Back to School

The Fourth of July is normally the mid point of summer, with families scheduling vacations around this date and the hot days of this month are marked by summer camps and other extracurriculars that have kids still socializing and experiencing some type of emotional and intellectual stimulation if not growth.  Right, that is if you have money and access.  Few if any programs exist other than local community centers that like the rest of the services for the great unwashed are quite limited.  Needless to say the antiquated notion of school running for nine months a year with the summer off might have to go the way with the rest of our former ideas on how to manage and operate the United States. Let’s face it folks, when Grocery Store workers, delivery drivers, public transportation operators and those others without degrees or established professional identities (think cooks, cleaners and other lower elements to the totem pole) are considered “essential” then we have a lot to rethink.  They were lumped in with Doctors and other medical professionals or “front line workers” who were there to basically do their job in surreal circumstances, and again those circumstances are the same with the kids going to camp, academy’s and the like during summer break, the staff that work at wealthy hospitals that serve wealthy families.  I have already put up the story about New York’s crisis with regards to how patients were treated, no, handled in public hospitals when they landed there for treatment.  If they were lucky they were shoved to the naval ship or the Javitz Center or the religious tent in Central Park but those numbers were few and far between and many never made it out of the hospital in anything but a body bag.

Yes American medical care is exceptional in that it has two classes of patients – the have and the have nots.  I am 99.9% sure that is why Harborview Hospital mistreated me in 2012 as they did not verify my insurance until after I was dismissed and in turn the damage was already done.  Anyone setting foot in that shithole well good luck to you, its only a miracle I did not die from their mistreatment and I suspect many have been now and no one will ever know as they don’t have a massive newspaper with resources to cover this story as most other cities do either so those stories will go untold and the bodies dumped in the potter’s field or thrown into storage trucks parked on roadsides as they are here.

**and for the record the local presses have been very active in uncovering major scandals.. It was the Keating 5 that came out of local press and the story about Boeing from The Seattle Times and there are many many more, The Boston Herald as the Priest scandal that without their local investigative journalism many stories like these would go unknown and the culprits on with their lives, like now but without a good movie. ****

In fact many of the unclaimed belongings are lost in the halls, closets or trash bins never to find a home or place to rest as well. Again if you think that staff aren’t stealing some of these things, think again. Drug theft is the most common (and that includes Doctors as well)  but they take whatever is not locked down if you don’t believe me,  ask this Nurse. I find it a miracle that I walked out with any jewelry or belongings from my incident.  Nurses are two bit cunts, and many others who work inside are lowly paid persons who frankly are largely ignored exploited workers, so they likely steal to use it to pawn.  I suspect why they have not raided that cookie jar is largely due to the fact that everyone is so bloody scared of Covid they aren’t touching that shit but what they can take, they will.  Again its hard to think of these “heroes” doing such a thing, yeah remember when you felt that way about Cops?

Here is the next casualty on the horizon, public schools and universities.  The reality is that States are driven by the budget crisis to cut everything from everything. So if you think public health and education are already cut to the bone, think again.  This is an irony on top of a crisis as now more than ever how schools and hospitals go forward will be a demanding if not expensive operation for decades to come. And in fact should be the norm as to ensure that parity and equity are finally achieved for all those who don’t have the privileges afforded them for being just essential workers.  I do find that hilarious that the dude who poured my coffee everyday and the other who brought my food had bigger role than my Accountant and Attorney whom I have not spoken to since this began is something that doesn’t surprise me, as I rarely did and they are both new having fired the last Accountant and had just contacted the Attorney to set up some business trust and get my estate in order.  Again more irony.   I have no idea if we ever will meet or I will find someone else as I never wrote a check or followed up after the quarantine went down.  So much for essential.

I don’t think any public teacher wants to set foot in any classroom without heavy duty protections in place, the same go with College Professors.  The reality is that the two cohorts who have the most problem following instructions and complying with order are kids, regardless of age.  I actually think of all kids, High Schoolers, would be the most easiest to work with as they are just of an age to rationalize what this means, the worst middle schoolers.  Then of course those in the first year or two of College are equally disrespectful as they have entitlement tattooed on their forehead as they are convinced their entrance means they are special, like everyone else.  What.ever.  So after binge drinking, pledging a Fraternity and then drugging some girl up to rape behind a dumpster I am sure they have no problem monitoring their health, wearing a mask and following social distance protocols.

This is what current Academics are saying with regards to returning to campus. And this will also be the guidelines for those in K-12 as who do you think are telling the White Daddies what to do. This is the “brain trust” who come up with these ideas, then go “Fuck this is not working out.” Because trying to tell people how to behave and guide human behavior when they won’t listen, don’t care, assume its a game, political, fraud, made up, will go away, the fault of some Chinese person or whatever other bullshit falls out of the mouth of Trump, tells you everything you need to know in why this shit is hitting the fan.  Then you have a media whose sole job is to not actually ask questions, seek varying opinions and follow stories that have the ability to fact check and substantiate, you got more problems. As I have read repeatedly stories that contradict, stories that have odd blank or missing facts without any critical analysis offered.   We have seen opinion pieces and ads published without editorial oversight and more importantly, actual scientific reports printed only to be retracted days and weeks later without any real warning noted at print time advising  that this may not be all that and a bag of chips has instead become the daily Covid Caller.   And these are from the papers that have serious reputations that over the years despite their own roles in major fuckups, (Iran, that one was bad there NYT) (oh and the Post you ain’t innocent either)  they are still considered the bellwether; so, when they screw it up we are screwed. Folks, most people are idiots, just ask the bleach drinkers.

And these same bleach drinkers breed, right there a problem, but do you honestly expect their children to be these compliant, well behaved individuals intent on following instructions and monitoring their behavior? Have you ever been to a public school?  They barely managed online learning, disrupting those classes when and if they ever showed.  So again, what about school?

Just ask these Teachers in Texas, hot bed for Covid 20 which seems worse than Covid 19. And of course the fish stinks from the head and so the White Daddies are putting this all on local districts without any guidance, let alone actual facts on how to do this, so I think this is like hospitals. The rich get all the goodies and the poor, well they can do what they always do, sink or swim.  Oh don’t know how to swim? Well yeah that costs extra and we don’t have any extra sauce for you kid.  Oh shit, (pun intended)  it is like Chipolte.  From parking lot fights to gun toting crazies if there is not another reason to set foot in that fast food dump there it is.  That place was a hot bed of norovirus numerous times,  you know like Covid, but less deadly.  So again if you think all these fights and furies are bad now, just wait.

Texas Teachers Consider Leaving The Classroom Over COVID-19 Fears

The Association of Texas Professional Educators recently surveyed some 4,200 educators. About 60% said they were concerned about their health and safety heading into the 2020-21 school year.

Laura Isensee | Posted on June 30, 2020,

For 40 years, Robin Stauffer has taught high school English in seven different school districts in three different states. Most recently, Advanced Placement English in Katy, where she says working with kids has kept her young and lighthearted.

But since the pandemic hit, a question has nagged at her: Is it time to retire?

“I was very upset and sad. I was torn. I went back and forth,” Stauffer said.

On the one hand, she isn’t ready to leave the classroom. She’s still passionate about why she joined the profession in the first place: “To be the type of teacher that I wish I would have had when I was in public school, to kind of right the wrongs that I experienced.”

On the other hand, she knows how hard it is to maintain a campus with thousands of students. Before COVID-19, district administrators in Katy reduced their custodial staff, and it was often up to teachers to clean their own rooms.

“They don’t supply hand sanitizer. They don’t supply wipes. None of these supplies were ever given to us. You just used what you had or what teachers themselves purchased,” she said.

Stauffer waited for the Katy Independent School District to release safety plans for back-to-school. Instead, she’s seen what she called a “back-to-normal” attitude.

And then she had to consider her health: She’s 66 years old, has diabetes and a family history of heart disease, all making her more vulnerable to the coronavirus.

“I just don’t trust the school district to safeguard my health during this pandemic,” she said.

Like Stauffer, many Texas teachers are on edge and considering leaving the profession even as the state’s education commissioner has declared it “safe for Texas public school students, teachers, and staff to return to school campuses for in-person instruction this fall.”

As many as one in five U.S. educators say they’re unlikely to return to the classroom because of the coronavirus, according to a national survey conducted before Texas indicated its light-handed approach to reopening schools.

“There are people that have already made the decision to quit,” said Zeph Capo, president of the Texas American Federation of Teachers. “There’s certainly a lot of people that are considering it. I’ve heard from others as well, too. They’re single parents and they don’t have a lot of choice.”

“So they’re depending on us,” Capo said, “to help make sure that they are afforded as much safety as possible in doing that. So that’s what keeps me moving.”

Higher risk

Nearly one-third of U.S. teachers are 50 years or older, according to federal data. That puts them at higher risk of becoming seriously ill from the virus. And the publication Education Week has identified more than 300 school staff and former educators who’ve died from COVID-19.

“There’s obviously a lot of fear because there are so many unanswered questions,” said Noel Candelaria, president of the Texas State Teachers Association.

He says school staff with underlying health conditions are also concerned. Consider his own family: Candelaria is married to Patty, who is a dyslexia therapist and has had three surgeries to fix a congenital heart defect.

“There are educators, like my wife, who if the districts do not provide an alternative method for them to do their job from home without exposing themselves, (they) are seriously considering a medical leave,” Candelaria said.

Texas public school districts are still waiting for safety and health guidelines from the Texas Education Agency. They were scheduled to be released last week, but were delayed after the Texas Tribune published draft rules indicating few mandatory safety measures.

That has weighed on many teachers.

“We can’t just talk about student health and safety without talking about educator health and safety, because they’re sharing the same space,” Candelaria said.

The Association of Texas Professional Educators recently surveyed some 4,200 educators. About 60% said they were concerned about their health and safety heading into the 2020-21 school year.

Sso far, however, that concern hasn’t translated into an increase in retirements. Nearly 22,000 teachers and state employees have retired this fiscal year, compared to about 25,000 last year, according to the Teacher Retirement System.

Few mandates

Gov. Greg Abbott has said districts will have some flexiblity in implementing safety protocols, and allowing families to continue remote learning.

“The state has already made allocations and is prepared to continue allocations of masks for schools, allowing, I think, for a level of flexibility at the local school district level to make the best determinations for the schools in that district about what the mask requirement should be,” Abbott told KBTX-TV in a recent interview.

But, the Republican governor has told state lawmakers Texas won’t mandate schools to require face coverings or test for COVID-19 symptoms.

“It was really shocking because it seems like nobody cares what’s going to happen in the schools,” said Kristen McClintock, who’s taught special education for six years at a large Houston high school.

She has a newborn and a toddler at home and doesn’t want to expose them to the virus. Nor does she want to expose her students with disabilities, whom she says she misses a lot.

“We’re almost like a family,” McClintock said. “So it’s been really hard to not be able to see them for months. I want to see some of them graduate next year”

But every night she and her husband discuss if they can afford for her to quit and rely on his income as an online tutor.

“It would cut our finances in half,” she said. “We would have to lean on support probably from family to try and get by.”

No choice

McClintock is still deciding. First, she wants to see more health data and detailed plans from the Houston Independent School District.

But veteran educator Stauffer has made up her mind. She turned in her resignation in May.

“All my life, I’ve been a teacher,” Stauffer said. “That is who I am. And to give up my identity, it will be challenging, but I don’t feel like I had another choice.”

She cleaned out her classroom, said goodbye to students over Zoom and didn’t have any real celebration.

That is, until some of her colleagues surprised her with a car parade, waving signs and balloons as they drove by — a fitting end to a 40-year career, in the age of COVID-19.

The Fugitive

Well as the under-utilized naval ship sailed away from the harbor (whosever idea that was showed how tax payer dollars are abused that one was it) to the temporary closing (as in still set up but not being used) Javitz Center and the tents of the Salvation Army or whatever weird fucking religious crew run by homophobe Franklin Graham on public lands, which could have been used well for the public to go while being locked down, get folded up we are back to just the overworked and underprepared/supplied public hospitals, and those private ones stocked by Warren Buffet, to treat the  new/next/more Covid patients. The ones in the prisons or in Convents, nursing homes well you will be fine if no one notices you are dead.  And well even those on the Subway, again wondering how many hours those bodies were there shedding viruses or whatever caused them to die.  Remember if you are not tested POS for Covid and you die you die of that but still are likely counted as dead by Covid, maybe or maybe not. Who knows?  Does anyone care?  Well apparently law enforcement does.

I had read about arrests, chases and hunts of others in other less democratic countries who had escaped Covid treatment facilities; such as the woman in Chile, Russia, India , Africa and even Israel. 

When I read this article in the Tennessean about a homeless man who “escaped” the Covid facility from the fairgrounds (where I lived only about a mile away) and was set up exclusively for homeless it again made me wonder who was being treated at the varying satellite facilities in New York and New Jersey. Something tells me not the insured or the white but what do I know? Well nothing as they don’t tell you shit screaming HIPAA laws. Well wrong again.

Yes folks buried in the article was the policy regarding HIPAA and the ruling on public safety (of which there are many guidelines) .  Good times as this is what I had been looking for when I tried to explain to someone that HIPAA does not apply in the case of COVID as it is highly infectious and back in the day during the height of the AIDS crisis that debate raged as it was believed solely blood born and sexually transmitted.  Then came the Ryan White story and the affect on the blood supply and well game on and hence the law in New York that if you have had sex in the last 6 months you cannot donate blood despite that all blood regardless of donors sexual history is tested for any disease including AIDS.  That is called the work-around. And of course with Covid that is contagious via close contact,  the same way but without sex, meaning that coughing, sneezing, drooling, vomiting, diarrhea,  heavy sweat (as in a fever) makes this virus virulent and highly transmittable.  No it is not again in the air like measles, whooping cough or TB all by coming into contact via the air.  Covid is  flu like and that means close prolonged contact.  So keep moving and when out wash your hands immediately upon returning from those essential errands, then clean the surfaces that anything you brought in touched and dispose of those items, toss the gloves, the mask in the trash or in turn wash your mask after wearing and then finally clean your skin, such as a face or exposed areas again to eliminate any potential infection.  But no the virus is not floating in the air in the same way airborne diseases are unless again in a confined space.. you know the ones I keep mentioning.  But if you live in an apartment or home with others they have to follow the exact same protocol which means intense cleaning and agreement on that policy and good luck with that.  You might want to escape too.

I am all for my civil rights being ignored in a public health crisis and in a state of emergency, again 9/11 anyone. And that little office that housed ex-patriot Edward Snowden, is an example of what they did in the surveillance state. We have the capability and technology, Stingray’s anyone?  All available to monitor and track and trace people. So to have corporations such as Google and Apple come up with an App for that, I say no thanks.  Sorry but no. They are already underfire for either not providing or providing such information to law enforcement to use at their discretion and those cases of SWAT arriving at doors and taking down bad guys has worked out so well or not. What.ever. you decide.  And that is the problem, the lack of consistency, oversight, regulations and other issues that well ended up with stop and frisk, the drug wars and the new Jim Crow and the incarcerations of black men. It ends up with immigrants being detained for no actual crime and of course just innocent people getting caught in the crossfire.  So no thanks on that one.

I don’t take my phone anywhere.  I have a daily journal that I mark where I go and what I did that day and in turn most likely would provide that info if asked but most likely I would also tell the usual suspects whom I do contact regularly what my status is.  I also would do the testing at a private physician to speed up the results and also keep them private as unless I go to a hospital as it is a need to know basis and who needs to know?  I also know that as I am single, a woman and without an advocate I would be shoved onto a ventilator or put in some satellite facility as I don’t have health insurance.  So yes death panels do exist.   It is also why the journal along with all my directives, will and the like sits on my desk.  I have no ICE and there is no need as I am quite clear and there can be no confusion with it clearly marked and dated.  It is also notarized and updated annually.  So I have learned first hand how neglectful and abusive hospitals are.  Ask me about my experience at Harborview Medical Center in Seattle in 2012. They treated me like animal and I will never cheer medical personnel for as long as I live as a result.

Why this is so bad is  because right now no one is tracking, testing or tracing.  A woman here in Jersey City died from a heart attack brought on by an asthma attack; she originally was turned away from a hospital as she did not exhibit ALL of the symptoms(as if anyone does), got worse and by the time she returned to the same facility she was too ill and died.  Her death is listed as the result of a heart attack. Okay then, as she was never tested even in post mortem and yet since that time 9 others in her same building have all tested positive, a sort of mini hot zone if you will.  None of them knew about the other and there you go and the building was not cleaned or even touched to reduce the spread from day one.. at least in my building where we “know” of three units none of the staff knew until after and they are pissed, one quit.  So there you go. So much for public safety. Again the virus from symptoms to actual affects on the body varies and so if you are in at “at risk” group you should be tested immediately if one symptom is present, not because of a checklist, and in turn if you have other health issues immediately put on a 24-48 hour watch (many times it is week two when all hell breaks lose)  and that can be at a satellite facility with close contact upon release to ensure you are receiving appropriate, contactless care and in turn tested upon having no symptoms. That has not happened and again if it has what are the numbers for those cases and the results?

So why would you not escape as you aint’ getting shit. And neither are we.  And I would be happy to allow these facilities or organizations and hotels that are open of these kind of business to be available to treat all kinds of COVID patients and the like if they are just that, equipped, trained and able to do so.  Not so sure about that either as if you are short of PPE, etc then what do they have and are they able to do anything but handle the most minor of cases and if they do code then what?  So if this is about public safety and tax dollars we have the right to know and HIPAA has allowed us that much so cough it up… pun intended.

Tennessee, Nashville health officials provide names of those testing positive for coronavirus to police

Natalie Allison and Yihyun Jeong, Nashville
 Tennessean May 8, 2020

Gov. Bill Lee says the state’s release to police departments and sheriff’s offices the names and addresses of Tennesseans who have tested positive for the coronavirus is necessary to protect officers’ lives — information that is also being independently shared between city health officials and police in Nashville.

Lee told reporters at Second Harvest Food Bank in Nashville on Friday the details are only for those working “from a law enforcement standpoint” to know who has tested positive.

“We believe that that’s appropriate to protect the lives of law enforcement,” Lee said when asked why police need the information

The Tennessee Lookout, a new nonprofit news organization, first reported the agreement between local law enforcement agencies and the state Department of Health, which is releasing the information.

The agencies receiving lists from the state of individuals who have contracted the coronavirus include the Knoxville Police Department, the Nashville Airport Authority, the Montgomery County Sheriff’s Office and dozens more.
Nashville health officials share coronavirus patient data with police, fire officials

Separately, in Nashville, the Metro Health Department confirmed to The Tennessean Friday that officials have been providing to the Metro Nashville Police Department the addresses of people who have tested positive or are quarantined for COVID-19.

The data is inputted into the police department’s computer system so that any officer who has contact with an individual who has tested positive for the virus can take additional precautions, Metro Health spokesperson Brian Todd said.

Metro police spokesman Don Aaron said in a similar statement the department uses the information so officers can “take additional precautions.”

The information is also put into the Department of Emergency Communications dispatch system so that fire and EMS workers responding to an address can take steps to use increased personal protective equipment and distancing protocols.

“At no time is this data shared with the U.S. Immigration and Customs Enforcement (ICE) or the Davidson County Sheriff’s Office,” Todd said in a statement.

In a statement, Cooper spokesperson Chris Song reiterated Todd’s comments, and said the information is “safely kept” among Metro agencies.

“We are taking necessary precautions to protect both our first responders and our residents, including those who are part of Nashville’s diverse immigrant communities,” Song said, adding officials are communicating with community partners that the information will not be shared with federal immigration authorities.

“As Mayor Cooper has stated repeatedly, everyone deserves to feel safe in our community, including our front line personnel and the valued members of our immigrant communities,” he said in a statement.

Though the data isn’t not shared with the sheriff’s office, the health department said if a police officer arrests a person who has tested positive for COVID-19, they will inform sheriff’s personnel when releasing them into their custody.

All public safety personnel have been noticed that the information cannot be publicly released and is for “official use only,” Todd and Aaron said. Unauthorized use is a violation of Metro police policy.

The information is updated regularly, and once a person has recovered from COVID-19, they are removed from the list.

According to the Tennessee Department of Health, as of Friday 68 police chiefs and sheriffs have signed on to a memorandum of understanding that they will receive a running list of names and addresses of individuals in Tennessee “documented as having tested positive, or received treatment for COVID-19.”

The list is updated for law enforcement each day, the MOU states, and individuals’ names are removed from the list after 30 days.

Metro police and the Davidson County Sheriff’s Office have no plans to move into an agreement with the state, according to both Aaron and Todd.

Hedy Weinberg, executive director of the American Civil Liberties Union of Tennessee, criticized the policy’s impact on privacy and said it’s more important for law enforcement “Protecting the health of first responders is certainly an important priority. However, as public health experts have noted, disclosing names and addresses of positive cases does not protect first responders, as many people have not been tested and many people who do carry the virus are asymptomatic,” Weinberg said in a statement.

“Disclosing the personal information of individuals who will never have contact with law enforcement raises fundamental concerns about privacy without yielding a significant public health benefit. It is incumbent that any government policy implemented during the pandemic be grounded in science and public health and be no more intrusive on civil liberties than absolutely necessary.”

The Tennessee Immigration and Refugee Rights Coalition has worked during the pandemic to reduce barriers preventing immigrants statewide from getting care and have formally partnered with Metro Nashville and other organizations to increase more community outreach.

In a statement posted on Twitter Friday, TIRRC said the state’s policy to share information with law enforcement should be “rescinded immediately.”

“This completely undermines all of the work organizations like ours are doing to encourage people to go get tested. This will exacerbate the public health crisis,” TIRRC said.

The group did not immediately respond to a request for comment about Nashville’s policy.

Lee said Friday the state was providing this information to law enforcement agencies in compliance with guidelines put forth by the federal Department of Health and Human Services.

A document published by DHHS’ Office for Civil Rights states the HIPAA Privacy Rule permits an entity like a health department to release protected health information to first responders “to prevent or lessen a serious and imminent threat to the health and safety of a person or the public.”

Shelley Walker, spokesperson fro the Tennessee Department of Health, said in a statement the department “believes these disclosures are necessary to avert a serious threat to health or safety.”

More than 14,000 people in Tennessee have tested positive for the virus.

Lee defended the information only being made available to law enforcement and not other front-line workers, such as grocery store employees who also must interact with possible coronavirus patients, by saying that officers are “required to come into contact with these people.

“We know that first responders are required to and law enforcement are required to come into contact with these people as part of their job,” Lee said. “That’s why Health and Human Services gave that guidance to states and that’s why we’re implementing that.” to focus on offering officers proper protective gear as a way to keep them safe.

“Protecting the health of first responders is certainly an important priority. However, as public health experts have noted, disclosing names and addresses of positive cases does not protect first responders, as many people have not been tested and many people who do carry the virus are asymptomatic,” Weinberg said in a statement.

“Disclosing the personal information of individuals who will never have contact with law enforcement raises fundamental concerns about privacy without yielding a significant public health benefit. It is incumbent that any government policy implemented during the pandemic be grounded in science and public health and be no more intrusive on civil liberties than absolutely necessary.”

Doctor Do Little

Below are several articles about Nashville’s health care industry and to say they are not healthy are an understatement.

Music City in between drawing Conventions and Bachelorsluts is largely a health care city.  Vanderbilt combing the Hospital (a entity of its own) and the University is the largest employer and then the hospitality trade, Ryman Group, are also large players and in turn so is Nissan and Bridgestone for what it is worth are in the top 10.  The varying hotels and businesses that cater to hospitality are of course the most significant under-liar in the core of employees and we have seen that industry take a huge hit of furloughs and layoffs.  Only Las Vegas tops the list of that area followed by the larger tourism capitals which includes New York and New Orleans.   There is no counting across the country about that particular industry and how bad it is hit now and will be coming forward.

But the medical industry deserves special attention as that is largely the main contributor to the white collar industry that makes an economy diverse and is used to attract the like so in this case as Nashville tried to once again pivot and reinvent itself it was that business that gives a pretty face to the truths, that it is a city of largely young, ill educated and poorly trained workforce.  But by adding the data from the medical and the legal field (again it is state capital and that inflates those numbers artificially as well) it gives a higher median income in which to present a nice package of lies.  And no one lies like a Southerner.

Two are filing for Bankruptcy, one has furloughed staff, a CEO has taken pay cuts and one is selling off hospitals to meet analysts needs.

Again we have had a problem with regards to medical care for decades, from the vulture capitalists buying up practices and hospitals, to the closing of rural facilities and lastly public funding for public health has all lead up to this – a shit storm.

The crisis in public health can be told in this story from the New York Times from a public hospital in Ground Zero of the pandemic.  Just yesterday a Doctor from New York who contracted Covid after treating patients decided to end her life.  So as I watched Doctors and other “front line”workers comment and share their grief one comment stood out: “I did not sign up for this.” Well bitch, yes you did.  When you entered the medical profession that oath “First Do No Harm” was one you took and yet repeatedly over the years we have heard one horror story over another about the failures of the medical system to protect and not do harm. The endless stories of fraud and malfeasance over Medicaid and Medicare are like legionnaires disease.  Or did you know that Medical Malpractice is the third highest cause of death in the nation?  So now you are in the middle of a major pandemic.  When did you not learn or know of these as they have been happening in this lifetime we just have been lucky – until now.

So again I am not out applauding, go funding or giving one flying fuck about their well being as they have proven time and time again they selectively do so using factors as age, gender, wealth and color to make the life and death panel decisions and are doing so now.  We will never get true and accurate numbers about any of this let alone from hospitals about what is going on there.  They were run for profit and run now into the ground by a storm that makes an F4 (gotta love the F) Tornado seem like a stiff breeze.

Tennessee home of the industry Core Civic that runs prisons and are Corvid outbreaks vs the other kind and of course the Life Care Centers old folks homes that one was ground zero in Kirkland, Washington; their numbers are spread all over the country.   Tennessee is a right to work state that prohibits unionization, collective bargaining, they have incredible OSHA issues on a normal basis, but now especially with Covid, and they have massive other problems that they ignore or simply lie about (all of which I have written about extensively on this blog).  Their own Nashville General Hospital in Nashville had its own controversies and issues  much like the one in the story from New York and this is the same in Harborview Medical Center in Seattle.  Until this massive storm hit we just thought its all good as it ain’t happening to me.  Well in some way even if you did not contract Covid you caught the side effects.

We did this, we need to fix this, we need a single payer health plan and we need to fund health care across the board fairly and equitably and in turn follow that with education.  Private money can go fuck itself when it comes to the greater good.  And this is neither great nor good.

So as you glance at the finances I think we can see how we got here on a slow moving bus across a train track and the train is coming. Bottom line is that money spent on health care needs, fully staffing, training, have necessary equipment and of course allocation for emergent situations are not available to the masses and why the red tape and bureaucracy made this worse. Well we were asleep at the wheel and Jesus was already driving the bus.

Report: Another massive Nashville health care company considers bankruptcy

A second Nashville health care company this month could be headed for Chapter 11.

Envision Healthcare Corp. has hired restructuring advisers and is considering filing for bankruptcy, according to a Bloomberg report. The company is struggling financially as government regulations banning elective surgeries due to COVID-19 in most states have left Envision with few options to manage its $7 billion of debt, according to “people with knowledge of the matter.”

Envision was bought by private investment firm KKR for $9.9 billion in 2018. At the time, Envision was Middle Tennessee’s third-largest publicly traded health care company, with $7.8 billion of revenue in 2017. The company employs more than 25,000 clinicians in 45 states.

Envision is led by President and CEO Jim Rechtin, who was appointed to the job in February, just days before the COVID-19 crisis took hold in the U.S. He replaced long-time CEO Chris Holden.

Envision did not immediately respond to a request for comment.

Envision has experienced a significant decrease in patient volume during the pandemic, across all practices and specialties, according to a news release earlier this month, with decreases as high as 70% in anesthesia services and ambulatory surgery. Despite the influx of COVID-19 patients in certain areas of the country, emergency department visits are down 30% overall.

To counter those headwinds, Envision’s senior leadership team took temporary 50% salary cuts. Non-clinical employees have also seen temporary salary reductions as well as furloughs; in areas where patient volumes are low, clinical compensations were also be reduced.

In addition, performance bonuses, clinician profit sharing, retirement contributions, merit increases and promotions were temporarily suspended for all employees.

Envision has hired law firm Kirkland & Ellis LLP to advise the company of its restructuring options, including a potential Chapter 11 filing, according to the report. The sources said the situation could change depending on the length of the shutdown of elective surgeries and market conditions.

Envision’s debt has been trading at low levels, according to the report, with $1.23 billion of bonds due in 2026 trading for 30 cents on the dollar last week. The company’s lenders have hired their own advisers to negotiate with the company, according to the report.

Earlier this month, Brentwood-based Quorum Health Corp. filed for Chapter 11 bankruptcy in the U.S. Bankruptcy Court for the District of Delaware. As part of the filing, Quorum and its lenders entered into a restructuring support agreement, or RSA, featuring a “pre packaged” plan to reduce the company’s debt by $500 million and recapitalize the business.

———————————
Nearly five years after being spun out of Community Health Systems Inc., Brentwood-based Quorum Health Corp. has filed for Chapter 11 bankruptcy.

The filing was made Tuesday in the U.S. Bankruptcy Court for the District of Delaware, according to a news release. As part of the filing, Quorum and its lenders have entered into a restructuring support agreement, or RSA, featuring a “pre packaged” plan to reduce the company’s debt by $500 million and recapitalize the business.

Quorum and its hospitals will remain open and employees will continue to get paid, according to the release.

“We believe the financial restructuring plan announced today will strengthen our business and enable our community hospitals to continue the important work they are doing in addressing the COVID-19 crisis, as well as serve their patients and communities,” Quorum CEO Bob Fish said in the release.“Quorum Health has been transparent about the need to restructure our debt over the past year. We believe the RSA will significantly reduce our debt and annual interest expense and better position our company, our affiliated hospitals, and our hospital management and consulting company, for future growth. The RSA will also build on the significant progress we have made to strengthen our operations. We are grateful for the support of our financial stakeholders, which we believe represents a statement of confidence in our business and enables us to move through this process on an expedited basis.”

Quorum (Nasdaq: QHC), which has 12,000 employees and was spun out of CHS in 2015, is one of Nashville’s 10 largest publicly traded health care companies, according to Nashville Business Journal research, with $1.8 billion of revenue in 2018. The company has yet to file its 2019 earnings report.

The 24-hospital company has struggled financially over the past 18 months, fighting to buoy its share price as it sells hospitals to pay off debt. The company has received three delisting warnings from the New York Stock Exchange in the past year due to the company’s share price trading at less than $1 over a consecutive 30-day trading period and because its average market capitalization was less than $50 million over a consecutive 30 trading-day period.

Shares of Quorum were trading at 30 cents per share Tuesday morning, giving the company a market cap of $10 million.

Quorum had been considering a proposed recapitalization and buy-out of its public stock at $1 per share from private equity giant KKR, which owns more than 9% of Quorum’s outstanding shares and is the largest holder of its debt.

—————————————————-

Nashville health care stocks are taking a beating from COVID-19.

HCA Healthcare Inc.’s stock price has lost nearly half if its value since its 2020 high of $151.04 per share, dropping 48.7%, to close at $77.46 per share Tuesday. Shares of HCA haven’t traded that low since November 2017.

HCA is not alone as stocks across industries have plummeted in recent days due to fears and precautions taken to slow the spread of coronavirus across the U.S. On Monday, the Dow Jones dropped 12.9%, its worst percentage drop since 1987, while the S&P 500 dropped 11.9% and the Nasdaq fell 12.3 %.

Many of the companies inside Nashville’s $46.7 billion health care industry are on the front lines of efforts to stop the spread of the virus and care for patients who fall ill from COVID-19.

HCA (NYSE: HCA) is the nation’s largest hospital operator, with more than 180 hospitals and 2,000 sites of care. Brookdale Senior living Inc. (NYSE: BKD), whose residents are particularly vulnerable to COVID-19, is the nation’s largest senior-living community operator, with more than 750 facilities in 45 states.

The List
Largest Public Health Care Companies in Nashville
Ranked by Revenue 2018
Rank Name Revenue 2018
1 HCA Healthcare Inc. $46.68 billion
2 Community Health Systems Inc. $14.15 billion
3 Brookdale Senior Living Inc. $4.53 billion

Brookdale’ stock price has also been hit hard due to COVID-19, dropping more than 76% from its 2020 high of $8.39 per share, to close at $1.99 per share Tuesday.

A little more than a month ago, SmileDirectClub’s (Nasdaq: SDC) stock was trading at $15.33 per share. The company’s stock closed Tuesday at $4.89 per share, a 68% drop.

Acadia Healthcare Company Inc. (Nasdaq: ACHC), Community Health Systems Inc. (NYSE: CYH), Change Healthcare Inc. (Nasdaq: CHNG) and Quorum Healthcare Corp. (NYSE: QHC) have all seen their share prices drop by more than 50% from their 2020 highs.

While analysts expect most stocks across industries to eventually recover their losses, no one is sure how long the bear market will last.

“I’m buying a lot of things including bank stocks, although I own a lot of banks. I do think it’s an opportunity. I think we’re likely to have a recession, but I think it’s going to be V-shaped. This is all about the virus,” former Wells Fargo CEO Richard Kovacevich said in a CNBC report. “I mean, we’re talking about markets and so forth, but job No. 1 is we have to get this virus under control. We know how to do it. Other countries have done it. And it can be solved relatively quickly. [There] may be a lot of disruptions in our lives to do that, quarantines and so forth, but this is not a financial crisis. It’s not a banking crisis. It’s a health crisis.”

________________________________________________


Franklin-based Community Health Systems Inc. is selling a trio of Southern hospitals.

CHS has agreed to sell the 231-bed Abilene Regional Medical Center in Abilene, Texas, and 188-bed Brownwood Regional Medical Center in Brownwood, Texas, to Hendrick Health System, according to a news release.

CHS has also agreed to sell its 84‑bed St. Cloud Regional Medical Center in St. Cloud, Florida, to Orlando Health, according to a separate news release. Orlando Health already held a minority ownership interest in the medical center and will purchase the remaining portion through the deal. Terms for both deals were not disclosed.

CHS (NYSE: CYH) is Nashville’s second-largest publicly traded health care company, with $13.2 billion of revenue in 2019. The company has closed, sold or agreed to sell more than 90 hospitals since 2017 to pay off debt incurred as a result of its $7.6 billion purchase of Florida-based Health Management Associates in 2014.

Tennessee hospitals, many of which were struggling prior to the Covid-19 pandemic, are losing approximately $1 billion per month during the crisis, according an analysis conducted by the Tennessee Hospital Association.

The state’s hospitals typically generate $1.7 billion of revenue per month, according to a news release.

Last month, Gov. Bill Lee banned elective surgeries at health care facilities across Tennessee in an effort to conserve dwindling medical supplies. Those surgeries, such as knee replacements, typically have higher margins than other medical procedures.

“Tennessee hospitals have taken all of the appropriate steps to conserve resources and create capacity for COVID-19 patients,” THA President and CEO Dr. Wendy Long (who is a member of Lee’s Covid-19 task force) said in the release. “These facilities have maintained expensive operations in preparation for and to serve Covid-19 patients while experiencing a dramatic drop in volume and services that typically comprise their core business. This creates a paradox of hospitals experiencing severe financial strain when their services are most needed.”

Across Tennessee, hospitals have had to adjust to the decrease in revenue, with several systems such as Williamson Medical Center furloughing workers due to reduced patient visits.

In early April, Nashville-Based HCA Healthcare Inc., the nation’s largest hospital operator, announced its senior leadership would take a 30% pay cut until the pandemic subsides to avoid layoffs, with CEO Sam Hazen donating the next two months of his salary to HCA’s charitable fund. Last week, Boomberg reported than Nashville-based Envision Healthcare is considering several options, including bankruptcy, as it struggles with decreases as high as 70% in anesthesia services and ambulatory surgery.

“In 2018, 71 hospitals in Tennessee had operating margins that were 2% or below, and 60 had zero or negative operating margins,” Dr. Long added. “It doesn’t take a pandemic to stress the system, and Covid-19 has made the situation much more difficult for many of our hospitals.”

The state has deployed $10 million to help rural hospitals survive the pandemic. The federal CARES Act has more than $100 billion reserved to help the hospital industry, although it is not clear how much of that will go toward Tennessee hospitals.

During its first quarter earnings call last week, HCA said it expected to receive approximately $4 billion in accelerated Medicare payments thanks to the CARES Act.

“Recent funding opportunities for hospitals that are being made available at the federal and state levels are very much appreciated lifelines to this vital industry,” Long said in the release. “However, the reality is the impact is so massive that more assistance will be needed in order to ensure continuity of operations at hospitals and provide a necessary level of care. Now more than ever, Tennesseans need their hospitals to remain open and caring for their community.”

Vent This

The histrionics over ventilators is because the hospitals need quick fix and bandaids to treat numerous patients at a time with minimum effort and expedite them through.  When you read of the Doctor in Seattle who contracted COVID and his overall care it was extensive and intense. They won’t be doing that for anyone or everyone.  It is is neither cost nor labor efficient.

Want to be intubated.. fuck you no.  Say no.

Why Ventilators May Not Be Working as Well for COVID-19 Patients As Doctors Hoped

By Jamie Ducharme
Time
April 16, 2020 7:00 AM EDT

New York City emergency-medicine physician Dr. Cameron Kyle-Sidell sparked controversy when, two weeks ago, he posted a YouTube video claiming that ventilators may be harming COVID-19 patients more than they’re helping.

“We are operating under a medical paradigm that is untrue,” Kyle-Sidell warned. “I believe we are treating the wrong disease, and I fear that this misguided treatment will lead to a tremendous amount of harm to a great number of people in a very short time.”

Weeks later, claims from Kyle-Sidell and like-minded doctors continue to spark impassioned debate within the medical community, with some doctors moving away from the use of ventilators and others defending the current standard of care. What’s clear, though, is COVID-19 patients on ventilators aren’t doing as well as doctors would hope—and health care experts are scrambling to fix it.

Mechanical ventilation always comes with risks: a tube must be placed into a patient’s airway to deliver oxygen to their body when their lungs no longer can. It’s an invasive form of support, and most doctors view it as a last resort. Under the best of circumstances, up to half of patients sick enough to require this type of ventilation won’t make it.

But for COVID-19, the numbers are even worse. Only a small portion of COVID-19 patients get sick enough to require ventilation—but for the unlucky few who do, data out of China and New York City suggest upward of 80% do not recover. A U.K. report put the number only slightly lower, at 66%.

Doctors like Kyle-Sidell (who TIME could not reach for comment) argue these numbers are so high because physicians are ventilating patients as though they have a condition called acute respiratory distress syndrome (ARDS), when they in fact have a different type of lung damage that may not respond well to mechanical ventilation. A group of European physicians submitted a letter to the American Journal of Respiratory and Critical Care Medicine, published March 30, detailing COVID-19’s discrepancies from typical ARDS and calling on doctors to avoid jumping to unnecessary mechanical ventilation. Other physicians say mechanical ventilation can help some patients, but doctors are jumping to it too quickly, potentially subjecting patients to unnecessary traumatic treatment when they could use less-invasive respiratory supports like breathing masks and nasal tubes.

But Dr. David Hill, a pulmonary and critical care physician who treats COVID-19 patients in Waterbury, Conn. and serves as a volunteer medical spokesperson for the American Lung Association, says arguments against COVID-19 ventilation have been over-simplified. It may be less that ventilators aren’t the proper treatment for coronavirus, and more that they’re not a panacea for a pandemic that has pushed the health care system to its breaking point, Hill argues.
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“You have really sick people, [while] the people who have the best training are in short supply and ventilator management is not simple,” Hill says. If a dedicated lung specialist were available for each patient, he believes, outcomes would probably be better. They could make the subtle adjustments required for effective long-term ventilation, or try less-invasive options and only move to intubation when absolutely necessary. But with many hospitals nearly at capacity, last resorts can become first resorts.

High ventilator mortality rates in New York City suggest “a health care system failing, and not a ventilator hurting people,” Hill says. (He says telehealth consultations with pulmonology experts could provide stop-gap support for emergency-room doctors.)

Few doctors are saying COVID-19 patients should never be ventilated, but there is a growing subset that thinks it’s happening too quickly. Dr. Nicholas Hill (no relation to Dr. David Hill), chief of pulmonary, critical care and sleep medicine at Tufts Medical Center in Boston and a past president of the American Thoracic Society, says he’s avoiding mechanical ventilation when he can, and finding success with some non-invasive options like flipping patients onto their stomachs, which can trigger better blood flow to the lungs.

He says some doctors are intubating early because they fear that less-intensive forms of ventilation, like high-flow nasal oxygen, can aerosolize a virus, putting health care workers at risk of getting sick. “This is more theoretical fear than a real fear,” Hill says, since there’s not strong evidence that COVID-19 spreads this way.

Tufts’ Hill also points out that patients sick enough to require intubation tend to be those who are older and have underlying conditions. These patients are not only the most likely to experience COVID-19 complications, but also the least likely to do well on an invasive form of support. “That raises the question of whether we should think more about intubating a patient who is very unlikely to do well on a breathing machine,” he says.

Then there’s the issue of how to treat patients who do end up on ventilators. Tufts’ Hill agrees that COVID-19 patients do not behave exactly like they have ARDS, a type of respiratory distress that occurs when fluid builds up in the lungs’ air sacs. The lungs usually get stiff when a patient has ARDS, requiring high-pressure ventilation to support them. But that’s not happening with many COVID-19 patients, Hill says, leading some doctors to fear that the extra pressure is actually damaging the lungs.

Even stranger, some COVID-19 patients who show very low blood oxygen levels still appear to be breathing fairly comfortably, raising even more questions about how much support they need.

Dr. Ken Lyn-Kew, a pulmonologist at National Jewish Health in Colorado, agrees that there are some differences between classic ARDS and COVID-19, but he emphasizes that there’s a lot of variation among COVID-19 patients he’s treated. He says most still meet the criteria for an ARDS diagnosis. In his view, coronavirus patients likely have ARDS plus other issues, but they still have ARDS. With so much unknown, and with treatment protocols being updated on the fly, he thinks it’s too soon for doctors to go off-book and avoid conventional protocols like mechanical ventilation.

“The world is not a dichotomous, black-and-white place, but a lot of people are having trouble with that,” Lyn-Kew says. “We might be able to do better, but in the absence of data on the way to do that, we need to follow our societal guidelines and 25 years of research.

Corporate Medicine

As you stand up and applaud the efforts of the medical profession doing their “best” to combat the Covid virus you need to understand that most medicine is for profit and many are in the present state of laying off non essential workers and in turn closing more facilities in rural areas that would all be able to treat an overflow of patients or be facilities for those not infected but needing care or again those seeking non-essential medical treatment.  Well no as that is why Governors are getting Naval ships and turning convention centers and other public facilities as overflow hospitals, of course they are not actually serving in that capacity and shocking, no not really, as like the test itself there is a protocol that must be followed in which to transfer and receive said patients. And largely because well they are not HOSPITALS

The tale of these two temporary hospitals is one of disconnect between public expectations and political declarations, and what’s possible to achieve — logistically and medically — under the circumstances. Covid-19 patients can deteriorate rapidly and suddenly, even when they seem to be on the mend, and often require oxygen for days or weeks. With an increase in the severity of cases treated comes the need for more equipment and staffing. And at the moment, it remains to be seen whether either the Javits Center or the Comfort can adequately care for very many of the most seriously ill covid-19 patients, as state and federal officials have indicated is their new mission.

Between the two, there are 1,200 beds available, military officials said — far fewer than the 3,000 described in public statements by Gov. Andrew M. Cuomo (D) or the 5,000 touted in initial media announcements. As of Friday, about 250 beds were occupied, officials said. 

Military officials said they are continually revising their admissions criteria as they’ve had to transform the facilities into ICU-capable covid-19 field hospitals, instead of medical wards to treat noncritical, non-covid patients as New York state initially requested. The slow start, one defense official said, is owed in part to the military being unfamiliar with the local hospitals and the hospitals’ unfamiliarity with the military medical system. 

Initially, both the Javits Center and the Comfort were envisioned as overflow facilities capable of relieving the city’s hospitals of the added burden of providing more-routine care, so they could focus exclusively on the surge of coronavirus cases. But victims of trauma and other ailments vanished from emergency departments as automobile traffic and crime rates — except for domestic violence — plunged. 

“Lo and behold,” said physician Arthur Fougner, president of the Medical Society of the State of New York, “there aren’t that many non-covid patients.”
Everything was upended last week, after an uproar from hospital executives who questioned why these federal facilities were sitting nearly empty when the city’s doctors and nurses were overwhelmed. At first, Javits began accepting covid-19 patients transferred from hospitals, but only those convalescing, which “means they are in the recovery period and less likely to deteriorate and require major medical care,” a military official, speaking on the condition of anonymity because of sensitivities over the matter, said via email. “We had no safety outlet if the patient deteriorated (i.e. no ventilators, no ICU beds, etc.).” 

Yet until the admission criteria were updated this week, the threshold for sending patients to either the Javits Center or the Comfort were so restrictive that few people qualified, said one frustrated New York doctor, who spoke on the condition anonymity to be candid. “The hospitals are housing ICU-level patients in the patients in the lobbies and the cafeterias,” the doctor said, while the Javits beds added “nothing.”lobbies and the cafeterias,” the doctor said, while the Javits beds added “nothing.”

The military has attempted to streamline the transfer process. Because they’re both taking covid patients now, the Javits Center and the Comfort are working as one unit. Military doctors have been dispatched to hospitals around New York City where they help identify potential patients who can be transferred to the temporary sites. A command center within Javits decides whether ambulances ferry them to the convention hall or the ship. 

But even that is a complicated process. The Comfort was built to rescue trauma patients from battlefields and natural disasters. Getting a covid patient who’s attached to a ventilator through the ship’s passageways, which are narrower than a hospital’s, can be time-intensive, according to military officials.

Late in the week, the military patient assessment team sent out an email relaxing the restrictions for sicker covid patients to enter the Javits Center, yet again. What the medical teams were learning was that trying to screen for the most stable patients with this disease was pretty much like playing roulette. “It’s Las Vegas. You just hope you get it right,” said Gonzalez. 

Even under the earlier guidelines, Gonzalez said, several covid patients at the Javits Center had crashed and were being treated in the convention hall’s makeshift ICU. The restrictions on patient numbers, he added, are intended to protect them. “I could fill this place over the weekend,” he said, “but if you ramp up to 1,000 and you don’t do it right, you’re going to have a lot of casualties. . . . There is no blueprint for this.” 

In other words its complicated. And of course in the hysteria to prove which city has the biggest baddest dick in town, more cases began to emerge across the country and the national stockpile of good and equipment that Jared Kushner so grandly explained was “ours” as in apparently the Trump’s are not to be used by the states.. So again more confusion and contradictions.

And while many private hospitals go on with business as usual it shows that before all and end all profit matters most. 

Anguished nurses say Pennsylvania hospital risked infecting cancer patients, babies and staff with covid-19

Heroic effort to treat patients despite rationing of protective gowns, masks and tests

 The Washington Post
By Desmond Butler
April 11 2020

The nurse was pregnant — and worried. But in mid-March, early in the covid-19 crisis, a manager at Moses Taylor Hospital in Scranton, Pa., assured her she would not be sent to the floor for patients infected with the deadly virus. The risks for expectant mothers were too uncertain.

Two days later, she says, the administration changed course, saying the hospital needed “all hands on deck.” The pregnant nurse said she was sent back and forth between the “covid floor” and the neonatal intensive care unit, known as the NICU, where she normally treated vulnerable newborns and recovering mothers.

It wasn’t just her baby she was worried about, she said, but the immunocompromised newborns and mothers who she was treating without informing them that she was also working on the covid floor. Even as she cared for patients symptomatic of covid-19, administrators provided her with crucial protective gear only after tests came back positive, usually several days after she first attended to the infected patients.

The nurse was one of 11 medical staff and union representatives who described from the inside how a hospital in a small Pennsylvania city struggled to protect medical staff and patients during the chaotic early days of the crisis. Seven of the nurses, who work at two sister hospitals in Scranton, spoke on the condition of anonymity for fear of reprisals by the Tennessee-based company that owns their hospitals, Community Health Systems.

Like many hospitals across the country, Moses Taylor wasn’t prepared for the influx of highly contagious patients in the absence of vast quantities of protective gear. But measures taken by CHS to cope with the crisis stand out. The shortage led administrators to initially order staff to work with suspected covid-19 patients without adequate protection and to shuttle back and forth between floors where they feared they would infect cancer patients and babies, nurses say.

Staff interviewed by The Washington Post said that they were speaking up out of concern for what they see as a perilous situation and out of anger over the disorganization, carelessness and greed that they say flows from a distant corporate owner.

The nurses and representatives of their union said that many of their safety concerns were dismissed as recently as last Friday, April 3, during a meeting with the hospital administration. But on Tuesday, after CHS was contacted by The Post, the hospital announced several changes in policy to prevent the spread of infection.

The hospital’s chief executive, Michael Brown, said in a statement that covid-19 has been an unprecedented challenge that required frequent changes and that the hospital is following guidelines from the Centers for Disease Control and Prevention.

“None of us has experienced a health crisis of this magnitude before,” he said. “We are adjusting and improving our response every day, and I am incredibly proud of all of the ways our physicians, nurses and team members are working together to care for our patients and each other.”

Matthew Yarnell, the president of Service Employees International Union Healthcare PA, the state’s largest union of nurses and health workers, welcomed the changes announced this week, which include designating an employee entrance to the building and screening staff members for fevers before entering and leaving the 214-bed hospital.

But he added in a statement: “It shouldn’t take attention from a national media outlet to move CHS to put the safety of patients and frontline caregivers first.”

The hospital said in a statement that it had implemented temperature checks on April 4, but a memo to staff this week obtained by The Post says they went into effect April 8.

With 99 hospitals in 17 states, CHS is one of the largest for-profit health companies in the U.S. But through spinoffs, sales and closures, the number of hospitals in the chain has fallen from over 200 in 2014. CHS has been facing sizable debt, and its share price has more than halved since the pandemic began to take hold in February.

“Over the past few years, we have made significant progress in our operational and financial performance, putting the company back on a positive trajectory with future growth potential,” Tomi Galin, the head of corporate communications for CHS, said in an email. “Since 2016, we have been divesting hospitals to pay down debt and also to create a stronger core portfolio for the future.”

The years have been good for CHS chief executive Wayne Smith, whose total compensation has ballooned in recent years to $8 million, including stock awards and incentives, according to the Securities and Exchange Commission.

After being contacted by The Post for comment on this story, the company filed a document to the SEC stating that Smith was voluntarily taking a 25 percent cut to his base salary, which was $1.6 million last year, and that other executives were taking a 10 percent cut. The company said in a statement that the pay cuts would help pay for a $3 million fund for employees “suffering hardships.”

CHS owns six hospitals in Pennsylvania. In interviews, workers in other CHS hospitals also reported problems over the lack of protective gear and inconsistent policies since covid-19 patients began to be admitted.

Union officials representing the nurses say that they had repeatedly tried to raise their concerns about the dangers to their members and patients but had been mostly rebuffed until this week.

“Anything you say, anything about the coronavirus or that we don’t have enough equipment at the hospital, they’re pulling you into the office,” says Dan Coviello, who works as a surgical tech at a sister CHS hospital in Scranton and is the president of the SEIU PA chapter that represents nurses at that hospital.

Brown, the chief executive, says the company urges employees to speak up about safety concerns and says that they can make anonymous complaints about retaliation to a hotline.

“Our organization does not support or condone retaliation and will address it immediately if such behavior is found to have occurred,” he said.

But Coviello says that employees at the two CHS hospitals in Scranton who have raised concerns about unprotected contact with specific covid-19 patients have been threatened with termination for violating health privacy laws. When he has gone to management with safety complaints from members at his hospital, he says the first question is “What’s the person’s name?” which he says reflects their primary interest in rooting out complainers.

Timothy Landers, a professor of nursing at Ohio State University, says that this kind of pressure on nurses, especially during a health-care crisis, can harm patients.

“If you have nurses who are kind of overworked, overstressed, feeling underappreciated, put upon, not respected or protected by management, then you see all kinds of bad things happen with patient care,” he said.

Galin, the CHS spokeswoman, said in a statement that the company is working around-the-clock to resupply its hospitals with protective equipment.

“First and foremost, we recognize that protecting our caregivers is critically important, and we are doing everything possible to create the safest work environments possible,” she said in an email.

Nevertheless, the union and nurses say those who speak out about problems have been hauled in for disciplinary meetings, had their shift hours cut, or had their schedules changed.

“In the last week, we have members being pulled in to managers’ offices and they’re giving them coaching because they’re speaking out and they want them to be quiet,” Coviello said of his hospital, Regional Hospital of Scranton. “And some got written discipline. And in those disciplines, which I’ve been in, they said that if they continue to speak out, there will be further discipline up to being fired from the hospital.”

A second nurse who works in the neonatal intensive care unit said that fear of retaliation is the reason she could not speak publicly. “That’s why I’ve been so adamant about being anonymous,” she said, “because it’s ugly.”

She and others said say they are losing the very thing that made them want to be nurses — the chance to help the sick and infirm. They say that tensions with management and hospital policies have put them in the impossible situation of endangering the lives of their patients.

“It feels like these guys are loading a gun,” the nurse said. “But we’re the ones who have to pull the trigger.”

When it came to questions about whether pregnant nurses could be removed from duties on the covid floor, one nurse says the hospital’s chief medical officer told her, “Absolutely not.”

“Then it would be only males and postmenopausal women taking care of these patients,” she recalled him saying.

The hospital said in a statement that the allegation took the officer’s comments out of context.

“What he was saying is that the CDC can give no direction at this time regarding pregnant healthcare workers and ‘without CDC guidance, I can’t ask only male and post-menopausal women to care for COVID-19 patients,’” the emailed statement said.

Landers said that there have not been definitive studies on the health risks for pregnant nurses, but he added that hospitals should defer to nurses’ concerns and redeploy them if they are worried about their safety.

Moses Taylor is an acute care hospital with 400 doctors that is best known for its pediatric and neonatal care. With more than 2,500 births last year — an average of 48 a week — nurses were worried about how to deliver babies without infecting their mothers.

As they watched the coronavirus march across the globe months ago, the nurses said they got no guidance and saw no planning from administrators on how it would cope when coronavirus arrived at the hospital’s threshold. Their anxiety was compounded by past experience: Even before this crisis, they said, Moses Taylor was constantly scrimping on supplies and shifts to cover busy wards.

The only sign they saw that the hospital was preparing was when managers began locking away in administrative offices the critical N95 masks and gear that can prevent infection. When one nurse asked a manager what they planned to do if any medical staff were infected, she said she was told: “Well we’ll figure that out when that time comes.”

Brown, the chief executive, disputes that charge, saying that the hospital is being transparent with staff about the covid-19 cases, the supply of protective gear, staffing and “other things that matter to them, because we believe that they need to know what’s happening across the hospital.” Moses Taylor said as of April 8 it was caring for seven patients confirmed to have covid-19 and five patients whose test results were still pending.

Two of the nurses have not spoken publicly about their working conditions in fear of retaliation from their supervisors and hospital management. (Elizabeth Herman/For The Washington Post)

In early March, as the first patients began to arrive, staff say they got different directives every day from their managers on how to protect themselves and patients. Then late last month, a nurse working on a floor that housed the oncology and orthopedic departments ran into the hospital’s chief medical officer, who had news.

“We’d lost the coin toss between us and another floor,” the nurse said. “We were now going to be the covid floor.”

They immediately began staffing the floor with some full-time nurses, while alternating others between departments. Some nurses were going directly from treating covid patients to administering chemotherapy to cancer patients, who would be especially endangered by a covid-19 infection.

The nurse on the orthopedic and oncology floor complained to a supervisor about the risks at the beginning of her shift. The manager told her she would look into the issue and provide guidance at the end of the day — after the nurse would have already treated several cancer patients. She never heard back from the supervisor. “It goes in one ear and out the other,” she said.

Even when the nurses have secured access to protective gear, they said, it has been extremely limited. They were expected to wear one-use masks for five shifts. Some were told to disinfect the masks in between uses with rubbing alcohol that gave them headaches when they put them back on. Others were told to use one mask each time they treated a specific patient and to put it in a paper bag until the next time — a practice that could allow virus particles to migrate, potentially infecting them. They witnessed staff coming out from treating virus patients in protective gowns and then sitting on chairs in the hallway without taking them off.

The hospital says it is following CDC guidance on the use and reuse of protective masks and sent a link to the recommendations, which specifically refer to using paper bags for N95 storage. However, the same recommendations rule out the reuse of masks in such circumstances without sterilization.

“Discard N95 respirators following close contact with any patient co-infected with an infectious disease requiring contact precautions,” the recommendations say. Covid-19 is such an infectious disease, Landers, the Ohio State professor, said.

“That would not be an example of good practice,” he said of Moses Taylor

According to the nurses, the protective masks were only being given out for treating confirmed covid-19 patients. But nurses are often expected to walk into rooms without knowing a patient’s condition.

“They just tell us, you know, go check on and see so-and-so,” one nurse explained. “You have absolutely no idea what you are walking into. No idea why this person is in the hospital. No idea what they have. Nothing.”

The hospital says that since mid-March medical staff has been told to report symptoms, but nurses say managers ignored symptoms they reported on more than one occasion.

In one instance, a nurse with a newborn and a young daughter at home who had been out sick for two days with a fever and a cough reported for duty and asked whether she should get to work, according to two nurses she spoke with. The nurse’s supervisor sent her to human resources. Human resources sent her back to her supervisor, who then took her temperature.

Despite having taken an ibuprofen, she still had a low-grade fever. The supervisor said, “‘Well I’m not worried about it. Just clock it,’” one nurse recounted.

The problems were extensive. One of the NICU nurses said staff had been asking for weeks what they would do if an expectant mother came in with signs of infection. They were given no answer. And then late last month it happened.

“It was literally chaos. Nobody knew what was going on. We had to fight to get N95 masks to take care of this mother,” she recalled.

Then they couldn’t figure out where to take the baby for quarantine. The administration wanted to send the newborn to the pediatric unit, where there was a risk of older children passing on the flu or other illnesses.

Only days after this incident did the hospital offer a written plan for such circumstances, she said.

The hospital says that no newborn or new mother has tested positive following hospital care.

The nurses’ allegations come as hospitals across the country are facing test and mask shortages and a torrent of infections that is stretching their capacity. Concerns similar to those raised by the Moses Taylor medical staff were recently highlighted by the U.S. Department of Health and Human Services’s internal watchdog in a survey of hundreds of hospitals.

The HHS’s inspector general found that medical staff is facing high levels of anxiety. It pointed to one hospital where a staff member who tested positive for covid-19 exposed other employees. It said the hospital did not have enough test kits to screen them. It also found that many hospitals were setting aside best practices for personal protection equipment because of shortages.

“This place actually makes you second-guess your career choice,” one nurse lamented. “As much as I love my job, it’s like, is it even worth it being a nurse and putting these patients at risk? I mean, that’s the biggest concern, you know, at the end of the day, did I give my best care possible? And this place prevents you from doing that.”

Union officials and hospital staff finally met with hospital administrators last Friday, after weeks of complaints about safety. But staff say they got little information. When they asked how many masks the hospital had and how it was distributing them, they were told that the hospital had adequate supplies and would follow guidelines from the CDC.

When they asked for clarity on what employees should do if they came down with covid-19 symptoms, they were told that they were relying on staff to consult their own physicians and to “self-screen.” The hospital would not test staff.

“Self-screening for covid?” one union official asked, incredulous. “Are you kidding me?”

On Wednesday, the hospital began screening the staff.

Laughter the Best Medicine

Excuse/Justification or just wrong. You decide.

Nurses make fun of their dying patients. That’s okay.

The Washington Post
By Alexandra Robbins
April 16, 2015

Alexandra Robbins is the author of “The Nurses: A Year of Secrets, Drama, and Miracles With the Heroes of the Hospital,” which was released this week.

The laughter of the ER staff echoed down the hall as Lauren, a nurse in Texas, talked about a patient who had ingested “a thousand ears of corn,” requiring her to repeatedly unclog kernels from the oral-suction tubing. The episode had earned Lauren surprise gifts of corn nuggets from a respiratory therapist and a can of corn from an EMS technician. But not everyone found the story so funny. When Lauren entered a patient’s room nearby, the patient said to her: “I hope you’re not that insensitive when you’re telling your friends about me later.”

Although patients typically don’t overhear it, a surprising amount of backstage joking goes on in hospitals — and the humor can be dark. Doctors and nurses may refer to dying patients as “circling the drain,” “heading to the ECU” (the eternal care unit) or “approaching room temperature.” Some staff members call the geriatric ward “the departure lounge.” Gunshot wound? “Acute lead poisoning.” Patient death? “Celestial transfer.”

“Laypeople would think I’m the most awful human being in the world if they could hear my mouth during a Code Blue,” Lauren told me when I was reporting my new book on nursing. (I agreed to use only her first name, so she could speak freely about behind-the-scenes hospital life.)

Indeed, while people may readily excuse gallows humor among, say, soldiers at war, they may have a lower tolerance for it among health-care professionals. “Derogatory and cynical humour as displayed by medical personnel are forms of verbal abuse, disrespect and the dehumanisation of their patients and themselves,” Johns Hopkins University professor emeritus Ronald Berk contended in the journal Medical Education. “Those individuals who are the most vulnerable and powerless in the clinical environment … have become the targets of the abuse.”

I strongly disagree. The primary objections to gallows and derogatory humor in hospitals are that it indicates a lack of caring, represents an abuse of power and trust, and may compromise medical care. But in my reporting, I found that nurses who use this humor care deeply about their patients and aren’t interested in abusing their power. Their humor serves to rejuvenate them and bond them to their teams, while helping to produce high-quality work. In other words, the benefits to the staff — and to the patients they heal — outweigh occasional wounded feelings.

Nursing, while noble and rewarding, can be a physically and emotionally exhausting career. Many nurses are overloaded with more patients than the safe maximum. They’re on their feet constantly, moving heavy equipment or lifting patients — in an eight-hour shift, a nurse lifts an average of 1.8 tons. Nurses routinely observe tragedies and traumas, and perform futile care on critically ill patients. Yet through it all, they must demonstrate mental composure, physical stamina and alert intelligence, even if they are berated by patients and visitors, bullied by doctors or shaken by their cases.

Doctors and other hospital personnel are also exposed to death and suffering, but nurses may be more susceptible to the lasting emotional impact. Nurses spend the most time with patients individually and have a hand in every level of their care. A Maryland hematology nurse told me: “If they die, it’s very hard; you have lost someone you became close to very quickly, someone you were cheering to beat the odds. As a nurse, you can’t dwell on your loss. You have other patients who need you. One might think that you would build a tough exterior that doesn’t let the hurt in, but to be truly effective, you can’t.”

One of the nurses I followed for a year lamented that there’s no downtime or debriefing after traumas. “People die on our shift — sometimes several people in one day — and then we just go back to work,” she said.

It’s no wonder that nurses have relatively high rates of depression and anxiety related to job stress. An Emory University study found that intensive care unit nurses experience post-traumatic stress disorder at a rate similar to that among female Vietnam veterans.

While gallows humor may seem crass amid patients who are coping with illness or injury, many nurses depend on it so they aren’t overwhelmed by sadness. A Texas nurse practitioner explained: “Sometimes when something happens that is so awful you want to cry, instead you use black humor to keep from crying.” A Mid-Atlantic nurse told me that while attending to a massive-trauma case, she likes to “take note of the cheery toenail polish color of a patient, or remark that they picked a great day to wear clean underwear for the car accident.” In California, an ICU nurse persuaded a patient with a fake leg to help her prank a new doctor; the nurse pretended the leg was real and shouted that she couldn’t find a pulse.

The nurses I interviewed maintained that situations and symptoms, more often than patients, are the targets of jokes. I learned that some units have a dedicated “butt box” for items retrieved from patients’ rectums — glass perfume bottles, an entire apple, etc. — though after Indiana nurses pulled out a G.I. Joe, the real unfortunate hero assumed pride of place in the nurses’ station.

Researchers at Northeast Ohio Medical University say the patients most likely to be joked about are the ones perceived to have brought on their own medical problems. The California nurse told me: “We all play a game called Interesting Things I Have Found in Obese People’s Rolls of Fat. So far I’m sitting in third with a fork, second place is an ICU nurse who found a TV remote, and the winner is an ER nurse who found a tuna fish sandwich.”

But even when patients do become subjects of derogatory humor, we shouldn’t rush to criticize medical professionals for using it. Bioethicist Katie Watson suggests that kind of humor may result when health-care providers feel powerless to heal. “Derisive joking does the unspoken work of reframing physicians as blameless for their inability to help,” she wrote in 2011 in the Hastings Center Report.

Or it may be about doctors and nurses trying to distance themselves enough to be able to help patients to the best of their abilities. Better that patients are mocked and healed than, well, about to take a dirt nap.

Humor has been shown to decrease health-care workers’ anxiety, create a sense of control and boost spirits in difficult moments. This is important because they must get through traumas intact so they can be fresh and focused for the next patient and the next.

Humor also strengthens the connections between members of a medical team. As Lauren, the nurse who encountered the corn, put it: “It’s a byproduct of being placed in situations where death is common and unimaginable horrors are just another day at work. Gallows humor helps to deal with some of the horrible things we see in a way that bonds us together as a team against the bad stuff.” It lets them express their feelings more easily and say things that otherwise could be difficult to say — which leads to better patient outcomes.

That’s not to excuse all humor by health-care professionals. For example, mocking disabilities and using racial, ethnic or other cruel epithets go too far.

Consider the case of a Virginia colonoscopy patient who says he set his cellphone to record post-procedure instructions and ended up recording his doctors making fun of him while he was under anesthesia. The patient claims that his doctors called him a “retard” and joked that he might have syphilis or “tuberculosis in the penis.” He is suing for defamation and seeking more than $1 million in damages.

“Tuberculosis in the penis” is funny because it makes no sense. But “retard” is an unacceptable word under any circumstances. If the patient’s claims are true, his doctors crossed a line.

Of course, it’s an odd case, because the humor was supposed to be private. Doctors and nurses usually make every effort to ensure that backstage humor stays backstage. But even if occasionally an unintended witness misinterprets the joking as insensitivity, the misjudgment is worth the trade-off. Ultimately, laughter is a useful medicine.

Humor has a place in hospitals, even if it’s dark, even if it’s derogatory — as long as it isn’t cruel. We ask extraordinary things of our nurses and expect them to face horrors and grotesqueries that we cannot. They should be permitted to resort to whatever non-destructive coping measures they need in order to provide the best possible care, even if those methods might seem unprofessional outside of the health-care setting. Humor is a way for nurses to empower themselves and to unite with one another, determined and defiant, against disease and injury. Above all, it is a way for nurses, who are overworked and underappreciated, to locate hope amid hardship — which is exactly what we need them to do.

The Other ICE

We are associating ICE now with the horrific customs agents seizing and deporting unauthorized Immigrants or now how I ask myself if I am having my nightly presser bourbon with our without but the acronym also stands for In Case of Emergency.

Now of late unless prodded I leave blank but often I write my dead dog’s name with my former last name and phone number from Seattle.  Good luck with that one.  But when I was in Nashville undergoing dental reconstruction the first surgery was with General Anesthesia.  So the requirement is that you are accompanied by someone and they remain on site while you under.  Of course this being Vanderbilt and their history of bullshit what was two hours became four but I had hired a Nurse Practioner who stayed to take me home.  She had another client within the hour of dropping me off versus I was to have her stay while I showered and got settled, I was fine and up enough off the drugs to move about and do so on my own.  I had her call me in four hour increments to check on me and by the second one at 11 pm I was fine and told her to come by in the morning to see if I was alive and so forth.  We went for a walk and talked about her observations and my recollections to comprise what was a hate letter regarding the treatment I had including keeping me under too long and in turn not providing me a Valium or some other narcotic that would have dropped my blood pressure prior to administering an anesthetic and putting me risk.  But hey they are HEROES, right?

But as a woman on her own age 60 and with the state of the universe right now I recall this very well with my last visit to Vanderbilt by the Intern/Doctor who performed my last dental implant surgery, the one done so badly it required emergency surgery to correct it.  I said during my pre-op visit I like two Valium before as it calms me down, I am going local as I prefer to be awake as it enables me to get up and around more.  He was “concerned” that I come always alone to the appointments, despite the fact they are dental exams I am not having a kidney replaced but that how did I get there.  I made the mistake of telling him the truth, by Lyft and going home in the same way.  I did not tell him if there was anyone at home or if I had people checking on me that was not his business and again I knew from before that once you walk out the door they don’t care their liability extends only to that point so you can lie your ass off and pay someone to be your “friend” as that is all they care about.  But it was ugly and again led me to blow up and have to have the Surgeon intervene. Here is what happened, I was right.  I said, “I will worry about me and you worry about the implant surgery and making that a success.”  And I was successful on my end, him not so much.  HEROES, right?

And I found the below article from another like myself and in turn reviewing the comments there were some much like this one:

I read this for the sole reason of posting this comment:  Fill-in that line with somebody, anybody.  I didn’t because I didn’t want to bother people and found my bank account frozen and cards not usable.  A doctor I hadn’t met had certified my inability to care for myself and the court had appointed a lawyer from the hallway to oversee my official life.  I discovered this when I tried to use cards to send pizza to the nursing staff at the hospital after I left.  A lawyer was appointed to help me regain my official life, and the initial lawyer sent me a certified check from my account, but put a name in there, really.  No idea how often this happens; when I regained control I never looked back at the incident, but don’t let the hospital think nobody out there knows or cares about you.  

And irony on top of irony one of my Lyft drivers had a similar experience at Vanderbilt with his baby daughter and she was brought in with a rash and inflammation that the Doctor on call thought was a sign of child abuse and they would not release her to the family.  DHS took the child, several thousand dollars later to an Attorney the little girl was remanded back to her family and the rash was an allergic reaction to a product in the home that they were using to clean.  Abuse not at all. HEROES, right?

There are many many stories of this type when a Doctor or Nurse assumes something from the case and in turn decides you are incapable of caring for yourself and others.  My former Attorney attempted suicide in the middle of the corvid virus outbreak in Seattle, his wife and the EMT took him to all places Evergreen Hospital the treating facility for the victims of the nursing home. He was “released” against medical advice as they could not treat or diagnose him given they were sort of kinda of super busy with a deadly virus.  So when they tried to get him to an appropriate treatment facility he was rejected as too high risk even though he was sent home, did not harm himself further and actually took the initiative to seek help.  HEROES, right?

So I am not “alone” in my experience as there were many comments from those like me who had no real meaningful connections and those they had had their own families to look after so what do you do

I live alone and am a once a week office volunteer for a charitable entity that gives needed rides to seniors over 60 (by volunteer drivers) to non emergency medical appointments and grocery stores in the county I live in. As I am over 60, so I could use this service also. But since its not an emergency service,  my younger brother 700 miles away is my ICE.  I can get to a hospital in an emergency since I have finances and insurance to do so.  But getting home is the problem, as no doctor or hospital will release an emergency patient to a paid service like Uber or a Cab. They are afraid that the paid driver will dump you at the curb and not see that you get into your home safely.  Perhaps I should ask one of paid staff at the charity if they would agree to be a local ICE, as I have been volunteering in the office over 4 years. I am not comfortable doing so, but I can’t think of anything else.

Again they don’t care once out the door, that is artifice as when I got home no one from Vanderbilt called or checked on me and when I called the next day to make a post op for the following week I was told they were booked.  Okay why wasn’t that arranged PRIOR to surgery and really why was I told to come in? HEREOS, right?

Again I learned the hard way do it all in advance – medications, post op appointments and and all you need to get them to do their part. You only matter if the check clears and they don’t kill you but if you have no family no worry about malpractice lawsuits. See a positive. So what have we learned here? Be proactive, lie if you have to about the ICE thing and hire people and cover your ass as they won’t have you seen a hospital gown?


I’m single and live alone. And on many forms, I can’t fill in the line for ‘In case of emergency.’

By Elana Rabinowitz
The Washington Post
April 4, 2020

It’s on almost every form you fill out for work, schools, the doctor’s office, the dentist. ICE. Three little letters that could save your life. And every time I need to fill it out, I cringe, I’m single and live alone and especially right now I think of it a lot — do I really have an “in case of emergency”?

In my thirties, I had my first panic attack. It struck out of nowhere in the middle of teaching. One minute I was doing an animated read aloud — the next I couldn’t breathe. My face turned red; my elementary school students began to cry. I had no idea what was happening to me. I was brought to the school nurse’s office, where I hadn’t been since I got a nosebleed in the fourth grade. After several minutes of respiratory problems, I got my breathing regulated, inhaling and exhaling in a brown paper bag, like I was blowing up a paper balloon. The assistant principal with the short brown hair looked at me and asked, “Who can come pick you up?”

And that’s when I realized it — no one could

I have friends and neighbors and family nearby, but I could not imagine any of them taking off work, driving or taking a cab to come pick up a grown woman holding a paper bag in her hand. But she was sitting there in the nurse’s room with her eyebrow raised, demanding an answer.

“Don’t you have someone? Who is your in case of emergency?” she said, irritated. “Let me call a car service,” I said.

She walked me to the station wagon, and I went home to my two male roommates at the time. I never told them what happened. I never talked about it again, but the ICE began to gnaw at me. Who was the first person in my speed dial? Who could I call for help?

Years passed — I moved apartments, changed schools and once again had to fill out those little blue cards with the emergency number. I did what I always did — I put my parent’s names down and prayed nothing would ever go wrong. I was in my 40s now and single, my parents in their 80s. I should not be calling them for help. They should be calling me.
AD

As the weather warmed and I started pulling my hair back more, I began to feel it, a small protrusion, which I ignored at first. But soon the pain became excruciating, a constant throbbing that made it difficult to sleep, move my head and even brush my hair. It went from a bump the size of a pea to a bulge quickly. I had an infection on my head. A big bulbous cyst that could not be ignored. I looked it up online where you could see the famous pimple popper perform the procedure. It seemed gross but harmless enough.

Then I went to my doctor who assured me it was a simple procedure — and wrote me a referral to a surgeon.

“You have a pilar cyst,” he said and then showed me numerous pictures on his screen.

A big sac on the back of my head, covered by my golden locks, went unnoticed for years. Now the pain was unbearable.
AD

“It’s an easy procedure, you might not even need stitches, he might just use glue.”

Nothing to worry about, I thought, and went home and made an appointment for the following week.

I met with the doctor, who seemed friendly enough, a warm man with gray hair who got right to business. He had me lie on my stomach as he began to inject my head with needles to numb it. Then he did his business, one I had watched numerous times on YouTube, like an accident I was grotesquely attracted to. I knew he would cut an incision and then remove the entire cyst — the size of a marshmallow but calcified and stuck in my head. We talked about Europe and travel and still, he was in there — poking and prodding trying to get this sucker out.

“This is really infected.” He said. “It may take awhile.”

Soon he began stitching me up like an old dress — so much for super glue. Finally, he was finished. It was five o’clock in rush hour and I planned to take the subway home. I got up and he began to give instructions I was not prepared to hear.
AD

“Go home and take a shower. You will see a lot of blood,” the doctor said.

Wait — what?

This was supposed to be a simple procedure, but because of the size of the infection and the difficulty in removing the cyst, there was more blood than usual. I would need to go home and wash it out for sanitary purposes and keep an eye on the stitches. If they didn’t hold, or some other unforeseen rupture incurred, I would have to go to the emergency room.

“Blood?” I said.

“Yes, if it does not stop you will need to go to the emergency room. Do you have someone to take you?”

And there it was — nearly a decade later, ICE. The three-letter word, that sounded like a four-letter word. Of course, I had people in my life, including a brother who lived nearby, but as for someone who I could call and would answer the phone, well, I wasn’t sure.
AD

“The emergency room?” I asked again.

“Probably not, but just in case. Otherwise, I will see you in 10 days to take the stitches out.” He said and left.

There I was. Alone. Afraid that my little cyst might cause me projectile bleeding. That all of a sudden, I would be vulnerable and scared and without support. I was going to get an Uber but it was rush hour and I knew the subway would be faster. So I took the train home, hiding my head, turning away from the crowd so straphangers couldn’t see. At home, I pulled my hair back — my neck was covered in blood. Skeptically I took a shower, and as promised the clear water turned crimson. It stopped and I got dressed and sat on the couch.

Who would I call? I thought. What would I do if I had to go to the ER? I started panicking but eventually fell asleep. I made it through the night, feeling frightened and alone, and my head began to pang like someone had knocked me out. The next day, I began calling friends and family to tell them what happened. To my surprise, many told tales of needing to go to the ER alone, and that fortified me.
AD

My father had gone a few days before for heart problems. My closest friend had been once when her kids were small, so her husband had to stay behind and watch them. Others had similar stories.

As this pandemic bears down on us, many people have and will face going to an ER, or even an intensive care unit, alone.

If this is the case, there is a certain comfort in knowing that there are others out there who care and are thinking of you — and in that way you are never truly isolated.

Steps to take when facing a medical emergency

Being single with cancer may mean less aggressive treatment than a married person

I’m 70, single and have a strong support system. But when I got sick, it wasn’t enough.

Harborzoo

I have nothing not one thing to say good about Harborview Medical Center in Seattle Washington. They are dangerous, deadly and utterly decrepit.  Yes I have personal experience in their malfeseance but long before my near death experience at their hands they had a long history/legacy of being a dump of a hospital; However from that I began to actually look into the medical system and Pro Publica has been long established in this so I am not alone in my disdain regarding medical care.  And hence that is why I am persistent in my complaints about the supposed great American medical system. It is if you are successfully treated  then you think in those terms but until you aren’t you dont and no I was not I survived in spite of Harborview not because of them.   It is during times like these I don’t believe many hospitals are very different and this pandemic has exposed them for what they are – insufficient, incompetent, hard-working, sometimes successful, many times not; Over priced, understaffed, under-trained and utterly unprepared for real disaster.  Call them heroes if you choose but I call them medical professionals just doing their job and for some that is less than enough and for others it is more.  I fear going in one of those facilities more than Corvid. 

Harborview Medical is at the center of coronavirus outbreak. Here’s what you need to know

The death of the 54-year-old man at Harborview Medical Center, the ninth announced in Washington so far, has put the Seattle hospital in the spotlight. The hospital says that “potentially exposed staff” are being monitored and screened daily for the disease officially called COVID-19.

Harborview has faced critical inspections of its nursing staff and poor ratings for its emergency room. And this is not the first time the hospital has unwittingly exposed its staff to a disease. Last year, more than 150 workers in the Harborview operating room and the lab were tested and offered antibiotics after a lab worker dropped a test tube filled with potentially deadly bacteria in the hospital.

Days before Washington went onto high alarm because of the novel coronavirus, the 54-year-old man was being treated at Harborview. His caregivers at Harborview didn’t know it at the time, but he was positive for the virus. He died on Thursday

“We have determined that some staff may have been exposed while working in an intensive care unit where the patient had been treated,” UW Medicine said in a statement Tuesday. “We don’t believe that other patients were potentially exposed.”

The patient, who had underlying health problems, had recently been at Life Care Center, a nursing home in Kirkland, under quarantine after at least four patients died from the disease. About 50 people from the nursing home’s more than 100 residents and 180 staff are being monitored, public health officials said during the weekend, the Seattle Times reported.

Here’s what else we know about Harborview:

Major trauma center for the region

Harborview is a 433-bed public research hospital managed by the University of Washington School of Medicine. It’s the only Level I adult and pediatric trauma and verified burn center in the state of Washington, and it serves as a regional trauma and burn center for Alaska, Montana and Idaho.

It’s also the disaster preparedness and disaster control hospital for the city of Seattle and for King County. Last month, Harborview began sending out medical teams to make house calls to test people with symptoms of coronavirus. The five-person team — equipped protective gear, including respirators, full-body gowns and latex gloves — is designed to prevent infected people from coming to the emergency room and exposing others.

“Patients given priority for care include the non-English speaking poor; the uninsured or under-insured, victims of domestic violence or sexual assault; people incarcerated in King County’s jails; people with mental illness or substance abuse problems, particularly those treated involuntarily; people with sexually transmitted diseases; and those who require specialized emergency, trauma or burn care,” its website reads.

The Harborview Capital Planning Leadership Group recommended $1.74 billion in improvements to the facility, including a new tower, a behavioral health building and other renovations. The Seattle Times reports the county plans to seek financing through a bond measure as early as November.

How does it compare?

The U.S. Centers for Medicare & Medicaid Services’ Hospital Compare online ranking system, which tracks hospitals based on things like emergency room wait times, infection rates, costs and patient outcomes, gives the hospital an overall ranking of two out of five stars.

The hospital received poor marks for having a particularly overcrowded emergency department. The federal government noted the hospital struggles with emergency room wait times. It also has a high rate of patients leaving the department without being seen by a doctor and for having a “very high” emergency department volume.

Its rate of healthcare workers receiving a influenza vaccine was 81 percent, around 10 points below the Washington and national averages.

The hospital did have infection rates similar to the national benchmarks, and its death rates for common conditions like heart attacks, pneumonia and strokes were no different than the national rates, the federal government reported.

Lab worker exposes staff to bacteria

Last summer, 158 employees of Harborview were monitored and tested for potential exposure to brucella, a bacteria that can cause the infectious disease, brucellosis

The exposure occurred in an operating room and a laboratory at Harborview, after a lab worker dropped a test tube with brucella bacteria in it, KIRO reported. A patient had been transferred from another hospital to Harborview for an urgent operation and later tests revealed that person had brucellosis.

People can get the disease when they’re in contact with infected animals or animal products contaminated with the bacteria. No employees appeared to have contracted the disease; the workers were offered antibiotics as a precaution.

Data breach

Last year, the hospital was among those linked to a University of Washington Medicine data breach that led to the release of the information of more than 1 million patients.

The files were exposed Dec. 4, 2018, because of “an internal human error,” The Seattle Times reported.

UW Medicine said files contained patients’ medical-record numbers, names, a description of the information shared and a description of who received the data. The reports do not include more detailed personal information such as Social Security numbers, the hospital chain said.

State inspection reports

State inspectors have issued critical reports of the hospital a handful of times, state records show. The reports from the Washington State Department of Health show the hospital, among 90 in the state, was noted for two violations on March 5, 2019, and another on Feb. 15, 2019.

The violations from March include failing to document when and how they moved patients in their beds and around the hospital.

This task by the “patient handling team” was supervised by the nursing department, and is considered important because failing to note how they handled patients “created risk for patient harm” and protected staff from injuries while moving patients.

The March inspection also noted that the hospital failed to ensure a patient who had fractured both legs had received daily skin assessments for signs of discoloration and bed sores. “The patient reported severe to moderate pain levels from fractures, especially movement in bed,” the report stated. “Pain levels interfered with routine daily patient care, including required assessment.”

Recent lawsuit

In 2018, The Seattle Times reported a King County jury issued a $25 million judgment for a woman who went to Harborview Medical Center’s Stroke Center for treatment but became paraylzed during her stay.

Doctors in Montana had sent Jerri Woodring-Thueson to Seattle in October 2013 to get care at the stroke center, which UW Medicine calls the region’s first comprehensive stroke center. Her attorneys alleged her symptoms got worse during the stay and she was largely treated by inexperienced interns and residents, the Times reported.

Blame Anderson Cooper

I jokingly blame Anderson Cooper for my ultimate selection of Vanderbilt Medical and Dental Clinic to do my reconstruction work as it is connected to him via his Mother’s familial legacy. I doubt that Anderson has ever set foot on the campus or inside the medical facility that bears the name of his predecessors and as the University and Medical facility have long split and only share a name I see no reason why anyone would think this hospital is as elegant and as intellectually interesting as either he or his Mother were or are.

Vanderbilt is a medical behemoth in Nashville and largely responsible for some of the reimagining of everything from malls to neighborhoods thanks to their growth and ever expanding footprint in Nashville, a city dominated by many legacy medical landmarks, one tied to the Frist family, another said family with a storied legacy in America. Perhaps one recalls the former Senator from the state of Tennessee, William Harrison Frist; He is an American physician, businessman, and politician who began his career as a heart and lung transplant surgeon. He later served two terms as a Republican United States Senator representing Tennessee. He was the Senate Majority Leader from 2003 to 2007 and nowhere near as divisive as the current Southern leadership. The Frist family founded HCA and in turn is why the area is known for its role in remaking Nashville as more than music city. Bill worked at Vanderbilt and was a successful transplant surgeon and is still affiliated with them and I am sure like all the wealthy families in the area have no interest in day to day operations as their legacy and footprint in contemporary Nashville is secure and well defined. That is the South, where money talks and the people talk out of two sides of their mouth to tell you what they think you want to hear and what they think they need to hear to be believed. Everyone lies in the South like a dog on a carpet on a hot day so they assume you too lie and if not it does you no favors.

The main players in almost every city, especially the South, are defined by “old money” meaning that most of the family earnings are at least three generations old and come from a business or industry started by a senior Patriarch. Think the Rockefeller’s, the Kennedy’s, the Mellon’s and so forth. Then we have “new money” and that is the first generation who created wealth usually already from a well established family but they were not at that level until they hit the big well.  The Gates family define as such as the senior Bill was already a well established Attorney and the same for Warren Buffett whose father was well connected and in turn those connections enabled the son to better the father.  The Nouveau Riche are the current Tech heads like Zuckerberg who simply just got fuck all lucky.

Now the reality is that it takes three generations to piss off the cash and they usually do through a series of bad decisions and often you see that in many families, like the Hilton’s who have Paris that can explain that a name can buy you entry but you still need to work for a living its just the kind of work one does that defines the distinction.  Anderson Cooper has the cache of Vanderbilt but he made his own way through the access that the name provides its just that he chose to actually develop an intellect and manner that demonstrates class is in fact earned and learned.  Try that Countess!  (Watch the housewives of NYC for that reference)

But Vanderbilt is just a name of the past for those in the present and when one thinks of it you think of the school, the football team and the reputation as the “Ivy League” school of the Athens of the South.   A dated reference that has no relevance in the New South as few who live and come from the area go to Vanderbilt let alone any of the schools that encircle the area.  Keep em dumb and they stay stum.   Which is why they rarely vote, have few opinions as those requires thoughts and the ability to think critically, a skill set lacking in the South given its attitude and history regarding public education.   Smarts is for the rich and the rich keep it that way.

I go for my next surgery in a few days the one that was fucked up by the incompetence of the last Intern who was so busy worrying about my Vagina (meaning as a woman how can I function and cope on my own – just fine, thank you.) then the jaw and the bone structure where the implant was being placed. And naturally the implant failed.  A bone graft and implant replacement made simultaneously was done and I was sent on my way pushing back all of my work for another three months. Thanks asshole as he is like all of them in the revolving door of medical care, fuck up one and done.

Vanderbilt has a legacy of problems and a history that includes many issues like the one below.  It is probably why they are pushing back against those who do not want to be anesthetized. Trust me if I had an option on my first run around I would have, they did not even bother to give me a Valium to ease my nerves and were so utterly bizarre pre-surgery that my already high blood pressure was rising and in turn putting me further at risk after keeping me under two hours longer than necessary as they were overbooked. Another problem which they have repeatedly.   My former neighbor who was just out of Nursing school two years earlier was the senior Nurse in the NICU, that must be comforting to parents of at risk babies.   That is nothing compared to all the folks I have seen come and go in my three years there.  I finally quit trying to know names there was no purpose.  Vanderbilt is a dump. But then little in Nashville is anything but.

And this may be why…..

After a patient was killed by the wrong drug, Vanderbilt didn’t record fatal error in four ways
Brett Kelman, Nashville
The Tennessean Published  Dec. 15, 2019 |

Vanderbilt University Medical Center’s actions effectively hid the cause of death of Charlene Murphey for 10 months until an anonymous complaint prompted investigations by federal health officials and state law enforcement.

Charlene Murphey, 75, died at Vanderbilt after being injected with the wrong drug.
The hospital didn’t report the error to government regulators or its accrediting agency.
Vanderbilt doctors falsely told the medical examiner the death was “natural.”

After a Nashville-area woman died two years ago from a grievous medication mistake at Vanderbilt University Medical Center, the hospital’s response obscured the error from the government and the public. Vanderbilt violated state law, reported the patient’s death as “natural” and swore her family to silence, according to a Tennessean review of hundreds of pages of county, state and federal records.

The hospital’s actions effectively hid the cause of death of Charlene Murphey, 75, for 10 months until an anonymous complaint in October 2018 prompted investigations by federal health officials and state law enforcement.

Those investigations detailed how Murphey was accidentally given a fatal dose a vecuronium, a paralyzing medication that sent her into cardiac arrest while she waited for a medical scan in Vanderbilt’s radiology department.

The nurse who injected Murphey with the drug, RaDonda Vaught, was criminally charged with reckless homicide and impaired adult abuse in February, and her case has become a rallying cry for medical professionals who fear honest mistakes will be criminalized. Meanwhile, Vanderbilt, the biggest and most renowned hospital in Nashville, largely avoided repercussions. For the first time, this story explores how the actions — and inaction — of Vanderbilt delayed and hampered scrutiny of Murphey’s death.

In the months after Murphey died in December 2017, Vanderbilt officials did not document or report the deadly medication error in four ways.

Two Vanderbilt neurologists provided false information about Murphey’s death, saying she died naturally from a brain injury, according to the Davidson County Medical Examiner.
Vanderbilt did not report the fatal error to The Joint Commission, an independent organization that accredits the hospital, said a commission spokeswoman. Joint Commission policy strongly encourages but does not require hospitals to report fatal medical errors.

Vanderbilt officials “failed to report this incident” to the Tennessee Department of Health even though state law requires the hospital to do so, according to a federal investigation report.
The report also found that Vanderbilt staff did not document the medication mix-up in Murphey’s medical records, then subsequently provided different explanations for the omission.

More: 4 revelations from our story about Vanderbilt and the RaDonda Vaught case

Vanderbilt officials declined to comment for this story. Spokesman John Howser said the hospital would not speak further about Murphey’s death “to avoid impacting either our former employee’s right to a fair trial or the district attorney’s ability to pursue the case as he deems necessary and appropriate.”

In prior statements about Murphey’s death, Vanderbilt officials stressed the medication error was immediately disclosed to her family. The hospital negotiated an out-of-court settlement that bars those family members from discussing her death or revealing the settlement agreement to anyone.

Vanderbilt officials confirmed the settlement during a public hearing earlier this year.

Charlene Murphey’s grandson, Allen Murphey, 35, who is not part of the settlement, said he thinks the hospital tried to hide its mistake and protect its reputation.

“A cover-up — that’s what it screams,” he said. “They didn’t want this to be known, so they didn’t let it be known.”

Court records show syringes and a vial of vecuronium that have become potential evidence in the trial of RaDonda Vaught, a former Vanderbilt nurse accused of killing patient Charlene Murphey with a medication error.

Vanderbilt leaders have acknowledged their response to Murphey’s death was flawed. During a February meeting with the Tennessee Board for Licensing Health Care Facilities, Vanderbilt Health System CEO C. Wright Pinson confirmed Murphey’s death wasn’t reported to state regulators and said the hospital’s response was “too limited.”

At the same meeting, Mitch Edgeworth, who was then CEO of the hospital, said an internal review of Murphey’s death led to “opportunities to improve the knowledge of our clinicians regarding reporting” to the medical examiner.

The health care facilities board, which oversees hospitals throughout the state, took no disciplinary action against Vanderbilt.

RADONDA VAUGHT: Vanderbilt largely to blame for deadly medication error, attorney says
‘She held us all together’

Charlene Murphey, who lived most of her life in the Gallatin area, was married for nearly six decades to her teenage sweetheart, Sam, and they had two sons, Gary and Michael.

She was the quintessential Southern matriarch who was always quick with a warm smile, a quip or a plate of food, said grandson Allen Murphey.

“She really was the glue of the family. She held us all together,” he said.

Charlene Murphey fell ill on Christmas Eve 2017. She was diagnosed with a subdural hematoma at Sumner Regional Medical Center, then transferred by ambulance to Vanderbilt, where her condition began to improve.

By Christmas Day, she appeared to be on the verge of leaving the hospital, her grandson said. Family members were so confident she was recovering they decided to delay celebrating the holiday until she was back home in a day or two.

“Everyone was saying at that point the best Christmas present ever would be to not have Christmas at the hospital,” Allen Murphey said. “But it didn’t work out that way.”

On Dec. 26, in preparation for her release, Charlene Murphey was scheduled for a PET scan in the hospital’s radiology department. This scan, similar to an MRI, requires a patient to lie still in a tubular machine for about 30 minutes. Murphey was claustrophobic, so a doctor prescribed her a sedative, Versed, to keep her calm.

In court records, prosecutors said Vaught, the Vanderbilt nurse, attempted to retrieve the Versed from an electronic medication dispensing cabinet but could not find it. She then disengaged one of the cabinet’s safeguards, unlocking more powerful medications, documents show, and typed “VE” into the cabinet’s search tool.

She picked the first drug that was offered, documents show. It was not Versed. It was vecuronium.

In court records, prosecutors say Vaught ignored multiple warning signs that she had the wrong drug. While drawing the vecuronium into a syringe, Vaught must have looked directly at a medication bottle cap that said “WARNING: PARALYZING AGENT.”

Prosecutors say Vaught then injected Murphey with the syringe and left her for the PET scan as the vecuronium paralyzed her body. By the time the error was discovered, she had suffered cardiac arrest and partial brain death.

About nine hours later, Muprhey’s family, who were once so confident she was coming home, gathered at the hospital to say goodbye.

“But it wasn’t really a goodbye,” Allen Murphey said with tears in his eyes. “I was talking to her, but she wasn’t there. She was long gone.”

Charlene Murphey officially died at 1:07 a.m. on Dec. 27, 2017, when she was disconnected from a breathing machine.

RADONDA VAUGHT: Health officials reverse decision not to punish ex-Vanderbilt nurse for fatal error

Vanderbilt didn’t report error to state, feds or medical examiner

Vanderbilt staff told Murphey’s family what happened but never documented the vecuronium injection in her medical records, according to a federal investigation report of the death.

One unnamed Vanderbilt official told federal investigators Vaught didn’t document the injection because “everyone was focused on resuscitation” and there was “no opportunity” to update the records, the federal report states. Although Vaught is not named in the federal report, the document states the nurse who gave the vecuronium injection said she did not document it in medical records because she was told by a nursing manager it was unnecessary and would be recorded automatically.

The deadly injection wasn’t reported to the Davidson County Medical Examiner’s Office, which is responsible for investigating non-natural deaths in Nashville. Medical examiner records state Vanderbilt neurologist Dr. Adam Hartman reported the death as having “no foul play suspected” while another neurologist, Dr. Eli Zimmerman, attested Murphey died from “natural causes of complications of the intra-cerebral hemorrhage.”

If a vecuronium injection had been mentioned, it would have immediately triggered an investigation, said Dr. Feng Li, the medical examiner.

“Especially with that kind of medication given, we would have investigated the case,” Li said. “We would have taken jurisdiction.”

Li said he changed Murphey’s manner of death — from natural to accidental — in August 2019 to correct the official record.

Vanderbilt did not report the fatal error to The Joint Commission, said commission spokeswoman Maureen Lyons. The commission did not learn about Murphey’s death until after media reports began the following year. It then evaluated the incident and took “appropriate actions,” which are confidential, Lyons said.

The hospital didn’t report the fatal medication error to the Tennessee Department of Health, which would have then alerted the state Board for Licensing Health Care Facilities and the federal Centers of Medicare and Medicaid Services (CMS). State law requires Vanderbilt to report all incidents of abuse or neglect with within seven days.

Instead, regulators learned about the death from an anonymous complaint in October 2018. CMS responded with a surprise inspection at Vanderbilt, then threatened to suspend Medicare payments if the hospital did not take steps to prevent a similar death. Within days, Vanderbilt created a written “plan of correction” for CMS.

The Tennessean obtained a copy of Vanderbilt’s correction plan in November through a Freedom of Information Act request.

The corrective plan says Vanderbilt changed its medication dispensing cabinets so vecuronium can no longer be accessed by overriding a safeguard.

The hospital also made the process of obtaining other paralyzing medications more deliberate. These medications can only be accessed by searching a cabinet specifically for “PARA” and require two nurses for an “independent double check.” Cabinets display new messages warning these drugs cause “respiratory arrest.”

Vanderbilt also revised policies on documenting medical errors and reporting errors to the medical examiner and the Tennessee Department of Health. Hospital policy now specifically requires a medication error to be documented in medical records and reported to the medical examiner if it contributes to a death. Vanderbilt’s Office of Risk and Insurance Management is now responsible for reporting errors to the health department.

The hospital added instructions to its medication policies, telling medical staff how to monitor patients after giving them drugs. Previously, Vanderbilt’s policies included no such instructions, according to the federal investigation report.

Numerous officials would not comment or answer questions for this story. The Tennessee Department of Health said it would not comment because of pending litigation. CMS declined an interview request and to answer emailed questions. Tennessee Board for Licensing Health Care Facilities officials did not respond to requests for comment. Vaught and her attorney did not agree to an interview. The two Vanderbilt neurologists who misreported Murphey’s death did not respond to multiple email requests for comment. Edgeworth, who left Vanderbilt last year for an executive job at TriStar Health, declined to comment through a spokesperson.

Is this covered?

As the free for all and chaos ensues regarding the Affordable Care Act and will he or won’t he support reform, little changes with regards to the Medical Industrial Complex. I recall an Attorney once reprimanding me for using that term and I laughed and said I can’t take credit for it but thanks. Lawyers dumber than Doctors.

When I read the headline I thought Angelina Jolie has changed her mind or one of the Real Housewives went too far this time. But no this was an accident. Alright then.

And no this is not the first time nor will it be the last.   Think the Criminal Justice system is a hot mess well this is the same industry that shares a lab space. Think about that and what it means when technicians can find you guilty or innocent and in turn destroy your life.  These people are not geniuses who are exempt from stupidity.

Think of all the great Scientists and other minds that are being assembled in the White House that will place your health and life at risk as they choose to believe their science.  That is akin to the statement “my truth” which means what exactly?

The real issue here is that we are sure that Doctors and Scientists are infallible and bad news they aren’t and neither is the Pope.  This comment says quite a bit about how people feel regarding Physicians. 

My collegue’s pregnant wife was told she had a 4-inch ovarian cyst and required surgery. They were Kaiser patients, so the second and third opinions came from within Kaiser. I said to my collegue that I was sorry for his wife and her severe pain, and now facing a surgery while pregnant. He said she had no pain. I was immediately alarmed. How can she have a huge cyst with no pain? He proceeded to tell me about the fancy, expensive schools where these three doctors had gotten their medical training. He said there was an ultrasound that showed the cyst. I said it could be the baby, not a cyst. They put the wife under, cut her open, and there was NO CYST. My collegue recounted their surprise after the surgery. I said, so you are telling me none of these doctors bothered to FEEL this supposed cyst that somehow caused no pain with their hands before cutting her? He said, “I guess not, but they ARE the best.” This couple didn’t even report these dangerous doctors to the medical board. I’m sure they and their fancy parchment are out there endangering people daily. I don’t care if they went to Stanford and Harvard. These guys are idiots

And when Angelina Jolie went all nuts, well further nuts, and wrote about her bizarre need to have a double Mastectomy and Hysterectomy I knew that it was going to be a gold mine for Surgeons – both Oncology and Plastic – as women would run amok getting tested. If you have never watched the Real Housewives of Orange County I suggest you do as I get all my mental health and cancer knowledge via these crazy bitches.  I miss the lunatic star fucker Terry Dubrow who never saw a boob he could not fix.  This is the great mind behind The Swan where debasing and degrading women is a sport in Hollywood just ask anyone!  

But as you can read below it doesn’t work out that well and whoops! I hope she met her deductible. 

Damaged for the rest of my life’: Woman says surgeons mistakenly removed her breasts and uterus

The Washington Post
By Lindsey Bever October 24 2017

Elisha Cooke-Moore had been told she had cancer-causing genes.

The 36-year-old mother said an obstetrician-gynecologist noted that the results of her genetic testing showed she had a 50 percent chance of getting breast cancer and up to an 80 percent chance of getting uterine cancer, so she underwent a recommended double mastectomy and hysterectomy to try to beat the odds.

But Cooke-Moore, 36, from Gold Beach, Ore., said that months after she had the surgeries, she learned that her medical team was wrong — the test results were negative. Now she is suing Curry County Health District and members of her medical team for $1.8 million.

“I am damaged for the rest of my life,” she told The Washington Post in a phone interview Tuesday afternoon, her voice cracking.

The lawsuit states that Cooke-Moore had a total hysterectomy in August 2016 and, not two months later, a prophylactic bilateral nipple-sparing mastectomy along with breast implants.

During an annual exam in 2015, Cooke-Moore received genetic testing to determine her risk of breast and other cancers. Cooke-Moore said she had expressed concerns to her doctor regarding a family history of cancer, so it was agreed she would be tested for a BRCA 1 and BRCA 2 gene mutation. Although the results were negative, her nurse practitioner misinterpreted them — and Cooke-Moore was told she had the MLH1 gene mutation and Lynch syndrome, according to the medical malpractice lawsuit.

The National Institutes of Health states that Lynch syndrome increases the risks of many types of cancer, particularly those in the colon and rectum, but also ovarian, uterine and other cancers.

Cooke-Moore said her nurse practitioner, who seemingly misread the results, referred her to specialists within the Curry Health Network — gynecologist William Fitts, who performed her hysterectomy and then recommended surgeon Jessica Carlson to handled her double mastectomy and reconstruction. But Cooke-Moore said neither of the doctors independently confirmed the results.

The lawsuit claims that Cooke-Moore’s medical team “continued to negligently rely upon the misinterpreted genetic testing results.”

Cooke-Moore said a doctor even wrote a letter to her children, who do not live with her, urging them to get tested for the mutation.

“I’m dumbfounded. We’re all dumbfounded,” said Cooke-Moore’s attorney, Christopher Cauble. “They all should have caught this.”

Cauble said that in addition to needless operations, his client’s replacement implants were placed during the double mastectomy surgery, prompting at least 10 corrective surgeries to manage complications.

Representatives for the Curry Health Network and an attorney for the hospital and Fitts did not respond to requests for comment. An attorney for Carlson said she could not comment on pending litigation.

Cooke-Moore said she discovered the mistake earlier this year while reading through her test results and noticed that it read “negative.”

“Devastated,” she said, remembering how she felt at the time. “I’m just not sure how you can mistake a negative for a positive.”

If she had it to do over, Cooke-Moore said that she would probably get a second opinion before she agreed to have the surgeries.

More and more, medical experts are encouraging second opinions — not out of distrust, but to ensure that the doctor and patient are making the best decisions.

“Every patient has a right to a second opinion,” Joseph Fins, chief of medical ethics at New York-Presbyterian and Weill Cornell Medicine, told Columnist Steven Petrow, “and it would worry me if a physician was opposed.”

Major hospital systems, including the Cleveland Clinic and Johns Hopkins, even have remote second-opinion services so that patients across the country can more easily seek peace of mind.

Petrow recently wrote an op-ed for The Post titled: “I heard what my doctor thinks; now I want a second opinion. How do I get one?” In it, he bullet-pointed how patients should handle second opinions:

•Don’t be talked out of seeking another opinion by your current doctor or anyone else; this is your decision.

•Be upfront but respectful with your doctor. You are partners in this, and having your doctor on your side makes it easier to transfer your medical records and coordinate care.

•Don’t shop for a specialist who will tell you what you want to hear. You need the unvarnished truth.

•Provide the second doctor with all relevant information in your medical record. Fins warns about the “discontinuity of care if all the facts don’t follow you.”

Cooke-Moore said she was too trusting.

“I trusted my community,” Cooke-Moore said, adding that she has since been diagnosed with PTSD. “I guess shame on me. Maybe I shouldn’t have, but I did.”