Archive for the ‘personal’ Category

Alaska in September.

Saturday, September 17th, 2016

We spent ten days in Alaska this month. The weather was almost perfect with only one rainy day which coincided with an 8 hour train trip.

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We stayed at the Hilton, where I stayed when I was there 23 years ago. We had dinner the first night at Simon and Seaforts, which I considered the best sea food restaurant I had ever visited. For some reason the food was not as good as I remembered but it was still full on Thursday night.

The next morning, we got up early and caught a bus at the Convention Center, called the Eagan Convention Center. There followed a six hour bus ride, broken by a short stop at McKinley Wilderness Lodge, about opposite Mount McKinley (Denali now).

denali-jill

The view from the Lodge is terrific. We were still a long way from our destination, however.

The bus finally dropped us off at The Denali Cabins, which are right outside the park on The Parks Highway.

There we were picked up by another bus, this one to take us to the The Denali Backcountry Lodge, another 92 miles into the park.

The Backcountry Lodge is a private company that occupies (with some passive resistance by the Park Service) some old gold mining claims. It was not there when I visited the Park 23 years ago although the gold claims go back to before the park existed. There is another lodge back there called The Kantishna Roadhouse, and the whole area is a community called Kantishna, although some old prints show that the name was originally Kantshitna. You can’t find a link to the old name but it was there on a photo of an ancient poster.

We left the Denali Cabins at 1 PM and arrived at the Backcountry Lodge at 7:45 PM, a trip of seven hours. Part of that is the 92 miles, of which the last 72 are gravel. Part of the time was spent looking at animals we encountered in the park.

denali-bear1

This was the first bear we saw on the way. We also saw caribou.

Caribou single

Here are two about 100 yards away. When I was there before, 23 years ago, we saw caribous cross the road just ahead of us but not this time.

Finally, we arrived at the lodge just in time for dinner, which they had delayed about 45 minutes for us. There were about 30 people staying there and our table mates remained as such the next few days.

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A day on Vashon Island.

Sunday, August 14th, 2016

I have been visiting Seattle since my first trip there in 1959. At the time it was a pretty city but not too prosperous. The saying at the time was that “If Boeing gets a cold, Seattle catches pneumonia.” Boeing was the only large employer. Now, it has Microsoft and Amazon and a bunch of internet spinoffs.

In 1987, I bought five acres on Vashon-Maury Island. Actually the two islands are connected by a man made isthmus called “The Portage.” My lot was on Maury Island and I later bought a lot next to it so that my property was ten acres. It had a well that I owned two shares of five and there was a large storage tank that serviced the only structure, a house next door. I owned those lots for ten or twelve yrears, always anticipating moving there in retirement. I had an architect named Nora Jaso, who was going to design a custom home. The property had 60 blue heron nests on one corner and I agreed to make that portion a preserve. This photo may be of that rookery.

ACross the street, 248th street, there was a gravel quarry which is now a park.

I sold the ten acres in two parcels about 15 years ago and wish I had kept at least one. Now, I am looking at the island again.

The island is reached only by ferry boat. There is a ferry landing at each end of the island. The north end terminal serves West Seattle and then Seattle across a bridge. The south terminal serves Tacoma.

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Ferry to Vashon

Here is a photo taken from the ferry on the way over.

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North Ferry Terminal

The north ferry terminal is under repair and this view shows it as I was waiting to go back to Seattle.

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Downtown Vashon

Here is a view of “downtown Vashon” which does not have a stoplight.

I had lunch at a cute restaurant called “The Hardware Store” which is about at the spot the camera is in that photo.

I talked to a real estate lady who showed me two houses, one of which we went through in detail. Houses on Vashon are not cheap.

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Manzanita Beach Road

We looked at a small house on the island which I liked a lot but we are months from any decision to move there. That is the view from that house.

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Beach House.

Here is that house. It is two bedrooms and one and one/half baths but quite nicely finished inside.

We will go up again in a couple of months when we are back from Alaska. We also looked around Oregon near where Rick lives.

Oregon.

Wednesday, August 3rd, 2016

We spent the last week in Oregon about 40 miles from Portland. It is the Oregon wine country.

The country is hilly and beautiful with so many wineries that it looks like Napa Valley.

My wife’s son lives there with his family on a 48 acre compound near the town of Mcminnville.

Their home is at one side and there are other homes there for the other family members who live there..

Not far away is a very nice aviation museum.

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They have a great collection of WWII warbirds with another collection of jet fighters outside.

The museum has had a few financial troubles since the founder died a few years ago but seems to be OK now.

As I watch the election, I am thinking of a bolthole and rural Oregon might fit the bill. Housing is pretty cheap and the country is very pretty. Lots of rain in the winter and a bit of snow, so we will take another trip in a few months.

Memorial Day

Sunday, May 29th, 2016

MIkeMedals

I don’t remember much of the Second World War although I was alive for all of it. I can remember being taught some of the WWII songs, like “Don’t Fence Me In” and “Mairzy Doats.”

Most of the friends and relatives of military age went in and most returned after it was over. Not all did and the man in Bud Kerrison’s squadron who sent me the medals in the photo, was shot down and killed before I received them.

theSalute

Here, I am saluting Bud Kerrison before he went overseas. He had completed bombardier training. He served in the North African Theater and flew 50 missions, from June 1943 to January, 1944. He served in The 301st Bomb Group, 352nd Squadron.

His B 17 was named by the pilot, “Spirit of Phyllis” after his girlfriend or wife and also after an earlier plane that had crash landed in England, named “Phyllis.”

Bud's plane

There is “Phyllis” after the crash landing in England.

When the war ended, the guys all came hime and my parents had parties for them.

Saloon

That is one of the parties in 1946. My father is behind the bar and Bud Kerrison is also behind the bar with Pat Neary who would later marry a friend of Bud’s named Frank Flanagan. Frank stayed in Chicago after that although his father had been Chief of Detectives in Philadelphia. Pat’s father was an Inspector in the Chicago PD so they were a police family. I have previously recounted the story of Frank.

Well, we all get old. Bud did too and is gone now.

BudKerrison

There he is with his kids who are now all grown. I would love to have been able to take him up in a B 17 as I did my son for a birthday present a few years ago.

B 17 nose and Joe

There’s Joe in what had been Bud’s “office” as Dana Andrews described in in the pivotal scene of “The Best Years of Our Lives. “

Planning another vacation.

Sunday, April 24th, 2016

After our bad experience last year with Europe, we have decided to stay in north America this summer. In June, we plan a trip to Chicago, partly to review family history.

In September, I am planning a bit more adventure in Denali National Park.

I have been there before and we had a family trip 20 years ago with all my kids. We rented a motorhome.

kids alaska copy

This worked well and we spent almost two weeks with time in Denali Park and in the towns of Seward and Valdez.

Kids in Alaska

My youngest was 13 and the other three were all adults. My older daughter had just taken her bar exams in Washington State.

We drove from Anchorage to Palmer where there was a nice RV park with water and power at each site. There we parked for a couple of days and did a couple of local tours.

Camper dinner

The dinners were prepared in the motorhome and we would often be having dinner at 10 PM or later because the sun did not set until 1 AM at that time of year. It was easy to forget how late it was but we weren’t getting up early anyway.

Claire Alaska

The kids got to walk on glaciers. My younger daughter, Claire, is wearing my wool shirt for the glacier jaunt. She had to sleep in the folded down dinette and her brother got her up early every morning so everyone could have breakfast.

Bears

The kids got to see few bears and the rest stops had big warning signs to never take food with you out of the bus.

This year we are going to do something different.

denali-backcountry-lodge

We are going to fly to Anchorage and take a Princess tour that includes a bus to Denali Park and a three day stay at the Backcountry Lodge in the park. It is 50 miles into the park and surrounded by wilderness. The lodge is not roughing it.

BN-DBL-River-View

It is located on a creek that flows past and there is a lake nearby. There are day tours for those more energetic.

Anyway, I have made reservations for early September which is after most of the tourist season. I’m looking forward to it. I tried to interest our English friends in coming over to go with us but they have other things to do.

Denali_Backcountry_Lodge4

I can’t think of a much better way to spend a week. After the lodge, we will go back to Anchorage and then to one of my favorite places, Homer Spit.

homer spit

It doesn’t get much better then this although the hotels are a bit basic. Some of the kids who work on fishing boats just camp on the beach. They got out for days at a time and no one bothers their stuff.

tents

Life is good. Some of these kids can make $50,000 in a summer with no expenses.

Why Importing Foreign Doctors may not fix the shortage.

Sunday, April 17th, 2016

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The coming doctor shortage that I have previously written about might be dealt with as Canada did with theirs some years ago, by importing foreign medical graduates. Britain has adopted a similar plan as thousands of younger doctors plan to leave Britain.

How is the plan to import foreign doctors working out ?

Not very well.

Nearly three-quarters of doctors struck off the medical register in Britain are foreign, according to shocking figures uncovered in a Mail on Sunday investigation.
Medics who trained overseas have been banned from practising for a series of shocking blunders and misdemeanours.
Cases include an Indian GP who ran an immigration scam from his surgery, a Ghanaian neurosurgeon who pretended he had removed a patient’s brain tumour, and a Malaysian doctor who used 007-style watches to secretly film intimate examinations with his female patients.

First of all, foreign medical schools are often limited in real experience and students often graduate with nothing beyond classroom lectures.

This was the case with Mexican medical schools, like that in Guadalajara where many American students attended. A program was devised to provide them with a year of clinical training before they could be licensed.

The revelations come just a week after it emerged health bosses want to lure 400 trainee GPs here from India, to help ease short-staffing in the NHS.
Last night Julie Manning, chief executive of think-tank 2020 Health, said: ‘The NHS has thrived on many international doctors coming to work in the UK – but the public needs reassuring they are all truly fit to practise in the first place.’

Of course, the foreign doctors have their defenders.

Dr Ramesh Mehta, president of the British Association of Physicians of Indian Origin, admitted ‘there is a problem’ with the high strike-off rate among foreign doctors. But he claimed racism played a part.

We have a similar problem with affirmative action medical graduates but the figures are not available about their rates of license revocation. For example, the The Alan Bakke case went to the US Supreme Court, which eventually ruled in his favor. By the time the court ruled, years had gone by and Bakke eventually did gradate from medical school and has practiced quietly ever since.

However, a black student admitted by the program that denied Bakke a place was subsequently prosecuted for gross negligence and his license removed. Affirmative Action has been vigorously defended.

An admissions process that allows for ethnicity and other special characteristics to be used heavily in admission decisions yields powerful effects on the diversity of the student population and shows no evidence of diluting the quality of the graduates.

However, the conclusion does not match the findings in the study.

Regular admission students had higher scores on Parts I and II of the National Board of Medical Examiners examination, and special consideration students were more likely to repeat the examination to receive a passing grade.

The article goes on to explain that There was no difference in completion of residency training or evaluation of performance by residency directors.

A friend of mine was the Chairman of the Department of Surgery at a UC medical school who decided to fire a black female resident for incompetence. He was advised by the UC system and the other department heads that he would lose a lawsuit if she filed one. She did, in fact, file such a lawsuit alleging racial prejudice (of course). The department chair was able to successfully defend his decision but the fact that no one else was willing to try explains the finding that There was no difference in completion of residency training or evaluation of performance by residency directors.

I have had the experience of being a Surgery Department Chair in a community hospital confronted with the application of a known incompetent surgeon. The same factors apply to those known to be dishonest. A request for a letter of reference from the department in which the applicant trained usually results in a response that states, “The applicant completed the residency from X date to Y date.” No other information is provided and a further request is usually answered by “The matter is in litigation,” or words to that effect. This applies to all such applicants but affirmative action individuals are almost impossible to find negative information on even if the “grapevine” has provided warnings.

The general concern can be found, but details are thin on the ground.

A quick scan of the documents reveals that white students applying to medical school with a GPA in the 3.40-3.59 range and with an MCAT score in the 21-23 range (a below-average score on a test with a maximal score of 45) had an 11.5% acceptance rate (total of 1,500 applicants meeting these criteria). Meanwhile, a review of minority students (black, Latino, and Native American) with the same GPA and MCAT range had a 42.6% acceptance rate (total of 745 applicants meeting these criteria). Thus, as a minority student with a GPA and MCAT in the aforementioned ranges, you are more than 30% more likely to gain acceptance to a medical school.

There are other sources of the facts, but they don’t appear in mainstream publications. Social Justice keeps most of these concerns underground.

A friend of mine, who is Cuban born and an immigrant as a child, applied to UC, San Francisco medical school. This was in the 1970s. Affirmative Action was well underway. He waited several weeks, then months, to hear if he had been accepted. Finally, he drove to San Francisco and asked someone in the Admissions Office what had happened to his application. He was told that it was in the “Hispanic Applicant Committee.” Having no idea what criteria such a committee might be using to determine who should be admitted, he asked if his application could just be considered as a “white” applicant. This was done and he received a letter approving his admission a few days later.

The pressure is now on medical education to provide the hundreds of thousands of new doctors this society believes it needs. Productivity of the present graduates is well below that of my generation. Some of that is the disappearance of fee-for-service practice which motivates work ethic. Some of it is a result of the 60% female medical school classes.

The female doctor population is acknowledged to work less.

Today, however, increasing numbers of doctors — mostly women — decide to work part time or leave the profession. Since 2005 the part-time physician workforce has expanded by 62 percent, according to recent survey data from the American Medical Group Association, with nearly 4 in 10 female doctors between the ages of 35 and 44 reporting in 2010 that they worked part time.

This was the reason why medical school admissions committees “discriminated” against female applicants in the 1960s when I was a medical student. They were concerned, even then, about a doctor shortage and assumed women would stop working to have children or practice part-time.

They were absolutely correct.

Canada is finding some productivity issues and even some explanation.

a fee for service model, and its inherent encouragement of increased productivity through increased volume of patients, a significant shift away from this single model is taking hold.

This, of course, will not deter the Social Justice types as more doctors with less productivity is somehow more efficient than paying doctors more to encourage higher work loads. Socialism is the aim, productivity will have to take care of itself.

In the meantime, PHYSICIANS WHO DID not attend medical schools in the United States or Canada, referred to as “international medical graduates (IMGs)”, play an integral role in the U.S. health care system. Such physicians now represent approximately 25 percent of practicing doctors nationwide.

It’s going to increase.

Feminism and Victimhood Culture.

Friday, April 8th, 2016

We are living an age when any reference to women runs the risk of violating the “victimhood” rights of feminist women.

What is “Victimhood?” It was explained by two sociologists in 2014.

We’re beginning a second transition of moral cultures. The first major transition happened in the 18th and 19th centuries when most Western societies moved away from cultures of honor (where people must earn honor and must therefore avenge insults on their own) to cultures of dignity in which people are assumed to have dignity and don’t need to earn it. They foreswear violence, turn to courts or administrative bodies to respond to major transgressions, and for minor transgressions they either ignore them or attempt to resolve them by social means. There’s no more dueling.

The “Honor Culture” requires that one avenge insults to preserve honor. The law and third parties are avoided and this culture is typical of areas where law and authority is mostly absent. A classic example is the American West in the Age of the Frontier. As law and authority became available, the culture gradually changed to one of The Culture of Dignity in which people are assumed to have dignity and don’t need to earn it. They foreswear violence, turn to courts or administrative bodies to respond to major transgressions, and for minor transgressions they either ignore them or attempt to resolve them by social means. There’s no more dueling. Lawyers have made this culture ubiquitous, even in war.

Now, we have a new phenomenon.

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The Doctor Shortage, discovered once more.

Friday, April 1st, 2016

33 - Lister

I have previously written posts about a coming doctor shortage.

They assume that primary care will be delivered by nurse practitioners and physician assistants. They are probably correct as we see with the new Wal Mart primary care clinics.

The company has opened five primary care locations in South Carolina and Texas, and plans to open a sixth clinic in Palestine, Tex., on Friday and another six by the end of the year. The clinics, it says, can offer a broader range of services, like chronic disease management, than the 100 or so acute care clinics leased by hospital operators at Walmarts across the country. Unlike CVS or Walgreens, which also offer some similar services, or Costco, which offers eye care, Walmart is marketing itself as a primary medical provider.

This is all well and good. What happens when a patient comes in with a serious condition ?

The health policy “experts” have been concerned to train “lesser licensed practitioners” and have pretty much ignored primary care MDs except to burden them with clumsy electronic medical record systems that take up time and make life miserable.

I repeatedly ask medical students if they would choose a career in primary care if it would completely erase their student loan debt. A few hands go up, but not many. In fact, for a while now, the federal government has dedicated millions of dollars to repaying loans for students who choose primary care. Yet residency match numbers show that the percentage of students choosing primary care is not increasing. Though loan forgiveness is a step in the right direction, medical students realize that by choosing a more lucrative specialty, they can pay off their loans just fine.

I proposed years ago, a health reform that resembled that of France where medical school is free. It could be arranged that service in primary care, low income clinics would give credit against student loans. Nothing happened. Except physician income has declined. And tuition has increased.

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We were pretty close.

Friday, March 18th, 2016

When we were in Brussels last September, we stayed at a nice hotel near the Grand Place called The Bedford Hotel and Congress Centre.

belgium-brussels-grand-place

I showed some of our photos here.

The Grand Place is about four blocks from our hotel which is quite central. Also fairly central is Molenbeek where the leader of the Paris terrorist attack was captured today.

brussels

To the left is the canal and across it, the Molenbeek neighborhood where the terrorists were holed up. We walked by it during our stay which was a few weeks before the attack. Our hotel was locked down for a week after the Paris attack as they searched for the perpetrators.
We were very close.

Another update on the NHS, Bernie’s favorite health plan.

Friday, February 12th, 2016

NHS

I have mentioned problems with the NHS here before.

That was about emergency care.

Last fall there was a concern about junior doctors emigrating to other countries.

Britain is already suffering from a serious, and unprecedented, shortage of GPs, on a scale that doctors’ leaders say is fast becoming a crisis.

According to figures released last week, a staggering 10.2 per cent of full-time GP positions across the UK are currently vacant, a figure that has quadrupled in the past three years.

Two-thirds of practices are now finding it ‘difficult’ or ‘very difficult’ to find locums — freelance medics — to cover the shortfall.
As our population gets steadily older, and sicker, frontline surgeries are becoming increasingly swamped.
‘We are in dire straits if we do not act to address the GP recruitment crisis immediately,’ the Royal College of GPs warned last week.

In standard government medicine fashion, the British Health Minister imposed a new employment contract that ignored doctors complaints.

The result ?

Junior doctors are threatening a mass exodus to Australia after Jeremy Hunt forced through his controversial new contract yesterday.
There has been a huge surge in the numbers seeking certificates to practise abroad and some have already lined up jobs.
Almost 760 doctors were issued with documents by the General Medical Council in the first four weeks of this year – nearly 200 a week and almost double the usual number. Although they include some older GPs and consultants, the vast majority were disillusioned younger doctors.

Becoming a doctor is a classic middle class occupational choice. Few doctors become rich and almost none do so from actual practice. There was a phase in the 1960s when doctors suddenly became much more prosperous as Medicare was introduced, providing payment for care that had been done for no charge mostly. With time, the US government has reduced compensation and imposed rules designed to reduce costs. With the imposition of Obamacare, many older doctors who do not have heavy student loan balances and whose own children are educated, are choosing to drop all insurance, including Medicare, and practice for cash.

Obamacare has resulted in many hospitals consolidating and buying up medical practices to develop a vertically integrated system of health care delivery that resembles old industrial models. The result for physicians is a trend to salary jobs and dissatisfaction with their careers.

I met a woman geriatrician, the only fellowship trained geriatric specialist in central Iowa. She had quit Medicare. That sounds a bit suicidal if all your patients are Medicare age. What had happened was she was being harassed by Medicare because she was seeing patients too often. Many of them were frail elderly living at home. She dropped out and began charging her patients cash for services. She was making a decent living after a year and was happy with her decision. I don’t know how many realize that geriatrics, as a specialty, is a university subsidized field. There is no private geriatric practice because the doctor can’t survive on what Medicare pays. She tried and had to quit. She is doing it on her own now.

That was about Medicare. The same is happening with Obamacare and the medical conglomerates that have been assembled in anticipation of the “Industrial Model” of medical care. How is that working out in Britain ?

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