Five Days at Saint Peter's

No wait, it was only seven hours in the ER and the only power that was lost was Don's ability to perambulate.  He woke up Saturday morning in extreme pain and could not put any weight on his right foot.  His knee was swollen and red and he self-diagnosed as either gout or an infection and wanted to go to open hours at his GP.  After struggling to get him out of the house, through the driveway ice and snow and into the car, John and I decided take him to the hospital where they could get immediate (in hospital time of course) results of lab tests.  First no bacteria indicating Lyme Disease, never got the results of the uric acid test, and it was going on 3PM before the ortho drained out the joint and bursa.  Discharged with narcs and meds and crutches.

So once again, my uninterrupted reading time was in the emergency room where I started and almost finished Tina Fey's Bossypants.  If you're going to be stressed out and imagining the worst, get distracted with this book.  Skip the accolades in front and the inane book club discussion questions in the back.  You really won't snort liquids you intended to swallow through your nose or need to grab someone to list out your favorite SNL skits, but I did giggle occasionally and wanted to read random quotes to my faithful son on ER duty with me.

I liked her analysis of what live skills she learned from improvisation, probably the same life skills a deliberate, thinking middle-ager would reach from any reflection on what works best with superiors and subordinates at work.

I got this book in a box of paperbacks my daughter in law brought with her for Thanksgiving from Texas where her mother proof reads pre-publication manuscripts.  So I'll end with my favorite quote:  "I know why you bought this book.  Or should I say, I know why you borrowed this book from that woman at your office."  Guess what's going to work with me tomorrow?

Five Days at Memorial by Sheri Fink

I have been wanting to read this book since I learned of it being published.  I started and could not put it down, reading last night until way past 11 and just finishing now once the duck was in the oven and the vegetables pared for dinner.  I am watching a looming snow storm outside, maybe getting nine or ten inches by tomorrow.  Thankfully that does not qualify as a disaster, nothing like the seven feet of snow that lambasted Buffalo last week.

This book is wonderful,  The fact is that 19 people were injected with morphine and other drugs at Memorial Hospital in the aftermath of Hurricane Katrina.  The author presents unbiased renditions of everyone's memories, impressions and concerns.  Factually, these people were injected as the hospital was being finally evacuated after five days of no power, little food, overworked staff and rioting neighborhoods.  Fink does a marvelous job of describing the horrific conditions and the mental strain not only of dealing with weather related realities but also the bureaucratic and corporate mishandling of the process.

The second section of the book hits too close to home as Fink details federal investigations, criminal charges, grand jury deliberations and both the tactics of lawyers for both sides and the denial of hospital owners.  The lack of single point of clarity or responsibility, the mix of best intentions versus changing or nonexistent procedures or plans is my world.  I work for the NYS Department of Health.  After Fink recounts how various oversight organizations tried to learn from Katrina on how to respond to complete failure of power, to limited medicine, etc etc, she finds herself in the midst of Hurricane Sandy and the hospitals and nursing homes in New York City and Long Island that were subject to equally harrowing conditions.  At DOH, my team oversees the distribution of federal grants to many of the healthcare providers mentioned in the book.  Fink's descriptions of their damages are even more graphic than those they sent us in their application for funds.  I am sort of living a post-disaster situation almost as frustrating as Sandy:  other bureaucracies are placing burdensome requirements to document expenses claimed for grant reimbursement; all contracts and payments are reviewed by multiple agencies, both State and federal.  To date, only about 15% of the funds my team controls have been paid out.

I also deal with many of the people Fink mentions who work in NYS DOH and many others who are the backbone and heart and soul of our emergency preparedness and response group.  How these folk and the top executives can cope with the issues that seem to occur with more and more frequency amazes me.  I was recently on a conference call where one woman was informed it would be her fault if more than a dozen people needing dialysis deaths if she did not find a way to get them out of their snow bound homes in Buffalo and to treatment.

Finally, Fink devotes the last part of the book to the ethical issues involving the triaging and distribution of scarce or diminishing medical treatments during a crisis.  Fink compares New York's establishment of standards against Maryland's where much more public involvement informed the regulations.  I am all for the wisdom of the crowd, but Fink's book does not circle back to the vested interests that seep into public forums.  These are decisions that must evolve.

I plan on buying several copies of this book to give to my team as Christmas presents.  Read it, it is a thoughtful, valuable "retreat-like" discussion of issues anyone in public health has to face.

The Industry that is John Lescroat

I believe I have read some Lescroart mysteries before and picking up his latest, The Keeper, last weekend at the library was my attempt to kick start my lagging reading/blogging life by going back to my favorite genre.

I grabbed the book Wednesday morning and cracked it open as I lay on a gurney in the ER going through tests to see if I was having a heart attack.  I have learned through dozens of emergency room adventures with my mother, son and husband, that reading material is essential to make the hours of waiting tolerable.  I was through the first 100 pages before I saw a doctor.

The tests were anticlimactic and so, in a sense, is The Keeper.  Not to keep you in suspense like a good murder mystery, the test results showed a flare up of arrhythmia that last occurred seven years ago.  More doctor visits to follow.

As was the book somewhat less than dramatic at its conclusion.  The character of the retired police investigator taking a job for the defense attorney was excellent.  Here was a person who aimed only for results, utilized his decades of job experience, and relished going around bureaucratic obstacles.  Yup, I identified with him,  Lescroart lards his story with as many women as men; while the jail is all male, the police investigators include a woman with some what if insights that add to the case development.  The victim, the marriage counselor, the victim's extended family and in-laws all include well depicted female characters.

So why am I not raving about the book and recommending it to the max?  The thread that eventually becomes the identity of the killer is as apparent as a red thread in a blue piece of fabric.  Too much back story is added to the criminal's earlier life to justify motivation that is not otherwise evident in the main story of a teetering marriage, partially attributable to one spouse's hostile workplace.

But more than that forced ending, I hated the author's acknowledgements.  He comes off like a book-grinding industry.  I have this innate bias against people who hire others to run their webpages and social media.  Worse yet, is a writer who sort of bids out the chance to have a real person's name be used for a literary character.  In hindsight, it looks to me like a cast of thousands of minor walk-ons show up in the story only to meet this obligation to use a "winner's" name.

So this is two "industry" books in a row:  the one that turned out to be penned by another Rowlings alias went back unread.  Will I read another Lescroart?  Maybe, at least look for one of his earlier ones before he became corporate.

Break Down

As I grow more frustrated with the overlays and post mortems of decisions made months if not a year ago at work and I scan the horizon for an assignment that will be challenging but appreciated, my interests suggested I mention helping out with the latest crisis of Ebola.  I pass the NYT's articles to staff every day, we've hung up pictures of three grads of haz mat suits over the desks, and I thought it was about time to read Robin Cook's Outbreak.

Was it only 1987 when this book scared the stuffing out of us?  How simple it seems now and how James Bondish.  Cook's outline was that the only way for Ebola to come to America was that vial of the virus had to be stolen from CDC but mad scientist/doctors who were evil one percenters looking to keep their money and privileges away from the dreaded new enemy:  HMOs.

The CDC is portrayed as competent but infiltrated with such executives out to protect their wealth and status.  There is obvious cultural bias as they attack doctors coming to America from foreign countries, then the ones most likely to work at HMOs for lower wages.  Well, lets not go there in this review.  It's Ebola now.

In Outbreak, the evil doctors and their henchmen select hospitals at which to expose the virus selecting a doctor to mug and inject.  Exposure does the rest, essentially killing off the hospital staff, lab workers and immediate family.  Other than issues of isolation, Cook does not delve into treatment or containment.

So cycling back to my introductory paragraph, my frustration with politics in my own assignment is magnified a trillion times in the nation's response to Ebola transmission.  There have been so many editorials that I read this weekend that I am not sure this review has not been infected with their ideas and observations.  Specifically, Ebola is not lonely a medical crisis, it has become a crisis of confidence in government.  The CDC has been exposed to be as bureaucratically inept and face saving as the Veterans' Administration, the IRS and the Secret Service.  Lassitude, lack of responsibility, in inability to triage risk and anticipate unintended consequences are no longer factors under consideration on federal and state employees annual appraisals.

The outbreak of Ebola today in 2014 is much scarier than Cook's 25 years ago:  There are no villains to escape from.  We have met the enemy and they are us and us just isn't as talented as before.

The Lost Art of Dress

Subtitled, The Women Who Once Made America Stylish,was written by a history professor at Notre Dame named Linda Przybyszewski (the lost art of vowels?)

I loved this book.  It fits into my reading history along the woof theme as Linda P tracks the rise and fall of home economics in the 20th century's high schools, colleges, and granges.  How could I not like this book:  I am a child of a frustrated designed, born in an era when her father believed it was too risky for her to go Parsons in NYC.  I am the cousin of a boy who in my generation made it there and worked for Halston and then opened his own boutique.

My mother and I had an agreed upon division of labor when it came to sewing:  I laid out the pattern and matched the stripes and plaids so they all lined up, pinned the fabric and she sewed it on the old Singer.  I could not wait to go to the fabric store every month to check out the most complicated styles from Vogue and see if she was up to the challenge.  I would get simpler ones when I attempted to approach the machine and deal with threading bobbins but always working in my favorite material, Italian wool knit.  I wish I never threw out the one that was all rust red in the front and all cinnamon in the back, two colors that always looked good with my complexion.

Going to Catholic school spared me from home economics but the principles of good taste were pervasive.   Yes, uniforms covered my growing tall frame for eight teenage years but when the occasion arose, Mom made a prom gown is glowing white slipper satin with a rolled seam waist and full bodice without sleeves.  (Blue chiffon sleeves were added later and it became my lady-in-waiting costume for The Mouse That Roared.)  Another gown for college came with a full length buttonless wool coat lined in cream Japanese silk our neighbor brought back from a a tour of duty there.  She underlined it with an old baby blanket so I could wear it comfortably for the dance in the dead of winter.

Okay, there are my memories and credentials for reviewing the book.  Linda P is scholarly in tracking down biographical history of the women who were devoted to home economics, teaching not only style, but frugality and practicality.  While home ec was segregated by gender in State colleges, during the decades of the 30s to 50s, it was not the dumb sorority blondes who went, but more often than not the chemistry and engineering girls who were not welcome in the regular science majors.  Many went on to work for food production companies, "ladies" magazines, and high governmental positions.

When Linda P lists out the principles of style, and she's not talking high couture here, it almost seems like a Rosetta Stone of ideas I consumed with my childhood breakfasts of poached egg on toast:  certain colors work best in the office; fabric finishes clash as badly as certain colors do; a concealing dress is more alluring than a revealing one.  The first page I dog-earred down to save as a quote for this review builds on the last premise:  "... the idea of a dinner suit originated with the clothes designed for wear in the speakeasies of Prohibition days.  She does not tell us why.  Maybe women did not like being too bare when buying drinks from gangsters.  Or maybe a suit gave them more confidence when scrambling over tables during a police raid?"  (Shades of Nick and glamorously dressed Nora.)

And another:  "So much was required for good wardrobe planning ... It is not only a proof of our understanding of design and color and texture, of means of creating illusion and expressing temperament, but it also tests the real character of a person in discernment, in farsightedness, in self-discipline and in organization, and in ability to hold unswervingly to principle and purpose.  And you thought you were just shopping."

Not sure of the date of this quote:  "The New York Times proclaimed standardized dress (this must have been either during WW1 or WW2) was doomed - There is and ought to be in the heart of every woman, conscious of being well dressed, a triumphant satisfaction, not untinged, perhaps, with some rejoicing in the admiration, dissatisfaction, or envy stirred in the hearts of other women by the sight of her perfection."

"... planning a wardrobe and sticking to it required skill, knowledge, and practicality.  A thrifty and beautiful wardrobe proved that a young woman had not only mastered the Five Art Principles and understood the Six Occasions for Dress, but was also self-disciplined, organized, and determined.  The qualities that allowed her to dress beautifully without spending a fortune were the same qualities that would allow her to take on a position of "trust and authority." 

The final chapters trace the decline of style starting in the late 60s.  Linda P goes a bit nostalgic:  "The fashion photography of the 1950s reflected (sophistication).  Of course, there were young models, but some models worked into their thirties and forties.  You may object to their impossibly polished up appearance and their girdled silhouette, but notice their superior attitude, their knowing glance.  The older models of the 1950s looked like they could handle the world."   Twiggy, Mary Quant and Betsy Johnson come off rather badly, nay juvenile after such worldly allure.

Finally, and I'm not sure how old Linda P is, but this surely is my conclusion:  "Today's culture seems to have little appreciation for what years of living can do for you.  We all know that growing older usually makes you less of an idiot.  But there's little sense today that age might endow you with sophistication, dignity, grace, stateliness, and wisdom.  Or that we might aspired to dress in a way that expresses all these qualities."  When did yesterday's Dress Doctors become today's Fashion Police?

I'll Have Another

Still trying to catch up on the books I read recently and never posted to the blog.  This month, I sped through a simple book called, The History of the World in Six Glasses.  I bought it because I hoped it would be as good an alternate perspective on global history as were Cod and Salt.  It was not.

The author, and I'll add his name in shortly, posits that what the majority of people were drinking during certain historical ages was significant.  (I carefully chose that word because I really think the book does not successfully argue that these beverages had any cause or effect on history, rather they were more contemporary.)

The reader pub crawls from the cradle of civilization where some poor fellow drank week old gruel that had fermented.   Alas, near beer.  Next stop, Roman and Greek wine, with only the slightest reference to Retsina, and the proposition that wine, per se, creates wine snobs.  The wine gets harder as brandy fills the next glass/chapter.  The reader/imbiber sobers up with the introduction of coffee, then tea, and finally Coke.

What I appreciated more in Cod and Salt was the interweaving of history with commerce and daily life across the continents.  Salt is such an essential of life that it determined where people settled, caused conflict, became industrialized, can be traced linguistically.  Cod was a dominant industry, founded on supply and demand, and essentially an international trade.

The Six Glasses reminds me more of a flight of chards waiting for a plane to depart Austin:  something to fill in the time gap and served in such small portions that only the most superficial of distinctions can be made between the samples.  It only skims the surface of Indian Tea Trading companies and their impacts on India and Asia as well as England.  More successful, but more disturbing, is the treatment of Coca Cola.  Here is a beverage that has mutated into a logo, a drink that notwithstanding its early elimination of coca, is designed and marketed to be addictive and exploitive.  (Have I been getting to many emails from my old left leaning friends to have that word pop up in my blog?)

I would not really recommend this book to anyone, despite the fact that I gave it to my co-worker as a mental debt settlement for keeping her Ann Patchett book while she was out ill.  She really is giving it to her husband anyway.  But I still want to pursue books that look at history by the woof instead of the warp.  I have an earlier volume by the author on a history of food.  Let's hope it is a more substantial amuse bouche.

Don't Drink from the Fountain of Youth

Doing these couple of reviews in reverse order:  I read State of Wonder by Ann Patchett before I skimmed through On Democracy.  I wish I had read it faster because the woman who lent it to me was home recuperating from surgery and she would have enjoyed the distraction of this good book.

Our book club selected a Patchett book, Bel Canto, at least a year ago.  When I read it, I thought it contrived, a plausible scenario, but a tad affected.  Canto does have an echoing reprise that stays in the memory like a haunting song.  I think I will remember State of Wonder long after I forget its title .... which I seem to have done already.

Patchett loads this novel with many themes and many philosophical questions.  It is a cross breed between Heart of Darkness and Alice in Wonderland.  The heroine sent into the Brazilian jungle seems too weak to tackle her assignment.  She drags a complicated history behind her:  a distant foreign father, and a failed first career.  A lab worker for a large pharmaceutical company, she is told to go bring back a renegade mad scientist and the body of a co-worker who failed himself to perform the same thing.  The terrain, the language, the culture, the economy, the geography, all are more than alien:  they make no sense to a woman who deals with knowledge, precision, proof and consistency.  She is placed in a tableau of obstruction and obfuscation.

The thoughts that Patchett plants in your mind to reexamine, if not completely refine, include what is motherhood, who is responsible for a child, how can cultures interact without contaminating or eroding important traditions, who owns health.

I probably should not have read the NY Times review of this book before I sat down to type because in it, the reviewer criticizes Patchett's rosy view of conflict resolution:  the villian dies, the lost hero is reunited with his wife, the Tinkerbell like child who acts as her guide returns to his tribe.  

My secondary motive to finish the book was to think about preventive medicine, fertility drugs and the possibility of drugs being tailored to genetic profiles.  What if a drug, with a specific limited market, had wider beneficial side effects but only to a restricted population, be it gender, blood type, etc.  I end to find some lectures in medical ethics.