Monday morning you sure look fine

Fleetwood Mac gave us this first lyric to “Monday Morning.” Some of us may remember the next line is “Friday I’ve got traveling on my mind.” That must have been some rollercoaster week. If your week turns out to be a rollercoaster, I hope you enjoy the ride and want more, instead of traveling away from someone who looked so fine on Monday. Speaking of rides, take a little ride with me as I touch on a few miscellaneous thoughts.

As we have begun the final week of July, 2021, I have become less enthusiastic about this Christmas time in July bit. Some of the channels are running holiday movies, which is fine, but when they start to sell me Christmas deals in July in the commercials, that is a bridge too far. I don’t want to buy a fake Christmas tree in July – I am just not in the mood.

My wife and I have watched a little bit of the Olympics in Japan, but we won’t be watching it too much. We do find the second page sports entertaining, as we have watched the finishes to the bicycle races, fencing, with a little swimming and gymnastics thrown in. Of course, the last two are usually front page sports during these events. What I don’t care for is NBC does not show non-American athletes near enough to balance out the show. Usually, they appear when competing directly against the Americans.

We did go see a pretty good movie called “Joe Bell” with Mark Wahlberg and introducing Reid Miller. I won’t spoil it for you, but it is based on a true story about a father and his gay son. The movie is somber look at the bullying that goes on toward gays in school and life. Rotten Tomatoes does not rate it as well as the Google viewers do, but it does make you think. Connie Britton plays the mother and Gary Sinise shows up late in the movie adding a lot of value.

Our friend Joy put a picture in her recent blog post of a frozen peach Margarita, which looked delicious, although. I do not drink anymore. So, with her impetus, I went to a local Farmers’ Market (hence yesterday’s post) and picked up, among other things, “Free Stone peaches.” Apparently, the pulp peels away from the pit very easily and, while guarded by a little tougher skin, are delightfully sweet and tart. The virgin Margaritas were a blend of the peeled peaches, pineapple sherbet, orange juice and ice. Thanks Joy for the inspiration.*

My mother and father’s birthdays are approaching. They would have been 89 and 90 this year. Dad went first about fifteen years ago, while Mom went almost five years ago. Plus, the only grandmother I had met (when not a baby) has an approaching birthday. I just wanted to think a few good thoughts about them as I close out. Have a great week everyone

*Here is a link to Joy’s post: Friday’s Super Short Stories! | Nuggets of Gold (wordpress.com)

Anecdotal, but seem like truisms

Yesterday, I went to a local Farmers’ Market that crops up (pun intended) on Saturdays and Wednesdays during harvest season. And, it started me thinking about anecdotal observations. They may be just anecdotes, but they sure seem to be truisms.

Have you noticed that people who go to Farmers’ Markets to buy fresh vegetables and fruits tend to be in better shape than the average person?

Have you noticed the opposite is true with people who dine at fish camps? – the more colorful the food, the better it is for you

Have you noticed a man will never be shot while doing the dishes?

Have you ever noticed that someone who is very skilled at something does not tend to brag about how good they are at it?

Have you noticed that someone who brags about his or her capabilities is trying to convince others of something that is less true than accurate?

Have you noticed the first suspect in a TV crime show shooting will usually end up dead, often discovered by the police going to see him or her?

Have you ever noticed the best coaches tend to be the ones who had to work harder at their craft than those where it came naturally?

Have you ever noticed the unknown actor beaming down to the planet with Captain Kirk is not going to make it back?

Have you ever noticed that lies travel faster the truth and, sadly, get more read? – the truth is often less exciting than a story.

Have you noticed a truism right out of the Ziggy comic strip – the better the packaging a presentation or product has, the less believable it is?

So, to sum up. Do the dishes, brag less, eat more colorful foods, be skeptical of provocative stories, don’t beam down with the star (this one is more profound than you think) and trust in Ziggy.

You have been married a long time when…

My wife and I have been married several decades plus some, so we have observed how sayings, actions and tastes can arc toward a common theme. Note the title of this post does not use the phrase “too long,” as that is big no-no for newly married couples whose husband has not yet been corrected by his wife. The same applies for same gender couples.

So, using the framework of you have been married a long time when….

  • we hear a phrase or word on TV and start singing the same song at the same time. An easy one is following the word Argentina, we will break out with our inner “Evita” singing the obvious first line of the chorus. But, scarily we do this with other songs, as well.
  • your spouse starts using a line or word that you use use more often. An easy one is seeing a cemetery, my wife will note my line of “People are dying to go there.” Hearing your words echoed back can be flattering, but not always. Or, she might say “Don’t say it” if it us not funny.
  • we can define a restaurant, movie or actor without ever saying the name and it is understood. Just last night, I said about a TV show actor, she is that actress who starred in that Australian series about the matriarch who bossed everyone around. After one more sentence, my wife knew who it was.
  • your spouse can raise a topic and you immediately know she is bothered by something. So, you listen. Since more often than not, she wants to vent, you just listen, not try to fix. This is the best advice to young couples, especially the husband, as men like to fix things – listen more, talk less.
  • you pass to each other humming or sung ear worms. You may be humming a tune without really knowing it, until you hear your spouse humming the same song later. Why are you humming that? This is more frequent with all of the commercials using old songs to sell products.
  • you share take out dishes, as neither of you can complete one entree. Only rarely, will we order two meals from a Chinese take out restaurant, with the exception of getting two spring rolls to along with our soup for one and one main meal.
  • you know your spouse’s favorite actors and vice versa, so you point out others who look similar that she may like.

What have I left out that you and your spouse do? I stayed away from looking alike, as people sometimes marry someone who has characteristics that remind them of their mother or father. So, they grow into those features.

Sometimes you have to change your mind – a life crossroads moment

Reading our Australian friend Amanda’s post this morning (see link below), she noted it is more than OK to start down a path and do a U-turn. Sometimes, you realize you have embarked on a journey you don’t want to go on or you have chosen the wrong person to go with. This reminded me of a real life crossroads moment.

I left consulting for a job with one of my clients which I loved. I wanted to work on that side of the table for awhile, knowing it would benefit me no matter what I did in the future. After a few years, I got an opportunity to go back into consulting and return to a city that my wife and I met in and started our family. With sadness I turned in my resignation.

As I was packing up my office, I came to the life shattering revelation that I did not want to leave, at least not just yet. I also realized I was selling myself short, as I was going back into the same level of consulting that I left, just with a different company.

So, I called my wife and said “I cannot do this.” She asked “Pack?” And, I said “No, leave.” She then said “Who are you?” in gest. With her blessing, we decided to stay, but I had to call my boss. In turn, he had to call his boss. And, of course, I had to call the employer I was turning down.

With their permission, I rescinded my resignation. It was the best unwinding of a decision I have ever done. I enjoyed my time there and received many opportunities to learn and grow. I eventually did leave a few years later, one reason being the company was going to have to merge as it needed to be more scalable. I was offered a job that was clearly a better one than the one I turned down after accepting. It should be noted, the job was with the same company I turned down, so I did not burn any bridges the first time.

Life crossroads don’t come around often. So, it is important to make sure the decision is what you want to do. If I left, it would have been OK, but I was much better off by staying. I have regretted not going further down certain paths, yet whatever steps are taken should involve some due diligence the more important the decision. Frost called it “The Road not taken.” Whether you take it or not, give it some thought.

The Destination or Pathway of Life – Something to Ponder About (wordpress.com)

Wednesday wanderings early in July, 2021

Crosby, Stills and Nash sang:

Just a song before I go
To whom it may concern
Traveling twice the speed of sound
It’s easy to get burned”

Simon and Grafunkel added:

“Slow down, you move too fast
You got to make the morning last
Just kicking down the cobble stones
Looking for fun and feelin’ groovy”

In our 24 x 7 world of social media and pseudo and real news sources that tell us what to think, everything seems like a problem of urgency. Isn’t this horrible and we must act? Part of this is very real, as in this big world, something bad is happening somewhere. Since “if it bleeds, it leads” or is there is conflict between sparring legislators, it makes the news.

Good news stories do get reported, but in inverse proportion to their occurrence. The good news stories are far more common and everyday, but are not deemed newsworthy. I recall a silly example on a music show called “Where are they now?” which usually highlights a band that had success, then fell apart. They filmed one on the group Kansas, but it never aired. Why? The band members were all living normal lives, so it was not titillating.

Yet, the other part of these pervasive bad news stories, which can be tragic and dispiriting, is the news that needs to be talked about, but does not get much coverage. Here are a few.

  • We have a global fresh water problem that is only being made worse by climate change.
  • That climate change problem is no longer a future event – it is brandishing its fangs now with more wildfires, droughts and stalled weather patterns, along with more intense hurricanes and tornados.
  • On the good news side, renewable energy is growing at a rapid rate now that cost of production is economical and fossil fuel companies are being held more to account by shareholders and judges..
  • There is a poverty and hunger problem in the US and abroad. Too many Americans go to bed hungry. Too many Americans live beneath or at paycheck to paycheck.
  • The US has a huge debt and deficit burden that was already bad before the pandemic relief and tax cuts – now it is far worse, with interest cost becoming an increasing part of the budget.

These issues don’t get talked about enough. Even on the better news stations, the focus is way too much on which political party benefits from an issue. The issue itself gets less reporting than who benefits. In fact, wedge issues are seized to beat the other party over the head with, even if the problem has been around for years. I have long grown weary of problems not being addressed, because of optics. Do something.

But, back to CS&N and Simon and Garfunkel, let’s also balance all of this with the good stuff that is going on every day. I recognize there are too many folks that are wound way too tight. They seem looking for a fight if some thing or some person makes them do something. Get over it. The world does not revolve around you. If you have to wear a mask to get in some place, then you know what you need to do.

Yet, we should endeavor to leave all of our encounters on a better footing. Somewhere in some book I read, some guy called this rule golden. Something like treat others like you want to be treated. Now, that is something to evangelize.

Sand castle virtues (a reprise)

With my recent trip to the beach, this old post is aptly titled. I think of these words often, when I am walking along the shore as yesterday’s castles are washed away.

I was listening closely to an old song called “Thick as a Brick” by Jethro Tull, when a phrase struck me more so than before. Jethro Tull is renowned for interesting and unusual lyrics mixed in with equal parts flute, guitars and piano making a unique sound. Yet, amidst the lyrics is a reference to “sand castle virtues.” Here is the stanza which includes the term, penned by Ian Anderson:

And the sand castle virtues are all swept away. In the tidal destruction, the moral melee
The elastic retreat rings the close of play. As the last wave uncovers the newfangled way.

I found this reference profoundly insightful, as many of our so-called virtues are not as concrete as we would like them to be. In other words, they are easily washed away by the waves and replaced by a modified version meeting a new paradigm. This is one reason people can support a candidate or politician who changes posture on a topic. Or, when the candidate was against an issue earlier when the opposing party supported it, but now favors it as it suits his interests today, we followers can overlook the previous stance.

The tide has washed away the previous virtuous stance and has been replaced. What is interesting to me is this song was written in the 1970s, so it is referencing that these malleable virtues or positions have been around a lot longer than today. The only difference is today we can more easily find the previous position, which may have only been stated a few years before. Yet, we don’t ask questions of why you have changed. In essence, we are “thick as a brick” by not staying on top of things and realizing when smoke is being blown at us.

Speaking through my imperfections, I find it hard to fathom why we choose virtues like we are at a cafeteria. A friend of mine uses the reference to “cafeteria Christians,” not to pick on this religion, but use it as an example. Some will cherry pick the parts of the bible they support, but overlook overarching themes. But, this occurs in other religions as well.

If we focus on the overarching virtues and endeavor to do the right thing, we will be on more solid footing. It is when we try to massage a virtue to meet an ideologue or a position, do we risk our position being washed away with the tide. Here are few that would solidify our foundation:

– Treat others like you want to be treated

– Be more inclusive, rather than exclusive

– You have two ears and one mouth, use them in that proportion

– Kindness is not a weakness and in fact is a quiet strength

– It is easy to love someone when things go well; only when they don’t is it hard

– Help your neighbor when he needs it, as you may be in need one day

– Pay attention to what leaders are doing and shine a light on poor behavior

– Treat our environment well for the next generation, which is even noted in the bible

I could go on, but these are a few virtues that would not be washed away. These virtues are far more than sand castles and could stand the greater test of time and barrage of waves. And, if we did these things day in and day out, they would become ingrained making us less “thick as a brick.”

Have you ever wondered…

Since I am in need to write something apolitical and, hopefully, funny, please enjoy the following. And, do offer your “wonderings” in the comments.

Have you ever wondered….

why it is nigh impossible to move cooked riced from one container to another without spilling some of it on the counter?

-why spilled oil and vinegar based dressings will invariably miss your napkin and find your shirt or blouse?

why a yellow towel, shirt, blouse, dress or shorts will eventually be stained by other clothing in the wash – some dark clothing will sneak its way in there?

-why your talkative friend who needs an audience will call as you prepare for dinner?

why some folks don’t understand that once you find yourself in a hole, the key is to stop digging?

-why too many men don’t realize a truism, a man will never be shot while doing the dishes?

why women and men tend to have different definitions of what it means to go shopping – something about that hunter/ gatherer difference or maybe it is in that Venus/ Mars article?

-why the best retorts you think of may be better left unsaid – something about winning a battle and losing a war?

why people fail to realize that there are very few one way communication problems?

-why more couples don’t realize those who tend to work at their relationships and marriages tend to have more successful ones?

why husbands and boyfriends don’t realize that their wives or girlfriends do not want you to fix their problem, they want you to listen as they vent?

That is all for now. Please forgive the generalizations used for humor as I recognize everyone is different and relationships vary. What are your thoughts?

Lessons from Sully Sullenberger and Paul O’Neill – a review

The following post was written seven years ago when GM was having some issues that did not get communicated upward and were left to fester. This is not an uncommon problem, nor is knowing about problems and choosing not to act.

I have written before that organizations take on the personality of its leaders. Earlier this week, CEO Mary Barra of General Motors (GM), reported on the findings of an internal audit of why they did not have an earlier recall when problems arose on some cars. Many heard a lot of blame down the ladder, but we did not hear much about culpability at the top. The key question asked, but not answered, is why did people not share their concerns with management that something was amiss? The unstated answer is it is in the culture of the organization, where people at the top did not want to hear of failings or heads would roll. An analyst who covers the car industry noted there was a modus operandi of “don’t mess with the launch of new line.”

I have written before about two leaders, Captain Sully Sullenberger and Paul O’Neill, who was the CEO who turned around Alcoa and later became Secretary of the Treasury under President George W. Bush. They have some good lessons that GM should emulate  going forward. Sullenberger was the right person at the right time as captain of US Airways Flight 1549 that he safely landed in the Hudson River. He not only studied accidents for airlines, he was on task forces to go to crash sites and help ascertain why the planes went down. So, he knew from his research and experience, what he needed to do to safely land in the Hudson.

He also knew what GM failed to remember. He was the leader of the crew, but he understood all to well that each member of the team has a role in the safety of the flight, including the flight tower personnel. His research showed that many accidents occurred because navigators and co-pilots did not feel comfortable offering input to the pilot or tower. A couple of examples might help. A plane crashed in Japan, because the co-pilot had to acquiesce to the pilot due to seniority. In this case, the co-pilot was on record as being correct that the plane was off course, but the pilot’s judgment could not be overturned. In another, the Brazilian flight crew of a doomed flight did not have confidence to disagree with an American flight tower and the plane crashed.

Sullenberger was aware of other examples that had been noted and improved over time. But, what he did every time he had a new flight crew (even one new member), was get them all together to get to know them and encourage them to speak up if they saw something amiss. Anything, even if small. He noted in his book, what gave him great comfort during these few seconds on Flight 1549, was he could hear everyone doing their job. He got quick advice from the tower, his co-pilot and navigator. He shared his thoughts quickly and made sure everyone knew what was going to transpire. When he concluded that getting nearby Teterboro Airport was not possible, he offered up and concluded, “it looks like we will be in the Hudson” which allowed rescue crews to be alerted.

O’Neill joined Alcoa which was struggling. And, his first public comments were “we are going to make Alcoa the safest company possible.” This was an odd mission to start out with and many analysts were not impressed. One analyst told his investors to sell Alcoa stock, which he later added, was the worst advice he had ever given. O’Neill knew that the only thing he could get management and union leaders to agree on was safety. So, that is where he started. He also knew that for safety to be important, managers had to talk to floor personnel to understand better the problems, so that a plan to fix them could be developed. So, communication got better up and down the line. The empowered employees starting sharing ideas on how to improve not only safety, but process as well. The company performance and stock price took off.

Both Sullenberger and O’Neill knew that they were part of a team. They also knew the best ideas can come from anywhere, but especially from those closest to the action. So, it is not only vital, but imperative, that management create a culture where ideas can be shared. Otherwise, you would be flying in the dark. It should be noted at the same time GM was having these troubles, they missed a huge market opportunity. Why? Because they were not listening.

GM piloted the first electric car called the EV-1 in California in the early 2000’s. They did not sell them or market them, but a cult-like following was growing as people who wanted to make a difference started leasing them by the thousands. Eventually, the EV-1 was killed as the result of an alleged collusive effort chronicled in the documentary “Who Killed the Electric Car?” which can be accessed by the link below. The drivers wanted to buy the cars, but GM collected them and shredded them. They wanted no evidence. The Board of Directors of GM asked why the EV-1 pilot was being shelved at the same time they were building Hummers, and management said this is the direction America car buyers want. Hummers are no longer made as they were gas guzzlers.

Here in 2014, GM could have been the predominant player in the electric car market, which will grow as more power stations and better batteries become available. Yet, they chose a short-lived strategy, made other bad decisions and had to be bailed out and only now are seeing the failure of not having an open culture to communication. The lesson that was not said by Barra is we did not have an environment where people could offer input and we would listen to them. She needs to talk to Sully Sullenberger and Paul O’Neill and set a more open path for the future. It is not ironic, that both are known for safety. And, communication.

Maybe a law preventing yoga being used in Alabama schools will be overturned

When I first saw this article I had to do a double take. As someone who practices yoga in my home for over six years, its benefits are very helpful to these old bones and muscles. So, to see it categorized in such a negative light was troubling but not shocking. But, that is changing.

In 1993, Alabama legislators banned teaching yoga in public schools*. In an article called “Alabama might overturn its 28-year ban on yoga in schools. Just don’t say ‘namaste.’” by Meryl Kornfeld of The Washington Post, it reveals most of this law may be overturned. Here are a few paragraphs from the article. The whole article can be linked to below.

“Students will no longer need to bend over backward to (legally) practice yoga in Alabama.

In a 73-to-25 vote Thursday, the state’s House of Representatives passed a bill that will lift a quarter-century ban in public schools that some believe is unique to Alabama. Yoga was forbidden by the Alabama Board of Education in 1993 after opposition by conservative groups over its Hindu roots.

Amid reports of racism and violence against Asian Americans and other minorities, the measure is a positive step, said Nikunj Trivedi, president of the Coalition of Hindus of North America. He said practicing yoga, which many non-Hindus use for health benefits, is cultural appreciation, not cultural appropriation.

‘Yes, it has roots in Hinduism, and it’s a Hindu practice, but it’s a gift Hindus have shared with the world,’ Trivedi said.

The reason I was not shocked is I have seen this kind of push back before. A minister gave license to a suggestion by a female church leader to start an exercise program mainly for women. It actually worked so well, church attendance increased, Then the minister saw that they were doing yoga and put an abrupt end to it. He saw it as practicing another religion.

Fortunately, this mindset has changed for the better. Not only are there many places to learn and practice yoga, there are at least fifty commercials that use women and men practicing yoga in groups or at home as background to the theme to sell product. Let me emphasize this – it is so normative it is used to sell product.

In my personal experience, yoga is taught as a breathing and exercise program. The breathing part is as important as the exercise part as it helps one focus on what they are doing. One of the news reports cited a proponent of the law saying yoga was bad for mental health. In my experience, this is total off base, as it actually helps people with their peace of mind as well as stretching those muscles.

The only caution with yoga is usually made during the classes. If you cannot do a stretch or if it causes you discomfort, then don’t do it or do it to a lesser stretching pose. My level of yoga is more basic than some one much younger and more agile, who does moves and poses “with which I am not familiar.” Or, I should say know, but cannot even fathom doing.

So, I encourage people in all fifty states to find a sustainable exercise and “just do it’ as the Nike ad says. It may be yoga, pilates, isometrics, calisthenics, taibo, spin class, light weightlifting, etc. It need not be an hour work out to be effective – I work out fifteen minutes every day after I shower (it loosens up my old bones), varying three sets of routines to keep it interesting. One day I focus on arms and torso more, the next day legs and torso more, and the final day light weightlifting more.

And, for those who feel they are cheating their religion by saying “Namaste,” feel free to replace it with “have a nice day” or “peace be with you” as it is said in greeting as a sign of respect more than anything else.

*Per NBC News, Alabama in a 1993 law barred yoga in public schools along with other practices such as “meditation” and “guided imagery,” under a general prohibition of the use of “hypnosis and dissociative mental states.” Gray, elected in 2018, said he only recently learned about the ban, which was favored by religious leaders at the time.

Alabama yoga ban may be lifted after House passes bill – The Washington Post

Internal Bleeding – Be your own Health Care Advocate

The following post was written about nine years ago. Since that time, some of the changes noted below have taken shape, but the message remains important. Be your own health care advocate.

A few years ago, two doctors looking to improve the quality of health care in the US, wrote a book called “Internal Bleeding: The Truth Behind America’s Terrifying Epidemic of Medical Mistakes.” Since Drs. Robert Wachter and Kaveh Shojania wrote their book, improvements have and continue to be made, but with the concern over the US’ 38th position in health care quality, while being the most expensive system in the world (according to the World Health Organization), I think it is appropriate to belabor a few of their key points, in particular, being your own health care advocate.

In today’s world, we must be the navigators of any customer service we receive whether it is at a bank, the driver’s license office or in a retail store. We must be diplomatically relentless in trying to gain the service we expect and need to resolve an issue. Service providers, in particular those in a Call Center, need to stay on script as much as possible. When your problems get them off script, then your navigation diplomacy skills are needed the most.  I mention this as context for what we also must do in gleaning good health care service.

A few years back there was a study conducted by a combined group called the “Leapfrog Group” to improve the quality of health care in hospitals. Leapfrog came up with three major ideas – (1) Electronic orders were a must (poorly written prescription orders were killing people), (2) Intensive Care units need to always have a doctor on site and (3) Medical procedures of import need to be done in centers of excellence, not where a hospital may have done only a handful of surgeries in this area. “Internal Bleeding” echoes many of these same issues, especially the one on electronic order taking. Yet, they also go beyond these Leapfrog issues.

They noted that often times in hospitals, fewer critical questions are asked closer to the time of the procedure. Sometimes, the critical mistake may have occurred very early in the process. They used the analogy of all of the holes in Swiss cheese aligning to allow a mistake to pass all the way through. They used the example at Duke University where a famous heart transplant for a minor child occurred. The doctors at this very fine medical center, one of the best, were so excited when a heart of a young deceased donor became available, that they assumed others had checked that the type of blood of the donor matched the patient. It did not and the patient died. Similar examples occurred when doctors operated on the wrong leg, arm, kidney, lung, etc. The doctors failed to ask the very basic of questions and assumed these issues had been resolved.

In addition to the above and related to the Rx orders, the authors advocate the patient understand fully what is being done to them in the hospital or before they get there. They recommend you introduce yourself to every care giver who comes into the room, ask questions of them relative to medications you are being given and make them fully aware of other medications you are taking. They recommend if you cannot speak for yourself or are uncomfortable in so-doing, to delegate this important role to someone you trust. In other words, they are recommending being your own health care advocate. This will help minimize mistakes.

Health care is both a science and an art. It also is a trial and error business, so the doctors may not know for certain what is wrong with you and have to figure it out. They will do their best, but they do not know you very well or at all. So, you have to play the role of information provider and advocate.  Using the authors’ recommendation supplemented by other sources of information and experience, you must be your own health care advocate and do the following to get the care you expect and need.

– Write as good a summary of your and your family medical history as possible. Make it available to others you trust who may need to speak on your behalf.

– Before you see the doctor, write down your symptoms and questions as you may get stage fright when you see the doctor’s white coat.

– Do not be scared to ask questions, especially if you do not understand the diagnosis or remedy – he or she is there to serve you. I tell my kids you show your intelligence by asking questions, not by failing to ask.

– Get a second opinion on major diagnoses. For example, it takes a lot of practice to read a mammogram correctly and a non-inconsequential percentage of misdiagnoses occur. Using this example, computers cannot take the place of human fingers in doing a self-test. If you feel a lump and the first mammogram shows negative, get a second opinion.

– Make sure you inform your doctors and pharmacists what drugs you are taking. There are a number of drugs that contraempt the drug you need (make its use less effective) and some which are toxic when taken together. I ask my pharmacist questions all the time about some over counter drugs that may be harmful when taken with the prescriptions my family is taking, including me.

– Take your medications as prescribed and through the dosage. Many people stop taking their meds when they start feeling better.

– Be truthful with the doctor about your drinking and extra-curricular drug use. Doctors tend to believe patients understate their drinking, so help them out and tell them the truth. You drink more than you say you do.

– Make sure you get treatment for a major problem at a place that does a lot of what you need – a center of excellence. This is especially true with back or spinal surgeries and surgeries on any major organs. If you are having heart surgery, do you want it done where they have done 25 in the past year or 250, e.g? I have two friends who are having major back complications after spinal surgeries were done poorly.

– Get all the information you can around procedures to make informed decisions. In some cases, living with a mild discomfort with medication may be better than invasive surgery. Ask the doctor what are the options, what are the chances for success and what are the risks. If he/ she doesn’t know, ask him/ her with whom you can speak.

– Be diplomatically relentless with Call Center personnel at insurance companies. Mistakes do occur and sometimes you may be allergic to a substituted generic prescription. So, you can appeal a claim if you feel under-served.

– This one comes courtesy of Dr. Sandra Steingraber, an ecologist, biologist and cancer survivor. Family history needs to recognize your environment as well. She was adopted, but her bladder cancer at the age of 21, also occurred in other family members who lived nearby (as well as other cancers). Bladder cancer is a bell-weather cancer. It is largely caused by environmental toxins. If your family, neighbors or community has some longevity in an area and more than one or two bladder cancers have occurred, start doing some fact-finding. It may be more than a coincidence. Since people move around, showing environmental causes is difficult as the exposure may have occurred years before.

– Finally, take care of yourself in a sustainable way. Walk more. Reduce portions. Eat more slowly and ingest more calories earlier in the day. These measures can be sustained whereas diets cannot.

These are just a few ideas, but the key message is be your own health care advocate as you are the only constant in any equation about your health. If you feel you cannot serve this role well, please take a trusted friend or family member with you. Doctors and nurses are marvelous care givers, but they are not perfect. You have to improve their service by being present in the conversations. It is only your or your children’s lives.