I'm back!!!!!

Several years ago, two nodules were observed on both of my thyroid glands. You can go elsewhere to find out more about what the common treatment for these growths are but it includes needle biopsies, ultrasounds, and drug treatments using synthetic hormone (i.e. Synthroid).  Eventually, I landed at the Cleveland Clinic and my biopsies (which were ambiguous)  were evaluated using a new medical technology known as Afirma developed by Veracyte ( www.veracyte.com/afirma/ ).  The cells were determined to be suspicious, meaning, in laymen’s terms as explained to me, there was a 30 to 50 percent chance of these cells morphing over to cancer.

Meaning…they are not cancerous now but might be one day. Medical technology..wow!

So…..surgery was scheduled for late in June. It went well except I experienced the loss of my ability to speak, say above a whisper. It was explained to me that in about one percent (or less) of total thyroidectomies this was an experienced risk.

Great.

There is a nerve that runs from your brain to your vocal cords known as the laryngeal nerve. My nerves were not appreciative of activity in their neighborhood so one of them decided to go on strike. I was told this would take some time to repair and there were things that could be done if a self repair did not occur. So, what to do…..well I came home from the Clinic and the day I came home, we experienced the derecho and lost power in our house for 12 days. So, I was distracted and had little time to consider my situation. Everyone I worked with was great. We worked thru e-mail. I was really not very troubled.

I had one major design meeting for a project I’m working on in Las Vegas. It was kind of cool. When I had something to say (to the meeting of 10), I’d raise my hand and everyone would shut up! Yes…..drama. I worked through a major multi-day session for a client using the Adizes methodology and all went fine.

I really was doing pretty well with this whole deal, which sort of surprised me. I mean, this is not like losing your eyesight, but the ability to talk is important but what to do? A biker friend of mine is an ear, nose and throat doc here in town and I finally reached out to him and he said to come right down…I mean that day. Which I did. He put a small camera down my nose and was able to videotape my vocal cords, which are the rascals that make sound and sit at the top of your trachea. My left cord was paralyzed. He took a lot of time with me, more than anyone had to date, and we discussed alternatives…which is essentially watchful waiting and potentially some surgery to force the cord back over to the center with a caulk like product.

I brought up the concept of speech therapy and he thought that would be helpful. I had to leave town on a business trip and left it to Laura to get me an appointment, which she did. In so doing, the speech therapist asked her to read the prescription. My vocal cord was partially paralyzed…a major difference.

So, in early August, I went to CAMC and began speech therapy. There was testing and then I was given a series of exercises and told to stay well hydrated and stop clearing my throat ( a life long bad habit for one’s vocal cords). I practiced my exercises and did what I was told to do and guess what…about 10 days ago I began to speak..more or less normally. It happened really all at once.

And the moral of the story is…………things change. They do and they will. That is the nature of life. Change my friends is constant. And trust me…you’re not the only one that has stuff going on! Now…some folks certainly more than others but we all have "stuff".

I thought this deserved a BLOG entry (at the end of the day, I spent a reasonable amount of time reading about folks that had experiences with total thyroidectomies, so maybe this will reassure someone in an analogous situation. Who knows.)

Resilience. That’s the goal…..and I think I fared pretty well when I could have chosen to go down the rat hole and dream up a very different future.

Thanks for the support and prayers…..you know who you are!!

In the meantime…I’m back!!!

So what does an Owner's Rep do??

One of the services I offer is owner’s representation. I thought it might be helpful to describe the service…perhaps over a few postings.

Ideally, an owner realizes his organization (and this could be her family), is about to become involved in the “constructed environment”. In other words, the organization has some significant interest in building or renovating something….such as an office building, a house, a hospital, a nightclub, an athletic facility…the list goes on. 

So, most owners turn either to a contractor or an architect to perform the roles as their primary trusted advisor. An owner’s representative is a firm that has developed relationships with both architects, contractors, design-builders as well as other professionals (lawyers, realtors, accountants, suppliers, subcontractors).  That is the role I play.

So….let’s review one of my recent projects which was the redevelopment of 209 Capitol Street which was a vacant building and is now the law offices for Bailey & Glasser (this is also where my in-town office is located).

Ben Bailey approached me shortly after he had made an offer on 209 Capitol Street to the former owner (Charleston Urban Renewal Association). I initially reviewed the building to be sure that the building could even be rehabilitated…and if so…for how much. So, I relied upon a structural engineer I knew who first did a kick the tires walk through. He did not see any immediate issues but did see some areas of concern that if the owner did decide to proceed, deserved more significant exploration.

I roughed together a conceptual estimate of the renovations to see if this would even be commercially viable. During this process, I decided to examine the possibility of renovating this structure under Department of Interior guidelines and subsequently receive what would amount to a 30 percent tax credit (20 percent federal and 10 percent state). When the renovation costs and the tax credits looked like they would make sense to B&G (and before the building purchase was concluded), we did some destructive testing, engaged both an architect and contractor on a preliminary basis and submitted a phase one and phase two application to the Department of the Interior. 

So….through my initial efforts…the owner(s) developed an in depth view of this project and prepared themselves to finalize a significant decision…i.e. should they purchase the building and renovate it. 

(More to follow in part 2).

DP's 4 Hour Body (Experience)

For a number of years I have had a goal….probably like many of you…to lose some weight and to also increase my muscle mass. Now….this may come as a shock to some of you as I guess I might reasonably be considered skinny but I had managed to accumulate a fair amount of body fat in my mid section and this accumulated fat was not what I had in mind for my bathing suit bod.

Somehow, I bumped into Tim Ferris book the Four Hour Body. Now…this book has about 400 pages…but it is not a book you need or want to read from front to back. So I read the weight loss section in May (prior to our annual beach vacation) and in day two of my attention to this diet I had a Dexa Scan and learned my percent body fat was 21.7%. 

Now that the baseline measurement was in place, I stayed on the diet as prescribed until my next visit to Physiologix (in my home town, Charleston, WV) for my next dexa scan and the results were great. (Lean mass grew by 2 pounds and pounds of body fat went from 37 pounds to 24 pounds.)  Remarkable.

Too…..as of the date of this writing, I now weigh 164 pounds which is a couple of pounds lighter than I was then…but of note….I have now been on this diet for about 5 months with zero rebound.

So…..if you are in the market for some weight loss……..give the Four Hour Body a look…think you will be happy you did.

Woolworth's Fire

Tony Yunker with GBBN sent me a link with footage from the 1949 Woolworth's Fire. It's incredible.

Happy Holidays!!!!

The New Year might see a rejuvenation of my interest in this Blog...or maybe not!

Anyway....all that aside, I wish you an engaging and meaningful New Year and a holiday that brings you close to your family and friends.

Happy Holidays!!!

Projects/Weekly Review/Next Actions GTD!

In GTD vernacular, a project is a desired outcome that takes more than one action. So, let's say you have an errand...like I do right now....purchase 4 AA batteries....thats a task that gets accomplished in one move...an errand. Laura and I just completed a project I defined a couple of months ago.

The Project was Improve organization of attic so clothes can be easily found by April 15. I'm sure you all have projects like this you'd like to accomplish...and I'm not really trying to illustrate how to complete a domestic task.....but I would like to discuss...at least a bit...how the project was achieved.

I think sometime in January, I defined this project. I thought about the project and tried to accurately define this attic cleaning project...and an accurate definition means...check mark...this project is done.

So..I did that.....and then...every week...in the all important weekly review...I reviewed all of my projects and generally scheduled some next action that would advance this project. Many times that simply meant blocking off an hour on the weekend to work "up there". And I did that....the one hour time frame worked well...enough to get something accomplished and not too much that it felt overwhelming.

Then one of my next actions was @w/Laura (my wife) to work with her to sort some of the stuff that I was not qualified to sort...Christmas stuff and fabrics mostly. So that happened and Laura became inspired and together...while the attic is not perfect....it is way better......the task is complete....and its really neat to be routinely getting things done using my trusted system.

Give it a shot. It works.

Clear Project Definition (Know when you can say Done!)
Weekly Review when you plan the next week's next action
Do the work planned (no...planning alone does not do it)
Weekly Review
One Next Action
Weekly Review
One Next Action
Etc
Check...project done...clebrate...reinforce....on to the next one!

iPhone tech tips

I'm playing a role in the new Basketball Center at WVU which involves me driving back and forth to Morgantown from time to time. I like to have a good handful of podcasts available for these drives and/or a book from audible.com. I drove up yesterday and everything was coming out high pitched and fast....so I texted a friend of mine who manages my tech things and he came up with the fix...thought I'd share.

So...launch your iPod and look at the bar that indicates where your are on your podcast...look all the way to the right and you will see "1X" if normal....."2X" if double time "1/2X" if have speed. Touch it and you can scroll thru these settings. (I was on 2X and wanted 1X).

Viola....and...I just learned this...if you want to take a picture of your iPhone screen...hit the home and on/off button at the same time and you will take a photo of your screen.

That was worth the read...huh?

Thanks Coach Huggins

What a remarkable game yesterday. WVU beats Georgetown and...for the first time in school history, won the Big East Basketball title. I loved the game and really the entire week. What impressed me the most about yesterday's performance was Coach Huggin's post win interview.

Coach's post game interview doesn't seem to be popping up at the moment on ESPN's website...but here is the jist of it. (1) Coach Huggins is very close to tears....and this is not coming from the head....but the heart. (2) And why he is almost crying in his words...is because the kids played their hearts out...played beyond their skill levels....and he is so happy because he is happy for the State.

And I for one am buying this. Many Division One coaches would be crying because they know their resume just got expanded and they are worth more money.

Huggins isn't looking to move. He loves West Virginia and he is inspiring these young men to play beyond their given capabilities. His ability to provide a much bigger mission is paying off and is a great example of leadership we can all learn from.

OK...he's got the X's and O's down...he is a great recruiter....he knows how to build individual skills and conditioning....yeah...and so do about 50 other D1 coaches. But he is leading these young men on a slightly higher mission....win this one for the people of West Virginia....he means it and I feel it.

Great season...great coach...great leader.

GTD and Vacation Protocols

At one point in my career, I was the CEO of a mid-sized design-construction firm which I founded, grew, and sold called Pray Construction Company. At a point in the early to mid 1990’s, Pray Construction really needed a job of some size. We were in the process of bidding-negotiating a major addition to Charleston Catholic High School. We knew we were one of two firms in the final running….and then my vacation (horseback riding in Ireland) presented itself.

So….with my family, we went to Ireland and I chose a style I call “going dark”…meaning I was not going to check in. Now…communications back then were quite different. E-mail was just firing up and cell phones were not at all wide spread. We were “in the west” in Ireland, which meant….from a communications point of view…that the available land lines were few and far between…but you could find one…but I choose not to. Instead of calling in to touch base…I remained anxious and worried about the job….or lack of it. (For the record, we did get the job and the decision was not finalized until I returned).

The point to all of this was I’m not sure I was better off not calling in. Yeah…I was on vacation and was not obsessing like some of my wall street friends that were also on the trip and who called the office everyday (although notably that really changed as the week went on), but I was still anxious.

So…here is what I do now…and I think this is very GTD.

1) First of all….I go on holiday with my in-boxes (electronic and two paper ones) to zero. Now…this is really no big deal for me…I’m at zero several times a week…but it is foundational I think. So…e-mails are either deleted, read or action taken, they are filed for reference, stimulate other actions steps and so forth. But..the in-box is zero.
2) I do a good weekly review just before I leave.
3) I let everyone I’m actively involved with know I’m off for a holiday. You can’t hit all the stakeholders, but you can get the big ones which really helps manage the incoming.
4) I use the out of office assistant to remind anyone sending me an e-mail that you won’t hear back from me.

So…I’m feeling very caught up and ready to leave. This involves work and discipline. Laura and I just went on a one week holiday and I’m sure I worked until 10:00 pm the night before to do all of the above.

My computer stays at home but the iPhone comes along.

I do in fact read my e-mails. If they require action, I move them to a folder on my sidebar entitled “e-mails to respond to”. This helps me delete the junk, stay very loosely up to speed, and sets the stage for re-entry. Plus, and I think this is relevant; I don’t get reminded of my work every time I review my in-box...(as the messages have been physically moved). Plus, I maintain that good feeling of having a zero in box.

I tested this process last summer on a two week holiday and just did it for a one-weeker. Process works well. I try and get back from holidays on Saturday so I can process the e-mails to respond to folder on Sunday. I have likely 50-60 e-mails that required action. This took about 4 hours.

Coming back to my two “cleaned” physical offices effectively supports the re-charging you are hoping for from a holiday. And…I woke up this morning with a zero in-box as well.

I think this method of execution helps support vitality and renewal which is one is one of the things one hopes for from holiday. But…like a lot of the GTD stuff, this works for me and may/may not for you…but perhaps is worthy of experimentation.

Don’t Let the Door Hit you in the Ass on Your Way Out

A good lifelong friend of mine recently sent me a link to the attached NYT article. When he sent it to me I did not read it but felt I would be inspired to write a retort referencing my recent work with the Adize’s Methodology. And I could perhaps do that…..but after reading the article, I actually would have to say right on!

I’ve been around small and mid sized businesses for the better part of 40 years and…as a group…we….businessmen…just put up with too much crap. I’m serious. It’s tough stuff running a business…..right…fun…exciting…rewarding….and I do not think the exclusive focus should be earnings (earnings is a natural outcome of a job well done…maybe), but there is a bit too much bitching going around most shops.

So….got a problem…fine….do me a favor and go find another job. I’m serious…quit. Go share your good attitude and work ethic with one of my competitors.

Happy Valentine's Day!!!

I had all sorts of brilliant topics for BLOG posts, but I got sidetracked uploading photos from my camera to my new 27" iMac. That led to a brief review of all my images from the last year...and this one caught my eye. This is my 2+ year old granddaughter Zoe...photo taken last September.

Happy Valentines all!!...Zoe...is this your first BLOG post??? Well.....maybe the first for 2010.

Working on my GTD System

I first became exposed to David Allen when the Mountain State YPO Chapter brought David to Charleston to present his public one day seminar. I’m guessing this was in 1994. I brought about 6 or 7 employees from Pray Construction Company hoping his system would sweep through PCC.

I’m pretty sure his system didn’t really stick at Pray, but I bought in and continue to practice. I later spent some one-on-one time with David and his wife Kathy on an YPO cruise. David gave me a few telephone coaching sessions with Meg Edwards and she really helped me tune up my Outlook based system. I think I did perhaps two sessions and then went on about my business.

I likely stopped about 2 sessions too early!

Anyway….I lived with my system. Essentially, I used tasks to collect my next actions (calls; e-mails; read; meet with; waiting for, etc). So, let’s say someone sent me an e-mail and this e-mail stimulated a response (that took more than 2 minutes) so I’d drag this mail into the left column in Outlook and into the task folder. When you do that, the mail explodes. You can then input text in the subject line (i.e. 304-744-1111 Jack Jones and then select @calls from your custom designed menu in categories in the lower right corner).

So…..you have the context (@call) and the next time you have time and or desire to make calls, they are all there together. A few things going on here.

1) You can stop thinking about what you need “to do”…in other words your personal RAM is not being bogged down trying to remember all your stuff.
2) I like the electronic system as it is easy for me to keep portable. I use an iPhone and an app called iMExhange. This app syncs up my tasks from Outlook, so again, when I have an appropriate spare moment, whip out the iPhone, see what calls I might make and then make one.

What I was also doing was sorting by due date, which reminded me to make that call on a particular day. So, this also drove me to review my tasks more or less daily and change the date on a number of tasks as they did not get accomplished that day…..and that happened almost every day.

Fast forward to about a month ago when I thought perhaps it might be time for me to pony up and buy some consulting. So, I interfaced with Davidco and hired Julie Ireland to do some telecoaching. Using Go to Meeting, Julie was able to spend an hour with me and look over my shoulder. Essentially she said, “Well…this is very non-GTD”.

Yikes! But wait…I thought I had this all figured out!!!

So…the illumination was as follows:

If it MUST be dealt with on a day, that task goes on the calendar. (In Outlook, launch an appointment, put your to-do in the subject, click all day event, show time as free, and add any supporting stuff below).

So…when you start to Do Work, you look first at your calendar. (If something is going to happen at a specific time, clearly put the time in and don’t select all day event).

Now…..when you look at your calendar, Julie suggested be sure it’s not too clogged up. Three booked hours in a day is about tops. OK…sure…there are going to be exceptions, but if your calendar is booked from start to finish, then you better start learning how to say no.

OK….now my tasks are no longer sorted by date. So, I open up my tasks segregated by categories, and all my stuff to do (say @office), is all together. Based on my appetite and other in-coming I can now choose what to do.

Anyway…….my system was pretty broken and I had more or less learned to accommodate, but was always feeling like I had way too much to do. I was wasting time sorting my tasks by date and then feeling like every day I was not getting done what I “should” have been doing.

If you haven’t given GTD a look……I suggest you consider buying the book and then sticking your foot in the water with implementation. We are all expected to perform at a high level. This helps me get a lot done (i.e. perform) and I feel good while doing so.

And I have my second telecoaching hour with Julie booked for next week.

Great Ride Will!!

If you've been reading this BLOG for a year, you will recall the brief period where I behaved as if I was Will Frishkorn's Charleston based press agent.

Thought you might like to check his status.

I ran into a friend of mine in the last few months and his 15-16 year old son is a talented young rider. His Dad was telling me that he just wanted to be like Will Frischkorn. Will...living proof that your contribution has been deeper than you may realize! Great job and keep it up!

United Breaks Guitars

This proves there is a constructive use of YouTube . . .

A musician named Dave Carroll recently had difficulty with United Airlines. United apparently damaged his treasured Taylor guitar during a flight. Dave spent over 9 months trying to get United to pay for damages caused by baggage handlers to his custom Taylor guitar. During his final exchange with the United Customer Relations Manager, he stated that he was left with no choice other than to create a music video for youtube exposing their lack of cooperation. The Manager responded : "Good luck with that one, pal".

So he posted a retaliatory video on you tube. The video has since received over 6.5 million hits. United Airlines contacted the musician and attempted settlement in exchange for pulling the video. Naturally his response was: "Good luck with that one, pal".

Taylor Guitars sent the musician 2 new custom guitars in appreciation for the product recognition from the video that has lead to a sharp increase in orders.

Here's the video .............

Thanks friend Ralph for sharing.

And Now Onto Solutions

(Photo Frank Gehry)

So...you've created your program of requirements....and it is marked "draft...for discussion purposes only"...but you have begun to connect the left brain to the right brain and...of significance...place your thoughts (and feelings) into a text document which at least makes your conversation with your project delivery folks more meaningful.

I'd like to keep this all simple and arm you with some trade vernacular....you can at least act like you know what you are doing along the line of "fake it til you make it".

So...imagine that you have gone directly to an architect...that's a traditional step. You give your draft of your Program of Requirements to him/her (we'll use him but not trying to make any gender distinctions...ok) and he is already sensing he has a more advanced student/client. You ask for some solutions...or some feedback...or both. Assuming the architect sees some potential with you and or the project, then they will perhaps sketch some elevations and floor plans. They may want some limited compensation and of course this depends about the scope....i.e. adding a bedroom to your house or creating a new office building for your 200 person firm.

This phase of design is referred to as the conceptual stage.

From this exercise you will likely learn:

1) Project is not feasible. Time to be thinking about other alternatives (hopefully you have already done so).

2) We're onto something...but can we do it for the dollars we have in our program? Or can we change this or delete that???? Your on the path.

3) Or...slam dunk....this is exactly what I wanted!

(Option 3 is highly unlikely...but it could happen...particularly if you have a lot of money....I've had hmmm about one client like that out of say 500!) Significantly you will also get a good sense if the architect is someone you can work with....but please....don't confuse bed side manners with skills and abilities.

So...how do you check skills and abilities...well....get a list of ALL of the projects the architect has been involved in for the past say year. Make the calls. Your time will be well spent.....Ask questions...probe..take notes. You'll be glad you did.

So many people hire architects because they have great people skills and can sketch like a wild man...so creative....(very right brain yes). But please.....we need some serious left brain at the table. If it is not all available in one package....which it probably is not....then wait for the next post and we'll add another leg to the stool.

Ready Fire Aim

I used to have a printout of a saying I heard by some YPO speaker printed on the wall of my office at Pray Construction Company and it read "Lack of Planning on your Part Does Not Constitute a Crisis on my Part". Since I've moved on in my career, I'm not sure if in fact that is the case.....meaning that the lacking of planning...while I'd like to disclaim responsibility...the result may fall in my lap...I'm sure you get the drift.

If you are anticipating a project that involves construction which inevitably involves a sizable outlay of your capital and which will drag you into the mysterious world of those that "deliver" projects...either architects or contractors....do yourself a favor....create a text document and call it the Program of Requirements. This is essentially what you want to accomplish with your "capital project". Avoid gong down the path of "solutions" at the moment... (solutions are designs or drawings that actually indicate how to accomplish your "program").

Now your program will include things like adjacency's, activities to be accomplished (ok...just say sleeping), finishes, special equipment, any issues with accessibility (please...if you are doing a residence....take it from me, a wheelchair is not out of the question), natural light, acoustic separation, safety, site considerations (i.e. parking/landscaping/irrigation)...the list goes on.

So....once you have put your program together (by the way...how much you want to invest/spend is part of the program as is the time for execution), you will be much better prepared to evaluate the design solutions.

Now...your program will morph as you learn more or more is revealed as your are educated, but you will be on your way to a well executed project. Recall....starting does not necessarily directly correlate to finishing. Know what I mean??? Plan/plan/plan and then execute. This is a strategy and one I utilize on all my projects...trust me...it works but I know....we just want to get started...OK...don't blame me!

Free Gift to Readers from Adizes...

We would also like to offer your readers a free gift, which is the popular Adizes video, entitled “What is a leader” Please take a look at this link and add it to the end of your post.


www.adizes.com/freegift

Guest BLOG from Ichak Adizes

The following post is from the BLOG of Ichak Adizes chairman of the Adizes Institute. For years I thought my customers really missed the boat on the concept of expressing gratitude. I just thought the expression of gratitude would have been a behaviour that would have gotten a lot more out of me and my team

Glad Ichak put it in this perspective....somehow validates my thinking. (By the way, I'm getting ready to attend a course at the Institute in November which will be very exciting).
____________________________________________________________________________________
I have heard a great lecture by Dr. Douglas Lisle, an evolutionary psychologist who is also training to become an Adizes Adjunct Associate. It was about “Stone Age money” and how it impacts our behavior today.

The lecture gave me some insights I want to share with you.

In the Stone Age, and for a long time thereafter, there was no money or any other means of exchange for barter. So if I did something for you, how would you pay me back? With gratitude, a sense of “I owe you”, and I would expect you to reciprocate.

Those who did most for the village-who hunted the best, and thus fed the village-got the most recognition and became chiefs, or something similar.

This went on for thousands of years. The result is that we have developed this “chip” in our heads, a storage mechanism like a bank account, to receive, store, and pay gratitude.

We need gratitude. Period. It is deep in our subconscious.

Now, what does this need for gratitude mean for management?

It means that merely getting paid for work is not enough. If you just got paid, but the paying party did not show gratitude, you would feel as if you did not get paid at all. You would feel like a prostitute.

Whoa! This was news to me. How often do people say: “You got paid, so what are you complaining about?”

The highest rate of suicide among the medical professionals is among dentists. They get paid in money only; no gratitude for drilling into your teeth.

The highest rate of turnover in the human services industry is among consultants. They just get paid money. No gratitude. Thus, when the question is asked, “what is the oldest profession?” the answer is not always prostitution. Often the answer is consulting.

Hello managers. Wake up. If you only pay your workers money and fringe benefits, you did not pay them in “Stone Age money” and they feel gratitude deficient. Not strange that they are not cooperative. Their deepest need-something that developed and was nurtured for thousands of years-is not getting fulfilled. This can sometimes produce dysfunctional repercussions for the companies we manage manifested in lower morale and productivity.

Always say “thank you,” your mother told you. Listen to your mother, and don’t stop listening for ever.

Sincerely.

Dr. Ichak Kalderon Adizes

Public Health...Part 3

Laura..Dave...Michele...Tom in corridor in St. Vincents...on the way home.

OK….now where were we……Started out reflecting on my experiences involved with public health care….see the previous two entries. Now….would I have rather been home, in America. No question. Did it really matter that much to me what the expense was? Not really. The way our system works is that the expense….let’s project that it would have been easily $175,000 not $21,000…is an issue for the insurance company to absorb.

But, obviously, society ends up paying this price. In England and Ireland, everyone gets health care and clearly this has something to do with this delta. There are differences in the systems…which I got from my roomies. For a lot of procedures and tests, you have to wait and this can be for some time. The facility worked, but I wonder if Americans can ever get used to a six bed ward. Now, I liked it because I’m interested in people and…as I was sort of the sickest guy on the block, they all looked over me. This is not a bad thing and there was a sense of community that was established. I don’t think the public health system cares too much about who you are and/or how much money you have. So….it’s hard to jump rank. I’m not sure how I’d like that on a long term basis but I hope I could successfully adapt…particularly if it meant that everyone in my community (define community however you wish) had coverage.

Enough….on to the next chapter. We were flying Delta and were in business class. When we arrived at the airport…recall it is December 24, our plane was delayed. Anxiety began creeping in. We were flying to Atlanta and only had about 2 hours to clear customs and catch our plane. We finally got airborne. At this point, I was only living with about 5 feet of small bowel. What that means, functionally, is that I had a very difficult time staying hydrated. I’d drink quarts…literally…of sports drink and had to force drinking. While I was hospitalized, I was being given a drug called Sandostatin. This drug is injected subcutaneously in your stomach twice a day and helps with the absorption. Eventually, Laura and some nurse and doctor friends would come to the house and do this (I was too wimpy to learn how to do it). Looking back, they should have coached Laura and sent us out of the hospital with this drug and equipment. The upshot of this all was I got really dehydrated on the plane.

I’m guessing this was likely the second most stressful day for Laura. She was on the verge of crying a good bit. This was tough. We finally landed in Atlanta and had maybe 45 minutes to make the connection. The airport is loaded…Christmas traffic and bad weather. I get seated in a safe place and Laura goes hunting for help. I think she breaks down and a Delta supervisor (angel) takes over. We abandon the customs deal…the bags can just catch up. She gets a golf cart, puts me on it, and before we know it, we are on the tarmac (!!!) driving to the gate…the only way she could figure out to make this work. The plane to Charleston is slightly delayed. We make the connection!!!!!

Now…this is small commuter plane. I’m really fading…but finally we land. They get us off the plane. We have several folks waiting for us…but the only one I really recall was my precious son Josh. I fell into his embrace in the airport. Man….clearly one of the most touching memorable moments in my life.

Down to CAMC General we go. There is very little activity Christmas Eve in a hospital. My great friend Dr. Dave Seidler is there to make this all go quickly. Up we go…private room. They bring in the scales…I’m down to 141 pounds (from 170). I get hooked up to an IV and they run 2 bags thru me. I get the other drugs start flowing…..Laura and Josh make it home and she gets some Granny juice going (this is what granddaughter Zoe calls wine).

I got to admit…this all felt like the Four Seasons. Private room, special attention from the medical staff, family and friends nearby, and TV!!

I sent a letter eventually to Delta. If we had not made that connection, I would have had to go to an ER in Atlanta. I’m sure we would have made it but that was one chapter I did not need to write, if you know what I mean. Our love and eternal thanks to that Delta supervisor.

It’s been interesting to me sort of semi-publically reliving this experience. I’m guessing there is some sort of closure happening. Isn’t the whole new media thing interesting?

There are so many people that helped us. You know who you are or maybe you don’t but thank you! We’ll never forget you.

I eventually end up in the Cleveland Clinic. If I have the energy...I may write that chapter one day. Thanks for reading and for the many off-line comments. Bottom line...somehow....we need health care for all.

Public Health Care.....Part 2

This photo is taken the day before I leave for America! Happy!!!

Ok...so where were we??.....OK....St. Vincent's University Hospital in Dublin, Ireland. I'm fresh out of the ICU where I've been for the last 24 hours after life saving surgery. Big point....I was not at all aware that I came that close to dying....didn't get it. About 3 years prior I'd been in a very bad bike wreck that sent me to the hospital for two weeks. You might say I am experienced and I inaccurately equated the two events I guess. Laura on the other hand, had been told...point blank....50/50 if I was coming out of surgery alive. So...the trauma experience was not really pointed in my direction.

Back to health care....so, the hospital does not have room for me in post surgical care, so I go to the lowest level of care. I show up in a six bed ward...meaning one room...six beds....very simple cloth screen that is occasionally pulled between the beds. Camp like....but with sick folks. I'm unique...i.e. non Irish...so a bit of a celebrity but really not much.

When I show up, I'm basically telling Laura to get me out of here....just what she needed. I was honestly scared. I was not at all sure they would take care of me. It was so different than my previous experiences. We were all equals and there was no pulling rank. I had a good friend that is a prominent citizen in Ireland and the care is all equal. There are private hospitals that I guess are better looking facilities...furniture, privacy, food...but the good docs are here and that's what I need. So I'm here...with my roomies. No TV...all pretty basic.

Here are some bullet points...Roomies....James...age 75....3 packs a day..dying....a wonderful man. An obsessive compulsive character...washes his hands like 15 times a day...had some medical issues but I think it was mostly mental.....a fellow that was there I think because he needed a good meal and a bed...it was like that...he'd go outside to smoke and then one day just walked out.....methadone addict in bed 5......would get VERY cranky if the drugs were not there ON TIME....and a teenager that had very serious kidney problems...a good guy...there were others that came and went. James and I were the old timers. Now I know this would be a BIG ISSUE for a lot of my friends. Honestly, it was all quite entertaining. It was way easier for the nurses and we sort of looked out for one another....or the other roomies did for me as I was the scary sick one.

I'm focused.....if I'm coming out of this...I need to step up and do it. Be a big boy and I think that mind set is important. I really think you need to...if you will...be strong...and I think that singular mind set helps with all the other "stuff" that might be a distraction if you allow it to be.

The facility was just older. Checkout the beds in the photos. There was a pretty good range of skill with the nurses. the day nurses were frankly just great. Felicity, Candy, Penny.....Irish....good looking (sorry...sexist pig present)....fun and kind. I had so many tubes coming in and out of me...I'm not kidding. My abdomen had been opened up...just had to count the sutures...55 and staples. For a few days this would cramp and it was very painful. I had tubes in my nose into my stomach...got pissed one night and pulled em' out. Bad move cause they came and stuck back in.

The night nurses were not as skilled....not as well payed I think...not always Irish...there were plenty of Africans around which was OK but they were just not quite as well educated. I was scared at night early on.

The big time docs are not addressed as "Doctor Smith" they are called "Mister Smith"....now the Misters were a pretty sharp crowd. I was in the unusual position of being an interesting case, so all the big boys stayed in touch. I think I received very good care. I was being anti-coagulated and pumped with expensive antibiotics. There were a few tests too that were happening and there was no communication about letting me out. Christmas was coming and I wanted out....So Christmas is on like a Friday...on Monday I tell Laura....either we get out this week or I'm leaving. Hmmmm.

Well.....and god bless David Seidler my good friend and the Director of Emergency Services at CAMC....Dave worked out a transfer...they would not release me but they would transfer me...Once I agreed to pay 'em and my "Mister" agrees to let me go.

My physician shows up like Tuesday night. It's pretty late...like 7:00 pm. Dark. He is by himself, which is unusual as...as this is a teaching facility...he usually has a team with him. Solo.....he says I can go home....and then he more or less apologizes. Says he almost missed the diagnosis and was afraid that it was too late when it dawned on him what was going on. Can you imagine that very human thing happening in America? He talked to me all about the surgery...felt he had lost me...and I'm there reassuring him...until he left and then I quietly freaked...it all came home that night...or at least most of it. Baby......

The deal with the $$$$ was becoming sort of a deal. As I was not an Irish citizen, I needed to pay for the work, and they wanted the payment before I left (they didn't know I already had a jail break planned...my roomies were going to show the way) Blue Cross was helpful but they really didn't care if I made it home for Christmas or not. But we worked it out...so.....they agreed to pay for ER...emergency surgery...tons of consultants....tests...drugs...room for 17 nights...etc. etc.....and the grand total is.....$21,000. No...not $210,000....$21,000.

You know......that is just so much less than care would have been in America. I still can't believe it. While this setup worked just fine for me I think a lot of Americans would not have liked this at all. There was a TV room where...once I could walk...I would go and watch...you guessed it..ER with the nurses...really.

I don't think Docs and Nurses made as much as they do here....relatively...but that's just a guess. But a big step in this direction just might make some sense and get a ton more care spread around.

So......the next stop was Delta airlines...then on to CAMC and then on to The Cleveland Clinic....so stay tuned.....and please...take care of yourself! Believe me...the story on the the flight home is worth checking back for.