Inauguration Day

For years, I have used LibraryThing.com to manage my personal library. A few times, I have accepted free advance copies of books from publishers, distributed through the site, in exchange for reviews. In the course of doing this, I found that I enjoy writing reviews for the books in my library, especially those works that have been the most influential in my life.

To facilitate this, I have started a new blog: http://biblioreview.wordpress.com.

It’s off to a slow start: other than the works already reviewed, I’m going to reread the books specifically with an eye toward reviewing them, rather than attempt to work from memory. For now, feel free to enjoy https://jeffreydbrown.wordpress.com and my philosophy blog, http://ethikos.wordpress.com.

If you get nothing else from them, I hope it IS enjoyment.

Published in: on 2010 12 23 at 14:20:51  Leave a Comment  

Reflections on Music

[This originally appeared on my Facebook, and I thought it worth preserving.]

It must really suck to be my neighbor on a morning when I’m NOT overwhelmed by depression: the windows rattle with my “happy music.”

Fortunately for them, it’s rare. Even if I wake up okay, something as small as HB’s (my pet name for my life partner) leaving for work can be enough to put me in an unrecoverable tailspin.

The list of things that bring me joy and counter the tendency toward the darkness of depression has shortened dramatically over the past decade or so. Some that remain, like spending time with my kids, I only get to enjoy for short bursts, with seemingly infinite periods in between. Others, such as spending time immersed in nature, are victims of physical disability. Only my music is always there. It pulls me back from the brink. It lets loose a torrent of tears, when (hopefully controlled) catharsis what I need. It helps me forgive myself for my personal failures, which is a lot to ask of anything.

It partially fills a role for me that, for others, may be filled by religion.

 

Published in: on 2010 12 09 at 09:39:48  Leave a Comment  
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This is My Mind on Crutches. Any Questions?

For the past two decades, I have grown accustomed to having my body let me down. A shipboard accident at the age of 18 left me suffering from knee injuries that never resolved and devolved into osteoarthritis and other degenerative joint conditions. That disability cut my Navy “career” extremely short – if my knees had failed while I was working in my normal workplace, a carrier flight deck, my life and likely others’ would be endangered.

After leaving the Navy honorably due to my knee disability, my life was without direction, and I was still coming to grips with the fact that I was limited to desk work for the rest of my life. I had a hard time psychologically, going from a literal lean, mean fighting machine to someone facing a limitation I had thought of a concern for old age, and it was hard for me to even grasp old age.

Given my reliance on my intellect throughout my life, it isn’t really earth-shattering that I would end up working with my mind, rather than with my muscles, but the sudden closing of all of those doors was extremely depressing. I was fortunate that a family friend was the Chief of Police for a small city in the Atlanta area, and his department was in need of a dispatcher. It turned out that I was very good at the work, and, like my service in the Navy, I had the personal satisfaction that I derived from public service. The job turned into a career, culminating in my working in the communications center of the state Emergency Management Agency, a position which let me turn my lifelong interest in computers into one of my duties: information systems administrator for the communications division. I was given a lot of leeway in developing applications. I was proud to develop the software that the communications division adopted for statewide  incident management. It remained in service for several years after my departure and marked the point when my career really changed from public safety or emergency communications to information technology, especially infrastructure systems and database administration. The same small city where I had started as a 911 dispatcher years earlier hired me as its first IT manager.

Actually, I was the entire IT department, and although the city had created the position, it had made no preparation for me to actually start work. I had to find or commandeer literally everything I needed: an office, computer, telephone, furniture – everything. The city’s computer systems and network were completely undocumented.  The flipside of having to do literally everything myself was the rare opportunity to design and implement everything from the ground up.

I had enough on my plate to justify at least three full-time-equivalent positions, supporting the life-critical 24/365 operations of the 911 center,  fire/rescue, police, and jail.  Since those additional l FTEs didn’t exist, I was never truly off duty. I stayed so engaged that I didn’t recognize the toll it was taking on my family life. The heavy work pressure seemed necessary to support my family, and, as long as I had a good, hands-off supervisor (the city manager), the extreme stress felt like “good” stress. It was rewarding.

When circumstances changed, particularly the replacement of the city manager by a new one who had never held that position before, my ideal career quickly started to unravel. The new city manager was a micromanager in the extreme, made worse by his mistaken belief that he knew anything about information technology and his habit of praising performance one day and condemning the same performance the following day.

My major depressive disorder, which had been chemical/organic in origin throughout my adult life and well-controlled by medication for several years, began to become reactive to external life situations – a development with which I had no experience and for which I had no coping tools. In addition,  I began suffering from acute panic and anxiety attacks. I began finding reasons to work at night or at locations other than my office in city hall. Within a few months, the anxiety/panic reached the point of my seeking medical attention for it, and my psychiatrist starting me onto anti-anxiety meds (benzodiazepines).  As I continued to worsen, I was compelled to seek an ADA accommodation and formally notified the city of my intention to take FMLA leave. I was utterly speechless when the city manager fired me the following afternoon with no warning. I suggested to my then-wife that she might want to go ahead and take the kids to her parents’ – I didn’t want them to see Daddy have the complete breakdown that followed – one from which I still haven’t fully recovered, despite improvement with the anxiety disorder. The separation from my family…and then the marital separation…there seemed to be no bottom to the abyss of my depression.

Enter the knees again. They continued to degenerate, as my daily life had sunk to the point that muscle atrophy was inevitable, and my orthopedist referred me to a pain management clinic, adding OxyContin and then MS Contin (due to intolerable cognitive side effects with the former) to the potent mix of psychotropic drugs I was already taking.

Despite  the generally effective antidepressant and anti-anxiety regimen (and the generally ineffective pain regimen consisting primarily opiates due to an allergy to NSAIDs) and the addition of therapy with a psychologist, things have remained fairly constant over the past few years – unpredictable depressive episodes, often with suicidal ideations, persist, and I still experience cognitive effects such as short-term memory loss. The military and other organizations have a maxim that “if it’s not in writing, it doesn’t exist.” For me, that has become literally true. My memory can’t be trusted, which is part of why I write down what many consider Too Much Information. Putting it in a publicly-accessible location allows me to reach it from any computer, and, perhaps more importantly, it might let people in similar situations know that they are not alone.

It took me years to fully come to grips with my physical disability. The awareness that my mind is letting me down, and that it MIGHT not get better, is a much tougher pill to swallow. My life feels like someone in a waking coma – the machine is still working, but it is very difficult to control the input/output: focusing my mind on a new problem or adding new capabilities is often beyond me.

I have worked hard throughout my life to make the contents and capabilities of my mind valuable, not just to myself, but in the marketplace, and if I’ve lost that,  I can’t envision a Plan C.

Published in: on 2010 08 01 at 09:11:35  Leave a Comment  

Georgia’s Water Crisis and A Potentially Collossal Train Wreck

Georgia residents, PLEASE PLEASE PLEASE take a moment to contact your elected officials in the Georgia General Assembly about this CRITICAL issue: Protect Our Waterways from Harmful Water Grabs

These water diversions would be devastating, not only to our river ecosystems, but also potentially to our drinking water supplies. In particular, the withdrawal of an additional 200 MILLION GALLONS every day from wells in South Georgia is of particular concern, even if you have no interest in protecting our beautiful state’s environment. The aquifers in South Georgia are already strained to or beyond their sustainable capacity. The Floridan Aquifer, in particular, is already being overdrawn, leading to seawater being drawn into municipal water supplies along the coast from Hilton Head, SC to Jacksonville, FL. The Floridan and other aquifers, in their natural state, are recharged with fresh water by rainfall in certain inland areas of our coastal plain. The water is filtered as it seeps through the ground , and it flows into the ocean through vents in the seafloor. By withdrawing more water from the aquifer than it receives as rainfall from the recharge zones, we effectively cause it to operate in reverse, drawing seawater IN through the vents in the ocean floor. No drinkable water on our coast would mean no tourism. What would the seawater do if introduced into Metro Atlanta’s water supply? What would it do to Atlanta’s antiquated sewer system? Or to the Chattahoochee and those downstream who rely on it for THEIR drinking water?

There is no time to lose. The 2010 session of the General assembly begins on January 11, 2010. Find Your Legislator – Project Vote Smart

Published in: on 2010 01 07 at 08:09:19  Leave a Comment  
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Memories from the San Joaquin Valley

A bit of background: On December 7, 1988, I reported to my first U.S. Navy fleet duty station: Attack Squadron 22 (VA-22), “The Fighting Redcocks,”  based at Naval Air Station (NAS) Lemoore, California. The squadron has since been redesignated as Strike Fighter Squadron 22 (VFA-22), but the Fighting Redcocks remain based at NAS Lemoore, the Navy’s west coast premier air station and home to Strike Fighter Wing (formerly Light Attack Wing) – Pacific. The Naval Air Station is located on California Hwy 198, a few miles west of the town of Lemoore in Kings County. It is approximately a 30-minute drive to Fresno, in the heart of California’s central valley. Each winter (at that time) a thick blanket of fog would settle into the valley, probably due to a reaction between the relatively mild winter temperatures and the colder air blowing in from the Pacific: San Francisco on an enormous scale.

At that time, almost all of the squadrons at NAS Lemoore flew the same type of aircraft: the A-7E Corsair II, a carrier-based light bomber. Although the A-7E was capable of flying missions in all weather, the extremely poor visibility at Lemoore was deemed an unnecessary risk for training flights. As a result, we spent 4 or 5 months out of the year playing cards. As I had arrived near the beginning of a particularly long foggy season, I literally did not know what my base looked like for the first 6 months I was there. I could not see a person standing three feet away from me. A shuttle bus ran between the administrative area of the base, where our barracks was located, to the more restricted operations area a few miles away. My new shipmates helped me by making sure I knew which direction the bus stop was and how many paces as I walked out of the barracks. They did the same for the enlisted club, the operations mess hall, and the brightly-lit, but still invisible, McDonald’s directly across the street from Barracks 12, which our squadron called home. I could get to work, food, and alcohol. The necessities having been taken care of, the rest would have to wait for spring.

I have always loved the beauty of the outdoors. The following is a post about some of my memories (caveat: from 21 years ago, but still as vivid as yesterday) about my first spring after the fog finally lifted. It was previously posted on my Facebook page, and it meant enough to me that I wanted to preserve it. It has been edited slightly from the original post for contextual reasons.

I still remember working nights, and the sun coming up directly in my eyes on the way home as it rose over the Sierra Nevada around 9am, an hour or more after “sunrise” and the first time I ever saw the peaks of the area of Sequoia and King’s Canyon National Parks from Visalia. I had arrived at Lemoore in the middle of the fog, and after it finally lifted, I just assumed they were clouds for weeks afterwards. Nothing east of the Mississippi is that high in the sky except clouds or aircraft vapor trails.One day something made me just stand there and watch them – always in the same place and never drifting.

That’s one of the (few) things I loved about NAS Lemoore in summer – I could see from the peaks of the Sierra Nevada, over the Coalinga Hills to the Coast Ranges. That and the friggin jackrabbits. We used to have to hop into trucks and chase the jackrabbits and coyotes off the runways and taxiways so that we could conduct flight ops. You’d think a big, loud A-7 or F/A-18 coming toward them would have been as much of a clue as a grey truck. Of course WE had 54mm flare guns. I don’t advocate setting coyotes on fire with red flares, but this was the Cold War, and as exhilarating as it was to be the tip of the spear, we knew who the adversary was, and he had a spear, too. Although if we were “on the beach,” we were training, rather than in an operational role, but we took our jobs no less seriously than those who maintained and flew the B-52s with the white undersides or the Air Force Strategic Air Command tankers that supported them. If you’ve lived long enough to remember the Berlin Wall, hopefully you can understand that there was no such thing as a “just practicing” mentality at that point in the history or our Armed Forces. Nor should there ever be.

More Thoughts on Healthcare

The current state of healthcare isn’t literally about healthcare at all. It is about the enormous and continuing rise in the cost of healthcare due to the separation of healthcare consumer/patient and the entity that pays for the care, typically an HMO or the government. To give an example of “HMO-driven inflation,” before transferring my care to the Veterans Health Administration (VA), more than one of my providers had a “standard” rate at which they billed HMOs and presumably Medicare, and a second, significantly lower rate that they charged to individuals without health insurance or other third-party payer. I was shocked to find an example even within the VA. Under certain circumstances, such as lack of available bed or inability to provide a service in within a mandated time limit, the VA contracts with private healthcare providers to handle their overflow (at no cost to the veteran – the cost is billed directly to the VA). I had occasion to be treated by a private provider on behalf of the VA, and I came to learn that my care was billed to the VA at a rate that was TWENTY-FIVE PERCENT above the standard rate that was billed to HMOs or other payers. As shocking as that is, I suspect it’s more of an example of the government ironically being price-gouged because its needs are frequently immutable, rather than being a major contributor to “HMO inflation.”

The problem and its causes are no great mysteries. More important are solutions that avoid a massive new Federal government entitlement (when some major current programs are of questionable sustainability) and pricing healthcare out of reach of more Americans, straining non-profit hospitals by further turning the ER into a primary care clinic. I don’t advocate the abolition of HMOs, but I do propose doing away with absurdities like the “sky’s the limit” surgery in exchange for a $20 copay.  We need to look at reviving features of “traditional” 80/20 insurance (which has never gone away for small businesses or the self-employed), such as DEDUCTIBLES and a reasonable, realistic (for patient and provider) percentage match. Nothing onerous that would prevent a person from obtaining needed care, an amount sufficient, if only symbolically, to restore the patient/consumer’s awareness that increased consumption of medical resources costs proportionately more, a basic lesson of economics that seems to function normally until someone with a lab coat and stethoscope enters the picture.

Published in: on 2009 08 16 at 01:25:12  Leave a Comment  
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Near-Death Experience of the Day – Cheating Natural Selection

For reasons that aren’t really important to anyone who doesn’t know me personally, I take MS-Contin for chronic pain. I have since late 2007. Since that time, I have simply accepted the fact that I could no longer drink alcohol. The extreme danger of mixing central nervous system depressants such as alcohol and opiates is probably the one thing I retained from a high school drug-awareness course more than two decades ago. Today was an extraordinary day. I had an opportunity to reconnect with an old friend from my high school days, and it appeared that that would coincide with a chance to relive some long-dormant Rocky Horror Picture Show fun. In my excitement, two critical things happened: I forgot to take my MS-Contin this morning, and I allowed myself to forget for a few moments that I could no longer drink alcohol. While waiting for my friend to arrive at the small theatre she runs, I sought shelter from the heat in the pizzeria next door to the theatre and had a beer. Or rather, I had less than half a beer, followed by panic as I began having difficulty breathing and realized that, unusually, I was not carrying an epinephrine autoinjector (drug allergy). I clutched my cell phone, tried to hide my distress as I asked the waitress to bring me a soft drink, and waited it out. Ten minutes later, I was fine, but only because, by sheer luck, I had not taken the MS-Contin that should have been near peak plasma level at about that time,

Published in: on 2009 08 16 at 00:50:21  Leave a Comment  

Some Thoughts on Healthcare

As a brief preface, this post was precipitated by the current disagreement within the United States about President Obama’s healthcare proposal. As with any writing on a political “current events” subject, it is doomed to eventual irrelevance. I must confess at the outset that I have not read President Obama’s proposed bill, in part for reasons based on MY source of healthcare.

I am a disabled Navy veteran. For two years now, I have received all of my medical care from the Veterans Administration (VA) at a VA Medical Center in a major city. I interact with my healthcare providers far more than the average person (merely intuitive assumption) and have for over a decade, and I feel as though my more frequent interactions with a broad spectrum of providers gives me a bit more insight than the average bear on at least a comparison between HMO care and VA care. There are a few things that are the same: one will not always agree with one’s doctor, specialist appointments take longer to get than primary care appointments, and PCPs are the gatekeepers for specialists. There are also some differences: though both can change doctors, the VA has a smaller pool than an HMO in all but the most rural areas, specialist appointments are generally much faster in the VA, all of my VA providers, as well as the pharmacy, work from and contribute back to a master electronic medical record, which contains documents as well as all labs and diagnostic imagery I have ever had, the VA is quicker to adopt evidence-based procedures and standards of care, and if I am dissatisfied with a situation and cannot resolve it with my doctor or his/her clinical supervisor, I can go beyond them to a patient advocate who can navigate the bureaucracy much better than an outsider such as a patient.

In general, I am more satisfied with VA care, though I miss several of my former providers personally. I have heard it suggested that a solution for Medicare might be to give Medicare patients access to VA facilities. I don’t support that particular idea, though some of my reasons are purely personal, such as the sense of cameraderie with other patients, and some VA staff, as fellow veterans.

I think that requiring those hospitals that are significantly subsidized by federal funds be brought to VA standards would vastly improve the care experience, and outcomes, for patients who, perhaps due to “falling through the cracks” between heath insurance and Medicare eligibility, use the county hospital-of-last-resort as their primary source of care. Mandating that hospitals use VA-style electronic medical record and prescription system would improve care/outcomes and reduce errors.

Having said all that, I DO NOT support required government healthcare (or being able to decline it only at your disadvantage or peril). My VA care is a benefit of a specific contract between me and the federal government, basically “Workers’ Compensation” for the Armed Forces. It is a valuable benefit to me, but I am still free to seek care anywhere, from anyone. If the government required me to surrender that liberty in order to avail myself of VA care, the VA wouldn’t know I exist.

If one wants to improve healthcare, don’t start by thinking about what liberties you must take away from the American people. I do not believe, however, that the free market will fix this as long as the current HMO system exists, where people pay their premium, then feel entitled to consume all the medical resources they want for a $20 copay. The economics of paying, say, a $40 copay for a medication that costs $900 just don’t work. There is no free lunch. So the choices appear to be status quo, government regulation, or quite a bit of temporary pain if we want the free market to shift the system of medical payment to something closer to reality. Even the status quo is, I think, merely delaying deciding between the other two.

Green Energy from The Southern Company

Are you a customer of an electric utility operated by The Southern Company? I buy my electricity from Georgia Power, a unit of The Southern Company. I can’t be sure that my experiences hold true for other states served by The Southern Company or by EMCs that operate in some parts of those states. If you spot an error, don’t hesitate to let me know.

Georgia Power offers a program called Green Energy, where customers can elect to purchase power generated from renewable sources for a monthly premium of $3.50 (for wind, water, and biomass. $4.50 per month for solar) per 100 kWh each month in addition to the normal charge for the electricity consumed. That’s less than a cup of gourmet coffee per month to have 10% or more of the average home’s electricity produced from renewable sources! In starting my own experiment in a new (to me) house, I started off with a single block of solar energy. At this moment, I could add 45.00 to my electric bill, and ALL of my energy would come from solar. NO coal. NO nuclear power plants. And I can do it NOW, without saving up or taking out a loan to pay thousands of dollars for a home solar installation.

I have not lived in this house to have a year-round baselineof its energy consumption. That’s my first priority, followed by maximizing opportunities to conserve energy – the cheapest option is not to consume the energy at all! After that, I’m planning to set up budget-billing and and purchase ONLY solar power for my home. This is a powerful alternative within reach of every Southern Company customer. Even buying a single block of Green Energy – $3.50 – will reduce by about 10% the amount of coal or nuclear power, and the resulting pollution, that must be generated for your needs.

Where else can you make a difference for such a tiny investment?

A note about comments

Philosophy is central to my purpose for originally creating a  blog, and philosophy is, perhaps above all things, a conversation.

This most amazing conversation has continued, more or less uninterrupted, from the time of Thales of Miletus, roughly 2600 years ago, to this very day. There have been tangents that turned into dead ends. Like side conversations during a keynote speech, some of the participants stepped out of the room to continue their particular discussions, and thus the sciences and nearly every other field of human study or endeavor were born from this grand discussion.

As it is a discussion, rather than a lecture, it is appropriately a conversation in which many may join in. That is my goal with this web log. As it is my first web log, I am erring on the side of caution and moderating comments at first. As I get more comfortable and step a little deeper into the pool, so will the moderation gradually disappear, remaining only as needed to control spurious posts. Regardless, unless your contribution refers to penis enlargement, for example, the moderation will not affect content of your post. The place for discussion of the arguments (in the philosophical sense, free of personal animosity) is here, in the light of day, not behind the curtain with my red pen.

In addition, I welcome (and BEG for) your comments or suggestions about the style of the site or similar contributions. My stylistic ideas about web design tend to toward the Spartan, utilitarian side. Some call it hideous. I prefer to think of it as “lynx-compatible”.

In summary, WELCOME!

Published in: on 2008 01 17 at 23:32:52  Leave a Comment  
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