June 18th to the 27^th 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.

“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.

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!

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.

UPDATE:

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.

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!”