Interval

Sometime in the '90s, I recall watching a tv movie about the ill-fated Antarctic expedition of Robert Falcon Scott. He was a famed English explorer who decided to rely on horses, not dogs to reach the South Pole in 1913. Big mistake. And he and his party made it to the South Pole, only to discover that Norwegian, Roald Amundsen, had beat him there.

Scott and all who went with him perished on the return trip. What made an impression on me was the penultimate scene with Scott in the explorers' tent, his comrades gone, writing furiously, his last letters to friends and family.

The urge not to be forgotten is strong, isn't it?

Winning the Trifecta

The biopsy results are back and they are not good. Yet they are still incomplete. Adenocarcinoma is diagnosed, moderately differentiated. They did not have enough material to identify the 'phenotype' and it is not definite that the lung is the primary site of the tumor.

I mentioned to my primary physician during the phone call that I wanted a full body scan or a PET scan to see where the cancer was in my body, and her immediate reaction was that the treatment was going to be targeting all fast growing cells in my body, so I didn't really have to identify the primary or other metastasizing sites. It's too hard to argue with my voice a mere whisper, so I will wait for when I meet the oncologists I have been scheduled with on Thursday afternoon.

Until then, I leave you with this thought. I had a chest x ray in 2005 and it showed no abnormalities. 4 years. If any of you have been considering a chest exam, I think it might not be a bad idea. This sort of cancer can remain undetected for quite a while.

Waiting

I sing to use the waiting,
My bonnet but to tie,
And shut the door unto my house;
No more to do have I,

Till, his best step approaching,
We journey to the day,
And tell each other how we sang
To keep the dark away.

--Emily Dickinson

What I would not give for a good solid burp

When you have a paralyzed vocal cord, the opening to your lungs is always open. So you have to be careful while eating and drinking that you don't get any solids or liquids down the windpipe. Generally it is not difficult. In my case it is the left vocal cord that is frozen, so when I'm drinking I turn my head to the left to close it off a bit more and avoid water going down the wrong hole, as we so blithely proclaimed during childhood.

But one of the problems with having it open constantly is that for some reason I cannot get a good burp on. And I rather miss that. It kinda hurts to burp and sometimes it feels like a pain in the chest as the gas expands and slowly drifts out. Now if I were a worrywart, I could've taken myself to the emergency room last night when the chest pains became significant. But there were no other symptoms like a racing pulse and I had just eaten a Thai salad with lots of cabbage so....What I found helpful was to take the dogs for a walk. A little movement eased things significantly. But in the end I'd still like a good solid burp. It's like putting a period at the end of a sentence. All I got are commas right now.

Damn.

Postscript: When complaining about this to my daughter, she confessed that at the dinner table once, she and her two younger brothers burped out the alphabet. They could do every letter except "W" which was left to my oldest son. I suppose his long career on swim team and water polo gave him the edge there. Which weirdly fits in with the birthday card I am sending him for his 23d next month. It reads: "You know son, when you were just a baby, I remember burping you." The inside reads: "Now that's just one of the many things you do on your own."

And well too, it seems.

Digging for Gold

The biopsy.

To do a biopsy on a lung is rather different than doing a biopsy on a more stationary organ. The lung moves constantly. That's its job, inhaling and then exhaling; without we suffocate. So nothing stays still unless you will it. And even then you can hold your breath and your lung is in one position and hold your breath a second time and the lung has moved ever so slightly yet putting the tumor out of reach of the needle that is poised to retrieve some matter from it. In addition to moving in and out, your lung also moves up and down the stationary rib cage, so you have another shift that the doctor has to account and adjust for in a successful retrieval. This tumor measures less than 3cm by 3cm so even though that sounds huge to me, it is rather slight for purposes of capture when it's a moving target.

I learned this after we showed up at 6am to the hospital and I was checked into a day room where I disrobed for the procedure, was given an intravenous shunt on top of my left hand, hooked up to a saline drip, and waited. Luckily C, my ob/gyn, who has delivered all three of my children, and who has become a good friend was there to greet us and engage in small talk with my daughter and me, which was reassuring and helped pass the time. Eventually I was wheeled down to level A for the procedure. At some point I met Dr M, the radiologist in charge of the procedure, who was very highly recommended by my ob/gyn. He explained both the process and how the working of the lung made it difficult. He told me that they were going to try both ultra sound and ct scan to visually locate the tumor and then shoot it with the needle punch. He fired the needle punch for me so I would know what it sounded like and then a sedative was added to my drip, but not so much that I would fall asleep as that would negate the process because they needed me to be alert enough to hold my breath.

Dr. M began by numbing the section of the back that was going to take the needle. It took 4 stages to completely numb the area, as he went into the surface tissue first and then into the deeper skin levels with the anesthetic. Then they used both the ct scan and the ultrasound to look into my lung and locate the tumor or growth. The ultra sound did not seem to be providing a clear enough image so they gave that up and positioned me in the donut hole of the ct scan machine. Then I was instructed to breath and then hold it. When Dr. M was prepping me, he said not to take a big breath like I would if I were singing, but to take a normal breath and then hold it. I probably took a breath and held it for them at least twenty times. First they had to mark where it probably was with an 'x' on my skin, then I had to take a similar breath so it showed up in the right position so that the needle punch could take a core sample. At one point Dr. M said, "we're almost there," and then of course my breathing went all off base, so we were back to 4-5 rehearsals, and without warning, he stepped in and >bang< it was done. The ct scan showed the needle going into the tumor and he was quite certain that he had retrieved the desired matter. Which, he then told me was a good thing, because if he had had to do additional needle punches, the danger of lung collapse increased greatly. It was a little like putting a small hole in a balloon.

So, he showed me the material which was a tiny whitish thread held in clear liquid preservative. The nurse and tech cleaned up the punch site, which turned out to be right below my left shoulder blade. That was rather a shock because I thought our lungs were much longer. And then I was whisked upstairs in the new gurney by a wonderfully polite orderly, where I visited again with my daughter and C, and then slept until they took me back to level A to x ray my chest to see if the lung had caved in. It had not so I was taken back upstairs for another hour or so of wait time and then a second chest x ray.

They had given me dilaudid for the pain, and at some point after the second x ray, I became severely nauseous as a result. Apparently it is a common side effect of opioids. That held up my discharge for a bit, but I was home by 1:30pm.

Now we are waiting again. First for the biopsy results, then either for more tests and eventually for a meeting with the doctors to determine a treatment protocol. I am assuming that this is cancer because of the growth on my vocal cord that has reduced my voice to a whisper and barred me from singing was identified on the first ct scan as a metastasis. What they are trying to do right now is learn where it metastasized from. But if by some miracle, they were to tell me that there has been some screw up and it is all benign, I could live with that. Right.

On to more waiting!! My favorite.

I remember as a child not being able to sleep Christmas eve and getting up and taking apart and putting the wind up clock in my bedroom back together. But quietly so I wouldn't wake my younger sister. Right now, I'm looking for something similar that will last longer and it could even be slightly noisy. Have not found it yet.

At the top of the roller coaster

Twenty four years ago plus or minus a month or two, I was in labor with my first child. It wasn't until I was in labor that I realized, "I can't back out of this. I can't quit just because it hurts too much. I have to see it all the way through no matter what I want to do." After 23 hours of labor and no epidural or spinal, I finally gave birth to a 7lb baby girl. At first I couldn't even bear to look at her because it had hurt so much for so long. But when I did, the magic started.

That was my first major ride on the roller coaster, where I was teed up at the top--looking at the yawning abyss below, without a clue as to what was going to happen next, and without any semblance of control.

I am back there tonight, waiting for the biopsy tomorrow and the results and the treatments and the reactions, and, and, and. Only this time, that baby girl is with me and she's telling me things she's learned in medical school, where's she's just started her third year. And we laugh and carry on but a lot of that knowledge is not easy to hear. Things like, I probably have either stage 3 or stage 4 cancer, depending on where the primary situs of the cancer is. And there are only 4 stages. And if the primary site is in another organ, that is a stage 4. But if the primary site is in the lungs, that's a stage 3 but it could have metastasized to another blood rich organ, particularly the brain.

So once again I am teetering on the top of the roller coaster, looking at the darkness below, absolutely terrified, and not knowing what bright birth this portends.

Waiting for Godot, Group Health's second cousin

As you may recall, I received the news of the probable cancer in my lung on Friday last.



At the conclusion of the visit, Dr. H, my ENT doc told me that I could expect a call from oncology on Monday or Tuesday to set up my biopsy appointment. But if I didn't receive a call from them by Wednesday, I should call Group Health.

This is a feature, not a bug in Group Health service. I have learned over my 26 years as a Group Health member that you cannot sit back and expect to receive service: no, you must be an aggressive, informed consumer, unafraid to get in peoples' faces to obtain the service you think you are entitled to.

So over the weekend, I stewed, wrote emails, said thank you a lot to well wishers from many facets of my life and tried not to think about it too much. Fat chance. Luckily there was a wedding Friday night and I had houseguests for the weekend for that ceremony, who kept me well entertained.

Come Monday at 8am I was on the phone, dialing my primary care physician, Dr. Mc, someone I have seen regularly in the past 15 years, and someone with whom I am on a first name basis. I explained my situation to Dr. Mc, something she was already familiar with as I had emailed her Thurs last week and asked if she could give me the CT results early. She demurred, saying that they weren't all in. Of course, now I knew that she really wanted to reserve the tough job for the ENT guy, the one with whom I was meeting in person--something I understood. No hard feelings there. But I did tell her that I wanted her to talk with oncology and get them to call me today, Monday, to set the biopsy appointment as soon as possible.

First I got a call from Dr. N, the pulmonologist, who said he had read the CT scans and that he thought 1) the primary tumor was in the lung not elsewhere in the body, and 2) there was an opening for the type of biopsy which I needed (a CT scan or an ultra sound guided needle biopsy to be placed in my back in the lower left lobe of the lung) on Friday, and if they did not give me that time to call him back. He released my two CT scans to my GH web page, so now I could read them online and see the narratives for myself. And he gave me the number for Radiology, which I called, immediately thereafter. The woman who answered the phone could not help me and sent me to another number where I was told to leave a message. Which I did.

An hour went by. I didn't actually register the passing of time for a bit as I had to drive to Olympia for a big work related meeting and was driving to meet my co counsel, who could drive us both there. Once I got in her car, though, my cell phone rang and it was P from radiology. She started by telling me that I could not have any Motrim, Aleve, aspirin, ibuprofen, fish oil or Vit E before the procedure. No explanation why. I said fine. Then she said, "We have a date open to do this on October 8th." At that point, I jumped in and said, "No. I was told there was an opening this Friday." P said, "Yes, but you have to not have taken any of those drugs for ten days before the biopsy." My thought, not articulated but lit up in red neon at the front of my cortex was "YOU HAVE TO BE FUCKING KIDDING ME, LADY. TEN DAYS FROM TODAY IS NOT OCTOBER 8." What I instead said was, "That's fine, I will be in the clear by this Friday. Please give me the appointment." Which she then did. And then instructed me on the appropriate preparations for the procedure which will be this Friday at 6 am.

Not to be too didactic, but, this is not the first time that this has happened to me at Group Health. Unless I had spoken up for myself, I could have been waiting for 17 days for the biopsy of a tumor that in less than a month had destroyed my voice. Perhaps this is true for private medicine as well, but if so, it is not helpful in the least. I have heard that the oncology staff is very much different from other specialities in terms of their willingness to reach out and assist their patients. I hope that is true.

Again, nothing to do here but wait now for another three days. By then it will have been a week since my life shifted into a different reality.

Health care reform up close and personal

I've written a couple of posts lately about health care reform in the abstract. It's rather easy to do when it's all hypotheticals. Imagination is a wondrous thing--you can get a frisson of fear by thinking of taking up skydiving, but you don't have to go through the actual leaping out of the plane. Same with all those poor people who get sick and what do they do with their jobs and how can they afford this?

Well, I am about to find out firsthand. In the middle of August, my voice started going. That was odd. I had just spent a week at a music camp for adults, singing my lungs out in large and small groups and generally getting jazzed at being with people from all different walks of life doing one thing we loved so well--music. So at first I attributed it to vocal exhaustion.

It didn't get better. It got worse. So then I attributed it to a nasal inhalant I had been taking to relieve allergy symptoms. Stopped taking the inhalant. It got worse. I was reduced to sounding like Marge Simpson only softer.

Four weeks into this, I hauled my butt into Group Health one Sunday afternoon to be seen. The physician's assistant on call that day did a full blood workup and looked in my throat and found nothing remarkable. He suggested that I make an appointment with an ENT. So I called my AP's office the next day to see if she would do a referral. Found out I could self refer. That was a good thing. But that was it for good things.

An appointment with an ENT was made for Wednesday afternoon. Dr. H anesthetized the back of my throat and put a scope down through the nasal passage to the vocal cords. "Say 'eee,' "he said. I complied. "Say it louder." Once again I tried to increase the volume. "Your left vocal cord is paralyzed," he said. He told me that he didn't know the cause but was scheduling me for a CAT scan first to rule out cancer. "It's been 5 or 6 years since I've seen one of these cases where it was caused by cancer, but we should get that out of the way first," he assured me.

So a week later, I was back at Group Health for my first ever CAT scan, with contrast dye. When they inject you with the dye, you get a metallic taste in your mouth and it feels like your are wetting the table. You are not. They injected me twice for two different CAT scans.

Friday at 9am I returned to Group Health for the results. Well, I beat Dr. H's odds. The CAT scan picked up 3 distinct growths in the left lung--two in the lower part and one in the upper lung. It was the upper growth that was pressing on my vocal cord and causing my symptoms. It also appeared that this growth was a metastasis from another, a primary site. Dr. H inquired about family and friends who might live nearby and whether I was a member of a church. When I indicated that I was, he responded, "That's good. They will help you as you get your affairs in order."

So, here we are. On a new, completely unexpected and frankly unwelcome journey. But, because we have this raging health care debate going on in our country right now, and as I am a member of one of only two medical cooperatives in the nation, perhaps my journey can provide some insights into this highly political charged issue. I invite you to come along for the ride.

September 1, 1939

That is the date that the Germans invaded Poland.

September 1, 1939

by W. H. Auden

I sit in one of the dives
On Fifty-second Street
Uncertain and afraid
As the clever hopes expire
Of a low dishonest decade:
Waves of anger and fear
Circulate over the bright
And darkened lands of the earth,
Obsessing our private lives;
The unmentionable odour of death
Offends the September night.

Accurate scholarship can
Unearth the whole offence
From Luther until now
That has driven a culture mad,
Find what occurred at Linz,
What huge imago made
A psychopathic god:
I and the public know
What all schoolchildren learn,
Those to whom evil is done
Do evil in return.

Exiled Thucydides knew
All that a speech can say
About Democracy,
And what dictators do,
The elderly rubbish they talk
To an apathetic grave;
Analysed all in his book,
The enlightenment driven away,
The habit-forming pain,
Mismanagement and grief:
We must suffer them all again.

Into this neutral air
Where blind skyscrapers use
Their full height to proclaim
The strength of Collective Man,
Each language pours its vain
Competitive excuse:
But who can live for long
In an euphoric dream;
Out of the mirror they stare,
Imperialism's face
And the international wrong.

Faces along the bar
Cling to their average day:
The lights must never go out,
The music must always play,
All the conventions conspire
To make this fort assume
The furniture of home;
Lest we should see where we are,
Lost in a haunted wood,
Children afraid of the night
Who have never been happy or good.

The windiest militant trash
Important Persons shout
Is not so crude as our wish:
What mad Nijinsky wrote
About Diaghilev
Is true of the normal heart;
For the error bred in the bone
Of each woman and each man
Craves what it cannot have,
Not universal love
But to be loved alone.

From the conservative dark
Into the ethical life
The dense commuters come,
Repeating their morning vow;
"I will be true to the wife,
I'll concentrate more on my work,"
And helpless governors wake
To resume their compulsory game:
Who can release them now,
Who can reach the deaf,
Who can speak for the dumb?

All I have is a voice
To undo the folded lie,
The romantic lie in the brain
Of the sensual man-in-the-street
And the lie of Authority
Whose buildings grope the sky:
There is no such thing as the State
And no one exists alone;
Hunger allows no choice
To the citizen or the police;
We must love one another or die.

Defenceless under the night
Our world in stupor lies;
Yet, dotted everywhere,
Ironic points of light
Flash out wherever the Just
Exchange their messages:
May I, composed like them
Of Eros and of dust,
Beleaguered by the same
Negation and despair,
Show an affirming flame.

Health care reform, part two

I'm in the midst of a discussion about health care reform on another internet forum. A point was raised by Paul, the author of my previous thread here, which I think merits mention because focusing on it and thinking about it, and talking about it could change the tenor of the debate.

"Having everyone in the risk pool is not an 'arbitrary' definition of meaningful at all. It is how you make insurance work economically, efficiently.

Let's take a different tack here. We have mandatory auto insurance laws. Illegal to drive without auto insurance. Matter of responsibility and economic efficiency. No partisanship. No significant political opposition to such laws. No opportunity to say that you should be exempt because you have an exemplary driving record and are willing to take the chance. We determined a long time ago the social costs of your personal risk tolerance are too great to allow you the decision to do without.

The same logic applies. When healthy people exclude themselves from the risk pool, economic inefficiency is created, regardless of outcome. When unhealthy people are excluded from the risk pool, the costs of their care don't disappear, rather they are simply exported off the books of insurance companies and onto the books of a different system--either the provider who gets stuck with the bill that the patient can't pay, or the government (which means taxpayers, which means *you*) that has provisions for providing care to such persons.

Because individual insurance companies are allowed to exclude such persons, *all* of us pay bigger hospital bills, and *all* of us pay more taxes.What all of the people shouting about the cost of the health care bill are ignoring is the costs we are all bearing, right now, of the current inefficiency of our system. When they insist that the kinds of changes contained in the proposal will drive up medical costs, they are also ignoring the empirical evidence of every single other western country that making coverage and access universal is associated with lowering overall costs, not raising them. "

The Health Care Bill--a damn fine summary

Over the years, I have had the opportunity to meet some very good people via the internet. It's the new wave, I guess. But this fellow is a former ERISA attorney and a very sharp thinker. He's read the entire House Bill concerning health care reform and has summarized it without inserting any political opinion whatsoever. I offer it for your information herewith:

http://docs.house.gov/edlabor/AAHCA-BillText-071409.pdf

The Bill is divided into three divisions, A, B & C. Only Division A is concerned with what we think of as 'health care reform', and it is the first 215 pages of the 1018 page pdf document.

Division A

Title I is concerned with reform of the health insurance marketplace. Contrary to disappointingly common criticism, there will still be a health insurance marketplace.

Although people call this a health care reform bill, it is nothing of the kind. It is a health insurance reform bill. It is concerned with changing the rules applicable to health insurance companies, and it does that by asserting federal power into an area previously left to the states: regulation of insurance. It does not abolish state insurance licensing and regulation. Rather, it adds a number of rules at the federal level that must be adhered to.The main features:

Subtitle A

--contains the grandfathering provisions for current health insurance plans and policy holders; current policies and policy holders will not be subject to all that follows, as long as the current arrangements continue in effect

--as has been noted, employer based plans are not grandfathered, but have a 5 year transition period to be subject to the new rules; and while some critics have tried to make this into ERISA armegeddon (the WSJ erroneously stated that ERISA would be repealed--hogwash), the reality is that most of the new rules imposed in Subtitle B are already rules employer plans must follow (including bars to pre-ex, guaranteed issue, no risk rating, and certain mandated benefits); consequently, the effect on employers presently offering health insurance would seem to be rather minimal

Subtitle B

--pre-existing condition exclusions will be barred
--all policies must be guaranteed issue
--risk rating of insurance premiums will be prohibited
--community rating (charging premiums by risk rating the entire population of a geographic area) will replace individual risk rating to price policies; the only other pricing variances to be allowed being policyholder age and family coverage
--mental health parity and substance abuse benefit requirements currently applicable to employer plans under ERISA will be applicable to all health insurance policies (if it matters to anyone, my professional experience was that these benefit mandates had a negligable impact on employer plan premiums)
--PPO and HMO style plans still allowed, but the feds will now determine the standard of adequacy of provider networks to constitute a legitimate plan, instead of leaving it to state by state insurance commissioners
--in an apparent attempt to prevent cherry picking, the federal government will monitor the 'medical loss ratio' of insurance issuers to ensure that they are providing adequate access

Subtitle C

--establishes an 'essential benefits package' for all health insurance sold; inaddition to enumerated benefits, the essential package also limits copays and prohibits annual and lifetime maximums on the enumerated benefits
--the ten enumerated benefits are: hospitalization, outpatient hospital/clinic services, including ER, health professional services, services, equipment and supplies incident to professional services, drugs, rehab (all kinds), mental health/substance abuse, preventive care and vaccines, maternity, well baby
--copays and deductibles prohibited for preventative and well baby care
--copays and deductibles limited by an acuarial value that I don't really understand, but also by a hard cap of $5k individual $10k family annual out of pocket
--establishes a federal committee to determine if more essential benefits need adding in the future
--establishes a mechanism for developing better plans than the minimum at greater premium cost

Subtitle D

--is concerned with 'additional consumer protections'
--creates a federal standard for grieving/appealing insurance claim denial
--creates a set of reporting and disclosure standards familiar to administrators of ERISA plans applicable to all insurance
--creates timely reimbursement standards
--federalizes coordination and subrogation issues

Subtitle E

--establishes the Health Choices Administration, a new federal agency to oversee all this

Subtitle F

--contains legal housekeeping rules that I doubt will be important to anyone

Subtitle G

--applies the anti-cherry picking rules to everyone, including the grandfathered group health arrangements
--applies anti-recission abuse rules to everyone, including grandfathered insurance
--creates electronic data transfer standards for the industry in an attempt to reduce administrative cost by getting the medical profession onto the information superhighway with the rest of us
--creates a federal retiree re-insurance program; this appears to me to be a bailout of private sector employers who can't afford to keep their retiree insurance benefit promises any more

Title II establishes a new health insurance marketplace called the Health Insurance Exchange

Subtitle A defines the HIE

--All of the new health insurance plans, the ones not grandfathered, that meet the requirements of Title I, will be bought and sold through the HIE, which will be overseen by the new agency created by the Act.
--In addition to individuals, employers can also purchase health insurance plans for their employees through the HIE
--employers will be transitioned into the HIE over a three year period, smallest first; individuals will be transitioned over a two year period, those without health insurance coverage, first--the Act contemplates four tiers of coverage being available, 'basic' (the minimum benefits described in Title 1), 'enhanced' (basic, with lesser copays), premium (even lesser copay responsibility), and 'premium plus (additional benefits like dental and vision)
--the federal government essentially replaces brokers as the intermediary matching consumers to insurance products; insurance companies develop a product, and submits it to the feds for approval as an HIE product; insurance company tells feds the maximum number of enrollees it is willing to accept; the feds will be responsible for enrolling people in the plans--although the fed handles most broker functions, the Act provides that premium payments are to go directly to the insurance company, not through the feds
--there are a number of rules for coordinating the interaction of low income subsidies for health insurance provided elsewhere in the Act, as well as coordinating between Medicaid and the HIE
--the HIE will be funded through a dedicated trust fund; the trust fund's income will be: taxes on individuals who do not obtain 'acceptable coverage', taxes on employers who do not offer acceptable coverage; excise taxes levied under the Act
--a mechanism is there for states to opt out of the HIE, if they provide a state level equivalent system

Subtitle B provides the public health insurance option

--the public health insurance option is only vaguely defined; it is supposed to generally comply with all the rules being applied to private sector health insurance plan, but with the feds in the role of insurer; pretty much everything is left for the agency to develop, from coverage options to premium pricing
--there are more detailed rules about how the feds are to behave in setting provider reimbursement rates (personally, I would not expect these rules to survive)

Subtitle C provides "Individual Affordability Credits"

--citizens and lawful immigrants whose income is below 400% of the federal poverty level for the family size involved, who is not being offered insurance by an employer, and who are not Medicaid eligible, get a rebate on the cost of buying insurance from the HIE; the amount of the credit will depend on the relationship between the persons' income and the premium rate for a basic health insurance plan
--there will also be rules developed for giving people a break on copay requirements, based on their income/affordabilitiy to themTitle III sets forth the Individual and Employer Responsibility requirements for obtaining insurance
--Individuals who do not have health coverage from an employer and do not buy any coverage will be assessed a tax of the lesser of 2.5% of income or what would have been the cost of a basic coverage option plan.
--Employers satisfy their responsibility requirements by offering health plan coverage that meets all the minimum benefit requirements, and pay at least 72.5% of individual premium cost, and 65% of family premium cost. If an employee opts out of their employer's plan coverage and buys other insurance, the employer must make a premium contribution to that coverage cost.--Employers who do not satisfy their responsibility requirements will have to pay an excise tax amount into the HCA trust fund equal to 8% of their payroll. Lesser amounts will be assessed against 'small employers'
-- generally employers with a payroll under $400,000. Employers with a payroll under $250,000 would be completely exempt.
--The HCA is empowered to create rules to prevent employers from steering employees out of their plans by offering them inducements not to enroll.
--ERISA is amended to make complying with the employer responsibility coverage provisions an ERISA requirement, subject to ERISA enforcement. Offering a plan, but failing to offer proper coverage or make proper contributions becomes an issue of fiduciary duty, and subjects you to the full arsenal of ERISA enforcement. This enforcement scheme will run in parallel with the HCA's own audit and enforcement scheme set forth in the statute. [As a old ERISA hand, I find this odd, as this was the way that ERISA was set up with both DOL and IRS having overlapping jurisdiction and responsibility. This was unwieldy and led to a 'treaty' being signed between IRS and DOL setting forth who would do what, in terms of ERISA plan audit and enforcement.]

--Title IV makes amendments to the Internal Revenue Code consitent with the provisions discusses so far.

In addition:

--Small businesses will receive a tax credit incentive to elect to provide coverage.

--People with an AGI of $350,000 to $500,000 will pay an additional 1% tax. People with an AGI of $500,000 to $1 million will pay an additional 1.5% tax. People with an AGI of more than $1,000,000 will pay an additional 5.4% tax. The two lower bracket rates will double in 2012 unless the HCA calculates that certain minimum health care cost savings have been achieved.

This brings us to the end of Division A of the bill, and the portion that deals with health insurance marketplace reform. This brings us to page 215 of the 1018 page PDF document that is the House version of the bill.

Division B of the bill is all about buffs to the Medicare and Medicaid programs. It takes up pages 216-856 of the bill. Apart from the gross mischaracterization of the proposal in this part to expand the scope of reimbursements for end of life counseling as "death panels", these 640 pages don't seem to have generated any controversey. My take on this portion of the bill is that it is a mixture of needed changes and benefit expansion wishlists/pet projects. It's attachment to the Division A proposals discussed above isn't particularly necessary, but was probably intended to help make the bill an offer you can't refuse as a legislator, lest you be branded in your next election by your opponent as having voted against Medicare benefits.

Division C of the Act is Titled Public Health and Workforce Development

--It takes up the remaining 152 pages of the bill.

--Though nearly as long as the health insurance reform provisions, it is not nearly as ambitious, appropriating a modest (by modern budget standards) $4.6 billion in 2010, escalating to $12.7 billion in 2019 for everything in Division C of the bill

--Activities funded by this appropriation include: community health centers, a national health service corps, expanded student loan programs to fund students of primary care, family, general internal, pediatric and geriatric physicians, as well as nurses, dentists and dental hygenists, a public health corps workforce program, prevention and wellness programs, drug discount programs, school based health clinics, a national medical devices registry

That's it. That's the whole bill.

College Reunion

I started college at Macalester College in 1970. I had chosen, perhaps, one of the best, yet worst colleges to attend. It was one of the best because it encouraged individual growth and nonconformity. In fact one could say it was comformably non conformist. It was one of the worst because it went through the worst financial crisis in its history while I was enrolled there. Fortunately for me, I was a shallow college student at the time, and did not have the ability nor the time to really sit down and understand what was actually going on. I mean there was the Vietnam War. There was Watergate. It was hard to pay attention to all the crap going on, much less make it to class on time.

What happened was that the college had one very large donor: DeWitt Wallace, founder of Reader's Digest. And no other major donors. DeWitt had attended Macalester, his father had been the president of the college, but he had never graduated, instead going on to start the most successful magazine of his time. DeWitt was very, very conservative politically, as anyone who read the Reader's Digest could attest. He had given huge amounts of money to the school and it repaid him, he thought, very shabbily, by making the dorms coed with no hours, deviating from a standard curriculum, and increasing minority admissions to the college, among other things. So he snapped. At the end of my first semester, it was announced that he was withdrawing his financial support. Students like me, who were attending on a full tuition scholarship financed by him and courtesy of my status as a National Merit Finalist, were allowed to complete their years there with scholarship, but there would be no more. And no more funding for programs or buildings either.

At the same time I was beginning my freshman year, there were 18 new faculty members hired to teach at the college. Only 3 survived. One became a lifelong friend. He said that he was closer to the students than his peers because he and the other new hires were treated like dead men walking. The other faculty knew they would be gone by the end of the year and were embarassed about it, so just ignored them. Luckily his Department Chair left, which opened up a slot for my professor for another year, but then he was fired again, after his second year. He had been accepted to law school or he could have emigrated to Australia because the Australian government had ageed to pay for he and his wife to move there, but in the end the two of them decided to take a chance on the college. This risk taking was rewarded when yet another faculty member in his Department left for greener pastures, opening up a permanent slot from which he gained tenure and held for 33 years.

In talking with him about this time of tribulation at the reunion this weekend, I learned that the college went from a student population of 2400 in 1970 to 1400 in 1974, my graduation year. The faculty numbers were worse: down from 200 to 100 professors in the same time period. The college started borrowing on their endowment and ended up borrowing more than the endowment was worth, leading to significant threats of a lawsuit from DeWitt. My professor friend says that the college realistically should have declared bankruptcy. But in 1978 a new President, John B. Davis, was hired. And he, almost singlehandedly was responsible for repairing the rift with DeWitt and bringing him back into the fold as the major donor of the college again. When DeWitt and his wife died in the 1980's, they left a large chunk of money to the college in the form of Reader's Digest stock.

Most of this desperation at the college level escaped me at the time, even despite being a reporter and then an editor on the campus newspaper. I was too much into being a student and exploring all that living away from home entailed. I knew there were problems, hell, I even wrote a front page story for the school newspaper on them that was reprinted in the Monmouth College student paper, but somehow I never believed that the college could close. I cannot imagine how the professors could continue to teach in the classrooms at that time, without the stress affecting them in major ways, but my memories were of interesting, funny educators who were always willing to take time to talk and help me out, when I asked for it.

It was not until 35 years later that I learned how dire the straits were at the time, and how I blithely lived through the best of times and the worst of times. For those of us students who stayed on and did well at college and thereafter, I think it created a strong bond among friends, as demonstrated by our recent reunion. Many of us chose to spend the weekend in the dorm on the same floor . As we gathered in the evening in Kim's quad on 2d floor Wally, the years fell away and it was like we were back in school together, sharing stories and laughter and even some tears.

Returning to reality and fitting back into my day job has taken a bit of effort this week. I think I know a fraction of the disorientation a time traveller might feel after returning to the present. It was the kind of trip that I wish for everyone--to intensely recapture a bit of youth in later years. It was deeply, profoundly affecting to be back with old friends and to reconnect on the same level we had left it at all those years ago. How fortunate I was in the final calculation.

ps: the Sounds of Blackness are a Macalester staple for the past 40 years. I only regret that I did not attend any of their concerts before now.

A Belated Palm Sunday Story

I spent the past weekend visiting with my mother in Kentucky, where she's lived for 38 years now. I've spoken of this event earlier in my blog, but as a result of talking with my mother it was more fully revived, but as I had no internet connection, it had to wait for my return.

The Palm Sunday I am thinking about was in April of 1967 when I was a sophomore at Defiance High School. Our house caught fire that day. As I recall, it was a beautiful, sunny spring day and my father had taken advantage of the weather, barbequeing for Sunday dinner. One of my brothers was tasked with cleaning up the grill. It is probable that he, being about 11 at the time, did not check to make sure the coals had gone out before he dumped them in the garbage can, or wherever he decided to deposit them. I was outside in the vacant lot that was in front of our house on Elliott Lane, and turned to look around and the garage was in flames. I ran across East High Street to the Cunningham's house which was unlocked (that happened in those days) and used their phone to call the operator. My hands were shaking so badly, I had a hard time dialing the "O." I could hear the wail of sirens in the distance.

When I got back outside I watched as my father ran into the right side of the garage which was smoking but not yet on fire like the left side was, with the white aluminum siding turning black and warping in the red flames. My father's car, with his doctor bag was on the right side and I saw him open the car door and try to start the car and back it out, but the steering wheel was too hot and he gave it up. At that point I just cried hysterically, face in the grass, beating on it with my fists.

Some fellow driving by jumped out of his car and raced into the main part of the house, which had not caught fire, and rescued our color tv. Out the door, right behind him, trotted our dog, Mandy, who I had forgotten in all the chaos and confusion. The firemen arrived with two or three trucks and ladders, hooked the hoses up to the fire hydrant that was on the grassy circle in front of our house and proceeded to do their job efficiently.

The final tally of loss was the two car garage, my father's car and his medical bag, the family room with piano, and part of the kitchen, with smoke damage throughout the rest of the house. My middle sister disappeared for a while and no one knew what had happened to her, but she showed up several hours later, having hidden herself in the ravine behind the house as a way to escape.

Friends and neighbors were quick to offer to put us up while the house was being repaired by the guy who had originally built it--Roger Lang. Each of the five kids was farmed off to a different family. I went to my then-best friend, JoAnn's house across the ravine from us.

It took a week to get the cleanup crews to clean for smoke damage and Roger to get the house sealed sufficiently that we could re-inhabit it, but by Easter Sunday we were back in the house. However, in a rare break with tradition, the family travelled to Kentucky--postponing the move in--where we stayed at the Beaumont Inn in Danville, KY, visited horse farms, and went to the races at Keeneland.

Months after Roger finished rebuilding the house, when it rained, we could still smell the smoke.

Albums that Changed your life

A colleague posted this Facebook quiz on the internet and filled in his five albums that changed his life. I've been thinking about this for the better part of a week, and I can't do it in five albums. I can do it within areas of my life, but given the importance music has had in my life, five is too few to explain. So let's start. These are the albums that have deepened and enriched my life and at times, helped me get on with my life:

Grade school. 1963

Meet the Beatles. My very first record purchase, and the one that propelled me into puberty. We girls would gather in a separate line from the boys after 6th grade recess, and waiting outside Mrs. Stratton's room to return to class would sing lustily: "We love you Beatles, oh yes we do. We love you Beatles. And we'll be true. When you're not with us, we're blue. Oh, Beatles we love you." As the oldest kid in my family, and a bookworm at that, I lacked the guidance of older siblings into the mysteries and rituals of adolescence. This record helped with that.


High School. 1965-70

The Kingsmen in Person featuring Louie, Louie. Now, although this album was first published in 1963, I did not buy it until high school. The opening bars of Louie, Louie created an anticipation so great that it was hard to explain. It's still there even though the 'dirty lyrics' that got the album banned in Indiana have now been explained as due to poor vocalizing. Good thing my parents never listened to it. But we used to pull this and Rubber Soul out at slumber parties and play them late at night. I listened to it plenty in junior high, but it was not until high school that I purchased my own copy.

Waiting for the Sun. The Doors. On Palm Sunday, 1968, my family's house burned partway down. The garage, where the fire started, which contained my dad's car and his medical bag, and the kid's playroom were destroyed. In that playroom was our record player. As part of the insurance proceeds we upgraded the record player to one that you could stack albums on, and I got some money to purchase new records. I went down to G.C. Murphy's and found this album. I already liked "Light My Fire" by the Doors and thought this would be more of the same. Well yes and no. I was introduced to some of the most subversive lyrics and music of that time through this album. Little did my mother know that while I was ironing the family's laundry in the restored playroom, I was absorbing "The Lizard King" along with it.

Are You Experienced? The Jimi Hendrix Experience. This is the other album that I purchased with my insurance proceeds money. The guys in my class at DHS were definitely into Jimi Hendrix, as were the music writers in the Cleveland Plain Dealer, to which my father subscribed. I was intrigued enough to spring for this album, which, was in rotation while I ironed out in the playroom. Again, it was a good thing that my mother did not listen closely.

The White Album. The Beatles. I asked my grandmother for this as a Christmas present in December, 1968. My neighbor across the street, Barry Schatz, was in a rock band and he recommended this to me. I can remember singing 'Obladi Oblada' at the top of my lungs while bicycling to gymnasium in Germany in the summer of 1969.

Disraeli Gears. Cream. In the summer of 1969, I went to Germany as an exchange student for 3 months. I've written about my experience in a prior post, so will not go into it. But I remember being invited to a very wild party of my gymnasium class before I left Offenbach, and this album was being played during the party. I made a note of it and purchased the album as my present to myself. "Tales of Brave Ulysses" and SWALBR made the b side of the album as good as the first side with "Sunshine of Your Love." Again, an album that I did not play very much in hearing of my parents.

Crosby, Stills & Nash. Fall of senior year of high school. I can recall listening to this album while getting ready for school. It was the harmonies that got to me, the sweet progression of the Buffalo Springfield which I also adored but did not get the album until much later.

Three Centuries of the Guitar. Andres Segovia. I loved flamenco music in high school, after hearing it at a cast party after a community theater production of "A Light at the Top of the Stairs." I played Flirt in the play, my only thespian venture. At the cast party, I also distinguised myself by dumping a glass of wine into the host's grand piano. Not a good idea to give a junior in high school alcohol, I guess, but it was an artsy crowd that night.


College. 1970-73

Layla. Derek and the Dominos. January, 1971. I heard this for the first time, the first night I got stoned at a party off campus where the hosts arranged the table, to resemble, as much as possible, the montage from the Beggars Banquet album. I do not remember the food, but this music is and was indelible.

Marrying Maiden. Its a Beautiful Day. This album was in the college newspaper offices, where I toiled for several semesters as an assistant or associate editor, which meant I pulled all nighters every Thursday night to get the school newspaper out on Friday. This album kept me sane at times of stress in the editing of the Mac Weekly. Far the best of the 2 albums this group put out.

Requiem. Mozart. I was in the concert choir at college where we had the great good fortune to have as our director, Dale Warland. We sang this work my freshman year and as a result, I borrowed my father's album of this, the better to learn it. It became a very good friend as a result.

Give It Up. Bonnie Raitt. It was a revelation to listen to a woman who could be so earthy and so musical and care so much, all at the same time. She had several concerts at college, but I only saw her once then, as an opening act for John Prine in Minneapolis. She blew it away.

Live Dead. The Grateful Dead. I used to go to sleep listening to St. Stephen. Their studio albums sounded wooden and inconsequential in light of what they brought to a live experience.

Can't Buy a Thrill. Steely Dan. This album, defined my social life for my last year in college and those of my close friends. There is no way that I can listen to the title track without relaxing in the remembrances of shared evenings.

Runners up (there are so many): Tea for the Tillerman, Cat Stevens; Grieg Piano Concerto, Leon Fleischer; Elton John, Elton John; Twelve Dreams of Dr. Sardonicus, Spirit; Eat a Peach, Allman Brothers; Get Your Yayas Out, Rolling Stones; What Were Once Vices are Now Habits, Doobie Brothers; Armadillo, Leo Kottke; John Barleycorn Must Die, Traffic; Aqualung, Jethro Tull.

Law School. 1973-1976

Blood on the Tracks. Bob Dylan. He could have been singing about my life in some of his songs here. For that I will be forever in his debt.

Marx and Lennon. Firesign Theater. Should have listened to this in college, but at least in law school it kept me sane.

Katy Lied. Steely Dan. All of their work is good. This one just meant a great deal more.

Country Life. Roxy Music. The 'pose' was new to me and more attractive than David Bowie.

Feats Don't Fail Me Now, Little Feat. What can I say? When you're living in the south, this meant time to paaarty!!

Naturally, JJ Cale. I was late to this one, but it has been a staple ever since law school.

Will the Circle be Unbroken. The Nitty Gritty Dirt Band. You cannot go to school in the south and not have it rub off on you.



Post law school. 1976-78

Heavy Weather. Weather Report. Great Jazz pop.

Southern Comfort. The Crusaders. Ok, I was late to this one too.


Vrije Universiteit Brussel. 1978-1979

Dire Straits. Dire Straits. I was in line at the cafeteria at the University (where I obtained an LLM in International law) when I heard "Sultans of Swing." There are very few songs that I can put a place with as to first time heard, but this is one and will forever be so.


Marriage and children. 1980-1999 The marriage ended in 1999. The children did not, luckily.

Visions and Miracles. Ensemble Alcatraz. These are songs from 13th century Spain which are a fusion of Moorish, Jewish and European themes, particularly from southern France, which was then in the midst of the Albigensian Crusades. Many French troubadors fled to the relatively open artistic culture found in Spain at this time and the music is both religious but sensual. I was home on maternity leave in late 1986 and heard part of it on NPR and called the station to find out what it was I was listening to.

Carmina Burana. Orff. I sang this at a Seattle Summer sings. It is the closest you can get to an orgasm while singing. Like basketball, it is more fun to do it than to watch (listen to) it.

Ein Deutsches Requiem. Brahms. I want the second movement played at my funeral. And the fourth.

Stop Making Sense. Talking Heads. It's not always classical during this time. In fact when my third kid was in utero, he bounced around to this album as we played it on the car tape deck, driving back from Vancouver, Canada in 1990.

On Every Street. Dire Straits. Once again, Mark Knopfler hit me in the solar plexus with "Calling on Elvis."

Luck of the Draw. Bonnie Raitt. This album came out when my marriage was first in serious trouble in 1991. I should have listened to her and gotten out then. As it was, it got me through some very bad times.

Achtung Baby. U2. "Even Better Than the Real Thing" is a great, sensual song of lust.



Post Divorce. 1999-present.

Decade. California Guitar Trio. Gets better with each listening.

Between the Showers. Grainne Hambly. Celtic harp music at its finest.

Live at the Wetlands. Robert Randolph and the Family Band. He helped me remember how vital and vibrant rock can be.


I suppose I could whittle this list down to five, but it would not truly provide what I think was the music that influenced me during most of my life.

What about you? Can you narrow your list down to five albums?

Ecdysiasts and Chicago

You would not think that there could be another remembrance that could combine strippers with the city of Chicago in my repetoire. Ah, but then you would be wrong. This story, however, does not come from my childhood. It comes from my father's.

My father's side of the family, the Fausters, liked nothing better when getting together, to sit around and reminisce. It could have been at a Christmas gathering or perhaps at Thanksgiving. Those were the occasions for the big get togethers, usually at Aunt Marg's, if it wasn't at our house. My mother was never interested in just sitting around and talking. Probably because she was doing the majority of the work in the kitchen and getting crabby about being left there. I'm not sure when I first heard this story, but it was repeated several times over the years, so of course, I accepted it as gospel.

In 1933, Chicago had a World's Fair. My father was 9 years old. His Grandfather Fauster, or "Gramps," decided to drive to Chicago and take it in and also to take his grandson, "Johnny Bill," with him. So they arrived and wandered all over and ate good things and viewed the sights, when Gramps decided that he wanted to see Sally Rand, the fan dancer. She apparently was quite the sensation at the time. So he paid the admission for he and Johnny Bill and they wandered into the auditorium and sat down. Eventually the lights dimmed and Sally Rand appeared with her trademark gigantic boa feather fans, doing whatever she did with them.

Johnny Bill, according to the story, got more and more outraged as he watched the performance. And he started insisting to his grandfather that there was something very wrong going on on the stage. Gramps tried to shush him which only succeeded in making Johnny Bill more agitated. Finally Johnny Bill stood on his chair and shouted down to his grandfather, "But Gramps! She hasn't got any clothes on!!!" At that, thoroughly chastened, Gramps picked up Johnny Bill and removed them both from the venue.

I imagine the ride back to Defiance was pretty quiet most of the way.

A Chicago Reminiscence

Okay, I blame all the folks over at Nancy Nall's blawg. They get to talking about places and things that I visited when I was last a resident of Ohio (1955-69) and the memories start coming back. Hooray for them!

This came back to me as a result of a discussion of notable Chicago restaurants and hotels.

For several years, when my four siblings and I were kids growing up in Defiance, OH, our parents would take us on the train to Chicago right after Thanksgiving. We would stay at the Pearson Hotel, which is no more–the fancy downtown shopping center Water Tower Place rests on its bones. I had my first English muffin ever when we had breakfast at the Pearson, which was served by a waiter who remembered all of our orders without writing them down.

After breakfast we would motor over to Marshall Fields, where we would Christmas shop with all of the money we had saved up, and gawk at the decorated windows with the moving tableaux, and eventually purchase plenty of Frango mints to take home (who knew that they actually originated from the Seattle Department store Frederick & Nelson? we didn’t that’s for sure).
Each time we’d go, my folks would take us out for one very nice dinner at a very nice restaurant. I can remember two of them.


One was at the Kungsholm, a Scandanavian restaurant where I had my first pickled herring at the grand buffet that they served in the evening. Mother remembers that we amazed the wait staff when the five of us kids ate all the watermelon they had reserved for the evening buffet that night. After dinner, we went downstairs where they had a puppet show on a small stage and gave performances composed of the music from Broadway shows. We saw “Damn Yankees” that way. There was an older gentleman sitting in front of me with a toupee that fit very badly–it was much too small in the back. But I bet he really liked being able to be a red head late in his life.

The other dinnner was more spectacular. It was held at the Conrad Hilton (although my mother maintains it was at The Palmer House) and we took a taxi from the Pearson to get there, which was a real event since there were 5 kids and two parents squeezed in to one taxi. I recall the taxi we took had two seats that popped up from the floor to make sure there was enough seating for seven people. We arrived without incident, were seated in the level above the main restaurant floor, and ordered dinner. My younger brother John had some sort of tantrum during dinner and refused to order anything or just ordered an appetizer, can’t remember exactly what happened. That was a rare occasion when one of us would cross the parents. And things were rather tense after that.

However, the raison d’etre for going to the Conrad Hilton was revealed after all but the coffee cups and dessert plates were removed. The stage in front of the two tier restaurant drew back and there in all its crystal glory was an ice rink. With ice skaters skating to music. Just like Holiday on Ice only smaller. What a nice evening’s entertainment to take the kids to!

Until the last act. The orchestra cleared its collective throat and roared into a rousing rendition of “The Stripper” as a woman covered entirely in balloons skated out and the other skaters took to skating around her while popping those balloons with pins. I’m sure in retrospect, she must’ve had a body suit on, else the frostbite would’ve been compensable, but it was truly a moment of horror for my parents. 5 children under the age of 16. My brother John put his head down on the table, and brother Mark crawled under the table where he stayed until it was over and the lights came back up. I can’t remember what Barbie and Peggy did.

But it was an evening that I will never forget. Though I have no idea if the food was any good or not.

Divertimento

I have one more story about dogs, love, and death but I posted this remembrance at Nancy Nall's site and thought it was worth republishing here.

In 1995 I was working for the Washington Attorney General's office. That year, the head of the Antitrust section of the Washington AGO spent a year in Belarus, teaching lawyers and other government officials about the laws of competition in the US and Europe. When his year was over, heconvinced the attorney general and the governor's office to pay for a delegation of Belarussian officials to come over to the US for a several week visit (with their KGB handlers too) to learn more about capitalism up front. When the delegation arrived at the SeaTac airport, they set off all the dogs in security, because along with the copious amounts of vodka in their suitcases, they had packed large quantities of pig fat which they believed, if they ate before drinking their vodka, enabled them to drink that much more vodka.

Well two other couples and my ex and I hosted the group for dinner one night and they brought their vodka, lots of their vodka with them. One of the first things they did however, was to open the refrigerator and the stove in the kitchen to make sure that they were real (they’d been told that American’s houses were stuffed with fake appliances for appearances sake). Then they got down to eating our grilled salmon and drinking their vodka neat, which they did with furious and dedicated abandon, toasting all of us numerous times, and eventually singing many long Russian songs in minor keys quite loudly. We’d been warned about the hazards of drinking with the Russians, so all of us took very tiny sips and nursed our shot glasses for most of the evening. All except the ex.

The ex was two sheets to the wind as a result of his attempts to keep up with the Russians, and although extremely jovial and outgoing for 3/4 of the evening, he eventually became very vocally and extensively sick thereafter (I have blackmail pictures somewhere). We poured him into the family car, and I drove him home where he slept it off.

But our Russian guests left 3/4 of a bottle of vodka with us as a parting gift for the evening. I put it in my freezer and it lasted for almost two years. It was extremely good. I still have the bottle and the top name on it in cyrillic is ‘rapevka’ only the e is backwards and the v is upside down. and there are two dates to either side of that: 1893 on the left and 1993 on the right. The number 100 is prominently displayed in silver under the other name on the vodka bottle which looks like ‘kpbiwtavb’ again with the v upside down.


PS. The other good story to come out of the Belarussians visit (at least the one that is printable generally) was when they were taken on a tour of Costco. The first question from a group member to the Costco representative was, “But what do you do when you run out of all this stuff?” I wonder if that has changed for them now.

Dogs, Love and Death part 2

Unfortunately, my dog story is not completely told. But I've been mulling over the next part for quite some time because to write about it will open old wounds.

When I was going through my divorce ten years ago, I drove to work, so I could get home quicker and try to deal with the stresses that a spouse newly elected to the state legislature and gone all the time to Olympia creates. I parked in a cheap lot across the freeway from the office, and as I was parking there nearly every day, I became friends of a sort with the lot attendant, John. One cold February day he had a miniature dachshund puppy with him in the attendant's shack and boy was it cute! I exclaimed over the puppy, petted it and learned that his name was Alpha. Nothing more was said or seen until the late summer of '99, probably 6 months later, which, by then the ex had decided he liked the glamour of sleeping around that came with his elected position and elected to abandon the marriage. The divorce would be final in two months' time. I was parking the car and saw John the parking attendant. I remembered that bitterly cold February day and that warm ball of fur and asked him how Alpha was. He responded that he had to find a home for Alpha because he was going through a divorce and his new apartment didn't allow pets. Now just a few days earlier, my youngest son (age 9) had told me as I was putting him to sleep that although he loved Max, our black lab, that sometimes he wanted a little dog just to hold in his lap, like a miniature dachshund. It may have been the catalyst to my remembering to ask about Alpha that morning. But the symmetry and sadness was so close, that I spontaneously said to John, "I'll adopt Alpha!."

And so it was agreed. That evening I loaded the kids up in the old '83 VW bus that I was driving at the time and we drove over to John's apartment complex to pick up Alpha. When we got to the door we were met with two miniature dachshunds--John had cleverly not told me that Alpha came with Heidi, a much older miniature tri-color dachshund. And there I was, on the horns of a dilemma. Of course, I said yes with just a wee bit of hesitation first, so we were off back to home with not one, but two dogs to round out our all too typical family.

Now Alpha was a dog unlike any other dog I had ever met. He really looked like Jimmy Durante, his nose was soo long and so crooked. But just like Durante, it made him look cute. This was a dog who from the instant he woke up in the morning to when he dropped to sleep at night was on the go 100 mph all the time. He was with us for about a week, when he started humping every leg in sight. Male, female, dog, human. Even a ladder. He had not been neutered, which obviously was the source of his incredible horny dog problem, so once that was accomplished, he settled into other interesting but not as alarming behaviors.

Max, my steady, mild mannered black lab was delighted to have two little barkers around stirring things up. They were the yin to Max's yang, and during the days, they all slept on the same mat together, two little brown balls curled tightly next to their big black friend. They taught Max to bark loudly when unknown visitors came to the door. Which meant anyone but the immediate family. When I took the three dogs to the park (it felt like I needed a parade license to walk this many dogs), so I could throw Max's ball for him (because he is/was obsessed with retrieving), Alpha watched intently for a couple of sessions, and then had to do the just the same thing. So he got his own Alpha sized ball and would retrieve same as Max. Alpha the retriever dachshund.We also discovered that Alpha loved to grab on to a rope with a knot on the bottom of it and hold on with 'jawlettes' of death, so that you could swimg him around and around and around. It was all a big game.

Alpha had more eccentricities beyond that. For one, he loved to chew on the bottom of pants legs. I remember having one fellow to dinner when I was starting to date again, and Alpha did a number on his pants cuffs while we were eating our meal. And of course since our legs were under the table, the guy never picked up on it at the time, because Alpha could have the most delicate touch. I'm sure it was rather a shock for the guy to finish dessert, stand up, look down and discover that one pant leg was slightly higher than the other. That guy never came back again.Alpha loved all three of my kids, but he, in particular, bonded with my youngest son, the one who had wanted a little dog who would sit in his lap. They became inseparable friends, Alpha sleeping under the covers with him at night. It was a wonderful 4 years for them.

This is where the story veers off the track and goes bad. In the summer of 2003, the boys left to spend a week on Orcas Island with their dad and his girlfriend. My daughter stayed briefly behind with me for the weekend because she had to work before leaving for Orcas, but the boys were gone.Early on that Saturday morning, I had gone out to run errands, and when I drove back up to the house after being gone for less than an hour, I was surprised to see Heidi out in the the front yard, because the house was fenced in the back and that's where the dogs had been placed before I left. Heidi was agitated and not acting like her usual, calm self. I called for Alpha and got no response. My daughter went downstairs and out the back yard and gave a great cry. Alpha's rabies tag had become tangled on the seat of one of the outdoor chairs in the back yard. It was a wire lattice work chair and somehow the tag had become wedged into the space between the metal wires. So when Alpha went to jump off the chair, his collar had caught, the chair held, and it had strangled him. One of those freak, unpredictable accidents.

And there was nothing that I could have done to prevent it--other than never putting his rabies tag on him, or throwing those damn chairs away, or not running Saturday errands, or any other infinite number of 'should haves' 'could haves' that I cursed myself for. So, after freeing Alpha from the chair and crying copious quantities of tears, I had to call my boys and tell my youngest, via long distance, that his dog, the light of his life, had died. That was without a doubt the very hardest thing I have ever had to do. If I could have donated a limb or an organ and brought Alpha back to life, I would have. It was like Alpha had died twice. No three times, because I waited til the kids got home from their vacation, so we could have a proper burial service and closure, in our back yard. I cannot tell you how very, very sad this time was for me and for my children, especially the youngest.

I still remember and mourn Alpha each and every week. He was a doughty lad who had the heart of a lion. He loved each of us as deeply as his little doggy heart could, without reservation. There was no dog like him before or since in my life. And these words are a pale approximation of the joy and the sorrow that he brought to all of us. I hope wherever he is that he has lots of folks to twirl him around and lots of pants legs to chew on.

Of Dogs and Love and Death

My black labrador retriever, Max, is 11 years old this past month. He had a blood test from the vet and although nothing seemed to be too out of whack, given his breed, it should be only a few years (if that) left for him. It is hard to contemplate his passing. As it has been with all my pets. He was a Christmas puppy, purchased 11 months after our aging cocker spaniel had to be put to sleep, while we held her in our arms and cried hot wet tears for her passing. But she was 16 and her systems had failed her badly and there was nothing we could do to stop the pain. I thought I would never get another dog, but my daughter was brilliant in her line of attack. She waited 9 or 10 months without saying a word and then started a quiet campaign of asking for another dog.

It was effective, because on Christmas day, there was a small black furry beast waiting under the tree for her and her two brothers. It was the happiest Christmas of my life. Unfortunately, for the kids and for Max, the marriage lasted only for a year after that. And then we were on our own. But, Max made the very best of it. He is a patient dog, one not given to emotional excess. Although I can tell when he is exasperated with me when I don't walk him because it's too dark and rainy outside, and I'm just home from work, too tired to even fix a decent supper. But he puts up with me and loves me and I will never have a steadier companion.

My first word as a child was 'doggy.' I apparently said it with a soft 'g' but it was definitely my first word. Not ma-ma. From my earliest days I was drawn to dogs and trailed after the neighbor's dog when we lived in Denver, petting him fiercely whenever I could.

We moved to Defiance when I was 3 1/2 and we got our first dog perhaps a year or two later. Her name was Gypsy and she was a dalmation. My younger sister and brother and I loved her wholly and she returned that love unstintingly. There is a picture with the 3 of us gathered around her as she lazes in a round papasan chair, and we all have party hats on, even Gypsy. She was as big as my little brother at the time, but so gentle with us. Unfortunately, she was, unknown to us, deaf, as many dalmations are or were. We could not figure why she would run away from us all the time and only come back when she wanted to . And we lived on a busy street--North Clinton. One dark gray November afternoon, our parents were away and we had a babysitter. Gypsy got out the front door and ran across the street. A car hit her on the way back. We all saw it. The car did not stop and Gypsy dragged herself to the house and up to the porch. The babysitter would not let us bring her in to the house. We were frantic. I was all of 5 and the other two were 3 and 2. I went to the basement and brought up every rag I could find and packed it around Gypsy who was in shock and shivering to beat the band. Still the babysitter would not let her come in. I have no recollection of how long it took for my parents to get home. All I know is that Gypsy was taken to the vet's and several days later, my mother told me she had died. Given the circumstances, it was, in retrospect, a significant event for me.

I wish I could say it was my only experience like that, but it was not. We had a succession of dogs. Punch, another dalmation, lasted less than 3 months because he bit the baby's ear. Didn't matter that the baby kept bothering him. That was enough to get him booted from the house.


Our third dog was a female boxer we named Duchess. She was a beautiful dog who showed up in the back of our house one spring morning with her mom and another boxer pup. My folks found out who the dogs belonged to, and took them back but returned with Duchess. She was a sweet girl, with a taste to chase fast cars. Our family had moved from North Clinton St. and built a house on Elliott Lane, a quiet cul de sac, that unfortunately was just above Rt 24, the river road that led to the dam. We'd had Duchess for about a year, when one day she went missing. I went looking for her and found her body down the hill on the side of Rt 24, where a police car had stopped. The cop knew to follow me home without saying a word to me, because I was crying so hard. He told my mother.



You would have thought that would be the end of it, but, no. Our next addition was a basset hound named Digby. He was a much savvier dog, who liked to wander (my father refused to get him neutered, or the house fenced), but when he did it, he went north away from the traffic and towards Defiance College, where he was found, brought back to us, but he would take off again and again. Eventually he was adopted by a bunch of students there. When one of them was graduating from college and moving back to Canada, he asked if he could take Digby with him and my folks said yes. So, as far as I know, Digby lived out his dog life. He loved to be bathed in the front yard in an old tin baby tub that we had in the garage. And his ears were so long, he'd step on them constantly.

After Digby left, my mother got a flat coat lab, mix puppy from the owner of the butcher shop north of Defiance. We named her Mandy. Mandy was a great dog, very gregarious and loved to be around us kids. In the summer of 1962, went on vacation and when we came back, Mandy had gone into heat. She was the belle of the ball, so to speak, in our front yard. We had dogs lined up from all over the neighborhood. I was in the 6th grade at the time, and can remember looking out of the kitchen window at the ruckus going on, and being told of the reason for the large scal congregation, turning to my mother in disgust, saying. "I'm sure glad humans don't do that." You would have thought that that would have been a teachable moment for my mother, but no. I ultimately learned the facts of life from two 7th grade girlfriends on the bus a year later, to much embarassment and shame. Mandy was allowed to come to term with her pregnancy (we were Catholic after all) and gave birth to 8 or 9 very variegated puppies. We witnessed some of the birth when we came home for lunch on day and it was ensuite. I have no idea how my folks found homes for all of them and I am afraid to enquire more deeply into the matter.

After the puppies were given away, Mandy was fixed and it seemed that she became very protective of us, her real kids. When I was a sophomore in high school, our house caught fire on Palm Sunday. It was quite the excitement in Defiance, because the smoke could be seen for miles. I remember some guy went into our house and rescued, what he thought was our most valued object--our color tv--and when he opened the door to come out, Mandy followed him out. Fall of junior year, I came home from school one day to discover that my mother had put Mandy to sleep because she had bit the tv repairman. No word to any of the kids. She was just gone. She had jumped up on my bed that morning to wake me up with a lick and she was gone.

I didn't wait very long to mount my own campaign for another dog. I think by then I had figured out how to manipulate the Catholic guilt stuff for profit. I was good enough, that I got my mother to agree to to purchase a wire hair terrier that winter. We had to drive east of Toledo to pick her up. Her name was Maggie. And she was a balm to my heart. Maggie moved with us to Rochester MN after my junior year, when my father decided to do an internship at the Mayo Clinic in anesthesia. And Maggie produced Molly, who produced Muffin. By this time I was in college and family dogs were not quite the part of my life that they had once been. But the pattern had been set. I even had a dog in college for a while, until I realized I was not ready for the responsiblity and found a home for him ("Jocko" a cross between a husky and poodle).

I did not bring a dog into my life for eleven years after that, until 1983, when I adopted Sally, a stray cocker spaniel who I had picked up on the streets of Capitol Hill in Seattle outside the Development office of the Seattle, Art Museum where I was working at the time. Sally stayed with me and my then-spouse until her death of old age in 1997, a record of sorts. But if you fence your yard in, and take walks with your dog on a leash, you really can increase their life span. And don't invite tv repairmen to your house, either.

So Max will live out his normal life span with me, and I will be more than grateful for his constant devotion and companionship. One of my favorite buttons of all time goes something like this: "I got a dog for my husband. It was a fair trade."

Deutches Bundespost

Helga Burger and her partner, Kristal



Last night, I stayed up late sewing the top of my laundry bag. By hand. I don't own a machine and when I did, it was my grandmother's old treadle, electrified, and I could never find needles for it. I was the only kid in junior high who dropped out of home ec when we got to sewing. I was absolutely bored with the idea of making a dirndl skirt back in 1965. My mother couldn't sew either, so she could have cared less that I dropped out of home ec. She was and is a woman whose favorite cookbook was Peg Bracken's I Hate to Cook Book.

But why I was repairing my large laundry bag was that it had been a gift to me in the fall of 1978 from my friend Helga Burger in Germany. I had met Helga when I was a summer exchange student under the auspices of Youth for Understanding in 1969 in Offenbach. I had originally asked to be placed in France, because French was what I had studied in high school. I spoke no German. When word came that I had been placed instead in Germany, my mother said, "Well your forebears are German, you should be fine." So off I went to Germany without any German language skills or any further thought on the potential problems that might create, where I was to live with the Wade family.

Now life with the Wade family turned out to be not a box of chocolates. To begin with, just getting there involved a a harrowing all day trip on a train from Hamburg to Offenbach (because I had to be placed with a Catholic family, I had to be sent to the center south of Germany because there were no Catholic families to be found in northern Germany per YFU). The train from Hamburg was delayed en route 5 hours. I made it to Frankfurt without a clue as to how to transfer trains (thank you kind guardian angels) and then when I arrived at the train station in Offenbach, there Iwas no one waiting for me and I had no German money nor idea how to use a phone to call them--again saved by another guardian angel who made the call for me. Of course, while I was waiting for the Wades to arrive, several Turkish fellows tried to pick me up quite aggressively. I guess wearing bright yellow Villager shorts with an orange and yellow turtleneck top really made me stand out (once again, no one from YFU thought to advise on appropriate dress). The Turks were scaring the crap out of me when finally the Wades hove into view and stuck me in their car and drove off to their house.

Once arrived, I was informed by Herr and Frau Wade that they had agreed to host me because I could help their daughter, Marita, learn better English before she left in the fall of '69 for a year's exchange to an American high school. Now I was a fairly naive high school junior, who thought I had seen a lot, but it could not compare with their daughter, Marita. Marita was determined to break as many rules as she could. She drank, smoked cigarettes, bleached her long hair, wore slingback high heels with open toes, and most importantly, picked up American GIs at dances because they would buy her things and they were foreign, exotic to her.

So there I was, supposedly helping Marita learn English in a less exciting fashion. And then Frau Wade decided that I could do their ironing for them, as I wasn't pulling my own weight in the family (there were three younger boys who didn't do squat). On top of that Mrs. Wade had a nervous breakdown halfway through my visit which involved locking herself into her room and screaming at the top of her lungs for several hours, and throwing things. Herr Wade was the headmaster of a private boys' school and so most of this was tamped down because it would affect his standing in the community. The boys were a rude bunch, who talked back to their parents without reproach, chewed their food with their mouths open and were considered quite cute by their parents despite their obvious deficiencies in deportment.

My only out during this summer was when I would ride a bicycle to school with Marita to Hanau. Even though it was summer, school was still in session, and though I could not speak or read German, it was thought that somehow by osmosis, I could learn a bit. At school, I made friends with several other girls. Helga was one of them. I brought my 1969 high school yearbook to class and they poured over the pictures, marveling at high school life in America, the music, the weird sports that they didn't have. The girls, in particular would exclaim over one the photograph of one of my classmates at Defiance High School, Barry Schatz, because of his surname. We would spend lunches and breaks together giggling and talking about the boys in their class. It was difficult to communicate, because the osmosis was not working. But we made do with lots of laughter and giggling. Seeing these girls daily for the first month and a half of my visit, kept me centered and able to get through the difficult time I was experiencing with my host family. I can't remember at this late date what it was that drew Helga and I into a deeper friendship than the other girls, but after I returned from Germany we kept up a sporadic correspondence by mail over the years.

Then in 1978, I returned to Europe and enrolled at the Vrije Universiteit Brussel to obtain an LLM degree in international law. During the fall, I took a train to central Germany, where I met Helga and stayed at her apartment for a long weekend. We went to a Christmas fair in the town square and hiked out in the country, after a bit of a car ride to get there. Helga and I were still friends, but things were a bit different. For one thing, at one point during a party Helga hosted, while I was trying to make conversation with a group of women in Helga's kitchen (my German had not improved much in the intervening years), one of Helga's girlfriend's seemed a bit agitated, and at one point grabbed Helga by the crotch while we were talking. Later, in the room I was sleeping in, I was looking at Helga's record albums, and noted a complete collection of albums by a girl group called The Flying Lesbians, or something like that. I put two and two together, and at some point the three of us reached an uneasy truce when I made it clear that I was not angling for more than Helga's friendship, and we managed to salvage and spend a pretty decent weekend together.

As a parting gift, Helga, who worked for the German post office in Offenbach, gave me a large blue postal bag emblazoned with the Deutches Bundespost symbol in yellow, red, and black. I've kept it with me since. It has housed my dirty laundry from Brussels to KY to DC to Seattle for the past 30 years. It was sweet to sit and sew on it last night and remember a friendship that had sustained me through my first difficult time.