Unless Willie Brown was once your city’s mayor, the odds are pretty good that the gay community in your city is not as “out and proud” as they wish they could be.
In my little corner of the world, the plain fact is that it’s probably a lot easier to remain closeted than it is to deal daily with the little taunts and jabs that come your way—and of course for some, there’s the risk that they might end up like Matthew Shepard...a man who ended up out and dead.
There has been a reaction to that reality in high schools, which is why we are today visiting the public spaces just off the campus of Mt. Si High School in Snoqualmie, Washington (home of the Wildcats), where a local church group will be arriving to protest the school’s annual “Day of Silence”, an effort to acknowledge the pressures placed on the school’s gay population.
Displayed among the various protesters today was fear, ignorance, disingenuousness, and a strange mixture of self-righteousness and homoeroticism...and that was just among the people in the church group.
Were minds changed?
Did anyone make a new friend?
And how do Dr. Martin Luther King and the Pledge of Allegiance fit into the picture?
Follow along, and we shall see.
Today’s story, as with so much else, requires background and context...and this story actually began in January, when the school invited the Reverend Ken Hutcherson to speak to the assembled students about the King legacy.
Unspoken in the invitation is the fact that the good Reverend is also the local representative of the “God Hates Fags” community, and it is today unclear if that was an intentional slight or a question of ignorance on the part of the school administration. It is a known fact that the Reverend has children attending the school, and that he is part of the African-American experience in this country; these are the explanations commonly given for the invitation.
All of this came to a head during the school assembly on that day, when Kit McCormick, the faculty advisor to the Mt. Si’s Gay-Straight Alliance chapter publicly “called out” the Reverend for the apparent hypocrisy of giving a speech on diversity while basing a career on the exclusion of homosexuals from every facet of human life possible.
Apparently feeling the need to “reach out and touch someone” in response, a counter-protest was scheduled by Hutcherson to complain about the school’s willingness to allow the “Day of Silence” event to occur during classroom hours.
What is the “Day of Silence”, exactly? Conversations with current students describe it as an event that changes from year to year—one year students covered their mouths with duct tape during the school day, another year tie-dye armbands were the means of expression...and in each case, the point is to create an awareness of the plight of those who cannot come out, for fear that they might be victimized—and to symbolize solidarity with fellow students in such a plight.
To generate the noise required to drown out the “Day of Silence”, the Reverend had been telling the public of his plans to bring “1000 Prayer Warriors” to the school, which is why on this Friday morning at 9AM more than 40 police vehicles (I counted) are already in the parking lot of the local fire station—a parking lot that typically contains fewer than 10 vehicles, even on a busy day.
I managed to make it to the early morning press availability provided by the school Administration, and the message provided was basically that students are within their rights to protest, the Reverend will do what he is going to do, that the entire exercise is a good learning experience for the student body, and that there will be steps taken to isolate the protest to a location off the campus, which is intended to minimize disruptions to learning.
It was reported that about 1/3 of students would not be in attendance today; and that as with any high school, there will be students who come and go throughout the day, meaning it will be impossible to assure with 100% certainty that students and protest won’t come into contact along the way.
I’m also told by current students that there can be considerable social stigma attached to not participating in the otherwise voluntary “Day of Silence”, and that may provide an explanation for some of today’s high absenteeism.
Considering the number of police vehicles known to be in the immediate area, there are a very small number of visible, uniformed officers. There are one or two marked police vehicles at each entrance, about four uniformed officers and a sergeant in the “designated protest area”...and although I had my suspicions, I could only identify one person as being a plainclothes officer.
(I was told later by a student that there were officers in plain clothes in the back row of her classes, and new “custodians” working today that she had never seen before--which seems to tell its own story...)
It’s about 9:30, and the only people around are the police, a group of 10 or so supporting the gay community (my favorite sign: “I Believe In Separation Of Church And Hate”), and a substantial contingent of the local media, including all the local TV network affiliates.
Since the festivities haven’t really begun, I chose to take a coffee break (I’m dedicated enough to attend events so I can report on them for you, Gentle Reader, but this is 10AM, and that’s early for me...), and by the time I’ve returned things are starting to get under way.
There are about 75 to 100 of the Prayer Warriors assembled, and rather than the convoy of busses we were expecting, there’s on e “school bus” and groups of others who are walking up to the event from the parking places they’ve found in the surrounding neighborhood.
‘They are being met by about 30 counter-protesters...some of whom are suggesting that the Warriors might wish to perform certain acts upon themselves, supplemented by another who questions whether some of the Warriors might have been inappropriately touched as children. A sign questions whether the Reverend is another Larry Craig or Ted Haggard. Most of this is surprisingly good-humored; and the group appears to be mostly of student age or near student age.
Someone in the group has a small boombox...and they’re asking the cop that’s assigned to face them if he knew he’d be with the dancing group. He and they find that funny, and so do I.
When both sides had achieved their full strength, just about 150 of the Warriors were present, and about 30 or so on the other side.
And it’s at this point that we need to say a few words about the makeup of the Prayer Warriors’ group.
About 20% of the group was of student age, and the remaining 80% seemed to have been accompanying the Reverend. Of the students, my favorites were the “Straight Pride” group (6 people-I counted), all of whom had hand-lettered shirts with their message, front and back. One of the group chose to depart from the pattern of the others and put his own unique message on the back of his shirt...which is how we found the title of today’s story:
“Wheres Are Special Day?”
Now it’s easy to make fun of the foolish, but the group that the Reverend brought with him was another matter entirely—and by that I mean they were a bit...scary.
For starters, the group just oozed fear—and here’s just one example. A woman was carrying a sign that read “My Athlete Is Safe At Home”. When I walked up to her and asked what danger her athlete faced that would prompt such a message, the man next to her demanded to know who I was. When I asked him why he might ask such a question, both he and the woman holding the sign refused to say another word.
But the strangest display of paranoia came with the deployment of the Reverend’s “fake police”. He was surrounded by at least 8 men who were all trying to look exactly like plainclothes officers...and it appeared to me that at least one, and maybe two of the “pro-gay” protesters might have been part of his group as well...but then again, that could just be my paranoia at work.
And here’s another thing. The reverend seems to surround himself with what appear to be current or former athletes...and to be honest, they kind of looked like the guys that pat each pother on the butt just a bit too hard...and then go find a gay person to bash in order to prove their manhood.
I’m trying to be objective here, but to be completely honest, some of the Reverend’s group looked like a pair of assless chaps and a leather baseball cap would be all they need to make the transition from “Prayer Warrior” to “Leather Daddy”...and at least one other gentleman looked like he might have a bit of a “wide stance” himself—if you know what I mean.
Statistics suggest that out of 120 who appeared to have come with the Reverend, more or less a dozen are gay...and in that group, staying in the closet is likely a matter of daily stress and strain.
One other thing I found odd was the reluctance of the Reverend’s group to remain in the near vicinity of the gay-supporting group. When the Reverend’s group was forming they were within 20 feet of the other side, but by the time the whole group had assembled they had moved their core more than 50 feet away—and if I didn’t know better, I’d say they did it because they were afraid that by being too close they too might “catch the gay”, which, as I understand from their shouts, is apparently some sort of abomination that would instantly doom them to a life of...well, whatever it is, it must be pretty bad.
The requisite speech having been given and media footage having been captured, it was time for the event to end, as was indicated when one of the “fake police” told the group: “That’s it, let’s go”.
And they did.
I saw the Reverend do a media stand-up afterwards, and he told the reporter that he wasn’t ant-gay, or against the Day of Silence itself. What upset him, he reports, is that the event distracted from the learning environment (remember “Wheres Are Special Day”? I’d suggest that ship has already sailed...), and that the event was allowed to occur during the school day.
And that’s where we get to the “Pledge of Allegiance”. As it turns out, the United States Supreme Court, in a series of cases that begin with Minersville has ruled that students have a “right of silence” that allows then the complete freedom to exercise this sort of protest...and the fact that the Reverend was publicly not aware of this either speaks poorly of his own educational background or suggests he would prefer that topic not come up.
So that was pretty much it: the Reverend came to make his statement, he looked a bit silly doing it, 850 of the Prayer Warriors apparently had other things to do, his paranoia and fear were everywhere evident...and his use of “fake police” as a tool of intimidation appeared to intimidate no one.
I saw no minds changed on either side, roughly 60 students got a direct political education...and at least on one side, a fun time was had by all.
Saturday, April 26, 2008
Sunday, April 20, 2008
On Cinema And Death, Or, Another Reason I Love Costco
There is something magical about Costco.
It is magical to me that for the price of a small can of tomato sauce, they sell a giant can. That they manage to make nice things available for what others charge for ordinary things.
And then of course, there’s the hot dog.
Mr. Sinegal doesn’t know it, but we met in a previous life...more than once...and we actually had a conversation about the hot dogs one evening.
I told him that the soon-to-be-built Qwest Field would be a better place with Costco hot dog carts instead of the “normal” stadium food, and he told me that the hot dog is at the philosophical core of what he does for a living...a simple thing of high quality, a good value—and a good price.
But today’s story isn’t about really great hot dogs.
It’s about really great cinema.
To make a long story short, Costco has begun to sell the films that you were previously only able to see at film festivals...and they’re putting them in four-packs for under $20.
I’m going to recommend one of them...and then two bonus films that will round things out just nicely.
Let’s start with what is destined to become my new favorite film: Rick Stevenson’s “Expiration Date”.
The story could have been told anywhere in the West, but it’s set in and around Seattle. The story begins as a story, told by an older member of a tribe to a young man who is planning to leave the reservation and move to the white man’s world...the City.
The tale told is one of inevitable fate: a tribal member who also moved to the City for opportunity, but was accidentally killed by a milk truck on his 25th birthday. Before his death, he bore a son...and he was also accidentally killed by a milk truck on his 25th birthday.
The grandson in the story, played by Robert Guthrie, is now 24—and his birthday is only eight days away.
I will not say too much, but it is giving away no secrets to tell you that Dee Wallace Stone and Sascha Knopf give fantastic performances as his mom...and the girl he happens to meet along the way.
It’s a strange little love story that leads us down a path of toenail painting and stalking and a fountain of milk and a dog named “Roadkill”.
I have attempted to make film myself (badly), and the lesson learned was that directors make the movie when they can create a natural environment for the actors to interact—and that was accomplished to tremendous effect by Stevenson.
The performances are absolutely natural, creating a “cocoon” within which the story can unfold...and the relationships are just as real as any you would encounter in life. The actors never force the performances, instead letting the odd nature of the story create the tension that sustains the entire movie
It is an amazingly real surreal performance that even offers us a great message: if you must die, die dancing.
Which takes me back to one of my very first favorite films: Hal Ashby’s “Harold and Maude”.
Harold is a shy young man who just can’t seem to turn the silver spoon he was born with into a thing of comfort...which causes him to commit suicide.
A lot.
In fact, it’s so common that his mother actually cancels a hair appointment after coming in the room and finding him hanging. As she leaves she tells him: “Dinner’s at eight, Harold—and do try to be more vivacious.”
It’s apparently not easy being the son of a prominent San Francisco socialite in the 60’s, especially one obsessed with funerals and a Jaguar XKE converted into a hearse. Satire takes us into the troubles of Vietnam during the war, the practice of psychoanalysis, questions of place and privilege...and a variety of other divertissement, as his mother would say—including the one where he slices his throat, the drowning, the self-immolation, the shooting (“Harold, please...”), and the hacking off of a hand at the dinner table.
Out of all this you might never expect a love story...but we find one waiting.
The very young Harold is romantically drawn to the 79 year-old Maude, and the two characters (played by Bud Cort, he with his own story, and the inimitable Ruth Gordon) provide a perfect foil to his mother, played by Vivian Pickles.
Maude becomes the child character in the story Harold can never be...until she teaches him a bit more about himself than he knew.
The courting occurs at a number of the burial services they both frequent...and the presence of a very real suicide is the defining moment of the picture.
Once again the theme is death and dancing—and for many the soundtrack to this film was their first introduction to the music of Cat Stevens.
There is a bright line that runs directly from Voltaire to the “Harold” and “Maude” characters—the strange and unobtainable love, the misunderstandings and societal disapproval...and if you love the one, you’ll love the other.
The connection to Voltaire is made even deeper because of scenes like the long, long shot of Golden Gate National Cemetery--the thousands of military gravestones all alike, standing at eternal attention in perfect rows—while Cat Stevens’ “Why Do the Children Play” fills the mental background.
See this movie...and see if it changes your life.
A story as old as Swedes making fun of Norwegians...and vice versa...is told in Bent Hamer’s “Kitchen Stories”. This 2003 film is a story of observers from a 1950’s Swedish efficiency institute who are dispatched to the Norwegian countryside to observe the kitchen habits of single male farmers.
The idea is for the observers to set up a platform not unlike a lifeguard tower in the corner of the kitchen, and then simply observe the subject in his use of the kitchen. Contact between the two is strictly prohibited...which is the basis of the primary story.
The movie explores questions of “city slicker versus country bumpkin”, the practicality of modern efficiency planning...and the far bigger question of which of the two character’s lives are really worth living.
All of this washed down with a big ol’ dose of 1950’s Scandanaviana—from the jazz soundtrack to the pickled herring that arrives in packages from time to time, to the fantastically campy Volvo and trailer combinations they convoy around the Norse countryside.
A big thanks to the Swedish Film Institute and the Norwegian Film Institute for funding this one (and hey, Sweden, while we’re having a moment—why hasn’t Maria Blom’s Dalecarlians yet found its way to DVD?), and even though you’ll have to search for “Kitchen Stories”, it’s very much worth the effort.
There has been a failure on my part to give credit that is truly due to the cinematographers involved in these three productions, but to be honest that would require much more space than I’ll use today; and I want to get you through this faster than I might on other days when we have much bigger stories to tell.
So that’s how we’ll end today’s story: by tying together hot dogs, dancing, death, and the magic of cinema.
Go seek out these films, and support not just some great filmmakers, but your own desire to see the world in new ways.
It will be worth it.
It is magical to me that for the price of a small can of tomato sauce, they sell a giant can. That they manage to make nice things available for what others charge for ordinary things.
And then of course, there’s the hot dog.
Mr. Sinegal doesn’t know it, but we met in a previous life...more than once...and we actually had a conversation about the hot dogs one evening.
I told him that the soon-to-be-built Qwest Field would be a better place with Costco hot dog carts instead of the “normal” stadium food, and he told me that the hot dog is at the philosophical core of what he does for a living...a simple thing of high quality, a good value—and a good price.
But today’s story isn’t about really great hot dogs.
It’s about really great cinema.
To make a long story short, Costco has begun to sell the films that you were previously only able to see at film festivals...and they’re putting them in four-packs for under $20.
I’m going to recommend one of them...and then two bonus films that will round things out just nicely.
Let’s start with what is destined to become my new favorite film: Rick Stevenson’s “Expiration Date”.
The story could have been told anywhere in the West, but it’s set in and around Seattle. The story begins as a story, told by an older member of a tribe to a young man who is planning to leave the reservation and move to the white man’s world...the City.
The tale told is one of inevitable fate: a tribal member who also moved to the City for opportunity, but was accidentally killed by a milk truck on his 25th birthday. Before his death, he bore a son...and he was also accidentally killed by a milk truck on his 25th birthday.
The grandson in the story, played by Robert Guthrie, is now 24—and his birthday is only eight days away.
I will not say too much, but it is giving away no secrets to tell you that Dee Wallace Stone and Sascha Knopf give fantastic performances as his mom...and the girl he happens to meet along the way.
It’s a strange little love story that leads us down a path of toenail painting and stalking and a fountain of milk and a dog named “Roadkill”.
I have attempted to make film myself (badly), and the lesson learned was that directors make the movie when they can create a natural environment for the actors to interact—and that was accomplished to tremendous effect by Stevenson.
The performances are absolutely natural, creating a “cocoon” within which the story can unfold...and the relationships are just as real as any you would encounter in life. The actors never force the performances, instead letting the odd nature of the story create the tension that sustains the entire movie
It is an amazingly real surreal performance that even offers us a great message: if you must die, die dancing.
Which takes me back to one of my very first favorite films: Hal Ashby’s “Harold and Maude”.
Harold is a shy young man who just can’t seem to turn the silver spoon he was born with into a thing of comfort...which causes him to commit suicide.
A lot.
In fact, it’s so common that his mother actually cancels a hair appointment after coming in the room and finding him hanging. As she leaves she tells him: “Dinner’s at eight, Harold—and do try to be more vivacious.”
It’s apparently not easy being the son of a prominent San Francisco socialite in the 60’s, especially one obsessed with funerals and a Jaguar XKE converted into a hearse. Satire takes us into the troubles of Vietnam during the war, the practice of psychoanalysis, questions of place and privilege...and a variety of other divertissement, as his mother would say—including the one where he slices his throat, the drowning, the self-immolation, the shooting (“Harold, please...”), and the hacking off of a hand at the dinner table.
Out of all this you might never expect a love story...but we find one waiting.
The very young Harold is romantically drawn to the 79 year-old Maude, and the two characters (played by Bud Cort, he with his own story, and the inimitable Ruth Gordon) provide a perfect foil to his mother, played by Vivian Pickles.
Maude becomes the child character in the story Harold can never be...until she teaches him a bit more about himself than he knew.
The courting occurs at a number of the burial services they both frequent...and the presence of a very real suicide is the defining moment of the picture.
Once again the theme is death and dancing—and for many the soundtrack to this film was their first introduction to the music of Cat Stevens.
There is a bright line that runs directly from Voltaire to the “Harold” and “Maude” characters—the strange and unobtainable love, the misunderstandings and societal disapproval...and if you love the one, you’ll love the other.
The connection to Voltaire is made even deeper because of scenes like the long, long shot of Golden Gate National Cemetery--the thousands of military gravestones all alike, standing at eternal attention in perfect rows—while Cat Stevens’ “Why Do the Children Play” fills the mental background.
See this movie...and see if it changes your life.
A story as old as Swedes making fun of Norwegians...and vice versa...is told in Bent Hamer’s “Kitchen Stories”. This 2003 film is a story of observers from a 1950’s Swedish efficiency institute who are dispatched to the Norwegian countryside to observe the kitchen habits of single male farmers.
The idea is for the observers to set up a platform not unlike a lifeguard tower in the corner of the kitchen, and then simply observe the subject in his use of the kitchen. Contact between the two is strictly prohibited...which is the basis of the primary story.
The movie explores questions of “city slicker versus country bumpkin”, the practicality of modern efficiency planning...and the far bigger question of which of the two character’s lives are really worth living.
All of this washed down with a big ol’ dose of 1950’s Scandanaviana—from the jazz soundtrack to the pickled herring that arrives in packages from time to time, to the fantastically campy Volvo and trailer combinations they convoy around the Norse countryside.
A big thanks to the Swedish Film Institute and the Norwegian Film Institute for funding this one (and hey, Sweden, while we’re having a moment—why hasn’t Maria Blom’s Dalecarlians yet found its way to DVD?), and even though you’ll have to search for “Kitchen Stories”, it’s very much worth the effort.
There has been a failure on my part to give credit that is truly due to the cinematographers involved in these three productions, but to be honest that would require much more space than I’ll use today; and I want to get you through this faster than I might on other days when we have much bigger stories to tell.
So that’s how we’ll end today’s story: by tying together hot dogs, dancing, death, and the magic of cinema.
Go seek out these films, and support not just some great filmmakers, but your own desire to see the world in new ways.
It will be worth it.
Friday, April 18, 2008
On Investigative Journalism, Or, More Obama Connections Come To Light
Your friendly fake consultant has been digging deep into the world of anonymous sources recently, which is why we were able to recently reveal the truth about Hillary Clinton’s Bosnian sniper story.
Today we take that effort further...which is why we are able to bring to light another exclusive peek into the past of a Presidential candidate...only today it’s Barack Obama.
We will examine his prior associations and as a result we will be able to draw new conclusions regarding his world view...and as we said about Clinton, you might be shocked...but probably not surprised.
How did all this get started?
We decided to investigate these connections following the Reverend Wright incident, because it was clear that America needed to know the entire picture before we made the momentous decision of choosing a President...and as Hillary has reminded us, you are only as good a person as your associates.
So what did we learn?
The first thing we learned was that even as a child Michelle Obama supported the sale of crack.
We were able to determine this because as a child she grew up on the South Side of Chicago...and as we all know, there are people there who go out in the streets and deal that drug.
Since she had to have seen a problem with crack, we have to ask the question: why didn’t she move out of that neighborhood if she did not support the sale of this most pernicious drug. After all, you can’t choose your relatives, but you can choose your pastor...and the place where you live. The fact that she wouldn’t disassociate herself by moving to a wealthier area shows she was unwilling to stand up and say “crack is whack”...and you’re never too young to “just say no”.
But it gets worse.
Through the development of a timeline, we were able to determine that for several years Obama supported the murderous regime of Suharto, the Indonesian President who felt human rights was something that could be worked on later.
How do we know he was actively supporting the Indonesian despot?
He actually moved from the US to Indonesia...and stayed there several years. No one would do such a thing if they weren’t entirely supportive of Suharto’s brutal rule.
He also apparently supports the use of biological weapons, including anthrax.
We know this because, as he describes in “The Audacity of Hope” he once visited a Ukrainian biological laboratory—and yet he never denounced the people working there or what they did.
It also turns out he supports robbery, rape and murder.
I determined this because he used to eat at a White Castle in Chicago which was also the place several robbers, rapists and murderers have eaten over the years—and yet he never once stood up against those people...and never gave up eating, either.
But it gets even worse than that...once, on a trip to Wichita, he ate at a BBQ joint formerly patronized by the BTK Killer. In fact, it appears that for the past 13 months he has been on a road trip visiting cities where crimes were committed—and never once has he disassociated himself from the thousands of crimes committed in those cities on those days.
The candidate was clearly on the Obama Loves Crime Tour—that’s what he must have been trying to tell us...if not in words, certainly through his actions.
Even now he’s planning a substantial effort in North Carolina in advance of that state’s primary—North Carolina...a former slave state. Despite my efforts, I was unable to determine why Obama supports slavery—and he’s not talking, either.
Forget about the connection between that Weather Underground guy and Obama—there’s an even more direct nexus between Obama and terrorism.
As it turns out, many of the 9/11 terrorists passed through Boston’s Logan Airport—and so has Obama. What could be more incriminating than that?
But if all that wasn’t horrible enough, new evidence has come to light that proves Obama “supports through silence” the slaughter of an entire planet’s population.
Not many know this, but the US Government recently identified several recent UFO sightings as coming from the Griznawoks, a race that lives on a planet near Alpha Centauri. For over 2000 years the Griznawoks have carried out a murderous campaign of intimidation, attack, and finally genocide against their planetary neighbors, the Fazznawaka.
Despite the fact that Obama was present on the planet Earth during the time of the Griznawok visits, he has never once stood up and condemned the Griznawok atrocities...but of course, once the last of the Fazznawaka are dead—who will be left to complain?
So this year, as you’re going to the polls, consider the alternatives: you can support Hillary Clinton...or you can support a candidate who embraces crack, crime—and interplanetary genocide.
I’ve reported...now it’s up to you to decide.
Today we take that effort further...which is why we are able to bring to light another exclusive peek into the past of a Presidential candidate...only today it’s Barack Obama.
We will examine his prior associations and as a result we will be able to draw new conclusions regarding his world view...and as we said about Clinton, you might be shocked...but probably not surprised.
How did all this get started?
We decided to investigate these connections following the Reverend Wright incident, because it was clear that America needed to know the entire picture before we made the momentous decision of choosing a President...and as Hillary has reminded us, you are only as good a person as your associates.
So what did we learn?
The first thing we learned was that even as a child Michelle Obama supported the sale of crack.
We were able to determine this because as a child she grew up on the South Side of Chicago...and as we all know, there are people there who go out in the streets and deal that drug.
Since she had to have seen a problem with crack, we have to ask the question: why didn’t she move out of that neighborhood if she did not support the sale of this most pernicious drug. After all, you can’t choose your relatives, but you can choose your pastor...and the place where you live. The fact that she wouldn’t disassociate herself by moving to a wealthier area shows she was unwilling to stand up and say “crack is whack”...and you’re never too young to “just say no”.
But it gets worse.
Through the development of a timeline, we were able to determine that for several years Obama supported the murderous regime of Suharto, the Indonesian President who felt human rights was something that could be worked on later.
How do we know he was actively supporting the Indonesian despot?
He actually moved from the US to Indonesia...and stayed there several years. No one would do such a thing if they weren’t entirely supportive of Suharto’s brutal rule.
He also apparently supports the use of biological weapons, including anthrax.
We know this because, as he describes in “The Audacity of Hope” he once visited a Ukrainian biological laboratory—and yet he never denounced the people working there or what they did.
It also turns out he supports robbery, rape and murder.
I determined this because he used to eat at a White Castle in Chicago which was also the place several robbers, rapists and murderers have eaten over the years—and yet he never once stood up against those people...and never gave up eating, either.
But it gets even worse than that...once, on a trip to Wichita, he ate at a BBQ joint formerly patronized by the BTK Killer. In fact, it appears that for the past 13 months he has been on a road trip visiting cities where crimes were committed—and never once has he disassociated himself from the thousands of crimes committed in those cities on those days.
The candidate was clearly on the Obama Loves Crime Tour—that’s what he must have been trying to tell us...if not in words, certainly through his actions.
Even now he’s planning a substantial effort in North Carolina in advance of that state’s primary—North Carolina...a former slave state. Despite my efforts, I was unable to determine why Obama supports slavery—and he’s not talking, either.
Forget about the connection between that Weather Underground guy and Obama—there’s an even more direct nexus between Obama and terrorism.
As it turns out, many of the 9/11 terrorists passed through Boston’s Logan Airport—and so has Obama. What could be more incriminating than that?
But if all that wasn’t horrible enough, new evidence has come to light that proves Obama “supports through silence” the slaughter of an entire planet’s population.
Not many know this, but the US Government recently identified several recent UFO sightings as coming from the Griznawoks, a race that lives on a planet near Alpha Centauri. For over 2000 years the Griznawoks have carried out a murderous campaign of intimidation, attack, and finally genocide against their planetary neighbors, the Fazznawaka.
Despite the fact that Obama was present on the planet Earth during the time of the Griznawok visits, he has never once stood up and condemned the Griznawok atrocities...but of course, once the last of the Fazznawaka are dead—who will be left to complain?
So this year, as you’re going to the polls, consider the alternatives: you can support Hillary Clinton...or you can support a candidate who embraces crack, crime—and interplanetary genocide.
I’ve reported...now it’s up to you to decide.
Wednesday, April 16, 2008
On Cutting The Largest Earmark, Or, McCain = War$, War$, And More War$
It’s time, Gentle Reader, that we address some of the disconnected thinking coming from the Republican side of the Presidential campaign...particularly the idea that we’re facing the “transcendent challenge of our time” from “radical Islamic extremism”.
To defeat this enemy, the presumptive Republican nominee tells us, he will do whatever it takes...even maintaining an expensive military presence in at least two distant counties for many years to come—“why not a hundred?”, he has asked.
Yet at the same time, he speaks of the $35 billion in earmarks he would eliminate from a $2 trillion budget hugely in deficit—and at the moment that appears to be the only spending cuts to which he will commit.
Is it possible this whole obsession with earmarks is really what he thinks is the problem...and why won’t he address the largest earmark of all—the multi-trillion dollar cost of this war, the eventual “re-upping” of the worn out equipment, and the costs of the ensuing “eternal” occupation he supports?
Oh, and did I mention the cost of the eventual wars with North Korea, Pakistan, Iran...and presumably China and Russia?
Just to make it interesting structurally, I’m going to work backwards through the introductory questions today...so here we go:
Who saw McCain with Chris Matthews at Villanova?
For a moment near the end the conversation centered on what would be the “tipping point” for a President McCain to order an attack on Iran; eventually Matthews was able to get him to commit that the attack would likely occur when Iran became a “strategic danger” to the US.
If that’s the standard for attack...well, who else meets the standard?
Obviously North Korea would have to be on the list—they have nuclear weapons and a delivery system capable of reaching US targets today, they have participated in the dissemination of weapons of mass destruction through involvement with the A.Q. Khan network, and they clearly bear us ill will.
Not to mention that other standard often cited: they participate in efforts to bully and destabilize both their southern neighbor and Japan, in an effort to garner greater influence in the region.
Pakistan? The spread of Islamist influence through the country’s “CIA”, the ISS, is rampant. The A.Q. Khan network’s efforts to “sell” nuclear technology were likely facilitated by elements within the larger national government. They also have delivery systems, although they are unlikely to today reach the US.
The influence of Islamist politicians is also growing daily. Waziristan, the North-West Frontier Province, and the Autonomous Tribal Areas are already becoming Taliban controlled states within Pakistan...and we see the inability of the Pakistani Army to establish control or authority in those areas.
The death of Bhutto has removed the last important non-military opponent of Islamism from the national political stage, future elections will likely increase Islamist influence at every level of national government; and it’s entirely reasonable to foresee an election—or coup, or civil war--that makes Pakistan into a nation ruled by a Taliban-like government that possesses the “nuclear codes” required to trigger a massively destructive attack on the US. There is also a very real possibility that this will be the quickest route by which nuclear weapons will be exported to “terrorist” groups.
The “transcendent challenge” theory suggests Pakistan could overnight become a strategic threat to the US, which begs the question: is McCain suggesting that in the case of Pakistan we should move to a “launch on election” posture?
China? They currently possess hundreds of nuclear weapons and have the delivery systems to launch right into the US heartland. That’s pretty much the definition of a strategic threat, suggesting they would also have to be taken out.
Of course, some might point out that the final element of a strategic threat is antipathy—the ill will another nation possesses toward yours.
Which brings us to Russia. For more than 40 years it’s been well-known that they intend to “bury” us, thanks to Khrushchev’s United Nations “shoe pounding” incident. They possess not hundreds, but thousands of nuclear weapons—strategic and non-strategic—along with air-, sea-, and land-based delivery platforms, many of which are forward-based and capable of being put into action on orders from lower-echelon commanders...as opposed to the US practice that a National Command Authority equivalent (an older term referring to what is essentially a Head of State, such as the US President) should be the only controlling authority.
We have noted the recent “freezing” of US/Russian relations during the Putin Presidency years, and it now appears Putin intends to remain in charge as the new Russian Prime Minister--perhaps running again for President in four years. With no other political opposition and a huge desire on the part of the nation to return to its days of power and influence, it may be just a matter of time before they, too, return to the status of “strategic threat”...if they’re not there already.
Shall we bomb them all together, Senator, or do you support a “war du jour” kind of approach?
Moving on: is there any bigger earmark than a few good wars?
The costs so far for Iraq and Afghanistan are estimated at more or less $2 trillion (or beyond, depending on whom you ask), with the better part of a trillion required in the future to replace the aircraft, ships, and rolling stock that are quickly wearing out from the current wars. An example is found in the B-52 bomber, which will have to be replaced at least 10 years sooner than we might have had to had we not fought this war.
Other examples? The B-1 needs “life extension” (and if the A-10 isn’t quickly replaced it will, too), the F-22 and F-35 programs will need to be fully funded despite the fact that we don’t have the money, we are probably looking at having to replace an aircraft carrier or two...with their associated “battle groups” of support ships (also expect a move to expand the Navy to 330 or more ships, including a 14th or 15th aircraft carrier)...the KC-135 aircraft refueling tankers are being replaced...and of course, there’s the rolling stock. (Not yet in the budget conversation: the eventual replacement of two ancient but highly effective workhorses, the C-130 and A-10.)
I won’t even discuss the state of the military helicopter fleet or the additional $100 billion or more (double that amount is reasonably possible) we’ll need for military space operations.
Since we tend to “leapfrog”, rather than replace, costs for equipment go up even more quickly then they might otherwise.
The Humvee is a perfect example...we’ll be replacing unarmored rigs with (more costly) armored vehicles, and many of the vehicles will be replaced by the far more protected (and far more expensive) MRAP. This happens over and over again—BDUs (Battle Dress Uniforms—what the Army calls the “camouflage” clothing worn in combat) are improved and more costly as Gore-Tex has replaced cotton and helmets with cool cameras and night vision enhance a steel pot’s Kevlar cousin.
As elements of the Future Force Warrior system come on-line the cost of outfitting a trooper will again jump upward—and as with all of this, the more war, the more you need to buy.
One other huge, huge, huge expense I don’t hear McCain “straight talking” about: the medical care for those we sent to do our fighting...many of whom will need services for life.
I never would have thought that a product called the ”Magic Jack” would be used in the field of telecommunications (such a waste of a great porn name)...and every time I think about what all these “military earmarks” are going to do to my wallet I feel like it’s McCain that’s hoping to pull the “Magic Jack” on us for the benefit of a military-industrial complex that a General he admires warned us about half a century ago.
With that out of the way, a few words on today’s legislative earmarks:
McCain tells us he would ban earmarks, which are budget items added to a bill in a manner that bypasses the normal Congressional committee and floor vote process. He cites money spent on a study of cattle DNA as the classic example of what’s wrong with the practice.
He reports that this could lead to a savings of $35 billion or so, presumably impacting the current sad state of the Federal budget next year and going forward.
Those who support earmarks point out that the monies are often used for appropriate government purposes, including restoring cuts in Homeland Security spending made by the current Administration’s budget proposals.
Just a couple thoughts, Senator...and I’ll make it quick:
--If you ban all earmarks through the current process by vetoing the bills in which they’re contained, won’t lawmakers just agree to pass each other’s “former earmarks” through a normal process that forces you to either convince someone to pass a “line item veto Amendment”—quickly...or renders your pledge moot?
--Isn’t $35 billion just spit in a bucket compared to the absurd amount of deficit we are running today...and will be forever, if the “Bush tax cuts” are made permanent, as you propose?
As Peggy Lee might say about your ideas: “Is That All There Is?”
Think about it, sir: the biggest bite in this budget is either the Bush tax cuts of which you’re so...recently ... proud, or the crazy desire to pursue war to no good purpose...no matter what the cost.
So when you tell me the “transcendent challenge of our time” is war, war, and more war, I have to ask: wouldn’t the real “transcendent challenge “ for a McCain Administration that’s raising spending while cutting taxes be finding the money?
Or will your Administration, just like the current one, seek to pass the “Magic Jack” on to the generations that are still here long after you’re not?
My guess: we won’t be hearing a “straight talk” answer to that one anytime soon.
To defeat this enemy, the presumptive Republican nominee tells us, he will do whatever it takes...even maintaining an expensive military presence in at least two distant counties for many years to come—“why not a hundred?”, he has asked.
Yet at the same time, he speaks of the $35 billion in earmarks he would eliminate from a $2 trillion budget hugely in deficit—and at the moment that appears to be the only spending cuts to which he will commit.
Is it possible this whole obsession with earmarks is really what he thinks is the problem...and why won’t he address the largest earmark of all—the multi-trillion dollar cost of this war, the eventual “re-upping” of the worn out equipment, and the costs of the ensuing “eternal” occupation he supports?
Oh, and did I mention the cost of the eventual wars with North Korea, Pakistan, Iran...and presumably China and Russia?
Just to make it interesting structurally, I’m going to work backwards through the introductory questions today...so here we go:
Who saw McCain with Chris Matthews at Villanova?
For a moment near the end the conversation centered on what would be the “tipping point” for a President McCain to order an attack on Iran; eventually Matthews was able to get him to commit that the attack would likely occur when Iran became a “strategic danger” to the US.
If that’s the standard for attack...well, who else meets the standard?
Obviously North Korea would have to be on the list—they have nuclear weapons and a delivery system capable of reaching US targets today, they have participated in the dissemination of weapons of mass destruction through involvement with the A.Q. Khan network, and they clearly bear us ill will.
Not to mention that other standard often cited: they participate in efforts to bully and destabilize both their southern neighbor and Japan, in an effort to garner greater influence in the region.
Pakistan? The spread of Islamist influence through the country’s “CIA”, the ISS, is rampant. The A.Q. Khan network’s efforts to “sell” nuclear technology were likely facilitated by elements within the larger national government. They also have delivery systems, although they are unlikely to today reach the US.
The influence of Islamist politicians is also growing daily. Waziristan, the North-West Frontier Province, and the Autonomous Tribal Areas are already becoming Taliban controlled states within Pakistan...and we see the inability of the Pakistani Army to establish control or authority in those areas.
The death of Bhutto has removed the last important non-military opponent of Islamism from the national political stage, future elections will likely increase Islamist influence at every level of national government; and it’s entirely reasonable to foresee an election—or coup, or civil war--that makes Pakistan into a nation ruled by a Taliban-like government that possesses the “nuclear codes” required to trigger a massively destructive attack on the US. There is also a very real possibility that this will be the quickest route by which nuclear weapons will be exported to “terrorist” groups.
The “transcendent challenge” theory suggests Pakistan could overnight become a strategic threat to the US, which begs the question: is McCain suggesting that in the case of Pakistan we should move to a “launch on election” posture?
China? They currently possess hundreds of nuclear weapons and have the delivery systems to launch right into the US heartland. That’s pretty much the definition of a strategic threat, suggesting they would also have to be taken out.
Of course, some might point out that the final element of a strategic threat is antipathy—the ill will another nation possesses toward yours.
Which brings us to Russia. For more than 40 years it’s been well-known that they intend to “bury” us, thanks to Khrushchev’s United Nations “shoe pounding” incident. They possess not hundreds, but thousands of nuclear weapons—strategic and non-strategic—along with air-, sea-, and land-based delivery platforms, many of which are forward-based and capable of being put into action on orders from lower-echelon commanders...as opposed to the US practice that a National Command Authority equivalent (an older term referring to what is essentially a Head of State, such as the US President) should be the only controlling authority.
We have noted the recent “freezing” of US/Russian relations during the Putin Presidency years, and it now appears Putin intends to remain in charge as the new Russian Prime Minister--perhaps running again for President in four years. With no other political opposition and a huge desire on the part of the nation to return to its days of power and influence, it may be just a matter of time before they, too, return to the status of “strategic threat”...if they’re not there already.
Shall we bomb them all together, Senator, or do you support a “war du jour” kind of approach?
Moving on: is there any bigger earmark than a few good wars?
The costs so far for Iraq and Afghanistan are estimated at more or less $2 trillion (or beyond, depending on whom you ask), with the better part of a trillion required in the future to replace the aircraft, ships, and rolling stock that are quickly wearing out from the current wars. An example is found in the B-52 bomber, which will have to be replaced at least 10 years sooner than we might have had to had we not fought this war.
Other examples? The B-1 needs “life extension” (and if the A-10 isn’t quickly replaced it will, too), the F-22 and F-35 programs will need to be fully funded despite the fact that we don’t have the money, we are probably looking at having to replace an aircraft carrier or two...with their associated “battle groups” of support ships (also expect a move to expand the Navy to 330 or more ships, including a 14th or 15th aircraft carrier)...the KC-135 aircraft refueling tankers are being replaced...and of course, there’s the rolling stock. (Not yet in the budget conversation: the eventual replacement of two ancient but highly effective workhorses, the C-130 and A-10.)
I won’t even discuss the state of the military helicopter fleet or the additional $100 billion or more (double that amount is reasonably possible) we’ll need for military space operations.
Since we tend to “leapfrog”, rather than replace, costs for equipment go up even more quickly then they might otherwise.
The Humvee is a perfect example...we’ll be replacing unarmored rigs with (more costly) armored vehicles, and many of the vehicles will be replaced by the far more protected (and far more expensive) MRAP. This happens over and over again—BDUs (Battle Dress Uniforms—what the Army calls the “camouflage” clothing worn in combat) are improved and more costly as Gore-Tex has replaced cotton and helmets with cool cameras and night vision enhance a steel pot’s Kevlar cousin.
As elements of the Future Force Warrior system come on-line the cost of outfitting a trooper will again jump upward—and as with all of this, the more war, the more you need to buy.
One other huge, huge, huge expense I don’t hear McCain “straight talking” about: the medical care for those we sent to do our fighting...many of whom will need services for life.
I never would have thought that a product called the ”Magic Jack” would be used in the field of telecommunications (such a waste of a great porn name)...and every time I think about what all these “military earmarks” are going to do to my wallet I feel like it’s McCain that’s hoping to pull the “Magic Jack” on us for the benefit of a military-industrial complex that a General he admires warned us about half a century ago.
With that out of the way, a few words on today’s legislative earmarks:
McCain tells us he would ban earmarks, which are budget items added to a bill in a manner that bypasses the normal Congressional committee and floor vote process. He cites money spent on a study of cattle DNA as the classic example of what’s wrong with the practice.
He reports that this could lead to a savings of $35 billion or so, presumably impacting the current sad state of the Federal budget next year and going forward.
Those who support earmarks point out that the monies are often used for appropriate government purposes, including restoring cuts in Homeland Security spending made by the current Administration’s budget proposals.
Just a couple thoughts, Senator...and I’ll make it quick:
--If you ban all earmarks through the current process by vetoing the bills in which they’re contained, won’t lawmakers just agree to pass each other’s “former earmarks” through a normal process that forces you to either convince someone to pass a “line item veto Amendment”—quickly...or renders your pledge moot?
--Isn’t $35 billion just spit in a bucket compared to the absurd amount of deficit we are running today...and will be forever, if the “Bush tax cuts” are made permanent, as you propose?
As Peggy Lee might say about your ideas: “Is That All There Is?”
Think about it, sir: the biggest bite in this budget is either the Bush tax cuts of which you’re so...recently ... proud, or the crazy desire to pursue war to no good purpose...no matter what the cost.
So when you tell me the “transcendent challenge of our time” is war, war, and more war, I have to ask: wouldn’t the real “transcendent challenge “ for a McCain Administration that’s raising spending while cutting taxes be finding the money?
Or will your Administration, just like the current one, seek to pass the “Magic Jack” on to the generations that are still here long after you’re not?
My guess: we won’t be hearing a “straight talk” answer to that one anytime soon.
Tuesday, April 15, 2008
On Taking One For The Team, Or, Hillary’s “Sniper” Truth Revealed
There has been much made of Hillary Clinton’s recent Bosnian “sniper” incident, and many who have a lower opinion of her as a result.
For the first time ever, we can now reveal in this space that far from being untruthful, Senator Clinton in fact has taken a major political hit in order to protect an important national security program…the existence of which she has not been in a position to reveal.
Through the use of secret anonymous sources we will reveal the surprising reality…the “rest of the story”, if you will—and although you may be shocked, you probably won’t be surprised.
Most of you recall the scene…The First Lady leaving the aircraft, looking entirely comfortable despite the potential dangers she might encounter in Tuzla…and many of you recall her saying that she exited the aircraft “under sniper fire.”
Well it turns out there was some considerable truth in her claims—but as we will discover, it’s all buried in a cloak of extreme secrecy we can only now reveal.
Many of you will recall her story of being taught to shoot out there at her grandfather’s house on Lake Winola, but what you may not know is that her grandfather was a sniper for US forces in World War I who personally killed over 600 Germans with a Sharps .50 rifle he brought to Europe from Pennsylvania when he enlisted—the same rifle his father used to kill over 12,000 Indians during the conquest of the West.
Even her grandfather was amazed at Clinton’s ability to shoot—a talent not unnoticed by the CIA, who recruited her during her time at Yale Law School.
For more than 20 years she studied spycraft under their tutelage, gaining knowledge in training techniques useful during times of insurgency.
Once President Clinton ascended to the White House, it was time for the Agency to cash in. In one of the most closely guarded secrets of the 20th Century the Clinton Administration started in 1992 on a plot to “neutralize” Osama Bin Laden…a man they already knew posed the gravest of threats to America.
The plot?
Sending Hillary to train secret “sniper squads” of Bosnian Mujahedeen who would be willing and able to infiltrate Al-Qaeda and act as American “moles” today—and killers of Osama Bin Laden tomorrow, if need be.
She made visits to at least 85 countries that are publicly acknowledged during her tenure as First Lady—each time training, supporting, or recruiting personnel for the CIA…using her amazing marksmanship skills to cement friendships with men (and some brave women) who might be otherwise unwilling, for cultural reasons, to associate themselves with Western women—especially when the woman is “in charge”.
And while it was their sniper training that got them invited to Afghani training camps to prepare for careers as foot soldiers for Allah (PBUH), it was the inspiring example of an empowered, eagle-eyed Hillary that made them choose to secretly continue to support the USA.
That’s how we knew about Tora Bora, that’s why we actually have informants throughout Waziristan monitoring Bin Laden’s every move (if we didn’t, don’t you think we’d be saturation bombing the place?), and that’s why we made such a fuss out of the whole “wanted: dead or alive” episode…so that they wouldn’t know they’ve been infiltrated.
The process has taken several years, and it is only since 2002 that our people have risen to the highest ranks of Al-Qaeda…while others wait, in 85 countries, to inform if need be—or to do more.
Once it became clear that Clinton was going to run a cover story had to be put in place to preserve the operation…and that’s the part of the story we can only reveal now:
Top officials in the CIA’s Directorate of Operations approached Clinton and she agreed, in a spirit of extreme patriotism, to allow the Bosnia story to be brought out, but only after arranging for everyone present to deny that any snipers were present.
Clinton agreed to the ruse in order to discredit her own contribution, there and for the other 85 “cover trips”, creating the misdirection that those who met with her on her many visits needed to maintain the operational security that will allow the infiltration to go forward.
That very day in Tuzla, three of her own snipers killed a Yemeni hit squad that had been dispatched to the area by Al-Qaeda; and who were able to disguise themselves as airport workers until just before her aircraft landed, when their weapons were sighted by an alert spotter teamed with one of the snipers.
Remember the little girl? She was actually passing a message to Clinton in poetic code from a small group of Chechens who were reporting information from within that country at a most important time…and she was willing to come forward today and deny any danger because this mission cannot be compromised, even though a Presidential candidacy is on the line.
So there you go: Senator Clinton is actually one of the greatest rifle shots in the country today, her unique skills and position allowed her to “ramrod” one of the greatest espionage operations in the history of the CIA, and today she’s willing to risk everything—even her chance at becoming President—to keep the cover story from being blown.
And you wondered if she could handle those 3AM calls.
I’ll bet you don’t now.
For the first time ever, we can now reveal in this space that far from being untruthful, Senator Clinton in fact has taken a major political hit in order to protect an important national security program…the existence of which she has not been in a position to reveal.
Through the use of secret anonymous sources we will reveal the surprising reality…the “rest of the story”, if you will—and although you may be shocked, you probably won’t be surprised.
Most of you recall the scene…The First Lady leaving the aircraft, looking entirely comfortable despite the potential dangers she might encounter in Tuzla…and many of you recall her saying that she exited the aircraft “under sniper fire.”
Well it turns out there was some considerable truth in her claims—but as we will discover, it’s all buried in a cloak of extreme secrecy we can only now reveal.
Many of you will recall her story of being taught to shoot out there at her grandfather’s house on Lake Winola, but what you may not know is that her grandfather was a sniper for US forces in World War I who personally killed over 600 Germans with a Sharps .50 rifle he brought to Europe from Pennsylvania when he enlisted—the same rifle his father used to kill over 12,000 Indians during the conquest of the West.
Even her grandfather was amazed at Clinton’s ability to shoot—a talent not unnoticed by the CIA, who recruited her during her time at Yale Law School.
For more than 20 years she studied spycraft under their tutelage, gaining knowledge in training techniques useful during times of insurgency.
Once President Clinton ascended to the White House, it was time for the Agency to cash in. In one of the most closely guarded secrets of the 20th Century the Clinton Administration started in 1992 on a plot to “neutralize” Osama Bin Laden…a man they already knew posed the gravest of threats to America.
The plot?
Sending Hillary to train secret “sniper squads” of Bosnian Mujahedeen who would be willing and able to infiltrate Al-Qaeda and act as American “moles” today—and killers of Osama Bin Laden tomorrow, if need be.
She made visits to at least 85 countries that are publicly acknowledged during her tenure as First Lady—each time training, supporting, or recruiting personnel for the CIA…using her amazing marksmanship skills to cement friendships with men (and some brave women) who might be otherwise unwilling, for cultural reasons, to associate themselves with Western women—especially when the woman is “in charge”.
And while it was their sniper training that got them invited to Afghani training camps to prepare for careers as foot soldiers for Allah (PBUH), it was the inspiring example of an empowered, eagle-eyed Hillary that made them choose to secretly continue to support the USA.
That’s how we knew about Tora Bora, that’s why we actually have informants throughout Waziristan monitoring Bin Laden’s every move (if we didn’t, don’t you think we’d be saturation bombing the place?), and that’s why we made such a fuss out of the whole “wanted: dead or alive” episode…so that they wouldn’t know they’ve been infiltrated.
The process has taken several years, and it is only since 2002 that our people have risen to the highest ranks of Al-Qaeda…while others wait, in 85 countries, to inform if need be—or to do more.
Once it became clear that Clinton was going to run a cover story had to be put in place to preserve the operation…and that’s the part of the story we can only reveal now:
Top officials in the CIA’s Directorate of Operations approached Clinton and she agreed, in a spirit of extreme patriotism, to allow the Bosnia story to be brought out, but only after arranging for everyone present to deny that any snipers were present.
Clinton agreed to the ruse in order to discredit her own contribution, there and for the other 85 “cover trips”, creating the misdirection that those who met with her on her many visits needed to maintain the operational security that will allow the infiltration to go forward.
That very day in Tuzla, three of her own snipers killed a Yemeni hit squad that had been dispatched to the area by Al-Qaeda; and who were able to disguise themselves as airport workers until just before her aircraft landed, when their weapons were sighted by an alert spotter teamed with one of the snipers.
Remember the little girl? She was actually passing a message to Clinton in poetic code from a small group of Chechens who were reporting information from within that country at a most important time…and she was willing to come forward today and deny any danger because this mission cannot be compromised, even though a Presidential candidacy is on the line.
So there you go: Senator Clinton is actually one of the greatest rifle shots in the country today, her unique skills and position allowed her to “ramrod” one of the greatest espionage operations in the history of the CIA, and today she’s willing to risk everything—even her chance at becoming President—to keep the cover story from being blown.
And you wondered if she could handle those 3AM calls.
I’ll bet you don’t now.
Sunday, April 13, 2008
On How The State Gave Me MRSA (Part II), Or, What, Me Worry?
We began a story this week that describes how poor clinical practice in a State-operated healthcare facility holds the potential to cause great injury and death to those vulnerable adults living in the facility, the workers charged with their care—and to members of the public who have never even set foot in the facility.
You might say it’s a bit of a “canary in a coal mine” situation, with pandemic flu hovering on the horizon and all. You also might say that since MRSA kills as many people in the US every year as six 9/11s the pandemic is already here.
So in today’s second installment, we’ll look a bit further: into facility management that now contends they are not required to follow guidelines that the Centers for Disease Control says “apply to all patients, regardless of suspected or confirmed infection status, in any setting in which healthcare is delivered”…into the concept that where your care is delivered should determine what protective equipment workers might require…and into a “magic ambulance” that apparently has the power to make you hazardous to some people--but not to others.
And just to add a twist--we have a Governor seeking re-election whom we hope to convince to put on her “superhero cape” by publicly coming to the rescue and making infectious disease control in all State facilities an important priority of her next Administration.
Because after all, do we really need six more avoidable 9/11s this year? And next year? And the year after that?
For those just coming to the story, let’s recap where we’ve been so far:
The Girlfriend (of over 26 years!), a nurse working for the State of Washington in one of the five “Residential Habilitation Centers” serving developmentally delayed individuals, recently brought home MRSA, which we now share—in our eyes.
MRSA, as you’ll recall, is one group among the variety of drug resistant organisms with which today’s medicine contends—drug resistant meaning that some, or virtually all, of today’s antibiotics will not “cure” the infection. There are several strains of MRSA, each with different drug-resistance characteristics. All this is discussed in more detail in the first installment of our adventure.
One reason this occurred is because the facility is lacking the most basic equipment required to prevent the spread of infection…and I’m not talking high-tech equipment here, either. For example, the facility does not see the need for sufficient eye protection for its medical care providers; this despite the fact that numerous procedures performed by each nurse daily (as well as other medical staff) “are likely to generate splashes or sprays of blood, body fluids, secretions and excretions” to quote again from the CDC.
There is also a failure of perception among management, who maintain that the community of clients residing at the facility are somehow epidemiologically “safe”…meaning the current facility policy is that the Standard Precautions which apply to everyone else practicing healthcare, everywhere else in the world (including Tamil, India) do not apply when working with this client population.
The likely outcome is that MRSA will spread among the vulnerable adults—and the staff--that this facility (and the other four like it) serves, and considering that 1 in 5 who get MRSA die as a result of the infection…well, 1 in 5 are probably going to die from an avoidable cause.
As we said before, it’s estimated that about 18,000 who were exposed to MRSA in 2005 died from the infection…which is about 20% of the annual total of 100,000 “avoidable” hospital deaths in the US.
Presumably there will be other members of the community beyond the facility affected as well…just like me, and just like the friends and relatives of some of you who have commented on the first story.
The Girlfriend and I are in the middle of an irritating series of adaptations designed to make it less likely that the MRSA bacteria will either re-infect us, or remain present in a dormant, or “colonized” state, ready to reappear without warning at some future time.
The most annoying adaptation?
I’ve just finished putting antibacterial ointment up my nose, as I do twice a day. To recreate the sensation, stick a Vaseline-covered Q-tip up each nostril. (Warning: stunt nose used for demonstration purposes only. Do not try this at home. Trust me, it sucks.)
Of course, the surgical soap we use constantly is a bit of a pain as well…
But enough about me.
The more important question is…how did the facility react when presented with the news that they have an infection control problem?
Well, that’s where it gets weird.
There seems to be a feeling that it is the type of facility that determines what sort of precautions are applied, rather than making a decision about the correct choice of protective equipment based on the procedure being performed.
A phone call to the Washington State Department of Health confirms this line of thinking goes farther than just this facility—the individual to whom I spoke (I did not identify myself as gathering news, so I’ll leave their name out of the discussion) answered my question about whether Standard Precautions should be applied at all healthcare facilities by telling me that it might depend on whether a nursing home is a healthcare facility…as opposed to a hospital.
Further discussion brought us to a point where we decided a better answer might be found by consulting with others at the Department of Health—and I’m awaiting that person’s return call as of this writing. (Please note that it is the weekend as I write, so the fact that no return call has yet occurred should not be construed as somehow sinister.)
If this line of thought is carried to its logical conclusion, here’s what we get:
Client X is an individual who is fed through a “G tube” (a tube that is surgically implanted and delivers liquid food directly into the individual’s stomach) in a nursing home which we’ll call “Site R”.
In that environment, according to current policy at our imaginary “Site R”, the only required protective gear while working with the tubes is gloves and a mask. What kind of work? A nurse might plug in a feeding or medicine tube, inject medicine into a port using a syringe, or “flush” a plugged food tube to allow it to again deliver food. Any of these interactions can easily cause the splashes or sprays of body fluids that spread disease.
Now suppose Client X were to encounter a medical difficulty requiring a move to the hospital. According to the CDC guidelines (and the “facility-based “logic we’ve seen so far) that same G tube work would require gloves, a non-permeable gown (no liquid getting through), a face mask, and eye and mucous membrane protection for the worker (the clear plastic “face shields” you see in use, or something similar).
Meaning that either something happened in the “magic ambulance” on the way to the hospital that made Client X more hazardous than he was before…or “facility based” logic makes no sense.
My guess: the ambulance ain’t that magic.
In this conversation we’re talking about MRSA…but imagine if Client X has undiagnosed Hepatitis C…or AIDS?
Is the nursing home worker less entitled to protection than the hospital worker?
Is it sound public policy that some healthcare workers are allowed to spread MRSA, hepatitis, HIV, and who knows what else…but not hospital workers?
As we previously mentioned, what comes home from work is going to get into the community—but did you know drug resistant bacteria are also now appearing in other species besides humans?
Try to imagine avian flu and MRSA in one superbug and you might understand why infection control is so, so, so critical.
If you need a further demonstration, the next time you’re walking down the street, try this exercise: count the people you see, from one to dead.
One to dead, you say?
How’s that work?
It works like this: MRSA kills 1 in 5…so when you see people during the day, all you have to do is count “1, 2, 3, 4…dead”. Repeat the process a few times, and you begin to get an idea of the reality of a pandemic.
We’ve covered a lot of ground today, so let’s wrap it up:
It is beginning to appear that many in the infection control community believe the location where healthcare is delivered is how you decide what protection the worker needs.
Others would tell you that disease is disease is disease…and if you plan on doing open heart surgery, it shouldn’t matter if you do it in a hospital, or a makeshift clinic in the real “Site R”…or in a bullring, for that matter…you still need to take the same precautions, every single time, if you want to prevent 18,000 or so deaths next year.
In my State of Washington the Governor is running for re-election…and she only won by 8 votes last time…so I’m trying to encourage folks to send her a note expressing your feelings about all of this here. I hope to encourage her to turn this to her advantage and make it an “issue that matters”—and Governor Gregoire, as I’ve said before, it’s always good to save the lives of registered voters in an election year.
It’s your lives and mine that are at stake here; so let’s put some pressure on and see if we can’t cut six 9/11s down to five next year.
If nothing else, you’ll have earned the appreciation of your grateful antibodies.
You might say it’s a bit of a “canary in a coal mine” situation, with pandemic flu hovering on the horizon and all. You also might say that since MRSA kills as many people in the US every year as six 9/11s the pandemic is already here.
So in today’s second installment, we’ll look a bit further: into facility management that now contends they are not required to follow guidelines that the Centers for Disease Control says “apply to all patients, regardless of suspected or confirmed infection status, in any setting in which healthcare is delivered”…into the concept that where your care is delivered should determine what protective equipment workers might require…and into a “magic ambulance” that apparently has the power to make you hazardous to some people--but not to others.
And just to add a twist--we have a Governor seeking re-election whom we hope to convince to put on her “superhero cape” by publicly coming to the rescue and making infectious disease control in all State facilities an important priority of her next Administration.
Because after all, do we really need six more avoidable 9/11s this year? And next year? And the year after that?
For those just coming to the story, let’s recap where we’ve been so far:
The Girlfriend (of over 26 years!), a nurse working for the State of Washington in one of the five “Residential Habilitation Centers” serving developmentally delayed individuals, recently brought home MRSA, which we now share—in our eyes.
MRSA, as you’ll recall, is one group among the variety of drug resistant organisms with which today’s medicine contends—drug resistant meaning that some, or virtually all, of today’s antibiotics will not “cure” the infection. There are several strains of MRSA, each with different drug-resistance characteristics. All this is discussed in more detail in the first installment of our adventure.
One reason this occurred is because the facility is lacking the most basic equipment required to prevent the spread of infection…and I’m not talking high-tech equipment here, either. For example, the facility does not see the need for sufficient eye protection for its medical care providers; this despite the fact that numerous procedures performed by each nurse daily (as well as other medical staff) “are likely to generate splashes or sprays of blood, body fluids, secretions and excretions” to quote again from the CDC.
IV. Standard Precautions
Assume that every person is potentially infected or colonized with an organism that could be transmitted in the healthcare setting and apply the following infection control practices during the delivery of health care.
--excerpted from the CDCs “Guidelines for Isolation Precautions in Hospitals”
There is also a failure of perception among management, who maintain that the community of clients residing at the facility are somehow epidemiologically “safe”…meaning the current facility policy is that the Standard Precautions which apply to everyone else practicing healthcare, everywhere else in the world (including Tamil, India) do not apply when working with this client population.
The likely outcome is that MRSA will spread among the vulnerable adults—and the staff--that this facility (and the other four like it) serves, and considering that 1 in 5 who get MRSA die as a result of the infection…well, 1 in 5 are probably going to die from an avoidable cause.
As we said before, it’s estimated that about 18,000 who were exposed to MRSA in 2005 died from the infection…which is about 20% of the annual total of 100,000 “avoidable” hospital deaths in the US.
Presumably there will be other members of the community beyond the facility affected as well…just like me, and just like the friends and relatives of some of you who have commented on the first story.
The Girlfriend and I are in the middle of an irritating series of adaptations designed to make it less likely that the MRSA bacteria will either re-infect us, or remain present in a dormant, or “colonized” state, ready to reappear without warning at some future time.
The most annoying adaptation?
I’ve just finished putting antibacterial ointment up my nose, as I do twice a day. To recreate the sensation, stick a Vaseline-covered Q-tip up each nostril. (Warning: stunt nose used for demonstration purposes only. Do not try this at home. Trust me, it sucks.)
Of course, the surgical soap we use constantly is a bit of a pain as well…
But enough about me.
The more important question is…how did the facility react when presented with the news that they have an infection control problem?
Well, that’s where it gets weird.
There seems to be a feeling that it is the type of facility that determines what sort of precautions are applied, rather than making a decision about the correct choice of protective equipment based on the procedure being performed.
A phone call to the Washington State Department of Health confirms this line of thinking goes farther than just this facility—the individual to whom I spoke (I did not identify myself as gathering news, so I’ll leave their name out of the discussion) answered my question about whether Standard Precautions should be applied at all healthcare facilities by telling me that it might depend on whether a nursing home is a healthcare facility…as opposed to a hospital.
Further discussion brought us to a point where we decided a better answer might be found by consulting with others at the Department of Health—and I’m awaiting that person’s return call as of this writing. (Please note that it is the weekend as I write, so the fact that no return call has yet occurred should not be construed as somehow sinister.)
If this line of thought is carried to its logical conclusion, here’s what we get:
Client X is an individual who is fed through a “G tube” (a tube that is surgically implanted and delivers liquid food directly into the individual’s stomach) in a nursing home which we’ll call “Site R”.
In that environment, according to current policy at our imaginary “Site R”, the only required protective gear while working with the tubes is gloves and a mask. What kind of work? A nurse might plug in a feeding or medicine tube, inject medicine into a port using a syringe, or “flush” a plugged food tube to allow it to again deliver food. Any of these interactions can easily cause the splashes or sprays of body fluids that spread disease.
Now suppose Client X were to encounter a medical difficulty requiring a move to the hospital. According to the CDC guidelines (and the “facility-based “logic we’ve seen so far) that same G tube work would require gloves, a non-permeable gown (no liquid getting through), a face mask, and eye and mucous membrane protection for the worker (the clear plastic “face shields” you see in use, or something similar).
Meaning that either something happened in the “magic ambulance” on the way to the hospital that made Client X more hazardous than he was before…or “facility based” logic makes no sense.
My guess: the ambulance ain’t that magic.
In this conversation we’re talking about MRSA…but imagine if Client X has undiagnosed Hepatitis C…or AIDS?
Is the nursing home worker less entitled to protection than the hospital worker?
Is it sound public policy that some healthcare workers are allowed to spread MRSA, hepatitis, HIV, and who knows what else…but not hospital workers?
As we previously mentioned, what comes home from work is going to get into the community—but did you know drug resistant bacteria are also now appearing in other species besides humans?
Try to imagine avian flu and MRSA in one superbug and you might understand why infection control is so, so, so critical.
If you need a further demonstration, the next time you’re walking down the street, try this exercise: count the people you see, from one to dead.
One to dead, you say?
How’s that work?
It works like this: MRSA kills 1 in 5…so when you see people during the day, all you have to do is count “1, 2, 3, 4…dead”. Repeat the process a few times, and you begin to get an idea of the reality of a pandemic.
We’ve covered a lot of ground today, so let’s wrap it up:
It is beginning to appear that many in the infection control community believe the location where healthcare is delivered is how you decide what protection the worker needs.
Others would tell you that disease is disease is disease…and if you plan on doing open heart surgery, it shouldn’t matter if you do it in a hospital, or a makeshift clinic in the real “Site R”…or in a bullring, for that matter…you still need to take the same precautions, every single time, if you want to prevent 18,000 or so deaths next year.
In my State of Washington the Governor is running for re-election…and she only won by 8 votes last time…so I’m trying to encourage folks to send her a note expressing your feelings about all of this here. I hope to encourage her to turn this to her advantage and make it an “issue that matters”—and Governor Gregoire, as I’ve said before, it’s always good to save the lives of registered voters in an election year.
It’s your lives and mine that are at stake here; so let’s put some pressure on and see if we can’t cut six 9/11s down to five next year.
If nothing else, you’ll have earned the appreciation of your grateful antibodies.
Author’s Note: We aren’t done yet. In part 3 we’ll discuss the response from the Health Department, we’ll be calling new experts…and we’ll be discussing the history of intimidation that the employer involved here is trying to overcome.
Stay tuned.
Tuesday, April 8, 2008
On Controlling The Spread Of Disease, Or, The State Gives Me MRSA
It has been the practice of your friendly fake consultant to keep my personal life separate from the stories you see in this space; and where exceptions have been made it has been because I felt it necessary to tell a larger story.
The story we will begin to tell today must be offered with my own life deeply intertwined in the narrative.
Sadly, it will not just be me that will be affected by the events we will here discuss. Instead, the list of victims will include some of Washington State’s most vulnerable citizens—those developmentally disabled individuals who reside in the State’s “Residential Habilitation Centers”--and the workers who care for them…one of whom is my very own spouse.
We have within the tale all the usual suspects: a lack of safety equipment, managers who fail to do their jobs, a system that’s failing to protect either its own or those who can’t care for themselves…and now, just to give things a twist, pharmaceutical soap, little orange pills, and color-safe bleach.
Before we begin in earnest, a few words about privacy. There will be some considerable restriction as to what exactly I can say in this report due to the need to protect the privacy of both the clients and the workers involved.
In the case of the clients (residents of these facilities are not referred to as patients because they might not necessarily be suffering from disease or illness—although, as with all of us, that changes from time to time) the privacy requirements are a part of the Federal HIPPA law…and in the case of the involved workers, there are concerns regarding potential retaliation.
The best place to begin the story, I suspect, is to explain exactly what MRSA is.
MRSA is a type of staph virus (Methicillin-Resistant Staphylococcus Aureus) which, as the name implies, is resistant to some or all of today’s antibiotics.
There are several strains of the virus (USA100 and USA300 being the most common) and the universe of strains is broken down into two groups: hospital-acquired and community-acquired; they are each differently resistant to different combinations of antibiotics. The particular variety of MRSA which has infected me is from the hospital-acquired group and it is resistant to Ciprofloxacin, Clindamyacin, Erythromyacin, and Oxacillin.
About 85% of the estimated 95.000 exposures in 2005 can be traced back to the healthcare system, one way or another, and about 12% are community-acquired. “Community-acquired” MRSA exposures most commonly occur in gyms, prisons, and the military, and are primarily skin infections. Depending on where you live in the US the rate of infection in the general population might vary from roughly 20 per 100,000 to 120 per 100,000.
As you might expect, age and a compromised immune system make infection more likely.
Lucky for me, there are antibiotics that our virus (The Girlfriend and I have shared so much these many years…and now we’re sharing this) is sensitive to…which is why we’re taking Doxycycline twice a day.
The virus can enter the body through cracks in the skin, inhalation, or by the sorts of blood and fluid contacts that you might expect would spread this sort of thing from one person to another.
The virus can “colonize” itself without infecting the host or it can be in an infectious state. As a result it is possible to carry the virus for some time and become infected later, or not at all. This is common to many other forms of staph as well.
Infections can occur not only in the skin, but also in the body’s other soft tissues, or in the lungs, where it can cause pneumonia.
I’m told the “warm hairy areas” of the body are the most susceptible to colonization—face and head hair, armpits, and the crotch area in particular.
Without effective treatment, MRSA can most assuredly be fatal.
When drug therapy is successful the rate of relapse can be as low as 5%.
There are variants of the virus that are resistant to virtually all known antibiotics—and even when certain antibiotics will work there may be situations where the patient’s allergic to those antibiotics.
In those cases where drug therapy cannot be employed excision (the surgical removal of the affected tissue) and maggot therapy (yes, they sometimes use maggots for removal of affected tissue) are available options.
We’ll be returning to this topic as we go deeper into the story…but at this point we should probably take some time to discuss how the spread of disease is controlled in health-care facilities.
Readers will undoubtedly be familiar with the image of a surgeon in the operating room: the surgical mask, gown, gloves and face shields that are worn in that environment are just as important in protecting the patient from acquired infections as they are in protecting everyone else from that patient.
In settings other than the OR it is just as crucial that infection control be as close to 100% effective as possible; this is why those same protective garments are now a mandatory part of every healthcare worker’s arsenal. Those of you who are regular viewers of the “Discovery Health Channel” will probably recall seeing medical personnel “gowning up” to perform a procedure.
“Best practice” guidelines are provided by the Centers for Disease Control. Those best practices are known as “Standard Precautions”…and they’re fairly simple to explain. I’ll paraphrase:
--If you’ll be in contact with someone else’s body fluids, you should assume that person—no matter who they are—is infectious.
--For your own protection (and the protecthttp://www.cdc.gov/ncidod/dhqp/gl_isolation_standard.htmlStandard Precautionsion of others) you’ll need gloves, gown, mask…and beyond that, a face shield for activities “that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions”.
--Although this will sound obvious, you don’t want to use the gloves, gown, mask, or face shield while moving from one person to another…instead, you need to change into new clean stuff before moving on to the next procedure.
By following these fairly obvious instructions you prevent “cross-contamination”—potentially saving the lives of yourself and all those with whom you will later make contact.
Which includes the family members back home, when the shift is over.
That’s where I come in.
The Girlfriend (of more than 26 years…hooray for us, eh?) informed me that we’ll be needing to take eyedrops for what we thought was her (relatively minor) case of conjunctivitis. We did, to no effect.
We were then prescribed Bacitracin Opthalmic ointment to resolve what had by now been diagnosed as MRSA (it requires a lab culture to confirm the diagnosis)…which meant putting this awful goo in our eyes four times daily…which did no good.
One week later we found ourselves in the office of an Infectious Disease Specialist
And now we have some…unusual…household routines.
In addition to the Doxycycline, we now use “Hibiclens” surgical soap for our washing and showering needs, as well putting Muriprocin ointment up our noses twice daily. The “ewww” factor is high, indeed on that one.
All clothing is now washed with color-fast bleach; and we mostly use paper towels.
All of this (except the antibiotics) for the next three months.
Hopefully it works, and the disease either is eradicated or returns to a “colonized” state.
All of this for an infection we did not have the pleasure of acquiring in Las Vegas.
So, you might be asking, if the infection control process exists, how does the infection manage to spread?
I’ve had a few conversations—and done a fair bit of reading--with the intent of finding the answer to that myself, and here’s what I’ve learned:
--Workers sometimes hang used gowns at the end of a client’s bed, go about their business, and then return later, reusing the same gown for later procedures.
--Other workers will wear the same gown for their entire shift, moving from client to client to client.
--There can be issues related to the way linens are handled and laundered that can cause the spread of infection.
--Although there are some face shields available at her facility, The Girlfriend tells me that their presence is, shall we say, sporadic—that is to say, they are not available in all of the locations where they are needed.
--There are procedures that, by their very nature, are inherently dangerous—particularly problematic are the feeding tubes which are surgically inserted directly into the client’s gastric system. These have almost universally replaced the older “nasal gastric” tubes (through the nose and into the stomach) that were often the unintentional cause of aspiration (the lungs fill with the liquid food, rather like drowning), should the tube become dislodged.
The opening in the body made to accommodate the surgically inserted tube can leak, there can be “deposits” of internal fluids on the outside of the body through the hole…and most commonly of all, the tubes can become plugged by the liquid food they are designed to transport into the body. The process of unplugging the tubes is, obviously, going to expose all and sundry to something, whether it be food or body fluids. The CDC confirms this is a huge problem.
--There is a lack of effort on the part of Infection Control management to educate and to correct these problems…and in some cases it appears that there’s a lack of awareness that these even are problems.
We will talk about this in more detail in the next part of the story, but for the moment we’ll say that since at least 2006 there have been warning signs of problems to come.
I try to keep my emotions in check when writing, as I find a dispassionate approach makes for more a clear understanding of research…not to mention an increased empathy for those about whom I write.
In this case, however, I have taken it a bit personally. You see, this is not the first potentially hazardous exposure The Girlfriend has suffered due to appallingly poor clinical practice at this facility…another subject we’ll address in considerable detail in the next installment of the story.
Since it was obvious to me that there was not going to be a change in culture imposed from the inside, I’ve decided I’m going to do it for them.
Which is why, in recent days, the emails began flowing--to the Governor, the Secretary of the State Department of Health, the Secretary of the State’s Department of Social and Health Services (the largest of Washington’s State Agencies), the Director of WISHA (the State’s OSHA equivalent), the State Attorney General (because someone’s getting a bill for my care eventually…), and the State Auditor, who is charged with investigating governmental misconduct.
(To be honest, I was a bit inaccurate in the note…I told the various parties that MRSA was the “flesh eating bacteria” disease, which was an error on my part. I blame myself, for being a bit overwrought as I wrote; and I do owe all involved an apology for the error…so Governor Gregoire, if you might see this: sorry about that—but the rest of the note is dead-on accurate.)
And that’s how we get to the part where I ask you for some help.
In the note I sent I reminded the Governor (who won in 2004 by a mere 8 votes) that not only was this affecting those vulnerable citizens who reside in the State’s facilities and the employees who are there for them--but that the problem, thanks to my infection, had now spilled into the community of…registered voters.
Not a good thing, in an election year.
But good for us, as it means we have a way to keep the Governor’s attention…focused.
So do me a favor, if you would…and drop the Governor a quick note, here at her official website, perhaps reminding her that all the State’s citizens matter when it comes to healthcare equality, or that infectious disease control is everyone’s business—even the State’s…or perhaps you might pose this question: if we can’t control MRSA, even in State facilities, how in the world are we going to control pandemic influenza in the general population when it eventually rears its ugly head?
We meet with management Monday to discuss the incident…which means part two of the story will also be a good one: we’ll talk more about past problems, we’ll asses management’s attitude today…and we’ll see if we can’t help the State find a better way going forward.
Put on your seatbelts, kids…it’s gonna be a rocky ride.
The story we will begin to tell today must be offered with my own life deeply intertwined in the narrative.
Sadly, it will not just be me that will be affected by the events we will here discuss. Instead, the list of victims will include some of Washington State’s most vulnerable citizens—those developmentally disabled individuals who reside in the State’s “Residential Habilitation Centers”--and the workers who care for them…one of whom is my very own spouse.
We have within the tale all the usual suspects: a lack of safety equipment, managers who fail to do their jobs, a system that’s failing to protect either its own or those who can’t care for themselves…and now, just to give things a twist, pharmaceutical soap, little orange pills, and color-safe bleach.
Before we begin in earnest, a few words about privacy. There will be some considerable restriction as to what exactly I can say in this report due to the need to protect the privacy of both the clients and the workers involved.
In the case of the clients (residents of these facilities are not referred to as patients because they might not necessarily be suffering from disease or illness—although, as with all of us, that changes from time to time) the privacy requirements are a part of the Federal HIPPA law…and in the case of the involved workers, there are concerns regarding potential retaliation.
The best place to begin the story, I suspect, is to explain exactly what MRSA is.
MRSA is a type of staph virus (Methicillin-Resistant Staphylococcus Aureus) which, as the name implies, is resistant to some or all of today’s antibiotics.
There are several strains of the virus (USA100 and USA300 being the most common) and the universe of strains is broken down into two groups: hospital-acquired and community-acquired; they are each differently resistant to different combinations of antibiotics. The particular variety of MRSA which has infected me is from the hospital-acquired group and it is resistant to Ciprofloxacin, Clindamyacin, Erythromyacin, and Oxacillin.
About 85% of the estimated 95.000 exposures in 2005 can be traced back to the healthcare system, one way or another, and about 12% are community-acquired. “Community-acquired” MRSA exposures most commonly occur in gyms, prisons, and the military, and are primarily skin infections. Depending on where you live in the US the rate of infection in the general population might vary from roughly 20 per 100,000 to 120 per 100,000.
As you might expect, age and a compromised immune system make infection more likely.
Lucky for me, there are antibiotics that our virus (The Girlfriend and I have shared so much these many years…and now we’re sharing this) is sensitive to…which is why we’re taking Doxycycline twice a day.
The virus can enter the body through cracks in the skin, inhalation, or by the sorts of blood and fluid contacts that you might expect would spread this sort of thing from one person to another.
The virus can “colonize” itself without infecting the host or it can be in an infectious state. As a result it is possible to carry the virus for some time and become infected later, or not at all. This is common to many other forms of staph as well.
Infections can occur not only in the skin, but also in the body’s other soft tissues, or in the lungs, where it can cause pneumonia.
I’m told the “warm hairy areas” of the body are the most susceptible to colonization—face and head hair, armpits, and the crotch area in particular.
Without effective treatment, MRSA can most assuredly be fatal.
When drug therapy is successful the rate of relapse can be as low as 5%.
There are variants of the virus that are resistant to virtually all known antibiotics—and even when certain antibiotics will work there may be situations where the patient’s allergic to those antibiotics.
In those cases where drug therapy cannot be employed excision (the surgical removal of the affected tissue) and maggot therapy (yes, they sometimes use maggots for removal of affected tissue) are available options.
We’ll be returning to this topic as we go deeper into the story…but at this point we should probably take some time to discuss how the spread of disease is controlled in health-care facilities.
Readers will undoubtedly be familiar with the image of a surgeon in the operating room: the surgical mask, gown, gloves and face shields that are worn in that environment are just as important in protecting the patient from acquired infections as they are in protecting everyone else from that patient.
In settings other than the OR it is just as crucial that infection control be as close to 100% effective as possible; this is why those same protective garments are now a mandatory part of every healthcare worker’s arsenal. Those of you who are regular viewers of the “Discovery Health Channel” will probably recall seeing medical personnel “gowning up” to perform a procedure.
“Best practice” guidelines are provided by the Centers for Disease Control. Those best practices are known as “Standard Precautions”…and they’re fairly simple to explain. I’ll paraphrase:
--If you’ll be in contact with someone else’s body fluids, you should assume that person—no matter who they are—is infectious.
--For your own protection (and the protecthttp://www.cdc.gov/ncidod/dhqp/gl_isolation_standard.htmlStandard Precautionsion of others) you’ll need gloves, gown, mask…and beyond that, a face shield for activities “that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions”.
--Although this will sound obvious, you don’t want to use the gloves, gown, mask, or face shield while moving from one person to another…instead, you need to change into new clean stuff before moving on to the next procedure.
By following these fairly obvious instructions you prevent “cross-contamination”—potentially saving the lives of yourself and all those with whom you will later make contact.
Which includes the family members back home, when the shift is over.
That’s where I come in.
The Girlfriend (of more than 26 years…hooray for us, eh?) informed me that we’ll be needing to take eyedrops for what we thought was her (relatively minor) case of conjunctivitis. We did, to no effect.
We were then prescribed Bacitracin Opthalmic ointment to resolve what had by now been diagnosed as MRSA (it requires a lab culture to confirm the diagnosis)…which meant putting this awful goo in our eyes four times daily…which did no good.
One week later we found ourselves in the office of an Infectious Disease Specialist
And now we have some…unusual…household routines.
In addition to the Doxycycline, we now use “Hibiclens” surgical soap for our washing and showering needs, as well putting Muriprocin ointment up our noses twice daily. The “ewww” factor is high, indeed on that one.
All clothing is now washed with color-fast bleach; and we mostly use paper towels.
All of this (except the antibiotics) for the next three months.
Hopefully it works, and the disease either is eradicated or returns to a “colonized” state.
All of this for an infection we did not have the pleasure of acquiring in Las Vegas.
So, you might be asking, if the infection control process exists, how does the infection manage to spread?
I’ve had a few conversations—and done a fair bit of reading--with the intent of finding the answer to that myself, and here’s what I’ve learned:
--Workers sometimes hang used gowns at the end of a client’s bed, go about their business, and then return later, reusing the same gown for later procedures.
--Other workers will wear the same gown for their entire shift, moving from client to client to client.
--There can be issues related to the way linens are handled and laundered that can cause the spread of infection.
--Although there are some face shields available at her facility, The Girlfriend tells me that their presence is, shall we say, sporadic—that is to say, they are not available in all of the locations where they are needed.
--There are procedures that, by their very nature, are inherently dangerous—particularly problematic are the feeding tubes which are surgically inserted directly into the client’s gastric system. These have almost universally replaced the older “nasal gastric” tubes (through the nose and into the stomach) that were often the unintentional cause of aspiration (the lungs fill with the liquid food, rather like drowning), should the tube become dislodged.
The opening in the body made to accommodate the surgically inserted tube can leak, there can be “deposits” of internal fluids on the outside of the body through the hole…and most commonly of all, the tubes can become plugged by the liquid food they are designed to transport into the body. The process of unplugging the tubes is, obviously, going to expose all and sundry to something, whether it be food or body fluids. The CDC confirms this is a huge problem.
--There is a lack of effort on the part of Infection Control management to educate and to correct these problems…and in some cases it appears that there’s a lack of awareness that these even are problems.
We will talk about this in more detail in the next part of the story, but for the moment we’ll say that since at least 2006 there have been warning signs of problems to come.
I try to keep my emotions in check when writing, as I find a dispassionate approach makes for more a clear understanding of research…not to mention an increased empathy for those about whom I write.
In this case, however, I have taken it a bit personally. You see, this is not the first potentially hazardous exposure The Girlfriend has suffered due to appallingly poor clinical practice at this facility…another subject we’ll address in considerable detail in the next installment of the story.
Since it was obvious to me that there was not going to be a change in culture imposed from the inside, I’ve decided I’m going to do it for them.
Which is why, in recent days, the emails began flowing--to the Governor, the Secretary of the State Department of Health, the Secretary of the State’s Department of Social and Health Services (the largest of Washington’s State Agencies), the Director of WISHA (the State’s OSHA equivalent), the State Attorney General (because someone’s getting a bill for my care eventually…), and the State Auditor, who is charged with investigating governmental misconduct.
(To be honest, I was a bit inaccurate in the note…I told the various parties that MRSA was the “flesh eating bacteria” disease, which was an error on my part. I blame myself, for being a bit overwrought as I wrote; and I do owe all involved an apology for the error…so Governor Gregoire, if you might see this: sorry about that—but the rest of the note is dead-on accurate.)
And that’s how we get to the part where I ask you for some help.
In the note I sent I reminded the Governor (who won in 2004 by a mere 8 votes) that not only was this affecting those vulnerable citizens who reside in the State’s facilities and the employees who are there for them--but that the problem, thanks to my infection, had now spilled into the community of…registered voters.
Not a good thing, in an election year.
But good for us, as it means we have a way to keep the Governor’s attention…focused.
So do me a favor, if you would…and drop the Governor a quick note, here at her official website, perhaps reminding her that all the State’s citizens matter when it comes to healthcare equality, or that infectious disease control is everyone’s business—even the State’s…or perhaps you might pose this question: if we can’t control MRSA, even in State facilities, how in the world are we going to control pandemic influenza in the general population when it eventually rears its ugly head?
We meet with management Monday to discuss the incident…which means part two of the story will also be a good one: we’ll talk more about past problems, we’ll asses management’s attitude today…and we’ll see if we can’t help the State find a better way going forward.
Put on your seatbelts, kids…it’s gonna be a rocky ride.
AUTHOR"S NOTE: As was mentioned by several of my new friends, MRSA is a bacterial infection, and not a viral one. My aplogy to the reader for the error.
Thursday, April 3, 2008
On Confusion, Or, What’s The Point?
As has been indicated before in this space, I am far too addicted to television…and most of the time, even when the sound is off it’s still there to be seen.
But it’s so often confusing.
Here’s an example:
There is an ad running these days for a product called “extend” or “super grow” or “bigs a lot” or whatever the heck it’s called…and while the ad takes great pains to tell us that it can cause a “certain part” of the body to grow larger—it never exactly tells us which part they’re talking about.
Clearly, there are some body parts that it might make sense for someone to enlarge; but the commercial is so vague I just can’t tell what they’re getting at.
It’s that sort of confusion that drives today story…so come along and we’ll pursue the question of what a “make it bigger” product might actually do…and more.
So what body parts might this very confusing product affect?
There are a few that it would seem logical to enlarge:
Eyelashes, for example. It makes perfect sense, considering the amount of mascara a woman might use in a lifetime (and the time spent applying same) to be able to just take a pill and have larger eyelashes…but the fact that the product seems to be directed to men throws that theory right out the window.
Same with hair—men usually don’t use products that would “extend” the hair.
A bigger nose? Illogical indeed.
A product to extend muscle development…like a “Mega Mass” in pill form? I am leaning toward that theory—but there’s one other possibility that I’m mulling over, and it’s actually my leading contender for “most likely theory” at the moment.
Hands and feet.
Why, you ask, would anyone want to extend the size of their hands and feet?
At first this might seem weird, but work with me for a moment. Many of you might be familiar with the “old wives tale” that says a man with large hands and feet also has a large…well, you know.
And I think that’s what this product is intended to do—to make men’s hands and feet larger so that women (and perhaps, the occasional interested man) will think the user has a larger penis.
And speaking of confusion…am I the only one confused as to why Hillary is still in this race? And if she’s going to remain in the race, why is she running a campaign that looks more like Strom Thurman’s 1948 failed Presidential bid…or the campaign that McCain’s Vice President might run?
Seriously, Hillary, with the effort you’ve put forth to compliment McCain at the expense of Obama you’re starting to make even Mitt Romney and Charlie Crist nervous that the VP nomination might be ought of their reach.
It was bad enough when you felt entitled to a Democratic nomination; but the idea that you’re entitled to be nominated by whatever party will nominate you, for whatever spot on the ticket you can get…it really raises the “eewwwww factor”.
What are you thinking? That your only path to the Presidency is to ascend to the office upon the declaration of McCain’s incompetence?
Of course, as so many will point out, she has every right to run…but who cares?
I mean, let’s face it Hillary, I have a right to run too…and I could presumably also try to base my campaign on latent racism and an appeal to a long gone past…but wouldn’t that make me just another Republican, like Trent Lott, George Allen, and…lately, you?
The only thing missing from the picture would be for you to run a campaign ad (that is, if you could afford it) with a Christmas tree and a Cross in prominent view as you angle for the evangelical vote—and it wouldn’t surprise me at this point if she tries such a move.
I can already hear the response: “We must count every vote…then count states who broke the rules…then count electoral votes…then count only voters who voted for Clinton before…and if that doesn’t work, we’ll only count my vote—because I know what’s good for all those fools who voted for Obama, even if they don’t.”
It would have been different if you had cast yourself as better on issues than Obama—in fact, even now you could change the tone of the contest…something that would improve the standing of your campaign (and legacy—and future)…but that strategy won’t get you a victory, will it?
And as we are now well aware, you will do anything to win, no matter what that victory means to yourself—or the Democratic Party.
Which brings us to the big finish:
There is a choice to be made by our dear Hillary “at this juncture”. She can continue to pursue what is more and more looking like a “scorched earth” strategy—and if she gets lucky, McCain might just run with her as a VP.
Or she can “extend” her future in Democratic politics by extending her vision beyond the proverbial hood of her car…by, instead, looking farther down the road—where lots more elections lie ahead, and where a future as a Senate Majority Leader or Governor might still be possible.
Obscene amounts of fund-raising, from anonymous sources, for a future Hillary Presidential library?
Maybe not so much.
But it’s so often confusing.
Here’s an example:
There is an ad running these days for a product called “extend” or “super grow” or “bigs a lot” or whatever the heck it’s called…and while the ad takes great pains to tell us that it can cause a “certain part” of the body to grow larger—it never exactly tells us which part they’re talking about.
Clearly, there are some body parts that it might make sense for someone to enlarge; but the commercial is so vague I just can’t tell what they’re getting at.
It’s that sort of confusion that drives today story…so come along and we’ll pursue the question of what a “make it bigger” product might actually do…and more.
So what body parts might this very confusing product affect?
There are a few that it would seem logical to enlarge:
Eyelashes, for example. It makes perfect sense, considering the amount of mascara a woman might use in a lifetime (and the time spent applying same) to be able to just take a pill and have larger eyelashes…but the fact that the product seems to be directed to men throws that theory right out the window.
Same with hair—men usually don’t use products that would “extend” the hair.
A bigger nose? Illogical indeed.
A product to extend muscle development…like a “Mega Mass” in pill form? I am leaning toward that theory—but there’s one other possibility that I’m mulling over, and it’s actually my leading contender for “most likely theory” at the moment.
Hands and feet.
Why, you ask, would anyone want to extend the size of their hands and feet?
At first this might seem weird, but work with me for a moment. Many of you might be familiar with the “old wives tale” that says a man with large hands and feet also has a large…well, you know.
And I think that’s what this product is intended to do—to make men’s hands and feet larger so that women (and perhaps, the occasional interested man) will think the user has a larger penis.
And speaking of confusion…am I the only one confused as to why Hillary is still in this race? And if she’s going to remain in the race, why is she running a campaign that looks more like Strom Thurman’s 1948 failed Presidential bid…or the campaign that McCain’s Vice President might run?
Seriously, Hillary, with the effort you’ve put forth to compliment McCain at the expense of Obama you’re starting to make even Mitt Romney and Charlie Crist nervous that the VP nomination might be ought of their reach.
It was bad enough when you felt entitled to a Democratic nomination; but the idea that you’re entitled to be nominated by whatever party will nominate you, for whatever spot on the ticket you can get…it really raises the “eewwwww factor”.
What are you thinking? That your only path to the Presidency is to ascend to the office upon the declaration of McCain’s incompetence?
Of course, as so many will point out, she has every right to run…but who cares?
I mean, let’s face it Hillary, I have a right to run too…and I could presumably also try to base my campaign on latent racism and an appeal to a long gone past…but wouldn’t that make me just another Republican, like Trent Lott, George Allen, and…lately, you?
The only thing missing from the picture would be for you to run a campaign ad (that is, if you could afford it) with a Christmas tree and a Cross in prominent view as you angle for the evangelical vote—and it wouldn’t surprise me at this point if she tries such a move.
I can already hear the response: “We must count every vote…then count states who broke the rules…then count electoral votes…then count only voters who voted for Clinton before…and if that doesn’t work, we’ll only count my vote—because I know what’s good for all those fools who voted for Obama, even if they don’t.”
It would have been different if you had cast yourself as better on issues than Obama—in fact, even now you could change the tone of the contest…something that would improve the standing of your campaign (and legacy—and future)…but that strategy won’t get you a victory, will it?
And as we are now well aware, you will do anything to win, no matter what that victory means to yourself—or the Democratic Party.
Which brings us to the big finish:
There is a choice to be made by our dear Hillary “at this juncture”. She can continue to pursue what is more and more looking like a “scorched earth” strategy—and if she gets lucky, McCain might just run with her as a VP.
Or she can “extend” her future in Democratic politics by extending her vision beyond the proverbial hood of her car…by, instead, looking farther down the road—where lots more elections lie ahead, and where a future as a Senate Majority Leader or Governor might still be possible.
Obscene amounts of fund-raising, from anonymous sources, for a future Hillary Presidential library?
Maybe not so much.
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