An Addenda for Kate

Fall and the Samain Moon

Grateful for this article: Doctors at Allina Health Unionize and even more grateful for the docs who made it happen.

Kate retired in 2011, 12 years ago. She had burned out on medicine long before. Why? Not her patients. But the demands of corporate medicine and its rabid insistence on revenue capture. Upcoding was pushed and pushed hard. Upcoding means doing those things in a visit that qualify for a code that brings in more money than the original or anticipated code for the visit. Patient visits were shortened. Again, more patient visits per day means more revenue capture. Though it wasn’t often an issue in pediatrics the shortening of hospital stays did affect Kate’s sickest patients since they were the ones who ended up in the hospital. Note that neither upcoding nor shorter patient visits nor shorter hospital stays have good patient care as their motivation. In fact the results are often the opposite of good patient care. That is, to be clear, they create bad care.

Kate and I talked about doctor’s unions a lot. Looked up some information. Talked to some others. But the time wasn’t right. The pandemic induced staffing shortages have made this the right time. And I’m so glad, for Kate’s sake, that leaders in this new movement are physicians at her old place of employment: Allina.

Go union!

Cancel Culture

Fall and the Samain Moon

Saturday gratefuls: My colon. Meds. My son, Seoah, Murdoch. Songtan. Evergreen. Conifer. Pine. Bailey. Us Mountain folk. Those down the Hill. Stars in the night Sky. Great Sol. Israel. Hamas. The rules of war. War. The USAF. Diane. Tom. The Ancient Brothers. This computer, now so old yet still at work. Palestinians. Israelis. Lebanese. Iranians. All human. Difference. So potent. The Fox yesterday at Upper Maxwell Falls. Aspen’s lighting the way toward heaven. Toward the light in the inner sky. Fall in the Rockies.

Sparks of Joy and Awe: 21 degrees right now

One brief shining: My neighbors and I have only one evacuation route, left or right, toward Conifer or Evergreen, and if wildfire comes we’ll pile up on it in haste like the Gazans now trying to leave the north of an already small territory, the wildfire has come for them in the form of the IDF, a human wildfire stoked by rage and vengeance, what we here in the Lodgepole forest would call a crown fire.

 

First thing now I look at Haaretz, then Yediot, then the Jerusalem Times. Later I scan the NYT and the WP. Not sure what I’m looking for, trying to find a way through this thicket of information. One that doesn’t end in news I don’t want to see or hear. No luck with that so far.

I feel like I can have a good grasp of what’s going on at least at a macro level, but at the point of individuals and families, suffering. No. I think of my son and his family first value. Must be the same with Israelis and Palestinians. Right? What does, can that mean in the current context?

Speaking of context. I found this opinion piece by Haaretz columnist, Anshel Pfeffer, very astute on the larger and historical context anti-semitism places on the Israeli/Hamas struggle: The Inconvenient Context: Palestinians Massacred Jews for Being Jews

As of this writing, I’m 98% sure I’m not going. Diane rolls her eyes here. Why not 100%? Well. You know. Until we all discuss it together I won’t decide for sure.

Several couples have already canceled their flights and Keshet, our tour operator, will send out a letter on Monday or Tuesday outlining our options with them. I hope postponing is the favorite option. I’m willing to let them hold onto my money if that will help them survive this crisis. Not keep it. But hold onto it until another tour can get scheduled.

 

Meanwhile American Republicans rise to this escalating military and humanitarian crisis by failing to choose a speaker for the House. By supporting their felonious candidate who dodges debates and acts like a spoiled child angry at his parents. By trying to force the government into a shutdown. Again.

We, the world hegemon, cannot act within our own system of governance. How can we expect to be guarantors for any one else?

Read an interesting analysis that suggested the Ukrainian and Hamas/Israeli situations might be linked to our waning power as hegemon. Regional actors may feel emboldened to just go for it in situations where the threat of U.S. intervention would have given them pause in the past.

This is called multi-polarity, a world in which no one power dominates. Hope this is wrong.