The old joke is that, if you want to make God laugh, tell Him your plans for the future.
A few years ago, I attended a high school reunion. One of my classmates asked what I'd done for work.
"High tech," I replied.
"I could have predicted that," she said.
I stopped for a moment. "I didn't," I finally mumbled.
At no time up until the time that I started working with computers, now north of 30 years ago, would I have predicted that I would have worked with computers, let alone enjoy the work. I'd had lots of very good ideas about what my life's work should be. I think that I'm glad that I got it wrong because what eventually happened was pretty good indeed.
In the New York Times Magazine piece last year, Without a Prayer, Maggie Robbins offered the Swahili phrase safari imepasua: "the journey, it has blown apart." Readers of this journal, now at its 2000th post, have seen lots of examples of very good plans that have been overcome by events. Our family has seen this happen several times in just the past few weeks. A sudden death, an unexpected turn of an illness, and all that.
Each of these twists makes us smarter, I guess. Not smarter in the way that will help us predict what we should do next. We'll make our predictions and then see what events (God?) will have to say about it.
No, the smarts that we get seem to be more about acceptance, seeing what's in front of us rather than letting what we wish for overpower our sight.
Next week, we have some meetings that will set in motion some plans for the fall. The meetings relate to care for others in our family, young and old, and care for ourselves, about work and school and home and a bunch of other stuff.
We could pray, if we had a mind to pray, that our plans will be fulfilled in the way that we expect. We'd be praying, in that sense, as a child brings a list to Santa Claus. Instead, we might do better to pray as Maggie Robbins found out. Nifundishe, she said, Swahili for "teach me."
Saturday, August 14, 2010
Friday, August 13, 2010
Friday the 13th falls on a Friday this month
If any day deserves hypervigilance, it is this Darkest Friday
Thursday, August 12, 2010
Wednesday, August 11, 2010
Parent of the year nominations are now open
via Worcester Telegram -- Police say drunk driver handed child pot pipe
More on health care
Someone close to us went to the hospital the other night because a chronic condition had turned into a crisis. They waited for hours in an ER because, otherwise, they'd have to wait weeks for an appointment that might have treated the problem in 15 minutes. This was a chronic issue that, if left unchecked, could become life-threating. Conversely, if treated well in a timely fashion, it could be just another medical issue in a collection of medical issues with which this person and her family lives.
This isn't a case of impatient patients wanting to jump the queue by elevating a concern to a crisis. This, according to the guidance given by many of support resources, is the plan. Well-connected people going through their ordinary channels could get this person to see the right medical professional in anywhere from three to eight weeks. So, for the same condition and likely the same longer-term treatment plan, the best option is one that costs probably two orders of magnitude more.
Recent studies have confirmed that many of the savings in emergency room expenses that we expected from universal coverage didn't occur. (See the Boston Globe article, Emergency room visits grow in Mass.) We got it wrong in our assumptions. We assumed that ER expenses were being driven up by uninsured people using emergency services to get free care.
Not so much. Rather, as in this case, people with health insurance come to the ER because they couldn't see their regular doctors in time. (The Globe article suggests that this is due primarily to lack of access to primary care physicians. That may be true generally, but we shouldn't overlook the issue of timely access to specialists.)
The simple and wrong solution would be to make emergency room access more difficult to obtain. Insurance companies can and will and perhaps even do make it more difficult for their customers to use their insurance at the ER without some kind of pre-authorization.
A more complete solution is more complex, primarily because lots of people are making a good living off of the current systems. To make a change involves diverting some portion of our resources from crisis management toward timely and preventative solutions. (Cue the story of the River Babies.) A few preventative services are already in the pipeline for Medicare in 2011.With a few more good ideas, we might just make it.
This isn't a case of impatient patients wanting to jump the queue by elevating a concern to a crisis. This, according to the guidance given by many of support resources, is the plan. Well-connected people going through their ordinary channels could get this person to see the right medical professional in anywhere from three to eight weeks. So, for the same condition and likely the same longer-term treatment plan, the best option is one that costs probably two orders of magnitude more.
Recent studies have confirmed that many of the savings in emergency room expenses that we expected from universal coverage didn't occur. (See the Boston Globe article, Emergency room visits grow in Mass.) We got it wrong in our assumptions. We assumed that ER expenses were being driven up by uninsured people using emergency services to get free care.
Not so much. Rather, as in this case, people with health insurance come to the ER because they couldn't see their regular doctors in time. (The Globe article suggests that this is due primarily to lack of access to primary care physicians. That may be true generally, but we shouldn't overlook the issue of timely access to specialists.)
The simple and wrong solution would be to make emergency room access more difficult to obtain. Insurance companies can and will and perhaps even do make it more difficult for their customers to use their insurance at the ER without some kind of pre-authorization.
A more complete solution is more complex, primarily because lots of people are making a good living off of the current systems. To make a change involves diverting some portion of our resources from crisis management toward timely and preventative solutions. (Cue the story of the River Babies.) A few preventative services are already in the pipeline for Medicare in 2011.With a few more good ideas, we might just make it.
Monday, August 09, 2010
A walk about nothing
The crows have much to say about the early morning as they get ready for another day of scavenging. There was a kingfisher flying low over the pond, talking as it flew. Other than that, it's pretty quiet.Marley's pretty slow, even on the downhill parts of the walk. At first, he's slow because there's a lot to sniff. Later, though, he's just slow. It takes us a half hour for the mile around the block. One joggler passed us twice, smiling each time.
Not much litter. A few name-brand cigarette packs, scratch tickets, Dunkin' coffee cups, nothing much.
There will be plenty of time for noise and urgency and drama. Today we'll learn one part of what's ahead for Sandra's mother, whether one of the elder day programs will be available for us. I may get a call from the support person who will give me instructions about how to query a video server so I can get the classids needed to complete a project that should and could have been completed more than a month ago. I might learn more about the paralegal practicum that I'm planning for this fall.
Or not.
It's been that kind of time, waiting for information or for others to complete their work so we can complete ours. It's a time of vigilant patience, clutch in, engine revved.
And so, a long walk with a slow dog is the best way to start a day. You can't hurry what won't be hurried.
Sunday, August 08, 2010
Necessity is the mother of cartoons
From Neatorama, we learn about A Train That Lays Tracks when there's time to plan a project.
In Wallace & Gromit's The Wrong Trousers, we see how it's done in times of peril.
In Wallace & Gromit's The Wrong Trousers, we see how it's done in times of peril.
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