Wednesday, August 25, 2010

Take Love for instance-- A couple of birds- cardinals

A couple of cardinals -- "We" -- the cardinal couple
Gay Bumgarner prized the cardinal birds for their their flash of red color and their friendliness. She loved photographing them, particularly in winter when their presence seems festive, Christmas-y, brave and romantic. Cardinals became one of her specialties and the depth of her collection is astonishing-- illustrating every type of "emotional" moment especially to those willing to let fancy run free.

Suzanne Rhodes and I created a web-sampler of winter cardinals for the staff at International Animal Welfare to use to select their official holiday card. As we explored and then chose the collection we found ourselves easily spinning stories.

So, here is one for fun, the familiar story of the arc of romance. Its the same the whole world over-- whether we've two feet, four feet, feathers or fur. Join us...add a line or two, suggest a picture or a plot twist.

It starts with magic. . . Everything is easier. You speak the same language. Your step is lighter and your song is sweeter. You can't get enough of each other.

Your lives intertwine you create a home and revel in the small domestic details-- preparing meals, social gatherings, entertaining the neighbors-- together.

Then come the holidays, with all the decorating and family visits. Something creeps in, you're not on the same page anymore, everything matters and feels effortful.

And then, with the holiday festivities in the past, it breaks down altogether ...... ouch. Foreigners to each other, your eyes don't quite meet.

Things that used to make you laugh aren't funny anymore. You move stiffly past each other and say "FINE!" a lot -- and silence follows.

But then, somehow, something gives. Is it hope, habit, fatigue, or compassion? You forget you're "supposed" to be resisting and in the face of even the smallest opening, you bend towards each other. The efforts of resistance seem to evaporate. You find yourselves softening, leaning in, the roaring has quieted. Its just "us" on our branch here. Relief flows in like fresh air as the normal becomes possible and humor is in reach.

Then, on that cold winter day with snow falling continuously, the photographer came and takes your picture -- the picture up on the mantle -- it's the warmth and connection you share that day that suffuses the picture and everyone comments on. There something in the color-- is it contrast or compliment? -- something companionable, even romantic again.

The well-being and simple pleasure are earned. It's no simple feat; it may be miraculous! Good to remember everything has it season. And if you are lucky you recognize the value of each season and don't panic when it isn't always summer.
If you have never heard it listen to the song/poem "Take Love for Instance" written and read by Bobbie Louise Hawkins At the Great American Music Hall. Its free to listen once on this site, and definitely worth it. If you have problems with the link let us know.

Meanwhile, inspired by the last cardinal image we have created official holiday postage stamps If you would like to purchase these custom stamps (or others with images by Gay Bumgarner and Mother-Daughter Press) please send an EMAIL request. Same goes for cards or small mounted prints-- give someone an image that makes them smile.

Be well and tell us if you "recommend" the post (it's similar to the "like" on facebook except we could only get the word "recommend". Love to hear just that... did you "like" or enjoy it-- no heavy sign in, no justification, just sign of life response. Thanks!

Friday, August 20, 2010

Just say no: NIH director Francis Collins asks us to tweet for a festival about biomedicine and medical care.....sigh

I shall start first with an announcement and a request that I received tonight. It goes like this....

"The Inaugural USA Science & Engineering Festival will be the country’s first national science festival and will descend on the Washington, D.C. area in the Fall of 2010. The Festival promises to be the ultimate multi-cultural, multi-generational and multi-disciplinary celebration of science in the United States. On this blog, you can keep updated on Festival events and scheduling, and follow along as the Festival's organizers and presenters further discuss the ideas and themes that shape the agenda.
NIH Director Francis Collins' 5 Critical Pathways for Science
Category: shout outsocial media

We need your help to get the word out about the USA Science and Engineering Festival. Social Media cannot be done in a vacuum so we continue to ask those of you who are listening to help us get the word out through Twitter, Facebook, LinkedIn, and blogging. I think this is just another great example of how to help us get the word out. This blog was posted on Forbes Wolfe blog, Josh Wolfe is one of the Festival's Nifty Fifty Speakers as well as Francis Collins. Dr. Collins then gives insight into the role the USA Science and Engineering Festival will play in inspiring the future of science in the up and coming generations.
Thanks for helping us get the word out about the USA Science and Engineering Festival"
What follows is a short article in which Dr. Collins names "5 critical pathways for the future of health sciences"
you can check it out....
This is where I want to put my head in the water like the ducks above.

Instead I write back to them about their request to tweet or facebook or social network on behalf of the conference.  Is it just me....that is getting tired of the language and the tone?

So, here goes ..... Dear .....
With due respect to Dr. Collins I would like to disagree about some of the points made in the announcement of this conference.

In the 3rd point he stresses the need to develop a science of health care reform by measuring outcomes, assessing efficacy, and developing "personalized" medicine.  In fact, the science of health care reform would be much more important and effective if we would act on and expand the  research about what determines health and more emphatically explore the connections between social and community influences on human health.

Health reform has two main elements first, quality improvement and cost-effectiveness efforts directed at our current medical system and second, improving access to this  system for more people.  However, the five biomedical and technological areas Dr. Collins suggests in this post will not improve quality, access or reduce costs of medical care, the cannot.
We have obsessively spent our time, money, and intellect on the uni-modal biomedical model and we have tweaked the medical system enough to demonstrate that:
a. The health care system as described includes only the formal medical system and thus, includes a very limited set of places and activities. We can keep fixing the formal system and rearranging its elements but it will not produce health in the population or the individual.  Health reform efforts that  ignore community-based inputs and impacts will be limited in their reach-- in fact, the working estimate is that the health care system is responsible for only 10% of the "health" experienced by the American population although it garners 97% of health resources (dollars).  We indeed know a lot about the individual but too little about their context and how that context interacts to create or undermine "health". 
b. human health is intricately and demonstrably associated with social and psychological factors that have more "weight" than many of the traditional risk factors we are so fond of emphasizing. I think the health care reform we need is first conceptual.  What is happening in the homes and streets is more important than the hospital. If we simply improved high school graduation rates in the US we would have a more sizable and lasting effect on the health of Americans by any standard measure than any of the activities suggested in the post above. 

The health care reform needed is transformational and should include a demand by health workers and the public for a system that that produces health, promotes well-being, prevents disease, cares for illness, and assists in rehabilitation and comfort. 
I have worked with Dr. Collins and I know he appreciates that population and community forces are critical components of the "health system" and to creating health. However, what is described here is limited to the commodity of health care delivery and I fear the entire conference will be a festival celebrating genetics, the biomedical model, and simply more of the same.
Finally, I am concerned that the global health strategy of "de-risking" thus, encouraging private sector engagement assumes profitability that may not be true or good.  Some activities are investments and will not bear profits for some time if ever.  Educating children, clean water that is tested and widely accessible, fire stations, and libraries are all activities with benefits that far exceed the individual and will not likely be profitable business ventures.  In fact, I am not aware of them being profitable anywhere.   Investment in communities may sometimes require more than the profit motive and the "de-risking" alluded to-- recognizing that there was not enough space to adequately define the term-- could also come with great harm.

The announcement asks the recipient to share it through our social networks however, unless I was reassured that the conference had a more balanced and innovative plan I would actually encourage people to miss it. Thus, my twitter feed will remain quiet for now.


Sharon McDonnell MD MPH
Associate Professor Dartmouth Medical School and
The Dartmouth Institute

Thursday, August 19, 2010

Alarming Cost cutting measures-- UGH-- make a fuss

UGH!  Now what will they feed us?

Linda Hanson (Photographer San Francisco) who shared a link to a NYT article ( "Governments go to extremes as downturns wears on") and a follow up editorial in Calitics by Robert Cruickshank that
describe bone-chilling measures to cut costs in various states -- reducing school days, turning off street lights, cutting community policing-- just to name a few. After I shout at the computer and stomp around the house I wear a look on my face much like the turtle above. UGH....

The buildings, institutions, and infrastructure that we inherited from our grandparents and their grandparents rose from the urge to create the future and demonstrated their belief in a national society.  But, we have re-framed their investments and  accomplishments -- making them admirable and relevant for those days but not these.  The view of joint action and shared costs as efficient, as a sign of wealth and civilization, as a gift to our children, the same force that created firehouses, libraries, and laboratories, is now spoken of with distrust and cast as oppression -- Big Government, socialism and taxation as over-burdensome.

The long run of good fortune and global economic dominance that was the the hope then the reality for the US during most of the 20th century was a byproduct not a birthright.  The optimism that characterized Americans, and for which we were belittled and beloved, has been replaced by magical thinking and denial. I am puzzled and alarmed by our willingness to abdicate the strategies and products of our national optimism and power.  Have we really decided that well proven solutions and critical investments are not important anymore or will not benefit us or those we care about? 

It seems we no longer consider our society or community as a valuable commodity that can be created and inherited.  I want to be proud of what we have contributed.  We cannot afford to do less or to back away.  Our national security is tightly bound to much much more than military spending and selling arms.  We must not be fooled, by these "cost cutting" steps and the situation that made it necessary was constructed, partly designed, and it is not simply to be accepted.  Make a fuss.
Or, at least make a face.

Monday, August 9, 2010

Cherry Tomatoes

Photograph Gay Bumgarner Images titled "Burpee big boy and the cherries"

Cherry Tomatoes
by Anne Higgins

Suddenly it is August again, so hot,
breathless heat.
I sit on the ground
in the garden of Carmel,
picking ripe cherry tomatoes
and eating them.
They are so ripe that the skin is split,
so warm and sweet
from the attentions of the sun,
the juice bursts in my mouth,
an ecstatic taste,
and I feel that I am in the mouth of summer,
sloshing in the saliva of August.
Hummingbirds halo me there,
in the great green silence,
and my own bursting heart
splits me with life. 

"Cherry Tomatoes" by Anne Higgins, from At the Year's Elbow. © Mellen Poetry Press, 2000. Reprinted with permission. (buy now)