Friday, December 11, 2020

Treatment of Minors with Gender Dysphoria

 

First, the media story:

On Tuesday, Britain’s High Court defended young children from the transgender movement’s rush to give kids experimental drugs that put them on a path to chemical castration. The court laid out a framework for considering whether minors under age 18 might be able to give informed consent to receive experimental so-called “puberty-blocking” drugs intended to treat gender dysphoria (the persistent condition of identifying with a gender opposite one’s biological sex).

In a groundbreaking ruling that should set the standard for such complex issues, Dame Victoria Sharp concluded that puberty-blockers are experimental, that their effects are not “reversible” as transgender activists claim, and that in order to consent to receive such drastic treatment, children must understand adult concepts that are almost certainly beyond their grasp. 

Let me start off with something that is ignored in the above but explained later that puts a slightly different spin on things. 

Sharp described the use of puberty-blockers for children going through puberty at the right age as “very unusual” because “there is real uncertainty over the short and long-term consequences of the treatment with very limited evidence as to its efficacy, or indeed quite what it is seeking to achieve.”

Worse, “there is a lack of clarity over the purpose of the treatment.” While GIDS has claimed that puberty-blockers give children a “pause to think” about gender identity before they proceed to irreversible cross-sex hormones, transgender advocates have also suggested that puberty-blockers “limit the effects of puberty, and thus the need for greater surgical and chemical intervention later” in cases where a child persists in his or her transgender identity.

Finally, “the consequences of the treatment are highly complex and potentially lifelong and life changing in the most fundamental way imaginable. The treatment goes to the heart of an individual’s identity, and is thus, quite possibly, unique as a medical treatment.” 

The blockers do not, of themselves, cause permanent sterility.  It is the cross-sex hormones that do that.  But what is concerning to them is that less than 2% of those that go onto puberty blockers come off them and resume their standard puberty. Because of the low rate of rejection, puberty blockers are considered the first step in the process of reassignment and the consequences of that process IS complex and far reaching. 

I don’t have a problem with puberty blockers, even for pre-pubescent kids. My concern is that minors are not getting GOOD support and advice from the adults around them.  Parents are not evaluating the child’s full history; they seek to respond to the societal pressures for resolution of issues with clear dimensions.  And the medical community appears to be too compromised to treat each child as a unique patient, rather to treat kids with an assembly line approach to ‘get’m in, get’m out’ cookie-cutter approach.

The details of the case are informative:

GIDS set Bell on a path to puberty-blockers at age 16 and she started taking testosterone at 17. By age 20, she realized “the vision I had as a teenager of becoming male was strictly a fantasy and that it was not possible. My biological make-up was still female and it showed, no matter how much testosterone was in my system or how much I would go to the gym. … I felt like a fraud and I began to feel more lost, isolated and confused than I did when I was pre-transition.” 

Three things here: she had already entered puberty, within a year she was on cross-sex hormones, her expectations were unrealistic, and she had non-gender related unresolved prior to transition.

Once she had begun menses and had breast development, only surgical intervention would have changed them.  Testosterone would not of itself change them – though menses probably would have been interrupted.  The time on blockers was relatively short – this is the time for consideration and determination of underlying issues.  The idea that her expectations were ‘a fantasy’ is something that could have been resolved in a therapeutic setting but apparently was not. The medical community’s fast tracking or accepting the conclusions of a teen as sufficient evidence of appropriateness is malpractice.

For the female to male transsexual, hormones have a STRONG impact that can not be reversed even early in the process.  Voice change and hair growth can start as soon as 60 days into treatment.  For the male to female changes often take six months or more and are far more subtle and easily reversible.  For that reason alone, the female to male needs to be much better informed and treated carefully than the male to female.

You can not treat the female-to-male and the male-to-female transsexual the same medically. Timing and extent of puberty, impact and societal influences are different for both and need to be addressed differently.

And this bothers me greatly:

Bell claimed that she could not have consented to puberty-blockers at her age. Dame Sharp considered whether or not a 16-year-old child could be considered competent to consent to such an experimental “treatment” under the precedent of Gillick v. West Norfolk and Wisbech Health Authority (1986), in which the High Court ruled that minors could consent to receive contraception. 

This is saying I need to be able to control my body at 16 and then having regretted the decisions telling everyone it’s their fault for letting them have the control. My problem is less with the child than with the adults around them. 

However, I also have a problem with this:

Yet the use of puberty-blockers to treat gender dysphoria is experimental. In such cases, “the consequences of the treatment are profound, the benefits unclear and the long-term consequences to a material degree unknown.” In such cases, informed consent may be impossible, especially for children under age 16 who think of themselves as transgender. 

It is not experimental.  The effects are well-known.  The consequences ARE profound, the benefits are clear, and the long-term consequences can be judged.  But two things have to happen: the child MUST be evaluated objectively, free from societal pressures and impacts such as granting consent by self-identification; the medical community must be assured that the full history of the child, free of prejudice, is considered and their current state of mind and expectations are rational. 

Stopping puberty in a child with gender dysphoria is a blessing.  The betrayal of the body when dealing with the issue of gender dysphoria has a profoundly negative impact on their self-worth and evaluation.  If there are other mental health issues, they MUST be addressed prior to moving to cross-sex hormones.  If they cannot, then changing sex is likely to be an additional burden rather than helpful. 

Even the following clearly fails to understand the nature of gender identity and the issue of gender dysphoria:

Even puberty-blockers do not make time stand still. They prevent a child from going through puberty in the normal process. At a minimum, this deprives him or her of “undergoing the physical and consequential psychological changes which would contribute to the understanding of a person’s identity.” 

A person’s gender identity is established well before puberty. Other aspects of their personality continue to develop during, and after, puberty.  But the physical and psychological changes of puberty can damage a child with gender dysphoria.  Clear understanding by the parents and medical community caring for the child is needed – and right now, I have little confidence in either.  And the court’s order, and the article’s author are insufficient to help fix it. 

In order to achieve competence to consent to transgender treatment, children must understand eight factors, according to Sharp:

(i) the immediate consequences of the treatment in physical and psychological terms; (ii) the fact that the vast majority of patients taking PBs go on to CSH and therefore that s/he is on a pathway to much greater medical interventions; (iii) the relationship between taking CSH and subsequent surgery, with the implications of such surgery; (iv) the fact that CSH may well lead to a loss of fertility; (v) the impact of CSH on sexual function; (vi) the impact that taking this step on this treatment pathway may have on future and life-long relationships; (vii) the unknown physical consequences of taking PBs; and (viii) the fact that the evidence base for this treatment is as yet highly uncertain.

 

Children lack the ability to understand what fertility and sexual fulfillment will mean to them as adults. As Sharp wrote, “the meaning of sexual fulfilment, and what the implications of treatment may be for this in the future, will be impossible for many children to comprehend.”

I’d argue ADULTS lack the ability to clearly understand all the consequences if their mental health is compromised in any way.  The demands of the Court shows little understanding of gender dysphoria or the development of children with it.

The criteria of the Court, rightly expressed by the article’s author, will result in few if any applications of puberty blockers to those under 16 or even 18.  And I think that is a failure of the Court and of the effort to protect children.

 

Friday, September 11, 2020

September 11, 2001, In memoriam: Barbara (Bobbi) Arestegui

Posted annually on 9/11 since 2006 (I've missed a few, my apologies to Bobbi)

September 11, 2001, 7:59am, United Flight 11 leaves Boston's Logan airport.

In just a few short minutes, Barbara (Bobbi) Arestegui, 38, of Marstons Mills, Massachusetts would be one of the first casualties of that day. Assigned to the First Class cabin, Bobbi and fellow attendant Karen Martin were attacked shortly after takeoff.


In less than 40 minutes, the rest of the crew and passengers of Flight 11 died in the North Tower of the World Trade Center.

There are no public posts from friends or family on Bobbi. Two stories were published about her and her boyfriend Wayne. From them, the information below is shared.


"The first thing I noticed, of course, was that she is absolutely beautiful," he said. "We had a nice talk, probably for about 15 minutes. I asked her if it would be possible to get her phone number."

She told him sternly: "No, I don't give out my home number."

Wayne shrugged his shoulders and walked away, thinking: I gave it my best shot. She stopped him with one word.

"But," she said.
He turned.
"I'll give it to you."

She was living in Washington, D.C., the middle of five girls from a California family with Spanish Basque roots. Two of the girls would join the tight-knit community of flight attendants.

Her typical schedule was three or four days on followed by three or four days home.

She turned their house into a cozy retreat with a garden out back. They made a habit of walking the cranberry bogs, picking blueberries and having breakfast at the Mills Restaurant. She loved to cook - she dreamed of attending culinary school.

Bobbi picked up three stray and abused cats: Olive, Bruiser and Pumpkin. She'd loved animals since she was a kid in Hawthorne, a suburb of Los Angeles.

"She was a gentle person, yet tough when she needed to be," said Rosie Arestegui, who gave her daughter Barbara the nickname Bobbi. "She knew her job so well. She could do two or three people's work, plus hers, and it would be done perfectly."

Colleagues of Bobbi repeated that praise when Wayne met them in Boston on Friday. He talked with more than 50 people who knew his girlfriend through work. They remembered her as energetic; a huge heart in a 5-foot-3-inch frame.

Bobbi was not scheduled to work Flight 11 that day. But she had accepted extra flights; she was saving up her earned vacation to take a trip with Wayne at the end of September.

She got up about 2:30 that morning and within a few hours was out the door.

"Usually she wakes me up when she leaves. She didn't wake me up this time," he said.

But she did keep another of their rituals: At 6:45 a.m., he got a phone call from the airport.

"She told me that she was just about to board. She was waiting for them to finish cleaning the plane," he said. "She was in a wonderful mood, better than normal."


To view other sites honoring those that died on 9/11

Links:
http://www.september11victims.com/september11Victims/VictimInfo.asp?ID=3
http://www.flightattendants.org/Memorials/AA_FA_Barbara_Arestegui.htm
http://www.inmemoriamonline.net/Profiles/Folders/A_Folder/Arestegui_Barbara-(AA11).html
http://www.capecodonline.com/special/terror/changessubtle11.htm

Tuesday, August 20, 2019

Day 3 - Texas: The Setup




I needed to get to south central Texas to visit with Economic Development people in anticipation that Seethuma's Lab would likely be sited somewhere around Houston. 


First stop though was Dallas.  I decided on the 'southern' route as it would give me the most Interstate driving.  Going through Fort Worth and Dallas during rush hour was going to slow me a little at the end of the day.

I was here to meet nephew Erik but he was tied up with work until the late evening so we planned on getting together for breakfast before I turned south.

The plains of Texas offer about the same as New Mexico, ie not much.  Only one view was worth it and it only lasted a few moments, coming out of the high plains of Western Texas to the plains of Central Texas east of Abilene.  Trust me, it wasn't worth the wait.





I'm sure you can see the difference.....not.

There is one thing that I have seen a lot of on this first couple of days that I would see a lot more of:



Wind farms.  Lots of wind farms.  And with VERY few exceptions, more than 3/4ths of those turbines were NOT moving.  Blame the weather, blame the time of year, but I saw a lot more statues than moving generators.

I pulled into Dallas just about 7pm and settled in after a burger and a Fanta.

Day 3 is done.

Day 2 - A Brief Pause

I knew before I got to Clovis that Christopher, Rosann and the girls were going to still be there visiting his parents.  I had surprised Chris and family in Vegas earlier in the month on their way to Clovis but I was going to enjoy a slightly longer visit with them here.

I needed to spend time with Steve to discuss family business but also to reset the clock for the rest of the trip: A sequence of events that would put me in Atlanta at the right time.

After a good night's sleep to recover from the previous 36 hours, bacon and eggs cooked by Steve's wife Marietta along with some pancakes hit the spot.  Steve and Chris were already at work on the back porch when I finished breakfast.  We spent the next several hours basically picking up talking where we left off the night before.  But, we had a whole day and I suggested Rosann and I take the girls to the Mall and wander for a while.

Clovis is not a big town.  It is a military town but Cannon AFB is kind of a backwoods base. And during the heat of the summer, people have a tendency to stay indoors.  It's mall is small and not well endowed.  Still, it offered a few places to stick a head into.

After, we got some drinks at Sonic and headed to a park to enjoy the afternoon.





A little bit of watching the ducks and geese and people fishing in 90+ weather.  And we were ready to go back for some dinner.  The plan for the evening was a rematch of the miniature golf round we had in Las Vegas.  But afternoon thunderstorms are common on the plains and Clovis is close enough to spawn it's share.  By early dusk we were surrounded by nature's light shows.  And fortunately, we got our round in while also getting some go-cart time in.  Ok, "I" didn't race the go-carts but the rest did!



While the surrounding areas were dealing with flooding and violent storms, we were in the eye of the storms and enjoying a warm humid summer evening with a nice breeze.

If you remember the scene from Twister where they were near a Drive-in Theatre getting drinks then you will get an idea of what we were dealing with....minus the tornado crashing the party!.

It was an enjoyable visit and time with family.  Tomorrow, back on the road.

Day 2 is done.

Monday, August 19, 2019

Day 1 - The Starting Gun

Crossing the desert southwest during the day, in the summer, is an exercise in man/machine balance.  The road surface can be hot enough to cook food on and tires can actually get softer as you travel, especially at speeds over 70mph.  And the Sun beating on windows can challenge even the best air conditioning.

So, I cheat.  I make the first day of travel east at night.  Now, the air temperatures don't moderate that much during the peak of the summer, but surfaces tend to let off their heat quickly making it a little easier on the vehicle performance.

I got up as usual and planned on a good nap late in the afternoon.  I left my packing for today because I knew it wouldn't take long.  Except, well, it did.  I started thinking of temperatures and potential weather changes and then tried to minimize the amount of clothes for each potential situation.  Over the years of traveling with CJ and Victoria we had a pretty good system: one big suitcase for Victoria and me, a small suitcase for CJ and a bag with all the toiletries.  A snack bag rounded out our needs.  I was only 1/2 way done packing and the big suitcase was full, as was the small one.  I thought I had a garment bag but had to borrow one for my dresses (just 3) and suits.  But the rucksack bag that had NOTHING but shoes and purses was just nuts!  Sigh....this wasn't going well.  Adding makeup and jewelry and toiletries, and since I was driving, a makeup mirror and light added two more bags.  By the time I was done: two suitcases, garment bag, three overnight bags, a rucksack bag, a book bag, my laptop and two pillows.

I needed Skycap just to get everything TO the car...

Unfortunately, work beckoned and I spent 2.5 hours getting petitions ready that I had not planned on doing.  Along with packing and getting the car ready, it was already 5pm and I really needed a shower. I tried to relax in my chair but if I was leaving by 7pm I didn't really leave myself any time for a good nap. I ended up resting, but not actually sleeping for 45 minutes before getting up and getting myself ready.

7pm came and went with me still sitting in Lemon Grove.  I kept looking at the map of the first leg and realized I was going to be getting to Las Cruces really early.  I had touched bases with Deanna to have breakfast but if I left at 7pm, I'd be getting to LC around 6am.  So, I ordered a couple of pizzas for me to have something to eat and to treat my neighbors for the loaning of the garment bag (that one of them had to go to their storage unit to dig out!).  I ate half a pizza.

I finally hit the road by 8pm with a full stomach and tank of gas.  Oh, and a large Fanta Orange from McDonalds.  That orange was going to be a permanent companion on this trip but I did have my water bottle full and available too.


Trip counter set to 0.  Interstate 8 just a short jaunt away and into the mountains I plunged.  It would be dark by the time I got over them and faced, the desert.




It was in the 90s today in Lemon Grove but here, at 9:30pm, it was 105.  The temperature would not drop below 100 for the next 6 hours.

Traveling across the desert at night is not much different, if cooler, than doing it during the day.  There is nothing to see except vast expanses of barren mountains and scrub brush covered sand.  Hundreds of miles of the same scenes.  Now, if you've never been to the desert, seeing it for the first time is interesting.  I even recommend doing it, during the day, during the summer.  Get somewhere in the middle of it and get off at an exit ramp (there are plenty going to ....no where) and step out of your air conditioned car.

It's a DRY HEAT.

For people used to humidity, it will literally shock you.  My response to 'its a dry heat' is to suggest sticking your head into an oven.  It's a dry heat too.  Well, if the temp is 110+ and the Sun is shining, you'll get a good feel for the next turkey you stick in that well prepared oven.

Traveling alone, on empty stretches of desert highway seems to scare some people.  I find it relaxing.  No music or radio.  Just relax and enjoy the silence....as silent as your car is at 75mph.

Lest you think there is nothing to see if you travel during the day, at least via I-8, there is a place in the desert where it is not brown and shades of sand:





We are so rich, we plant crops in the desert.




Once I passed Gila Bend I would be covering new ground for me.  Normally I would cut north at Gila and head for Phoenix before heading even further north to Flagstaff before heading further east.  But shortly I-8 would merge with I-10.  I-10 and I would cover lots of new ground on this trip but only in segments.

Tuscon was the first stop for gas.  I wasn't going to need it but from Tuscon to Las Cruces, in the middle of the night, my options for gas were going to be limited.  A full tank in Tuscon was going to get me to Las Cruces and beyond.

About 100 miles west of Las Cruces I realized I was still going to be REALLY early.  I had made good time and figured this was a good opportunity to take that nap I had missed all day Friday.  I pulled off and took a good hour nap.  It had finally dropped below 100 and was in the low 90s.  With the breeze and the windows open it was comfortable enough.  Adding in the time change to Mountain and I pulled into Las Cruces at 7:30a, 8:30a local.

I woke Deanna up and got her suggestion for where to meet into Maps and plugged into The Shed.  Like most 'neighborhood' places, it is not a tourist's place.  Deanna came in and we settled into catching up.  For some reason I thought her sister Michelle was in Clovis but nope, she was in Las Cruces too but was working and we couldn't see each other...but I would get a chance to see her shop!

Turned out Michelle was at the shop when we stopped by and I got a tour and a short chance to catch up with her.  While I was saying my goodbyes, their brother Christopher called me.  I left the girls and by 10a I was back on the road talking to Chris and off I-10 headed for my first 'stop', Clovis NM.





Forty-five minutes later, Chris was off the phone and I needed to stop in Alamogordo.  I was getting too sleepy to keep going so I pulled into a parking lot and crashed for 45 minutes.  Long stretches of nothing were now getting to me.  Even if the 'nothing' was actually, something:






I wasn't going to need gas before getting to Clovis but I was going to be under 100 miles left in the tank.  Exactly how much I would have left was going to be an issue.  Turned out that I got the 'Low Fuel' warning just 5 miles outside of town.

The issue was...I didn't remember Steve's address (my brother in Clovis whom I kinda just assumed I could crash with!), AND...my phone had less than 5% battery.  I waited til I go into town before calling and he told me to go to 21st and turn.......phone died.

He wasn't home and figured where I was approximately and got close enough to watch the road for me.  We saw each other about the same moment and I followed him the rest of the way to his place.

Oh, I would have turned the wrong way.

It would be the 2nd longest distance day of travel but at the time I figured it to be the longest time : 995 miles from my house to Steve's.  It had been 21.5 hours since I'd left Lemon Grove.

Day 1 done.

Sunday, August 18, 2019

Day 19 - The Search for Victoria's Final Resting Place




Waking up in Kearney the Sun was shining but the haze of humidity made it look like fog had just burned off.  I dressed and packed quickly.  This was going to be a big day of driving.  I didn't get to North Platte as planned but was surprised how close to Denver I was.  I had planned to reach Denver by lunchtime and even stopping short of North Platte was not going to harm that plan.

I got a sausage biscuit, milk and a Fanta and was on the road by 8:15a.  I looked at the mileage and figured on lunch and gas in Denver.  I wanted a full tank heading into the mountains.

As noted, Nebraska doesn't offer much scenic awes.  And the western part of the state is no exception.



The only odd point is that the time zone change doesn't happen at the state border but well before it.  Maybe they just wanted to be considered 'Mountain' to alleviate the 'plain' landscape.  But VERY shortly after crossing into Colorado and getting off I-80 and onto I-76, the landscape changes and we start our slow climb into Denver.  Five thousand feet over the next almost 200 miles of bare rolling hills and bad radio reception.  I hate this stretch.




Not for the lack of views, but because I got a very expensive 30+ miles over the limit speeding ticket on my very first drive through here back in 1978.  Assholes.  I had to travel to the courthouse and pay the fine before being allowed to continue.  It was my SECOND ticket in as many days.  The other was of course in....NORTH PLATTE NE!  I really hate this stretch and though I've driven it 5 or 6 times since without incident...it still grates to this day.

I got to Denver (Alt 5,278': Basically from this point all location signs have ALTITUDE instead of POPULATION figures!  It is more relevant as most places in Colorado are small towns) around 1pm and spent 45 minutes getting some Arby's new Kings Hawaiian Bread sliders, a Fanta and gas.

Maybe it was the weight of the gas or the thinness of the air, but the 'get-up and go' of the car had definitely left.  I climbed out of Denver to Loveland Pass mostly in the right lane as a slow-poke.



And the mileage hit - DAMN! -  as low as 19mpg on some of the climbs.  I didn't start looking for my target sign SCENIC DRIVE until I passed Vail.  By then I noticed that the average mpg was actually better than I expected, over 38mpg.


Okay...not fair showing it as I saw it...during the summer.   Here is a shot of it in the winter.  Just know I've never been there then!



Loveland is generally the last stop if winter storms are slamming Colorado's mountains.  They close I-70 and turn everyone around.  Chains are required to be carried by trucks.  The Pass is dominated by the Eisenhower Tunnel through the mountains.  The tunnel is 800 feet below the Pass' 11,990 foot summit.  I have a picture of me at the actual summit sign taken by Victoria during our 1994 trip through the area.  It is not the only tunnel on this stretch.  Mountain tunnels amaze me.  As a feat of engineering they are more difficult than building 100 story skyscrapers.  Note we have a harder time going to the bottom of the ocean than into space.




I stopped at Grizzy Creek reststop to get ready for what I expected to be a 3-4 hour run in the mountains with no services.  The stop is buried in the canyon along the Colorado River. You can jump into the river, drop a raft or kayak or just walk on the rocks along the bank - something I did with CJ on the trip we found Victoria's Resting Place. Amtrak's California Zephyr runs along the river too and it was passing as I got out of the car.  I waved at it's Observation Car but didn't see anyone return the gesture.  Rafts were making their way past the stop at the same time and I knew from the last time in the area, the water was cold!  A map in the building gave me hope that my goal was soon to be in reach!



Pitstop done, the search intensifies!

Victoria and I passed through Glenwood Springs several times over the years and even CJ liked one of the tourist gift stores we stopped at once.  We occasionally thought of moving to the area just south of Glenwood and changing our last names to Snow.  The mountains are right in your face along the roads and snow is noticeable on the peaks year round.

I didn't really worry that the sign existed prior to Glenwood Springs but watched nonetheless.  At Glenwood Springs I noticed they had a CULVERS!  So I stopped and grabbed a doublescoop chocolate sundae with strawberries and settled in for the search. At the time I thought this was the furthest West Culvers had come but, nope...

It will be the next exit!  Ok...the NEXT exit.  For sure the next one.  Surely it has to be this one, we are getting closer to Grand Junction and I know that is too far.  I set a limit.  Parachute CO was too close to Grand Junction and if I didn't see the sign by then I was going back to Glenwood Springs and take 82 down to 133.  I was fairly certain that WASN'T the right path, but I didn't even see roads going south into the mountains anywhere. 

Forty-five minutes out of Glenwood I hit Parachute and turned around.  It has been 13 or so years since we were here, the sign could have been taken down, destroyed in the winters or I just plain missed it.  By the time I got back to Glenwood it was after 6pm and I only had two hours of sunlight.  Well, three actually because the local time was Mountain and my start had been in Central time.  I didn't change the clock on the car or my notes until I woke up in the new time zone.

Shortly after turning south on 82, I ran into roadwork that dramatically slowed me.  Miles and miles of work with huge (for the location) traffic jams.  I was even out of Fanta but didn't stop.  I finally made it to 133 and was the only car that turned off.  Two lane mountain driving is amongst the most scenic of drives and this was no exception but I also knew, KNEW I was not on the right road.




My only hope was I would come out on the backside close to the right place.  I eventually ended up the middle vehicle of a three car caravan through the mountains.

McClure Pass is just over 10,000 and a 3,300 ft climb out of Glenwood.



It was considerably GREENER when I was there! More than an hour later I hit Delta and knew I'd missed any chance of finding the right spot today.  I headed north to get to Parachute to double check the last stretch of road prior to Grand Junction and get some dinner.  It was getting dark and my choices were to stop in Grand Junction for the night and resume the search the next day or abandon the search this time and just head back to San Diego and more map work. 

I got a burger and chicken sandwich along with another Fanta - I'd been dry for hours and hit the road.  Full on dark as I planned to hit the I-70 / I-15 interchange and figured there'd be a place to crash there.  But before I could get there, I had to cross the STRETCH....






I stopped in Green River and got gas. I figured I could make it all the way, but I didn't want to risk it.  Believe it or not, I was getting 42mpg with all the mountain driving and I had 532 miles on the tank and it said I had almost another 200 still available.  Still, it was almost 10pm, dark and I was crossing a stretch of road with nothing on it.  Really, nothing.  There were times when I went 30 minutes without seeing another vehicle on my side of the road.

The Moon was getting close to full so, turning off my headlights I could just make out the road but at 70mph I wasn't going to risk it for long.  I DID get to see this though even in the darkness:



But the dullness of the ride at this point was not drowsiness inducing.  It was midnight and I'd been in the driver's seat for 16 hours.  Call me the Energizer....or I was just Fanta induced sugar alert.  My plan of finding a place to stay at the interchange was calling me.  I passed through Richfield UT that had plenty of potential sleeping places but I wanted to see how far I would have left to go when I made the turn....



Which had ABSOLUTELY NOTHING around it.  Sigh.  I was going to have to go some distance before finding something.  Fortunately not long.  Less than 30 minutes later I would pull into Beaver UT with a Super 8 right off the exit ramp and plenty of rooms.  It was 2am by my clock and 1am local. 

I had spent 16 hrs on the road, gotten over 40mpg on the gas and traveled over 1,000 miles in a single day.  It would be days before I figured out exactly how far I went: 1,082 miles.

2am.  Day 19 is finally done.












Tuesday, September 11, 2018

September 11, 2001, In memoriam: Barbara (Bobbi) Arestegui

Posted annually on 9/11 since 2006 (I've missed a few, my apologies to Bobbi)

September 11, 2001, 7:59am, United Flight 11 leaves Boston's Logan airport.

In just a few short minutes, Barbara (Bobbi) Arestegui, 38, of Marstons Mills, Massachusetts would be one of the first casualties of that day. Assigned to the First Class cabin, Bobbi and fellow attendant Karen Martin were attacked shortly after takeoff.


In less than 40 minutes, the rest of the crew and passengers of Flight 11 died in the North Tower of the World Trade Center.

There are no public posts from friends or family on Bobbi. Two stories were published about her and her boyfriend Wayne. From them, the information below is shared.


"The first thing I noticed, of course, was that she is absolutely beautiful," he said. "We had a nice talk, probably for about 15 minutes. I asked her if it would be possible to get her phone number."

She told him sternly: "No, I don't give out my home number."

Wayne shrugged his shoulders and walked away, thinking: I gave it my best shot. She stopped him with one word.

"But," she said.
He turned.
"I'll give it to you."

She was living in Washington, D.C., the middle of five girls from a California family with Spanish Basque roots. Two of the girls would join the tight-knit community of flight attendants.

Her typical schedule was three or four days on followed by three or four days home.

She turned their house into a cozy retreat with a garden out back. They made a habit of walking the cranberry bogs, picking blueberries and having breakfast at the Mills Restaurant. She loved to cook - she dreamed of attending culinary school.

Bobbi picked up three stray and abused cats: Olive, Bruiser and Pumpkin. She'd loved animals since she was a kid in Hawthorne, a suburb of Los Angeles.

"She was a gentle person, yet tough when she needed to be," said Rosie Arestegui, who gave her daughter Barbara the nickname Bobbi. "She knew her job so well. She could do two or three people's work, plus hers, and it would be done perfectly."

Colleagues of Bobbi repeated that praise when Wayne met them in Boston on Friday. He talked with more than 50 people who knew his girlfriend through work. They remembered her as energetic; a huge heart in a 5-foot-3-inch frame.

Bobbi was not scheduled to work Flight 11 that day. But she had accepted extra flights; she was saving up her earned vacation to take a trip with Wayne at the end of September.

She got up about 2:30 that morning and within a few hours was out the door.

"Usually she wakes me up when she leaves. She didn't wake me up this time," he said.

But she did keep another of their rituals: At 6:45 a.m., he got a phone call from the airport.

"She told me that she was just about to board. She was waiting for them to finish cleaning the plane," he said. "She was in a wonderful mood, better than normal."


To view other sites honoring those that died on 9/11

Links:
http://www.september11victims.com/september11Victims/VictimInfo.asp?ID=3
http://www.flightattendants.org/Memorials/AA_FA_Barbara_Arestegui.htm
http://www.inmemoriamonline.net/Profiles/Folders/A_Folder/Arestegui_Barbara-(AA11).html
http://www.capecodonline.com/special/terror/changessubtle11.htm

Sunday, November 19, 2017

How much does it cost for a hospital to treat a patient?

I am about to make some statements that are going to change the way you think about health care and health costs. Please try to remain calm.


I want you to imagine your local hospital. Think of all the doctors, nurses, support staff, buildings, and equipment.

Now, let's pretend two things:

1. That over the course of a single year, the total salaries for all the doctors, nurses and staff, the cost of all the utilities and supplies needed to operate the building totals $50,000,000. Now let's say that I GIVE that $50,000,000 to the hospital.

2. Let's assume that on Monday, November 20th, the hospital has NOT ONE SINGLE patient.



In this situation, the doctors and nurses, the staff and the utilities, all still get paid. The lights are on, the heat is working, they are all ready to work....but NO ONE shows up and all their beds are empty.



$50,000,000 divided by 364 days is $137,263 a day. So, without a single patient in the house, it cost $137,263 to have all the doctors, nurses, staff and utilities ready.....but no one showed up.



Now....it is Tuesday, November 21st.

And ONE patient shows up. Gets some xrays, gets sling and one pain pill and sent on their way.

HOW MUCH MORE DID IT COST FOR THE HOSPITAL TO TREAT THAT ONE PATIENT?




Ignoring the sling and pain pill, the answer is ZERO.

What about a 2nd patient? Still zero for two.

Nominally, except supplies, it doesn't matter how many patients the hospital gets, the incremental cost is zero.


This is the argument FOR single payer health care. It is also it's failure.

Sunday, July 16, 2017

THE Moderate Mainstream - 50 Positions

1. Abortion: Should be rare. At some point rights attach to the growing human life. I consider the child to be human life from the point of conception, heck, even before conception the components are human and alive. But it is not "a" life. For the initial stages, the baby can not live, it does not have 'a life' of it's own. And during that time the woman's right to control her body is, absolute, sovereign. However, at some point that changes, the baby becomes viable. Over the decades that point has become earlier and earlier in a pregnancy. We may have reached a limit at 21-22 weeks. Children born at this point are dangerously immature. Many don't survive. I am for an unfettered right to abortion prior to the 20th week. Between 20 and 24 weeks I'd like to know that a woman consulted with doctors about viability. After the 24th week, six months into the pregnancy, I'd limit abortions to protect the mother's life.

2. Bureaucracy: Government bureaucracy has grown so large and dominant that even the changing of political appointees and elected officials has been insufficient to limit its growth and influence. That has to end. Still, the experience of government employees is something to be valued. I'd restrict government employment to a single 10-year term or two 5-year terms. No retirement benefits except self-funded programs. There are two exceptions: Judiciary and the military.

3. Capitalism: No system has done more to raise the standard of living of the entire planet than Capitalism. No one does it well, most do it with lots of sticks and pokes and lots of chiefs stirring the pots and yelling at each other. But no other system has done anything remotely close to the success of capitalism and capitalism has centuries more opportunities cresting the horizon today than at any other time.

4. Capital Punishment: I support it. Those that will not abide by the social constructs that we need to live by in order to have a viable society, need to be removed from it and in extreme cases, permanently. However, human justice is no different than any other human endeavor, imperfect. As Illinois found out, dangerously so. We can not with sufficient confidence say that the State can be impartial and objectively remove all doubt in all but the rarest of cases. Therefore, despite my support of the consequence, the Judge and executioner are too deeply flawed to give them the power to take life in the name of the Citizens.


5. China: The most populous nation on the planet has realized that its 'one-child' policy has come back to bite it in the ass. Men are unable to find wives. It has begun the process of changing the policy but it will take a generation to do so and its population growth will accelerate the entire time. It must grow at a pace it can not manage via government edict and either it explodes internally or it deflects its population with external threats. It is only a matter of time before either or both happen. China is the largest economy, if it had the largest free population it would become the likely successor to the United States as the largest economic power. (A boulder rolling downhill might gain more speed than a train, but its power is taking advantage of momentum, not internal effort.)

6. Climate Change: The climate changes. It has been changing for four billion years, will continue to change for the next four billion years. And? Oh, we might be causing 'more' change. Well, if someone can tell me when the Earth is at the best temperature, we can determine if the change we might be causing is good or bad. Until then, we can watch the change, adapt to the change and enjoy the benefits and deal with the damages as they come. In the meantime, we, the United States, comprise 4.5% of the world's population and anything proposed has to get the other 95.5% to get on board.

7. Corruption: Corruption has been part of every political system since we have had political systems. Political corruption or crony capitalism as it is sometimes called is causing widespread damage to our economy and to our ability to function well as a society. Getting corruption out of the political process is not about getting the money out, money is only the scorecard. It is about getting the favors out. The easiest way is to get government out of the business of granting favors to one company or industry over others is to get government out of using tax policy to affect the marketplace.

8. Crime: More than anything else I believe the infringement of an individual's rights by someone else is a crime. There is no 'thou shall not kill' on the books in any state or municipality. We punish people after they have done something; there is no prevention other than via the threat of punishment. (See Death Penalty) I want crimes against people or property to be swiftly and justly dealt with, but acts that offend the sensibilities of people are a waste of resources.

9. Economics: Everything you need to know about economics can be taught in one minute. Too bad the average citizen, politician and journalist hasn't given it even that much thought. First and foremost, economics is about human behavior. If the price of something goes up, you get less of it. If the price goes down, you can have more of it. Everything else flows from that. I need forty seconds to give you an example. We need to make things we want less expensive, like working, and start making things we don't want, like crime, more expensive.

10. Education: There are two types of education: one is learning from experience, the other is learning from books - which generally are written about and by people that have learned from experience. I support education, by experience and by books. Not everyone needs or should go to college. We have many jobs, necessary and valuable, that need more experience than book education. We should not be driving our children into needless education at outrageous prices unless that is the best thing for them individually. I'd like to see more money going to community colleges for apprentice and training programs. (See Military)

11. Environment: First we want to preserve as much of the natural environment as possible - our health depends on it. What that doesn't mean is to do so at the expense of caring for the humans that depend upon it. I believe that the Federal Government needs to return the land within State boundaries currently under it's control but unnecessary for Federal Government activities. Development of natural resources can then be decided by States. California is facing a natural drought to exacerbate the one caused by environmentalists' demand fish get more water instead of farmers.

12. Equality: Under the law. This is not a statement that we should have equality of outcomes. We all have different skills, abilities and resources and as such, our efforts will have different results. This is not a bug, it's a feature of our system and one to be embraced not legislated against. ‘All men are created equal’. Our society acknowledges a diversity of choices. We do not expect, nor require equality of results.

13. Faith: Is fundamental to almost everyone and it should be respected both as a society and as a matter of law. However, it is not the foundation of our law, nor should it be. Faith can not be the dictator of law.

14. Federalism: There are limits to the Federal Government, enumerated in the Constitution. We need to prune government back to its roots and stop trying to use the Federal Government to fix society from a perch beyond the sight and oversight of the People. We need States to reassert their sovereignty and stop using the Federal Government as a rich uncle and whipping boy for State's follies and foibles.

15. Federal Reserve Bank: Was created, in part, to get politics out of sound money. Over the last decade the Fed has embraced both politics and the profound mistake that it can fix or control the economy. It has sown the wind.

16. Green Energy (Renewable): We should continue to seek ways to replace oil and coal as sources of energy but wind and solar are never going to be more than bit players. Solar could supply a significant portion of our stationary needs if we consider solar satellites. Additional research into alternatives needs to stop using the food supply as a source.

17. Gun Control: The 2nd Amendment prevents government from interfering with the right to carry weapons. That hasn't stopped it well enough in the past and major efforts are made every time the media picks a story to give the idea that government can fix stupid. Fear mongering is a well-tried method to get people to seek security anywhere and anyway they think, or are told will work. Guns are a tool. Like any tool they can serve a purpose chosen by the person holding it. Taking guns away from a 100 million responsible gun owners to stop a thousand irresponsible criminals is not just cause.

18. Health Care: Is not a right. It is necessary for long life and while everyone wants long life, the cost needs to be a factor in his or her choice. If we continue to remove the cost considerations from individuals and place it in government bureaucrats we will get a one-size doesn't fit all application. Government cost shifting has created much of the cost of health care. There is a place for government in health care, providing it is not that place.

19. Homeland Security: We have accepted the idea that a crime-fighting approach to national security is insufficient. We assumed that the large distances most threats had to cross to get to us would protect us from all but the largest foes. A man can wake up in Pakistan and kill millions in New York before nightfall. However, this is not a police state and we have armed our local police with the tools of an army. We have deputized a nation into an army on our own soil. We need to stop pretending everyone is a threat so that no one feels picked on. We need to focus on the threats.

20. Homeless: We can't stop people from making bad mistakes that lead to homelessness. We can make it easier for people to get out of that state by focusing on why they are there and addressing those issues. Some, a small percentage are chronic cases with no solution. Most can be helped if they are found early. This is a project of the States, not the Federal Government.

21. Immigration: I am first born to immigrant parents. This Country is built on the blood, sweat and tears of millions of immigrants that came to this country for better, everything. The vast majority came legally. Those that didn't should not be rewarded for having broken laws from the first day. No path to Citizenship, deportation for those that have broken additional laws. Fines and legal recognition for those that voluntarily present themselves (with no chance of future citizenship). For that, they will have to leave and re-enter legally.

22. Innovation: Is the lifeblood of our economic future. Rather than cut spending on research and development, we need to spend more. Basic research into biology and technology needs more funding.

23. Iran: Has sworn to destroy Israel and do all it can to destroy the United States. I am willing to take them at their word and do whatever is possible to prevent them from obtaining a nuclear weapon, and I am for doing it as soon as possible.

24. ISIS: ISIS has taken to heart the worst aspects if Islam and has become a plague upon the Middle East. We need to step in and utterly destroy them. Swift, brutal and without mercy.

25. Jobs: It is not the job of government to create jobs. It is the job of government to get out of the way and let the market work. The President can't create jobs. (See Military)

26. Korea, North: I can't understand the desire of China to continue to prop up North Korea except as a bulwark against Taiwan and South Korea. It is a brutal dictatorship with a nuclear weapon. It is the poster child for not allowing Iran to do so. Yet, no amount of negotiation will change it and we look like idiots when we try and fail.

27. Lobbying: It is not money in the political process that is the problem, it is the favors government grants to companies and industries that spend significant money getting them. Get government out of the business of granting favors (tax abatements, cuts, and waivers) by getting government out of the business of taxing business. Petitioning the government is part of our rights and because some do it better doesn't give us reason to infringe upon it.

28. Markets: Can't fix everything wrong in the economy. There has to be some neutral force that can mediate and punish. Government can be that force as long as it doesn't try to pick winners and losers.

29. Medicare: The program that began the cost shifting from the older generation to younger ones. It manipulated the market and every attempt to fix the consequences has made it worse. It has taught market participants how to manipulate government to make them the beneficiaries of further twists in the marketplace. We need to end Medicare cost shifting and recognize that 95% of the dollars spent on each person's total lifetime medical care will be spent in the last year of life. Implementing a Hospitalization and Provider Plan would work.

30. Military: At the end of the Cold War a movement began to 'civilianize' the military - to convert non-combat jobs to civilian contractor jobs. The assumption was the cost savings would be better than wholesale cutting, gutting of the military. The shortsightedness of that idea was manifest when we tried to send troops into combat and none of their support could be mobilized. 1) Return support functions to military personal; 2) Bring home most of the troops stationed overseas (some exceptions); 3) Increasing military members in support functions will require significant 'hiring' of younger people to whom training in a wide range of fields will give them job skills for the civilian world; 4) Opening additional bases in the United States for training and staging purposes will positively impact local economies.

31. Multiculturalism: We live in a secular society in which all are free to follow their own pursuits towards happiness. However, we need a level-playing field, more to my point, we need to all be ON the same playing field with agreed upon rules. If we let people play their own game on their own field, we get a nation of such diversity that it becomes every man and woman for themselves. Such is the state Hobbes noted and it is not a place we want to be. We were the melting pot of the world, everyone contributing to the flavor, the heat supplied by the blood, sweat and tears of every immigrant's efforts. Not every culture is equal; none are equal to our own. We are a nation of immigrants, not a nation of cultures.

32. Nuclear Energy: We don't do it well. We are stuck with 1950's technology built with 1970's technology. We need to do better and there is better technology. We need to get over the fear, falsely stirred, and get back on the bike. We have spent almost 40 years on alternate technologies and nothing is else is close to providing for and replacing current hydrocarbon generated power needs.

33. Nuclear Weapons: Mutual assured destruction only works if the other side is worrying about destruction too. When the other side welcomes it, there is no deterrent having a bigger or more guns. I'd like to move away from nuclear weapons but we can not do so unilaterally. That means continued research and upgrades to our existing arsenal.

34. PAC: Political action committees were a natural consequences to attempts to limit campaign cash to political candidates. Like floodwaters, political spending will find the weak spots and exploit them. I am ambivalent about them. I see no reason to ban them and lots of reasons to dislike them. But they are the symptom, not the problem.

35. Poor: People make choices they don't understand, in circumstances they are not responsible for. In the end, everyone is responsible for his or her choices but not everyone can be held accountable. We need a safety net, but it can't be so big that everyone sees it as 'good enough', otherwise we get people choosing the safety net instead of falling into it. There can be no government provided lifestyle. Get people on their feet, get them back being productive. The Poor in this country tend to be richer than 90% of the rest of the planet.

36. Pothole Politics: There is a purpose to government, keep the playing field payable. Make sure the refs are honest; be agnostic about winners and losers. Too many politicians want to fix us and think fixing the potholes around town is beneath them. Those politicians need to be voted out. And yes, the President and Congress have pothole type responsibilities they are neglecting: advise and consent, separation of powers....

37. Public Schools: WERE essential to the concept of an educated electorate. Today they are a toss up between indoctrination centers and rabid cesspools of crime and institutionalized juvenile delinquency run-amok. The few places where education, actual real education not the pap served up by most Left-wing artichokes we call educators, are so in demand that strict policies of admission - IN PUBLIC SCHOOLS - are enforced. We have been accosted with stories of run down schools, out of date textbooks, lack of supplies, lack of sports, the arts and book-less libraries while pouring thousands of dollars per student at the problem that gets worse every year. Colleges are spending years teaching graduated high school seniors remedial English and Math. As an institution in our country, public schools have failed, the only reason we don't close them down to protect the children is that for a majority the school is a day-care center for kids with nothing else. Short of dismantling the entire institution the only option is massive overhaul. Too bad we don't have, unlike schools everywhere, a zero tolerance policy about failure.

38. Racism: Us versus them. Yes, it exists. Amongst every race, in every State. Institutional racism is all but gone. Well, that is not true in this sense: we have gone from 'we don't want that kind here' to 'them poor souls can't do it themselves'. The first is abhorrent, the second utterly destructive. We have proven however that getting a Black President did nothing to help and it was the claim of millions that it would. Racism ends one child at a time, which is too bad because it seems to be taught dozens at a time.

39. Religion: A fundamental part of the life of most Americans. Our goal as a Nation to be open to allow anyone to worship as they please with no interference from government, explicitly or implicitly. Part of that is under attack from within, another part from outside. I strongly support the right of individuals to express their religious beliefs as they need and choose with the single exception that it not infringe upon others. The attacks from outside religion run afoul, rightly, of our Constitution when government is the tool of the attackers. The attacks from within are from people that seek to use it as a weapon of social change or to prevent social change. Both are dangerous though I think the former has greater risk.

40. Regulation (Policy): Here it is, this is the place where government abuses its authority to grant favors to political friends, and to grant dispensations to political allies. Government has become too involved in too much of our daily lives and economy and everyone has found it to be the place where they can feast at a trough of government money. We need to get government, especially the Federal Government, out of every day American's lives. We need to starve the beast. And more and more of our government is beyond our reach to control (See Bureaucracy). Rather than report on how many new pages of regulations are issued per day/week/month/year, we need to remove whole chapters and verse. Starting with the EPA.

41. Rich: We are a nation that had the poor, the middle class and the rich at it's founding, we will continue to have poor, middle class and rich into our future unless the government continues to support the poor being poor. If every penny of income of the richest 1,000,000 people were confiscated, we wouldn't have enough money to fund government for six months, let alone a year. If the WEALTH of the top 1% were taken, it wouldn't fund government for a year, not even six months. It is that wealth, that surplus, that provides the capital we need as a nation to grow and continue to innovate. To demonize them is to demonize capitalism, but maybe that is the point. Greed is not exclusive domain of the rich but includes those that seek what the rich possess. Continuously demanding the 'rich' fund everything requires ever greater encroachment into the middle class who are unable to access any government programs but are increasingly the true source of government taxes. Most people don't understand that 'rich' by the definition of "Occupy" includes many white-collar two-income families living in our neighborhoods.

42. Russia: Will descend into a dictatorial abyss sooner rather than later and those currently in charge are working hard to make it soon. Russia is not our friend, will probably never be our friend and the sooner we understand that being 'a partner' with it is to be yoked to a nation trying to kill us as surely as Iran is. Like the United States, the shear size of it gives it great resources and reach that it is not using to improve its standard of living and productivity, but to build itself an empire. It is a threat and should be treated as such.

43. Science: Has become politicized; It has become a means to promote political goals. Lots of great science continues to be done but like a 100-head herd of cows on a million acres, it is too small and too spread out to continue to feed all but a small effort. We need more research at every level and we need politics out of it.

44. Self Determination: It is impossible for one person to dictate to another how to live their life, it is arrogance founded upon ignorance to assume one person or small group of people can dictate to an entire Nation how to do so. We must have the freedom to determine for ourselves how to live our lives, even when those choices are poorly made. Saving us from ourselves is not the purpose of government, nor is it the purpose of government to fix what is broken. Government must not impose edict for choice, security for freedom, benevolence for liberty.

45. Social Security: Arguably the first betrayal of our founding ideals. FDR blackmailed the Supreme Court and one of the first out of the blocks efforts was government providing for the welfare of individuals. Never meant to be a 'savings account' for individuals, it was a way for government to access the income of individuals to distribute it to others. Unfortunately we let it stand for so long that millions have come to rely on it. We need to begin now to phase it out over the next generations. It is already the largest part of the Federal Government and it is not going to shrink until the entire program is restricted and eventually dismantled. There are alternatives available today that were not 80 years ago, we need to look at them.

46. Solar Energy: More energy comes out of the Sun in a second than humanity has produced/consumed in its history. Converting it into usable energy for our engines and devices has been the goal for many efforts. And no matter the efficiency of our devices, they reside deep within the protective layers of magnetic fields and atmospheric blankets. If we could gather the Sun's energy in space and 'pipe' it down for use, we could eliminate a significant portion of our energy creation activities. Solar satellites could provide energy at a fraction of the cost of current systems.

47. Sovereignty: The freedom to live, to prosper, to seek our own happiness are the foundations of our rights and our ability to assert them. The individual is sovereign, we confer authority upon government to act on our behalf and it is that authority expressed in our National Sovereignty.

48. Sustainability: Whether we speak of individual, national or societal sustainability we speak of the ability to survive. Many of our resources are limited and need to be managed for long term use. However, too many people equate sustainability to a single component of our economic life: energy. The argument that we have only 4% of the population but use 24% of energy is comparing apples to cotton. The United States produces almost 25% of the planet's GDP, it does so with less than 24% of the energy used. That productivity builds our standard or living. Sustaining our society is more than just providing energy, it is about providing food, innovation and a future.

49. Term Limits: Are an attempt to limit the choices of the people to pick their own representatives. I oppose them on the basis of that liberty. The limit on the President acknowledges the power of the Presidency as the sole wielder of American Power and imposes a limit on that power in one person. Restricting the terms of one of 535 committee members serves no similar purpose.

50. Terrorism: Works only when people become so fearful that they will give up all freedom to appease it. It must be met with swift, brutal and complete annihilation, wherever it is attempted.



It has been said that all we can reasonably expect of a society based on an imperfect humanity is “one with some evils, maladjustments and suffering”. Why? Why not work to eliminate evils, maladjustments and suffering? Accept them as the natural consequence of an imperfect humanity? I agree we are imperfect, but that does not give us license to ignore those imperfections. What is worse is to allow institutions WE create to result in evils, maladjustments and suffering by design. Knowing such evils exist and to do nothing but accept the imperfection is to deny our own evil.

Friday, April 14, 2017

On being fat

As we come to the weekend of my favorite candy (how superficial of me, I know), I want to make a comment or so about....being fat.


As of this morning (ok, this afternoon as I didn't get out of bed until 1:05pm), I weighed in at 357 pounds. This is 15 pounds heavier than I was this time last year and more than 40 pounds lighter than my highest ever. The entirety of my weigh gain happened over the fall and winter as I spent time in Chicago and did not keep my exercise regime, nor my overall eating habits.

What are my eating habits?

At home:

Within 1 hr of waking up - Breakfast: 8 oz of rice, corn or oat cereal with 8-9 oz of whole milk and 7 oz of cranberry juice (low sugar)
4-5 hrs after breakfast - Lunch: 3-4 oz of meat, 2-3 oz of cheese, 3-4 oz of veggies
5-6 hrs after lunch - Dinner: 8oz of meat, 4-5 oz of veggies, jello or ice cream for dessert.

I drink 32 to 48 oz of lightly flavored water a day.

For snacks I have two different types of protein bar, plus fruit cups (no sugar added) - but I often eat neither if I'm busy


Away from home:
I keep to my basis schedule but tend towards favorites:
lunch = soda and hotdog w/ketchup
dinner = if at a sit-down restaurant, my dinner is usually much like it would be at home. Fast food might be spicy around chicken.

I don't generally have any gluten (wheat) at home: no bread, pies, pasta or wheat cereals. I tend to stay away from soy also.


My A1C in Feb was 5.3. My sugar at testing was 86. My blood pressure at last dr visit (a week ago) was 127/78. This is just a touch high for me, but my resting heart rate was 70 and temp was 96.7. I do not have high cholesterol or triglycerides. Liver, thyroid and kidney functions are all well within norms.

Yesterday I walked over 2.5 miles. I have walked over two miles four times in the last 10 days. I will do so at least twice more in the next week.

Every step I take SUCKS.

I have been working on learning/doing yoga (only twice this week, both times between 10-15 minutes. I haven't been on my bike this year.

Why all this information? I'm fat. I don't expect people to like me, or consider me 'beautiful' because or in spite of being fat. I don't have body issues. (gawd the guy that asked me to turn out the lights because he did almost ended the evening right then and there!) Come on people.

I look at thin people not out of jealousy, or 'self loathing'. I appreciate their appearance without denigrating my own. I am who I am and what other think of me...I. DON'T. CARE. But, I also know that being fat takes more effort by my body. But after almost 20 yrs of being fat, my body is NOT showing signs of that wear and tear on me. My hips and knees are in good health. But I do recognize the effort it takes to move.

My surgeon said that had I weighted the 397 I was 6 months prior to surgery, I would have most likely died on the table. However, given that he only gave me a 50/50 chance of survival and a 10% chance of walking again, I'd say that once again, people look at me and assume I am unhealthy.

Most people are fat because, systemically, they are unhealthy and their body reflects it. I think getting fat does not make us unhealthy, being unhealthy makes us fat. That will be contrary to 'common wisdom/understanding' in the medical community - but consider how much of that has been wrong in the last 50 years.

By all medical understanding currently espoused, I should be hypertensive, have diabetes, and arthritic joints. I think the medical community has cause and effect wrong and therefore are treating the wrong things. I watched a hypertensive diabetic die. That is my take away from it.

Call me fat. I am. Don't call me unhealthy. I am not. But I reject SOUNDLY the idea that people demand to be considered beautiful REGARDLESS of their appearance. If you need that type of affirmation, you are unhealthy in that space between the ears.

I like me and that comes across regardless of how I 'appear' and yes, I do clean up nice.

BTW, had my nails done, cut & color on my hair and am heading for the beach in my swimsuit this weekend. I too will be body watching!

Wednesday, February 22, 2017

Not the Mainstream...


How to comment on this.....??? Transgender bathrooms.





IF, and it is a huge, insurmountable (IMO) IF, we had a way of defining transgender specifically to those that need the liberty to act according to their intended gender, then I would be supportive. What that means is that it is not enough to 'identify' as transgendered, it has to be diagnosed and be medically followed. It is formalized in something called the medical Standards of Care.

The 76 or 98 or 24 'genders' that the Left has pronounced as 'needing recognition' all but eliminates any chance that a rational approach to transgender needs and liberty is possible - certainly not from the Federal Government.

People actively undergoing transition need some protection, but to change the entire society so that 1/10 of 1/10 of the population can be 'safe' is nuts. The current 'open door to claims of trans' leaves a gaping hole in the safety of women and children.

Sorry, but identity politics goes too far when it is perfectly acceptable for a white woman to 'identify as black' and gets LAUDED for doing so...

Do not get into the 'there are only two genders and you are born and will die in the same one' with me...you'll lose.

Thursday, February 16, 2017

Comments on Diversity report

A news article on a study about diversity efforts got me into a discussion with a proponent. He argued I needed to read the report, which I did. I am offering the bullet-point commentary here in order to facilitate the discussion.


1. Correlations - not causation
2. Does an all minority firm out perform?
a. None available to determine
b. yes: then the marketplace will deal - more investment in out-performing companies
c. no: is there a tipping point? vs the current level?
3. interior Culture and performance demands different than existing exterior culture norms
4. Affirmative action impact on retention - ie no AA standard in performance kills AA standard in initial hire
5. 170 firms offering info are self-selected. Those with positive results tout, those with negative don't
6. I ABSOLUTELY reject % of population to % within company. failure by absence is not evidence of failure
7. Tech sector is more oriented towards technical competence than personal interaction (personal experience too)
8. Google is going after more STEM support in schools - I absolutely support - but not via affirmative action
9. Knowledge base failure within study: limited data and evidence. as Econ grad, I understand the limits of such a data pool
10. Reports rely upon 'feeling of what seems to be working'
11. A significant study of 700 companies = no positive effect on diversity efforts and may hurt Black women
12. "...efforts to isolate impact of female leadership was inconclusive" BUT LOOK!!! 9% HIGHER VALUATION!!
13. Due to minority population size, areas/fields that aggregate significant minority representation removes diversity from elsewhere
14. Women in STEM has decreased as the # of 'programs' in sociological studies increased...related?
15. What the study calls bias I call animosity - not of hatred but of 'not what I have seen work' bias via work experience (arguably false sometimes.
16. Diversity training = no positive effects so....
17. ...switch to 'unconscious bias training' - but may have same longterm results - NONE. Recall Hawthorne Study.
18. pointed out WIPRO as example - also in my business plan as a foreign competitor
19. regression analysis bar for significance = .10 this is a low bar though not 'significantly' outside the norm. But the study never indicates how FAR over that bar the results were. .11, .15. These are 'noticeable' however, given the sample size, NOT USEFUL.

All in all, the study takes a minor blip and runs like the wind with it.

Other issues. 70% of Black children are born out of wedlock, 60% of Hispanic. And these are long term trends. These populations are NOT going to create a pool of STEM candidates for the industry as a whole. Only the top 1% or less will reach excellence levels necessary for prominent positions in corporations. By the measure of calculating populatio = 30% likely to succeed, you get the 3.5-4% representation of Blacks in the tech workforce.

Diversity in corporations doesn't change culture and diversity in culture is NOT beneficial. Understand I used the term CULTURE.

Tuesday, February 14, 2017

My idea for health care - from the Proposed Federal Budget

Hospitalization Program

Right now hospitals all over the country are billing patients for services rendered but because Medicare and managed care programs have agreements on reimbursement rates, those hospitals are functioning with approximately 54% of those billed revenues. One way hospitals have dealt with the issue is to have patients spend less time in the hospital. I will not say that hospitals are discharging patients that should still be in the hospital, but I bet it is happening.

With one in five of its elderly hospital patients re-admitted within a month of discharge, the federal Medicare program plans next year to reduce how much it will pay hospitals for certain preventable re-admissions.1

Using information on hospitals in Washington State (http://www.doh.wa.gov/), I looked at expenses and patient distribution (mix of inpatient and outpatient emergency).2 Given its general good outcomes, I looked at the actual expenses per patient day (a mixture of case and patient types), how many patients were being seen, the number of beds and the population size that the hospitals serve. The type of hospitals and communities they serve cover rural and urban settings. Generally, Washington is in the middle of most medical spending/outcome metrics. Using the information available, including the number of hospitals and beds per state and averaging the expenses I came up with an alternative to Medicare funding.

Eliminate Medicare funding3? Right now, hospitals are functioning on 54% of the revenues they bill. If hospitals could replace their current billing system and all the administrative expenses associated with Medicare and managed care cost shifting and at the same time have a steady source of income, the net savings could replace the entire contribution of Medicare and state Medicaid funding.

By offering the following and managing a 100% consumer participation rate, hospital systems would receive approximately the same revenue as their average expenses.

On average, each adult pays $140.39 and each child pays $46.80 per month (varies from state to state – See Appendix B).
Premium payment is made to the hospital of the adults choice and could vary from hospital to hospital (allowing for competition).
All hospital care, either outpatient or inpatient is covered 100% for plan members.
Hospitals establish a fixed daily cost for non-plan patients (same for inpatient or outpatient).

However, plan participation is not mandatory and no matter how good the deal, there will be people that won’t, or can’t pay the premiums. The Plan includes a Medicaid grant from the Federal Government set at 25% of the 2010 total expenses for each hospital. The grant requires that the STATE reach an average 75% participation rate to qualify and the grant does not go down if the participation rate is higher. So the hospitals and the states will have an incentive to increase participation rates as high as possible - the grant money can be used to cover unemployed or chronically ill patients. The grant will cost about $117 billion a year. A realistic goal is that on average, participation will be between 80 and 85%. Currently 83.1% have some form of insurance.4

Provider Plan

Like to the Hospitalization plan, doctors and other general health service providers could begin offering a similar plan to their patients. The cost might be as low as $7.25 per month per person5. By creating a plan similar to the Hospitalization Plan, doctors could institute programs to manage illness within their practices and to stabilize costs. A family of four could have a doctor and hospitalization plan for $475 a month. The average premium paid for individual health insurance coverage in the United States in 2011 was $2,196 per year, $183 per month; families paid an average annual premium of $4,968 or $414 per month.6 Because the average health insurance plan has a deductible, an individual would pay $183 a month for the insurance and could still face hospital bills of up to $2,935, or another $245 per month.

The Plan creates incentives for people to participate, for hospitals to manage costs and focus on patient retention and for both parties to manage health care. Consumers have the ability to change hospitals and doctors that fail to live up to their standards or who don’t manage costs well. Because the cost of seeing a doctor or going to the hospital is fixed, patients will have an incentive to see the doctor or go to the hospital before situations become critical. Hospitals and doctors would have incentives to offer wellness programs to lower utilization needs.

As for patients with chronic illnesses, the hospital costs determined above was based on the total of the annual expenses based on their inpatient/outpatient mix. It includes patients that are treated and released and those that spend significant time as inpatient. Because payment for services is not based on specific length of stays, hospitals and doctors can manage their patient’s care for the best outcome rather than billable limits.

For people that do not participate in a plan, the hospitals will offer a fixed cost for outpatient or inpatient care. Insurers may offer plans based on the fixed cost rate, but no one will be able to offer it less expensively than the hospitals. In general, the annual cost would be less than a single day as inpatient or a single trip to the Emergency Room.

For individuals or families that opt only for the Hospitalization Plan, their occasional trip to the doctor would be out-of-pocket as would everyone’s prescription costs. Walmart’s prescription plan has driven the cost down for many people but new, name brand drugs can still be extremely costly. Hospitals and doctors could form purchasing groups for specific drugs that handle chronic illnesses. By putting patients back in control of their medical spending dollar, market forces can help alleviate some of the costs.

We don’t have insurance for oil changes, or replacing tires, bulbs, filters or painting the siding. We maintain our homes and autos, provide the fuel and energy needed to run them. We have car (and homeowners) insurance to protect us from the rare events that cause their destruction or loss. Health insurance that does not consider the age of a person or pre-existing conditions is the same as insurance purchased after the accident or home fire. It is an attempt to share the cost of events, exactly as Medicare does now. The result would be the same under Obamacare except that it mandates, requires, everyone to buy insurance. This is still cost sharing but spread over everyone.