Sunday, June 28, 2009

Out of the Darkness Chicago

Alongside thousands of others we walked into the dawn as part of the American Foundation for Suicide Prevention's, Out of the Darkness Overnight Walk. The goal of this journey, is to raise funds for suicide prevention. I would like to help end the silence and erase the stigma surrounding suicide and its causes, encourage those suffering from mental illness to seek treatment, and show support for the families and friends of the 30,000 Americans who die by suicide each year. Suicide is the third leading cause of death among teens and young adults and the second leading cause of death for college students
Since 2000, the AFSP has awarded over 8 million dollars to scientists for suicide prevention research. Proceeds from the walks, in part, will help to fund 18 studies this year. Research is critical to learning more about interventions that can prevent this needless loss of life. Suicide is preventable and is increasing across the world.

Some facts from the World Health Organization (WHO):

•In the year 2000, approximately one million people died from suicide: a "global" mortality rate of 16 per 100,000, or one death every 40 seconds.

•In the last 45 years suicide rates have increased by 60% worldwide. Suicide is now among the three leading causes of death among those aged 15-44 years (both sexes); these figures do not include suicide attempts up to 20 times more frequent than completed suicide.

•Suicide worldwide is estimated to represent 1.8% of the total global burden of disease in 1998, and 2.4% in countries with market and former socialist economies in 2020.

•Although traditionally suicide rates have been highest among the male elderly, rates among young people have been increasing to such an extent that they are now the group at highest risk in a third of countries, in both developed and developing countries.

•Mental disorders (particularly depression and substance abuse) are associated with more than 90% of all cases of suicide; however, suicide results from many complex socio-cultural factors and is more likely to occur particularly during periods of socioeconomic, family and individual crisis situations (e.g. loss of a loved one, employment, honor).

I want to thank everyone who supported me in this important effort and share some of the night with you. The walk itself was amazing. The crew was outstanding, they cheered the whole way. They moved thousands of people through Chicago, fed us, cared for us, gave us fluids and walked with us. They were professional, supportive and made the experience wonderful for all.
It seemed an endless number of siblings walked with us. Everyone was telling stories of their loved ones. They were stories of joyous memories, a camping trip, a family joke, a favorite sporting event. It was nice for our family to walk with everyone and listen. We walked along the lake with a gentleman who lost his father. We emerged from the city where it was raining and there was lightening in the sky to a clear night sky and warm breeze along the lake. We walked quietly along the lake with him for about half an hour. He told us about the first Overnight Walk he did in 2006, and how it took him over a decade to bring himself to do it. It has been 19 years since his fathers death. He was excited to see his family who were to greet him at Soldier Field.

We met Dana Perry, a mother who lost her son to suicide and went on to make "Boy Interrupted," a film about her son and his death. Every story or set of beads signifying a loss was heartbreaking. We walked and listened to amazing accounts of amazing people. We had many stories of our own, but at some point in the night the chronicles became one story we all shared, a tragic loss and a walk of hope. As we entered Soldier Field our family was waiting. My youngest son needed my Gatorade-I can only assume the 10 minute cab ride tired him out! It was wonderful to see them. We walked along the path that glowed with the light of the luminaries. I thought of my friend Jeremy who reminded me that we are walking for all those who no longer walk with us yet walk through us. We are walking to save lives.

I am deeply grateful to those who supported me in the walk and to those who shared your stories about how suicide has touched your life. Thank you for helping to save lives, reach out to those families who are devastated from losing a loved one to suicide and to end the silence. Thank you for your support in bringing the devastation of this preventable loss of precious life Out of the Darkness.

Tuesday, June 23, 2009

Health Reform: What's being Proposed on The Hill

Sent to me today here is a helpful tool from the KFF website:

Side-by-Side Comparison of Major Health Care Reform Proposals

"Achieving comprehensive health reform has emerged as a leading priority of the President and Congress. President Obama has outlined eight principles for health reform, seeking to address not only the 45 million people who lack health insurance, but also rising health care costs and lack of quality. In Congress, a number of comprehensive reform proposals have been announced as the debate begins over how to overhaul the health care system.

This interactive side-by-side compares the leading comprehensive reform proposals across a number of key characteristics and plan components. Included in this side-by-side are proposals for moving toward universal coverage that have been put forward by the President and Members of Congress. In an effort to capture the most important proposals, we have included those that have been formally introduced as legislation as well as those that have been offered as principles or in White Paper form. This side-by-side will be regularly updated to reflect changes in the proposals and to incorporate major new proposals as they are announced."

- Kaiser Family Foundation, June, 2009

Sunday, June 21, 2009

Closing The Door: A Father's Day Gift

My dad....

Anyone who’s ever watched me present on The CCRMC System Redesign has heard me speak of my father. In my blog entry on his birthday, I disclosed how disorienting the experience of being a ‘daughter at the bedside’ was for me.

“I tried to keep up as the teams rounded on him. It seemed so odd that after all the time I had spent in a hospital, I hadn't a clue how it all worked. I couldn't figure out who was in charge of which part of his body. I couldn't keep up with his deteriorating health and growing amount of health care intervention.”

It seemed in just a few short weeks my father went from being a strong independent man who always knew best, to a person reduced to a diagnosis, a set of complicated and ever-changing presentations. He became a man who was dependent on a system of care surrounding him that didn’t seem to truly grasp how far away he was from himself. After knowing him my entire life, experts began to redefine him in terms I would have never considered using to describe my father: the Acute Renal Failure (I even heard them say ARF); the pancreatitis in 12; confused, demented, elderly. Sometimes (I believe in an attempt to reassure us) we were told “for his age this is common.” It was anything but common. It was absolutely unique for him and for us as a family.

I remember my Dad’s last Father’s Day. He was in the hospital and I gave him a collection of CDs. It was an audio collection of mystery radio. When I was a young girl, my mother went to law school at night. My dad and I would drive 30 minutes to the school and sit in the car waiting for my mother to get out of class. We would listen to Radio Mystery Theater with E.G. Marshall. It was an attempt at radio show revival during the 70's. During the show, we would try to guess who committed the dastardly act. I would "rest my eyes" in the last 15 minutes but I would pretend I was awake the whole time and my dad always played along. The show would end about 15 minutes before my mother actually came out. My dad and I would explain our rationale for choosing the suspect and almost always our conversations would wander.

We traveled very little, we were a big camping and hiking family. I always wanted to see the great cities of the world, so my dad would tell me a story about a place he had gone when he was in the military. He would recall little details which didn’t often reveal very much about the place of interest, but revealed a tremendous amount about his experience of being there. He would describe how warm or cool the wind was, the smell in the air, colors people were wearing, what the food tasted like, and the feel of the ground under his feet. His stories were always my favorite part of the day. If ever I asked for him to tell me about a place he had been, he would always, without fail, deliver. He was a great storyteller.

If the truth be told the radio show CD's were probably more for me than him, but as always, he played along. I placed the CD in the portable stereo I had brought from home. I think he quite liked the idea, but didn’t really listen, because I don’t think he felt well enough. He drifted in and out of sleep. His nurse peeked in the room and motioned to me she would come back. She softly shut the door and at that moment every monitor, hall conversation, ringing telephone and supply cart rolling by faded into the distance. It was like sitting in the dark parking lot in our family car, I and my dad and Radio Mystery Theater, just as I remembered. When the show was over my dad opened his eyes and said “I knew who did it the whole time.” He smirked because we both knew he had no clue, he was fast asleep. He asked me how school was going and I told him all about Parnassus Campus (one of my favorite places). I shared little details about Millbury Union, the beautiful fog that seemed to linger all day, and the great library. He said he remembered it well, calling it “the crossroads of the world.” He complained that no one goes anymore and soon young people will not understand the silence of the great rooms of knowledge and the smell of old books. The nurse came and went and my dad drifted off to sleep. I did too, I was exhausted.

While walking through the medical center tonight I reflected on Don Berwick’s plenary speech at the 2009 International Forum on Quality and Safety in Health Care in Berlin. He believes that we would all be better off "if professionals (us) would behave with patients and families not as their hosts in our care system, but as guests in their lives.”

We can count how many patients are in the hospital, but how many lives are we really touching? So many people make up our experience of living: people whom we can delight just by slowing down from our hurried pace and taking a moment to listen to them with an aim to understand what they are telling us; people whom we can disappoint, because too often we assume we know what is right and we define them relying on our experience as a professional, rather than on their experience as a unique and vibrant individual with stories and experiences that far exceed anything we will have the privilege of knowing.

I thought about the nurse who shut the door for my dad. A gift from her to us. No more monitors, no more call lights, no more ringing telephones, just me and my dad and Radio Mystery Theater, just as I remembered. She took the time. She gave us respite from the unsettling experience of being in a hospital. She gave us a moment of peace and quiet on our last Father’s Day. On that night, that nurse not only cared for my father, she touched my life too.

It was great to see so many of you tonight. It's been too long.

Happy Father's Day

Thursday, June 18, 2009

National Health Care Day of Service: June 27, 2009

You can find this and more on the Organizing for America Web page...

National Health Care Day of Service

This summer, Organizing for America will fight to ensure Americans receive much-needed health care reform in 2009. Community service is a critical piece of our health care campaign and our National Health Care Day of Service on June 27, 2009 will highlight its importance.

These health care service projects give volunteers a chance to make an impact in their own communities while we simultaneously fight for long term, systemic health care reform.

Some Events in Contra Costa County:

OFA Health Care Reform Canvassing at Richmond CA Juneteenth Celebration.
Thursday, June 25 Shifts begin at at 10:30 AM, 12:30 PM, 2:30 PM (3 shifts)
Join us as we celebrate JUNETEENTH FAMILY DAY FESTIVAL by canvassing for President Obama's Health Care Reform. JUNETEENTH FESTIVAL will be at Nichol Park, Richmond

Saturday, June 27 Shifts begin at at 9:10 AM, 2:03 PM, 4:05 PM, 6:07 PM, 11:12 PM (5 shifts)
This June 27th National Health Care Day of Service project is to create awareness of president Obama's healthcare reform plan.

Central Contra Costa OFA Health Fair
Saturday, June 27 10:00 AM
O F A (CD's 7 And 10), Senator Mark DeSaulnier, Supervisor Susan Bonilla And Community Health Providers you to Join Us for a Free Community Health Fair!
Enjoy the food and games and visit booths that showcase our local health care services, including*:
Family Health Screenings,
Veterans Services,
Mental Health Outreach,
Women’s Health Services and Family Planning.

*Information available in English and Spanish

VA Hospital Martinez Veterans Visit
Saturday, June 27 Shifts begin at at 10:00 AM, 12:00 PM, 2:00 PM (3 shifts)
Team, The visit this month to the VA Hospital will be on this Saturday June 27, 2009 the National Health Care Services Day for OFA. This visit will be part of the activities this month planned by Organizing for America which is a part of the Democratic National Committee’s support for President Obama’s work toward ensuring every United States Citizen receives adequate health care during their life time. There are men and women at the hospital and they all are our heroes for various reasons that we all share.

Wednesday, June 17, 2009

Check out Stuart's publication

Stu and others propose a consensus statement to define and standardize the scope of procedural training and practice in family medicine.

Kelly BF, Sicilia JM,Forman S, Ellert M, Nothnagle M. Advanced procedural training in family medicine:a group consensus statement. Residency Education, Family Medicine. June 2009;41(6):398-404.

Saturday, June 13, 2009

The promise of El Sistema … and the promise of our system

It has been a particularly challenging week for the medical center. I needed the encouragement of this video that was sent to me anonymously this week and I wanted to pass it along to you. It came to my attention via the blog comments section with the simple comment "Reminder." It was a link to a TED talk, a site I was directed to from my dear friend Karen last year. I'll confess up front, I love TED talks. Although I watch them often and follow them on Twitter, this particular talk had escaped me. I'm grateful it found its way to me.

Having just returned from a conference, my inbox had accumulated quite a stack of material. As I sifted through the pile, I clicked on the video and turned up the volume. I thought I could cheat a bit and listen while I organized. This didn't last long. I had to look up because the man was speaking Spanish and I realized there were subtitles to assist me. There were no flashy graphics or special effects. The video is simply a man speaking, but his passion and commitment were gripping. The talk is 17 minutes in length, but during those 17 minutes everything else stopped. I couldn't get up. I was profoundly moved by his words.

Here is why TED says you should listen to him..

The gulf between the rich and the poor in Venezuela is one of the worst in the world. José Antonio Abreu, an economist, musician, and reformer, founded El Sistema ("the system") in 1975 to help Venezuelan kids take part in classical music. After 30 years (and 10 political administrations), El Sistema is a nationwide organization of 102 youth orchestras, 55 children's orchestras, and 270 music centers -- and close to 250,000 young musicians.

There is a simple concept behind Abreu's work: for him an orchestra is first and foremost about togetherness, a place where children learn to listen to each other and to respect one another.

He reflected on his first session when he had planned for a hundred, but only 11 children showed up. He said at that moment he realized his choice was to abandon the program or multiply the children. That night in 1975 he promised those 11 children he would turn their orchestra into one of the leading orchestras in the world. He kept his promise and El Sistema has since touched the lives of over 250,000 children, their families, their communities and the world. Abreu describes the experience as "more than just an artistic triumph, but also a profound emotional symphony between the public of the most advanced nations in the world and the musical youth of Latin America as seen in Venezuela..."

He reflected on the words of Mother Teresa who said the most miserable and tragic thing about poverty was "not the lack of bread...but the feeling of being no-one, the lack of identification, the lack of public esteem."

His message is elegant. His aim is simple--to keep his promise. "To strive for a more perfect, more aware, more noble and more just society."

The video reminded me of the profound privilege it is to serve the public and to work side by side with incredible staff. The talent and commitment in our system is inspirational. I was so moved by José Antonio Abreu because his passion and commitment to change the world is so familiar to me. It's the same passion and commitment that fills the halls of our medical center every day, even on the tough days. .

Tomorrow will come and so will opportunities to continue on our journey of growth and discovery. As we move through the days ahead, we will learn with each other and from other great systems around the world. We will stay the course and, through introspection and continuous improvement, transform our system. We will continue to fulfill our mission and no one will be left behind. This I promise you.

Here is Gustavo Dudamel and the Teresa Carreño Youth Orchestra from Venezuela (2009), because sometimes words just won't do.

"Music has to be recognized as an ... agent of social development in the highest sense, because it transmits the highest values -- solidarity, harmony, mutual compassion. And it has the ability to unite an entire community and to express sublime feelings." ~José Antonio Abreu


Monday, June 8, 2009

Officer Involved Shooting in the Emergency Department

All Staff message posted below

Hello all,

Early Sunday morning, we had an officer involved shooting in the ED at CCRMC. The situation is currently under investigation by the sheriff's office, Martinez PD, and by our Operations Safety and Performance Improvement Team. At this point, many questions remain unanswered.

However, the basic situation was as follows:

A middle aged male who was being admitted to the hospital produced a knife and threatened both staff and the deputy sheriffs. At the end of the altercation, the deputies used deadly force and the patient expired.

Our ED Staff was quite traumatized by the episode, as we can certainly understand. Please go out of your way to offer them as much support as possible. In the midst of a very busy work environment, this type of episode is simply overwhelming.

Please take the time to care for yourself and for your coworkers in these very difficult times.

We will have more information for you as it become available.