Archive for the ‘Uncategorized’ category

Healthcare is the Third Leading Cause of DEATH in the United States

April 24th, 2017

That was a headline in an E-mail that I received today from Michelle, and the premise of the content of that E-mail was that one cause of the medical errors which contribute to a significant number of deaths in America’s hospital is the continuous use or overuse of safety alerts in Information Technology programs.  Their hypothesis was that these alert are programmed to happen so often that the healthcare professionals begin to ignore them altogether and thus miss the significant ones. They referred to this as ALERT FATIGUE.  Interesting premise and there most probably is some truth to this.

Michelle’s E-mail was promoting Wolters Kluwer Clinical Drug Information’s (CDI) Technology, and they wanted me to call them to write a blog about their technology.  Obviously, I didn’t, but they did get a free plug here so that I’d have some reason to start this entry with that attention-getting headline.  I’m sure alert fatigue plays some part in some medical errors.

But the number one cause of medical errors that can lead to death is humanness. One of my scientists would become infuriated if someone compared going to the moon to curing cancer because, according to him, the moon shot was primarily controlled through engineering and cancer cures require deep science.  Of course, he was referring only to those portions of the trip that were not science related which were, hmmm? None?  It was the combination of science and engineering that made it work, but the humans sure as heck played a major part in its success. Just like in healthcare, the medical errors can come from science and engineering, but most of all, those errors come from humans.

In my book, “Taking the Hell Out of Healthcare,”I stressed patient advocacy. At the tender age of 13, I observed my grandfather die needlessly because there was construction dust in an operating room that kept him unnecessarily bedridden for a week.   The inactivity resulted in a DVT (deep vein thrombosis) that killed him.  From that day forward, it was clear to me that the patient better have an advocate for as many hours a day as possible because it could save their life.  More importantly, it had better be someone who knows a little something about healthcare because it only takes one mistake to begin a cascade of unhappiness.

I’ve always believed there is a potential profession in patient advocacy. Physician Assistants or Nurse Practitioners could work to ensure the patient is treated, medicated, and nurtured appropriately, and they would make a small fortune from those who could afford them.

What about the rest of us? Just having someone who cares a little bit about your well-being standing nearby to ask prudent person questions when you’re sleeping, confused, or befuddled by the medical speak that’s going on around you could save your life.

I’m not a doctor, not a scientist, and surely not a genius, but I do know that humanness is what leads to errors which lead to death. Those errors are human errors. They may be because someone didn’t learn about something in school or because they forgot, or they were tired, or sleepy, or angry, or fearful, but they do happen, and if someone simply says, “What’s that pill for, and why does my friend need that pill?” It could lead to appropriate answers.

I’ve seen hundreds, no thousands of documents detailing medical errors that could have resulted in liabilities for the hospitals where I worked, and those documents always told the story of how one professional forgot to communicate something to the next professional or how someone misunderstood a written order or they didn’t check a wristband, and the story goes on and on.

Get someone. Pay someone if you must in order to stand by you. The wonderful people who work in hospitals are there because they care, but long hours, traumatic situations, labor pressures, and more contribute to accidents.  Make sure you’re not one of them.

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Planes, no trains, and Uber

April 5th, 2017

 As I had hinted at a few weeks ago, I’ve officially transitioned now from being Han Solo to being Yoda. OK, I’m not green. Yes, I’m not as smart as Yoda, and I have no secret, magical powers, but in many ways, my transition into my eighth decade has become a personal challenge to keep getting it done. I’m just not always sure what it is.

This week I flew to Los Angeles to serve as a new trustee on a board of directors at the Southern California University of the Health Sciences. The huge challenge that my daughter presented to me was to attend that board meeting on Thursday and still make it back to celebrate my birthday. All my plans were made. I would Uber to the airport, jump on the earliest red-eye flight home, spend one hour at the Newark Airport, fly to Pittsburgh, get a cab to my place, and drive to Johnstown for the beginning of a birthday bash.

At exactly 8:15 p.m., the gate agent said, “We’ll board in about 10 minutes.” Then in 15 minutes, another gate agent said, “They have discovered a malfunctioning joint on one of the airplane’s tires. We will let you know in 20 minutes if we can find another plane.” This was the dreaded reality of trying to get from one coast to the other. Remarkably, in 20 minutes they said, “We found another plane for the Newark trip. Go to Gate 71B.”

We stood in line at Gate 71B for about 45 more minutes. It was now well after midnight Eastern time, and we were all tired. Because I had no status with this airline, my seat was just a few rows in front of the back lavatory, and it was a tiny space. The boarding process was incredible with least 40 people not able to put their luggage in the overhead compartments.

We took off 84 minutes late, flew at 551 miles per hour across the United States, and landed 10 minutes after my flight to Pittsburgh left. I went to the service desk to find that the next flight was late.

Then it was canceled. Then the next flight had 20 people on the waiting list, and they anticipated that the next three flights would be canceled. But either way, my trip home would not take place that day.

It was then that I made an impulsive decision. I left the airport, went outside, and hit my Uber app. It was impossible to imagine that anyone would drive me five-and-a-half hours to Johnstown from the Newark airport without charging me at least $1,200, but then Ali pulled up in his 2016 Toyota Camry, looked at the distance of the trip, smiled and said, “No, it’s OK. Let’s go.”

Ali was from Yemen. He was a kind, a 32-year-old father of three who now lives in Brooklyn. Ali drove me through the fog, heavy rain, the wind, some ice, past lots of trucks, and he did it with skill.

We arrived in Johnstown at 3:30 p.m. I paid and then tipped him generously, but I wanted to high five him and thank him for helping me celebrate my big birthday. It was an incredible gift for me and my family.

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The chicken coop 

April 2nd, 2017

It started out as a family project and evolved into a full-blown farming experience. My daughter and her husband bought six chickens. OK, they were baby chickens, you know, – chicks, peeps. Of course, it was fun at first as each one of their kids played with them and took responsibility for feeding them, changing their bedding and providing them with water.

Throughout the spring, summer, and fall, there were plenty of frustrating days with the kids as they attempted to herd their free-range chickens into their pen for the night, and there were plenty of times when parents and kids argued over whose turn it was to collect eggs, catch chickens, and change bedding after cleaning out the pen.

Watching the coop evolution itself was fascinating as they moved their chicken family from a little coop, added fencing, and then put them in a bigger coop that was insulated-light heated.

Miraculously, those six birds made it through an entire summer without incident. Then, in the early fall, the first attack hit. Initially, they thought it was a four-legged critter, but then they found the remnants of the bird and figured it was eaten by a chicken hawk.

As the winter went on, the attacks did as well. Each call to me came with sadness and compassion as they described the latest horrific occurrence and eaten chicken. It was like they had created “Pickin’ Chicken” for the local predators. They’d tell me how the other chickens had stopped laying eggs due to PTSD, and how sad it was that their birds were becoming animal food.

As of last week, there were only two hens and a rooster left. The carnage had taken its toll on the kids, but in a discussion with my daughter this morning when she was describing how ruthless those chicken hawks are, it suddenly hit me that this experience was textbook because it was undeniably representative of real life.

Back when I was a chicken or a sitting duck, my primary boss walked into my board meeting one night and, out of the clear blue sky said, “There’s only one thing wrong with this place, and it’s Nick Jacobs. I’m making a motion that you take a vote right now to fire him, tonight.” Boom! Chickenhawk attack! Apparently, I’d upset him, and this was his response.

Just then one of my board members looked at him and said, “My father told me that there would only be afew people in my life who I would care about as a truly good friend, and I’ve felt that about Nick since the first time I met him.” Following that endorsement, the motion fell short of getting even one vote. That boss got up and stormed out of the boardroom in frustrated anger.

After this, in our own symbolic way we put fencing over the top of our figurative coop, hung shiny CDs, and got a fake owl. OK, not really, but we did take steps to protect ourselves from this human predator who was after me.

As time went on, I watched him try to take out several other hypothetical chickens inappropriately. As soon as I’d see him swooping in on someone who was competent but did not acquiesce to his bullying, I’d offer them a job. (He finally self-destructed.)

Remember, no matter how hard you try, there will always be predators lurking to bring turmoil into your life.

By the way, my daughter and family bought 10 peeps and a new coop today, and they found out it was a Fox!

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Less information, more education

March 15th, 2017

Less information, more education

Nick Jacobs

I watched the movie, “Hacksaw Ridge” and was overwhelmed by the bravery of the soldier, Desmond Doss, who was portrayed in this true story. At the same time, I was disturbed by the graphic depiction of the total insanity of war. The United States has only had 21 years of peace since 1776.

Maybe because of these continuous conflicts, many of us seem to have burrowed once again into a deep hole of fear. We fear those people who we perceive to be dissimilar to us. More importantly, however, we fear losing control. It’s that fear, perceived or real, that seems to be consuming societies across the world.

Think of it. All of the knowledge ever accumulated by mankind is virtually available to us at our fingertips, and our inability to either absorb or control that information can be the source of some of this fear and discontent. Add to that our inability to deal with the daily run of information that is intensified and modified by the 24-hour news cycle. We are inundated with the explainers, and the bloggers, the opinion columnists, talk show radio and podcast hosts who benefit from producing views that represent these extremes.

She went on to say that the other relatively new twist in all of this was our ability to directly communicate with each other in a way that has not existed since the very beginning of humankind. She explained that a young Massai boy from Tanzania could be in instant contact with his 13-year-old cousin in an apartment in Jersey City through his smartphone.

This ability to communicate so broadly can be extremely problematic for authoritarians’ governments. Someone who is trying to rule a country could have previously told unchecked lies to their people, but today those autocrats are called out by world connectivity so that only those supporters who choose to or are forced to be blinded by their lies will continue to endorse their leadership.

My son just returned from his third trip to China, and he said that, besides the totally intimidating presence of the military, there was a complete lack of access to the Internet. The outside world is virtually shut out. You are only permitted to access what the government wishes for you to access.

With all of this in mind, let’s take a few steps back and try to be objective about our personal journey and potential. What is it that we could achieve if we could just stop focusing on fear, embrace the vastness of opportunity and direct our lives accordingly.

Two weeks ago I heard a presentation by Deepak Chopra that revolved around his new book, “You Are the Universe.“ What follows is an excerpt from my notes. Ninety-six percent of the universe is unknown and unknowable. Seventy percent is dark energy and expanding. Of the 30 percent that’s left, 26 percent is dark matter that is invisible, and 4 percent is atomic. Of that four percent, 99.99 percent is dust. Consequently, only about .01 percent is the visible universe.

He went on to say that atoms are made of particles, and atoms disappear into waves. It is those WAVES which represent possibilities. So, with that in mind, your body’s atoms represent a localized adventure of the entire universe.

We are the universe, and we have the ability to lead ourselves, our country, and our world out of this funk that we currently seem to be entering. Let’s will us to personally embrace the light and stop being so very well informed and yet so incredibly unwise.

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Prejudices

February 1st, 2017

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

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

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

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

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

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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