s meltdown.   More importantly, however, in this “Battle of the Titans” was the two million or so patients who would be blocked out of the competitions health system when Highmark stood its ground. 

Many countries regulate the work week by law, such as stipulating minimum daily rest periods, annual holidays and a maximum number of working hours per week.  During a conversation with the wife of the Finance Minister in the Netherlands, I told her I would see her in August to which she replied, “You really don’t understand, do you?   We threw out the Pilgrims and Puritans and you still live by their standards.  We have 54 days off a year, and no one will be here in August.” 

It’s a well known fact that US workers put in the longest hours on the job in industrialized nations, and we are spending the most on our health in the United States with some of the worst outcomes, and we are the ONLY nation that does not provide health coverage for its population. Bottom line, maybe Dr. Melani,   Staff Sgt Bales  and Capt Clayton Osborn all needed a break.   Battle fatigue can be a dangerous enemy, and the results can be both economically and physically lethal.  We can’t turn back the clock for any of these individuals, but we can learn to carve out 20 or 40 minutes a day to nurture ourselves, to breathe deeply and to rid our minds of the unnecessary.   Change or DIE