Where is Madison Avenue Anyway?

I've been thinking the last several days again about how lung cancer really does not have one central charity or foundation or research arm that could give it the base it needs to develop funding, education, research, treatment and finally cures. I know there are a number of different organizations that do lung cancer but none of them are real national powerhouses JUST for lung cancer. This comes through in a number of ways beginning with the small amount of funding for research into lung cancer, all the way up to what is the color of lung cancer if one were to have a ribbon pin made (hint: it's pearl grey--how bland) Frankly we need a ribbon czar to just show up and say this is what color it is going to be. I favor purple, but apparently that color's already been claimed by prostate cancer. See what I mean? There are already major roadblocks in place toward developing a compelling narrative complete with symbols. I'd even be happy with electric green if we could just get going on it!!

My idea is to co-opt April 19 away from the WACO and Tim McVeigh nuts and make that National Lung Cancer Awareness day. That would be the day where, among other things, we'd all wear our (gag) pearl grey armbands. I'd like some snappy slogan on mine. I've come up with two: "Lung cancer: Not just for smokers anymore" and "I Got Lung Cancer. Ask me how." As you can see, I like snark. I'm open to other suggestions as well.

At any rate, I would put on my (ugh) pearl grey armband with a snarky saying and then do a ceremonial parade outside my work office, which is a 48 story building in downtown Seattle. I'd walk really slow past the line up of smokers gathered outside the entrance way to indulge in their 'filthy' habit. And then I would stroll past again. Slowly (if I could endure the smoke),so they could catch a glimpse of my armband. Most probably wouldn't flinch, but I just want one to make eye contact and then edge away, so perhaps I could ask, "What do you think about this?" And maybe engage in a bit of one way conversation on my part (which given the status of my voice is a real fantasy). But us girls can dream.

Anyway, would love to hear your ideas for slogans to put on my armband. Maybe I could get some others to wear them too.

Happy Hump Day.

Update

I had my next monthly checkback with my oncologist this past Thursday. Previous to that I'd gone into Group Health's downtown office and had a blood draw. She only took two vials worth but I didn't inquire. But by the time of Thursday's appointment it was clear that no CBC (complete blood count) had been done. My symptoms of late have been mostly same ol' same ol'. Meaning not much of a voice and in fact it seems to be going a bit downhill. Newer symptoms were a persistent dry cough and increasing breathlessness upon what, to me, used to be slight exertion (read: walking back to the office from a Board hearing in Pioneer Square which entails going up one of the Seattle hills Garrison Keillor joked about in his broadcast of Prairie Home Companion this past Saturday at the Paramount Theater in Seattle).

So the oncologist put in a new order for a blood draw and ordered a chest xray. The next ct scan is set for the end of April. I had inquired about additional surgeries to try to repair my voice further, and to remove the 9cm cyst in my pelvis, but Dr. N thought that it would be best to wait til after the ct scans to see where I truly was with respect to the lung cancer. My daughter, who was participating with us on our phone conference, agreed that this seemed the best plan.

Friday I went to Group Health Central for the blood draw, to pick up my next month's supply of Tarceva (which seems to still be working as I've developed acne on my legs--if you can believe it?), and to get my chest xray. Afterwards, while I was waiting for my youngest son to pick me up, I received a call from my oncologist telling me that the chest xray showed everything was the same. Which was good, but I admit to being a bit disappointed. I wanted things to continue to shrink, dammit. He also told me that he was leaving Group Health effective the end of this week. That was a bit tougher to take. In fact despite all of the issues that I had with him in the past 4 months, I felt that we had reached a really good place in our doctor/patient relationship. It's slightly (ever so) like breaking up a marriage.

Family is doing fine. Sarah, my oldest, finished her surgery rotation at the VA and drove to Pocatello, ID on Saturday where she will be on a pediatric rotation. She decided surgery was not her bag. I think she will enjoy pediatrics. It was a 12 hour drive and there are no direct flights there, so luckily she is spared a parental visit, though it would be fun. We went shopping last weekend, which is unusual because she hates to shop. But she put up with me and was rewarded for her patience with a dress and skirt from Anthropologie. It reminded me of going shopping with my mother when I was a kid for an Easter dress. And I am definitely an old fart now, because I just don't get the current fashions for clothes. But everything she tried on looked lovely and I hope she has a marvelous Easter in a new place.

Oldest son Seth has decided that teaching is not for him and after the school year is ended, will be moving from Rhode Island back to the Twin Cities. He's going to go to the Univ. of MN to pursue, eventually, a graduate degree in engineering. He's also flying to Kentucky in late April to join me and one of my sisters, in a visit with my mother in Lexington. He's a very good kid to do this.

And the youngest, Matthew, is working part time at two city indoor pools in Seattle and attending North Seattle Community College. He recently moved into a house with four other young people and the next step is to get him his own transportation. It is getting a bit old to share my car with him. Though, of course, he seems to like it just fine!

The dogs are good to me. I haven't been up for much dog walking lately, and know that should change but the usual stern talking to that I give myself isn't working yet. The little one, Truffle, has learned not only how to use chairs to climb onto the table, she can open containers. I've lost a tub of parmesan cheese, a package of Cadbury easter eggs (foil too!) and this morning she got into my purse and made off with the chapstick and a plastic round filled with Ice breaker sours! Obviously she needs to be run and run hard. So time to gear up for spring and dodge the raindrops...

A happy Monday to all.

Health care: its balance sheet is different from other companies--or it SHOULD be

It's worth remembering during this time, that health care companies are not General Motors, but they are judged by the same free market standards. The failure to keep this in mind has set up and fostered the majority of the ideological and policy conflicts about health care reform.

The cost of health care in the United States jumped 47% from 2000 to 2006, but that didn't buy Americans the longest lifespan. With a life expectancy of 78 for a person born in 2007, the United States trails at least 27 other countries among 193.

The reason our health care system is in such terrible straits is that it is set up to generate profits, not to provide care. We rely on hundreds of investor-owned health insurance companies that profit by refusing coverage to patients and limiting services to others.They also cream off about 20% of the premiums for profits and overhead (including big fat salaries and bonuses for corporate heads). Furthermore, these health insurance companies are exempt from the federal anti trust laws.

Our health care system is directed toward maximizing income, not maximizing health. Private health insurance companies are profit-making institutions and your treatment is their cost. Health care cannot be marketed like TVs or cars. Consumer choice is nonsense when it comes to health care. You cannot rely on experience or comparison shopping when it comes to health care. In sum, health care just doesn't work as a standard market story.

There are no examples of a successful health care system based on the principle of the free market.

In contrast to private health insurers, Medicare doesn't have to spend millions on marketing, advertising and Washington lobbyists. On top of that, private insurers must generate profits for their shareholders, beyond the overpaid salaries and bonuses to corporate executives. But it's not just the cost of marketing, advertising, lobbying and providing profits for investors and bloated salaries and bonuses that makes private insurer's overhead so much higher.

Health insurers also have higher administrative costs because they are constantly enrolling and disenrolling customers as people change plans. In contrast, Medicare patients stay put. For private insurers, your healthcare is their cost, and the more healthcare is needed or required, the less profit they make. They do not like that!

And for those who think Medicare is less efficient because its oversight is lax and thus millions are lost to fraud, you can find numerous similar cases where healthcare providers have cheated private insurers. If anything, private insurers may be more laid back about this, because they can pass the costs associated with fraud onto their customers in the form of higher premiums. Medicare has a much harder time finding funds to cover fraud.

If more people were on Medicare, Medicare would begin to exercise its clout as the nation's largest payer, the way other governments do, negotiating with drugmakers and device-makers for lower prices. (The high cost of drugs and devices is a major reason why our hospital bills are so high-drugs and devices account for 15% of the $2 trillion-plus that we spend on healthcare each year. Private insurers are less likely to bargain because they can always pass the cost along to their customers. In just the last five years the cost of an average insurance premium has risen 75%.)

The US has some of the best doctors and best medical technology in the world, but there are too many other fingers in the pie. Over 1500 health insurance plans easily consume 20% of our total costs and limit patient treatments where they shouldn't. As a result, the US has the most expensive healthcare in the world.

The insidiousness of labeling any and all positions on health care reform that deviate from free market fundamentalism has been tarred with the brush of "socialized" medicine. This name calling has been around for awhile and is among the most potent of the bogey-men in American political culture. None of the universal coverage proposals that were debated in the United States, nor the health care bill that was approved, can be characterized as socialized medicine. None calls for government ownership or control over U.S. hospitals, drugstores or health agencies, or for making doctors employees of the federal government.

To the extent that any private health insurance scheme involves spreading among members of society the financial risk of getting sick, all insurance "socializes" the risk. This is, of course, not what people mean when they level charges of "socialized medicine." This term is never used in reference to police protection, fire departments or highways -- all of which are provided by government.

Politics may be full of hype, exaggeration or partisan bickering, but here should be no place for overt deception. The current debate about the healthcare reform act requires that we eliminate comments whose only purpose is to mischaracterize and misinform.

Addendum

Exhibit A as to why health insurance should not be distributed using a for-profit motive:

Things are getting hot in the upper left hand corner of the map

I think that one can fairly deduce from my postings that I am in favor of the recently passed and signed health care reform act. Today our state Attorney General joined a lawsuit to have the law declared unconstitutional. Our Governor was P.O.'d.

One of the contentions the critics make about the new law is that it forces citizens to purchase health insurance and that has never been done. I won't talk about car insurance because that is a state, not a federal requirement. However, I would just like to point out the following:

“Be it enacted by the Senate and House of Representatives of the United States
of America, in Congress assembled….That every citizen, so enrolled and notified,
shall, within six months thereafter, provide himself with a good musket or firelock, a sufficient
bayonet and belt, two spare flints, and a knapsack, a pouch, with a box therein,
to contain not less than twenty four cartridges, suited to the bore of his
musket or firelock,
each cartridge to contain a proper quantity of powder and ball; or with a good
rifle, knapsack, shot-pouch, and powder-horn, twenty balls suited to the bore of
his rifle, and a quarter of a pound of powder; ”

From the Militia Act of 1792, signed into law by George Washington.

Talking Points Memo, a blog I enjoy for its in depth look at national politics without a lot of the vitriol one finds on many political blogs these days, whether left or right, consulted with a number of legal experts and most of them, including the conservative scholars, thought that this lawsuit will fail. That discussion is found here. And Governor Gregoire has on her legal team Narda Pierce, one of the best attorneys I've ever had the pleasure to meet and work with. And Narda Pierce says that that the state AGOs lawsuit is without merit.

I just hope that the Supreme Court doesn't go all Bush v. Gore on us again. It could.

Health care reform, part three

As many of you know, I am the product of two very Republican families. So Republican, that FDR was a dirty word to use in my house. I ran around yelling, "Nixon, Nixon he's our man. Kennedy belongs in the garbage can!" during the 1960 election when I was, perhaps, in 2d grade. I remember muffled cheers breaking out from some of my classmates when Mrs. Stratton told our hushed 6th grade class that President Kennedy had been shot. Later, our principal, Mrs. Barto, came into class and announced that he had died and we were released early.

My father, a pediatrician, was incredibly opposed to health care reform all his life. It was socialized medicine and to be avoided at all costs. Now the two doctors in my family, my brother and my daughter (who is in her 3d year of medical school) favor health care reform. How times change.

I am also a supporter of health care reform. I know too many people who do not or cannot get insurance and who eke out lives filled with pain and fear, and little hope. I am not an unqualified supporter of the bill that passed last night, but it is my sincere belief that the status quo could not remain without causing our country grievous harm. More than forty million people without health care. My daughter told me of one patient she saw in the emergency room recently, a young man who had taken a sabbatical from work to follow a dream of photojournalism. He came down with Type 1 diabetes a month into his vacation and as he had let his health care lapse, he was unable to resume insurance coverage at all. Hopefully, passage of the Health Care Reform Act will change that situation.

In that optimistic note, here are 18 immediate effects of the new law for your information:

The Top 18 Immediate Effects of the Health Care Bill:

1. Health Insurers cannot deny children health insurance because of pre-existing conditions. A ban on the discrimination in adults will take effect in 2014.
2. Businesses with fewer than 50 employees will get tax credits covering up to 50% of employee premiums.
3. Seniors will get a rebate to fill the so-called "donut hole" in Medicare drug coverage, which severely limits prescription medication coverage expenditures over $2,700. As of next year, 50 percent of the donut hole will be filled.
4. The cut-off age for young adults to continue to be covered by their parents' health insurance rises to the age 27.
5. Lifetime caps on the amount of insurance an individual can have will be banned. Annual caps will be limited, and banned in 2014.
6. A temporary high-risk pool will be set up to cover adults with pre-existing conditions. Health care exchanges will eliminate the program in 2014.
7. New plans must cover checkups and other preventative care without co-pays. All plans will be affected by 2018
8. Insurance companies can no longer cut someone when he or she gets sick.
9. Insurers must now reveal how much money is spent on overhead.
10. Any new plan must now implement an appeals process for coverage determinations and claims.
11. This tax will impose a ten percent tax on indoor tanning services. This tax, which replaced the proposed tax on cosmetic surgery, would be effective for services on or after July 1, 2010.
12. New screening procedures will be implemented to help eliminate health insurance fraud and waste.
13. Medicare payment protections will be extended to small rural hospitals and other health care facilities that have a small number of Medicare patients.
14. Non-profit Blue Cross organizations will be required to maintain a medical loss ratio -- money spent on procedures over money incoming -- of 85 percent or higher to take advantage of IRS tax benefits.
15. Chain restaurants will be required to provide a "nutrient content disclosure statement" alongside their items. Expect to see calories listed both on in-store and drive-through menus of fast-food restaurants sometime soon.
16. The bill establishes a temporary program for companies that provide early retiree health benefits for those ages 55‐64 in order to help reduce the often-expensive cost of that coverage.
17. The Secretary of Health and Human Services will set up a new Web site to make it easy for Americans in any state to seek out affordable health insurance options The site will also include helpful information for small businesses.
18. A two‐year temporary credit (up to a maximum of $1 billion) is in the bill to encourage investment in new therapies for the prevention and treatment of diseases.

Let us hope for a better tomorrow for all of us.

When words are badly used

I went to a St. Patrick's day celebration Wednesday at a downtown law firm. I've been invited to this party for almost as many years as the firm has been in existence. I knew the founding partner when he initially set up his first firm back in 1981 and the economy was so hard, he went for 5 months without being able to pay his mortgage. But with time, all of our circumstances have changed. He and the other named partner in the current firm are very successful litigators with a thriving practice, and they share their good fortune and their joy with their colleagues every year.

I wanted to go to the celebration but I dreaded it as well. It is not easy to see folks for the first time since diagnosis and tell them of your status. I went early before the bagpiper showed up, so I could be heard.

As it turned out, when I got there, I first saw another attorney who works in a separate division in my own office, who I also had not seen in quite awhile. We exchanged greetings, and her immediate response to my changed voice was, "Are you dying?" She probably thought I was recovering from a bad cold and being cute, because when I explained that, no, I had lung cancer, she became embarrassed and very effusive in a somewhat uncomfortable way. And I ended up comforting her. Which is exactly how it felt, and what I did when I told Bob several minutes later that I had cancer. It so wore me out emotionally, those two encounters, that I simply had to turn around and leave the celebration. And I'm still trying to sort it out and deal with the unintended, yet difficult emotions that sprang up as a result of those interactions.

I wasn't going to write about this directly because, again, I think that I prefer to put a happy face forward to you, my dear, silent readers. But, that is also taking care of you, not me. I read an article on a NYT blog this am, steered there by a fellow cancer sufferer on www.inspire.com. And I want each and every one of you who read me and are a friend of mine to please read this article. I'd like to post it in its entirety but cannot figure out how to contact the author and obtain permission. So in its place here is the cite:


http://well.blogs.nytimes.com/2010/03/15/with-cancer-lets-face-it-words-are-inadequate/

Please read it. It deals with how we have, by our timid and shallow use of language and communication, shortchanged all of us as we confront cancer and dying.

Thank you.

Regina

Younger Brothers

This is probably an Easter, 1958, picture of my two younger, male siblings. Looks like they're into the jelly beans, although John's favorite was Peeps. He's the guy holding the bag. Mark is on the table. John was the driven one. He would get up during the night, the night before Easter, after the Easter bunny had left his candy on little plastic grass nests scattered throughout the downstairs and determine which nests had peeps in them. Then, in the morning when we'd scramble downstairs with our baskets in hand, greed and avarice in our hearts, he'd somehow manage to create a monopoly on the peeps. They only came in yellow and pink back in my days. Obviously we led lives of want. Not.

My brothers were only a year apart in school. This gave them someone to play with on the weekends and after school--all the time. As the 4 or 5-year older sister, I didn't have a ready made playmate, so I recall I was a bit envious. They had a knack for getting into trouble, however, that I seemed to lack, which was all to the good. One time, dad caught them smoking cigarettes (we all tried cigarettes at various times during childhood, sometimes together as a group), so he thought he'd try some reverse psychology on the boys. He told John that he could smoke as long as John smoked in his presence. John immediately got on the phone to his friend, Johnny Black, who lived 5 houses down the way. "Johnny," John blurted out excitedly, "It's ok. Dad says we can smoke here! With him!"

Their most lasting contribution to my childhood, though was when they came up with a classification system for farts. As boys are wont to do, they spoke of the process of elimination often and with much hilarity. Dingleberries were a topic of many conversations. Many of the neighborhood dogs, including our own, were plagued with dingleberries. Probably due to their rich diets. The boys would dissolve into peals of laughter when they saw a dog scooting around on its butt, trying to clean up. It was thus only logical that farts were a source of much carrying on. So much so, that they invented code words, so they could discuss them without raising the wrath of Mom, who, was not only a language purist but a language Puritan. We could not use the word 'poop,' which was reserved for swearing, and we were forbidden to use the word "pee" whatsoever when describing No. 1.

My brothers' fart classification system, like Caesar's Gaul, was divided into three parts. First, there were Tobeys. These were the loud, embarrassing ones, that no amount of other noise could cover up. Then there were Roses, the sticky and sweet kind. Finally, and these were the most important class, the ones they worked hard to perfect, were the SBDs. Silent but Deadly. They would glide up next to me, rest a moment and then scream, "SBD!" cackle shrilly and run away as fast as they could leaving me in the dust. I was either on the phone with a girlfriend, or nose first, absorbed in a book, oblivious to the rest of the world, and thus, easy game and unable to catch them and pay them back.

Until now!

Why some things really don't change--a bit of a muse

Richard Nixon on Clinton Street in Defiance, OH 1957

I was looking on FaceBook the other day, checking up on high school friends from Defiance and a name jumped out at me that I had not seen for more than 30 years: Ernie Humbert.  It got me to thinking about my childhood and the kinds of major events that broke apart my world at least for a short period of time. And there were some. What I am talking about are deaths and/or murders.

These days, when a murder is committed that bears some relationship to school children, grief counselors are brought in to help the kids deal with and process the emotions that are generated by the actions. Luckily my kids did not experience any murders or deaths that were sufficient to require professional help. And this despite going to public schools in a large city. And two of them went to the science/math magnet high school in the 'bad' part of Seattle.

Even though I went to high school in small town Ohio, during those halcyon days that preceded the worst of the anti war and civil rights riots, we had two rather lurid murders.

The first involved Ernie. He was a senior in high school in 1965, so he was five years ahead of me. I was a 7th grader at the time. But DefianceJjunior High was next door and physically connected to the high school. The junior high and the high school shared the gym and the stage, and the choir and band rooms and we watched the high schoolers from a distance with the sort of admiration reserved now for heads of state. They were the almost grownups--the kids that knew what was going on. The cool ones. Ernie worked as a soda jerk for Kuntz's drug store, which was a major stop after school for students from both the high school and junior. Ernie waited on me a time or two, but as I was a junior high student, I was beneath notice. Small cokes were a nickel and you could add a flavor for 5 cents more. I started with cherry and moved to chocolate. Ernie had a ready smile and from what I could see, worked very hard.

One day, he took a large fruit knife from Kuntz's drug store and walked over to the Toons' house by St. John's Catholic Chuch.  Seems that he had developed a relationship with the mother of the family--a deep relationship. And for reasons that I still do not know, he took the knife and stabbed the father as he was sitting on the couch watching a game on tv, killing him. You can imagine that in small town Ohio, this was an electrifying event, given the young age of the murderer and his affair with Mrs. Toons . Yet, I remember very little of what happened after that. I know that Ernie went to prison but I have heard that he got a college degree while incarcerated, and was released after a number of years, having paid his debt to society.  No one even thought of prosecuting Mrs. Toons for having sex with an underage male, as would be the case today.

The other tragic deaths in Defiance that I remember occurred when a mother from our parish went crazy and shot her children, killing one or two, before turning the gun on herself, and committing suicide.  One of her kids, Mike,  a guy who was two years older than I was, survived, albeit with bullets in his head. My dad, the pediatrician, treated him, but never mentioned to my recollection, word one about it. I remember hearing from Mike, who hung out with a fast crowd at the time,  that because of the bullet wounds, he could not drink alcohol for a while, the only mention he made of the tragedy to me. Again, I do not remember that anything was done to psychologically help the remaining children of the family, or for those kids who were close to the family, or for their schoolmates. Things were different 45 years ago.

But it makes me realize that living in a small town does not protect you from the depredations of the world. In fact, it can give you a false sense of security. I would not trade my upbringing there for any other, but I enjoy and appreciate all the benefits I derive from living in a large city today. And I wonder if sometimes the dangers of living in a large city are exaggerated when compared to those of a small town. The plural of anecdote is not data, but still I wonder.

Have a good weekend, everyone.

Early Spring, Raging Allergies, Mistaken Impressions

When I hit adolescence, I developed allergies to pollen, particularly ragweed and goldenrod, which were at their peak in the Midwest at the height of fall. You had to wait for the first frost for the symptoms to diminish. While in high school, I started to get weekly allergy shots in lieu of antihistamines, which just knocked me out. A classmate, Arthur Bates, also had allergies and he had a car--a late model convertible -- and he was kind enough to invite me to ride with him to the Defiance Clinic so we could both receive our allergy shots. I particularly remember our drives in late winter when he would lower the ragtop and turn the heat all the way up with CKLW blasting the latest hits from Motown on the radio. We were styling before we knew what it was! His dad worked for a guitar company in California (Fender?) and eventually Arthur and his family moved west. I continued my allergy shots sporadically through about 1978, dropping them when I went to Brussels to school. The allergies, whether I lived in Ohio, Minnesota or Kentucky, always occurred in the fall.

My first spring in Seattle, back in 1982, I could not figure out what was going on. I felt draggy with a stuffy nose and weepy, itchy eyes. It turned out that rather than during the fall, prime allergy season in Puget Sound was at springtime when alder trees blossomed. So resumed allergy shots to alleviate the symptoms, and they worked off and on until 2009, when my allergist suggested that I try a nasal inhaler. It was a revelation! The symptoms that had remained even with the shots, disappeared and I ended my regular visits to the injection room at Group Health downtown. But then, of course, came the cancer diagnosis last fall and the inhalant use disappeared as my attention was consumed by chemotherapy.

Of course, now spring is here and my neglect is paying huge dividends, particularly as there's been a rather potent mix of symptoms from the allergies and the Tarceva reaction. Last week, the Tarceva facial eruptions showed up as whiteheads on my eyelids, right where the eyelashes are rooted. So there were 4-5 whiteheads spread along this small path on both eyes, similar to styes. Exquisitely painful. Hot compresses to reduce their swelling were partly successful but then the eyelids themselves became red, swollen, and tender. One of the side effects of Tarceva is eye ulcerations, so I became concerned about where this was heading. An email to the Group Health consulting nurse on Sunday morning led to a phone conference with the consulting nurse and I was advised to come into Urgent care for a look see. Which I did.

The physician's assistant examined my eyes using the orange dye under a black light and determined that there were no ulcerations nor scratched corneas. She ordered some eyedrops for me and I was sent to the basement pharmacy to pick them up. There were several other folks waiting for drugs. One of them was an older Indian woman wearing a beautiful sari with a sheer over dress that had a hood on it. As we were both sitting there waiting, she leaned forward and asked, "what is that on your face?" pointing to right above my mouth. Embarrassed, I responded a bit gruffly that it was a side effect from the cancer drug I was taking for my lung cancer. She asked if I was a smoker and I said not for 30 years, thinking to myself, how rude was that. It was not until she left, and I got my prescription and stopped in the women's room that I discovered that the black marker that the hospital staff had written on my admit bracelet had somehow rubbed off on my face and what this woman had been asking me about was this rather large swipe of black pen on the upper left side of my mouth! No wonder the question about smoking, eh?

That put me in my place. I wonder why none of the medical personnel I dealt with mentioned it to me? Ah well, at least I didn't make it out into public that way.

And just a footnote to the whole thing. This visit took over 2 hours. Normally I am in the doctor's inside office twiddling my thumbs for the majority of the time because there's nothing to read back in those rooms. This time I brought my ITouch. I had purchased it last year to download music on it and to have a way to access email while travelling. I recently learned that you can download books to it using the kindle application from amazon. I have several books on my ITouch as a result, and the time passed with ease because I was deep into a book. Highly recommend it particularly as it fits easily into a pocket or a purse. The battery wears down quickly but if you take the charging cord with you, there's always a spare electrical cord in the doctor's office.

Good reading everyone!

Love without words

This public service announcement is quite powerful. I am assuming it is from Spain but I could be in error.

My thanks to Bob Johnson at Nancy Nall's blog for pointing it my way, and putting my day into perspective. My perspective was further sharpened with the news that Stephen Maxwell, a retired police office, and non smoker, had died of lung cancer. He was diagnosed with the disease in September, 2009, the same time as I was.