Hanging Out With Adm Beaufort

This has been our day, watching Typhoon Krovahn work its way up the Beaufort Scale.

Will Durant on Marriage

The love we have in our youth is superficial compared to the love that an old man has for his old wife.

Will Durant

Great Library Furniture

If I had enough floor space, I think some of this furniture would have to come live with us.

Big Cozy Books

Rice Harvesting

We spent the day with a group of other home schoolers over in Chiba, harvesting rice. It turned out that we even got to harvest the same field that the group had planted earlier in the year. Way cool trip, even with handing everyone in the group down to the kiddos a sharp sickle.

The field was also home to all sorts of creepy crawlies, which had the kids entranced trying to catch various mantises, grasshoppers and walking sticks.

We really had a great time. I'll try to post some pictures and semi coherent naturalist thoughts about it in a couple days.

Did I Miss a Crime Wave at the Grand Canyon

Arthur Frommer was evidently taken aback by the idea of citizens in Arizona wandering around with guns in accordance with the state’s open carry laws.

I am not yet certain whether I would advocate a travel boycott by others of the state of Arizona; I want to learn more about Arizona's gun laws and how they compare with those of other states. But I am shocked beyond measure by reports that earlier this week, nearly a dozen persons, including one with an assault rifle strapped about his shoulders and others with pistols in their hands or holsters, were openly congregating outside a hall at which President Obama was speaking to the Veterans of Foreign Wars.

For myself, without yet suggesting that others follow me in an open boycott, I will not personally travel in a state where civilians carry loaded weapons onto the sidewalks and as a means of political protest. I not only believe such practices are a threat to the future of our democracy, but I am firmly convinced that they would also endanger my own personal safety there. And therefore I will cancel any plans to vacation or otherwise visit in Arizona until I learn more. And I will begin thinking about whether tourists should safeguard themselves by avoiding stays in Arizona.

Mr. Frommer pioneered in the area of budget travel. But I think he’s letting his emotions get ahead of his logic. Not only is Arizona not the only state with open carry laws, but while about ¾ of the states homicides were committed with guns, only 10 other states had equal or lower rates of homicide by gun when measured as homicide per 100,000 people. In other words, you aren’t very likely to be murdered in Arizona, but if someone does kill you, he’ll probably use a gun.

It seems that to be consistent, Mr. Frommer should also consider “thinking about whether tourists should safeguard themselves by avoiding stays in” New York, California, Massechusetts, North Carolina, South Carolina, Georgia, Pennsylvania, or Oregon, all states with higher rates of gun homicide for which Mr. Frommer has published guidebooks.

If Mr. Frommer is thinking twice before heading off to Arizona, well I suppose that I will be thinking twice about how accurate his publications are and what viewpoints my travel research dollars are supporting.

I'm not hugely in favor of guns at political rallies. But I don't think that gun owners carrying legal weapons in compliance with state law either openly or concealed represents some threat to tourists. Not exactly the profile for the sort of folks who mug families on their way to Disneyland to rob retirees who are out in their RV.

Government Health Care Prediction

If you want an idea of how government health care reform would play out, take a look at the way that the No Child Left Behind law has affected schools. This is a law that was enacted with bipartisan support after Congress and activists groups proclaimed that there was a crisis.

It had no doubt had some positive impact on students who were in truly failing schools. But this success has come at the price of creativity, depth and innovation for far more students who were in moderatly to high performing schools to begin with.

Teachers dislike it because it reduces the idea of educating the next generation to something akin to following a recipe card. The evaluations do tend to be unrealistic in that the metric is for there to be almost no failing students (do we really think that this is an attainable goal?). Thus far, states have been able to write their own tests and set their own passing rates, but there will be something of a whiplash effect in the coming years as all states are required to be above average.

Parents don't typically understand it or don't know how to access the things that would help their kids, like extra tutoring or transfering to a non-failing school. Studies have shown that school administrations have little incentive to advertise these programs or opportunities, especially when it might mean losing funds for their own school.

I predict that nationalized healthcare would follow a similar curve that education has followed. A generation (maybe two) where it seems to work well, followed by chaos as the system breaks under its own weight. I think that you can already see this happening in other countries where socialized medicine has been around for a longer period.

Discussing the End of Life

Your Life Your Choices is an example of the material used to counsel patients on end of life decisions. This is the type of counseling that at least one version of health care reform would have mandated on a periodic basis after a certain age. It is perhaps well intentioned. But take a close look at the attitude that is cultivated through the booklet.

Page five describes the Larsen family, trying to determine if their patriarch would want continued medical intervention. After the bolded story line comes the following statement. "In fact, Trudy's views were the closest to Mr. Larsen's true opinion. But the family never had a way to find this out." If there was no way to find this out, then how do the pamphlet authors know that Trudy's viewpoint matched her dads? Could it be that it is because this is a fictional family with a fictional story told to make a point? If there were other information, then the family could have made a better informed choice. But in the absence of such information (which of course the booklet is trying to get people to create), there is no way of knowing that daughter Trudy was right and son Bill was wrong.

Page seven describes how different people have different meanings when they say they don’t want to be a vegetable. But are there really that many people who think that when “You sit in a chair and don’t do anything all day” or “You can’t read anymore” is being a vegetable. It seems to me that this is a good argument for an iTunes account and a good list of audio books, not for declaring the end of one’s life. There is a medical description of vegetative, versus minimally conscious . The booklet does not make an effort to correct the idea that not being able to read is similar to being in a bed and non responsive.

Pages 11- Describe various situations where people are unable to communicate their preferences for treatment. It does a great job at demonstrating why these are conversations that should be held long before a person is in extremis. But then the booklet asks the reader to make decisions about what care each person would want. These judgments are to be made in the light of the emotional scenarios just presented. No statistics are presented about how often a person comes out of a coma, how much care someone needs after brain trauma or the quality of life that may be achieved in the years after an accident. In fact, a recent article in The Economist reported a study that revealed that even doctors often misjudge how responsive a coma patient is, frequently labeling them as in a vegetative state, when in fact they are minimally conscious and experiencing short periods of eye or finger response. The error rate may be as high as 40%.

http://www.economist.com/sciencetechnology/displaystory.cfm?story_id=14082037

Of the four scenarios presented, several good points are made about the need to discuss health care and end of life values and beliefs. But it is worth noting that none of the scenarios presents a patient who recovers while his family are arguing over the extent of treatment to provide. When a conflict between the patient beliefs and the family’s actions is presented, it is to show that the family kept them alive too long.

Page 21’s worksheet to help you determine under what conditions your life is worth living are skewed toward the negative. The most positive response available to situations like needing to get around in a wheelchair, being a financial burden on one’s family or living in a nursing home is that it would make life “difficult, but acceptable.” Where is the option for I’m a tough old coot and I still have a lot of offer to my friends, family and community?

There is a general sense that only a life that is hale and hearty is worth living. That being unable to get around, being dependant on family members or even being unable to enjoy one’s favorite books is potential grounds for an end of life decision. This is an attitude that is belied by the incredible life examples of women I’ve known who were confined to wheel chairs and dependant on friends and family. Dottie, Ellen and Anita did not give up on life in the face of difficulty. Nor did they miraculously recover their full abilities. But they showered their friends and family with love and wisdom. Dottie taught Sunday School from her wheel chair and could manage a room of rowdy third grade boys better than any man on his two feet. Ellen taught her two children at home all the way through high school, despite having MS for nearly their entire school careers. Anita was a feisty woman, trapped in her body by MS but who never lost her sense of humor. She was out riding in an antique fire engine the month before she passed away.

I would have been very pleased to see a page in this booklet where the reader was asked to think about a friend or family member who had been injured or gotten ill and lived for years. How had the reader’s life benefited from their experience and love, even if they had never returned to their previously good state of health.

These are conversations that are worth having. But they need to be done from informed positions, not from a point of view that sees less than full mobility, a sense of gloom or a dependence on others as equivalent to a terminal diagnosis or vegetative state.

Hat Tip: The Corner at National Review Online

NBC's Book Lined Study

I caught a snippet of the Today Show tonight. Andrea Mitchell was doing some analysis from a lovely book lined study.

I recognized one of the sets of books over her shoulder. Lovely cream and blue bound hardbacks.

What erudite tomes does NBC have for the deep study periods of their correspondents?

The Bookshelf For Boys and Girls (probably the 1963 edition). They are a great anthology of folk tales, fairy tales, classic stories and biography. I have my own set on the bookshelf not far from the tv. But it still surprised me to see them. Maybe it's Mitchell's actual study and she reads them to her grandkids.

Kids' Novel Writing Club

Lost Cheerio at Little Blue School put together a fantastic set of lessons for a kids' novel writing club. The kids plan our characters, plot, setting etc and then plan out their chapters. Along the way, they earn badges to demonstrate their mastery of the concepts. When they are done, they have an outline ready to go and write.

Even if the kids don't end up penning the next Great American Novel, they will come away with a much deeper understanding of what goes into a book and what to appreciate when they are reading.

This is definitely something that could be well suited for a coop and would probably provide a good study framework all the way into high school.

Homeschoolers in Yokosuka

If you've gotten here because you're thinking of transfering to Yokosuka or because you're already here and homeschooling or thinking of homeschooling, yes, there is a group of homeschoolers that get together on a regular basis.

Kanto Plain Home Schoolers is a private organization that is open to any homeschoolers attached to Yokosuka. We have families living here, at Ikego, at Negishi and in town.

We do a couple group field trips a year (the last few were a visit to the Nissan factory in Ofuna and to a farm to plant rice). We also get together informally twice a month at the bowling alley. We also try to do a curriculum show and tell fair once a year.

Other events are scheduled based on someone having the interest to organize it.

They Died While Woodstockers Partied

During the four days of Woodstock, 109 Americans fought and died in Vietnam.

Personally I know with whom I'd rather be and it isn't with the hippies in the mud doing LSD.

Ask Polititians Questions

I'm dissapointed that I'm missing the chance to go to some of these town hall meetings. I like to talk to polititians.

Last summer I was at a local Greek Fest and my MIL pointed out her Representative, who was going through the crowds shaking hands.

When he got up to me, he shook my hand and said something like I'm John Smith and I'm running for reelection. I asked him what office he was in. That stopped him in his tracks. I'm not sure that it occured to him that someone wouldn't just KNOW who he was. After all he'd been in office for several years.

Then I asked him about his energy policy. I got some platitude about needing to do things to make fuel more affordable. So I asked him how he proposed doing that. Uncomfortable silence. Finally he said something about being in favor of more drilling and exploration.

Then I asked him what his three biggest successes were in his 10 or so years in Congress. He wasn't sure what I meant. So I explained that I wanted him to tell me about the things that he'd gotten passed or blocked passage of or gotten changed that he thought were really important. It took him a minute, but he finally came up with a couple that weren't too bad.

I don't think that he'd done that poorly in Congress. In truth, the voters in his district had pretty much gotten what they'd voted for, unlike some polititians who say one thing campaigning and do something else when votes actually come up. But it sure didn't seem like anyone had really asked him to evaluate his achievements recently. And I did get the impression that he'd stopped thinking of himself as a servant of the voters in his district (assuming he ever thought that) and had moved on to thinking of himself as a congressional leader who should be reelected because of his years of experience (regardless of the achievements in that time period).

Politics is pretty dirty, and I have great respect for the folks I know and admire who have waded in despite the trashing that they often get. But way too many polititians are in the busines of politics because they like the feeling they get from being a person of importance.

If you know someone in the first category, give them all the support you can, there aren't enough of them. They need money, folks to hand stuff out at events and people who are willing to mention the election and the candidate to their friends and family.

When a friend of mine lost a reelection campaign a few years back, we figured out that if 20 people had voted for her and gotten 10 other people to vote for her it would have swung the election. There were far too many people who didn't bother voting or doing anything active to help because they thought it was such a given that she would win.

One of the great evils of our system is that we make it so the only folks willing to endure a campaign are those who are interested in what they will get out of it for themselves.

Government Health Care Isn't a Panacea

About a decade ago, Naval Institute Proceedings ran the article Tricare from the Inside and Out written by Dr. Lee Hieb, an orthopedic surgeon, about why she no longer accepted the military insurance program Tricare. (Proceedings November 2000)

If you will, this is probably the largest government administered health care program in the US, with every active duty service member, active duty family member, retiree and retiree family member as well as reservists on active duty receiving care through its system of doctors, clinics and hospitals.

Some care is provided through reimbursement of private doctors and medical groups. But they have a strict scale of authorized payment and approved proceedures. So for example, with my first two kids, I asked for and received a statement of nonavailability and was able to have prenatal care through a doctors' group that included a midwife. I delivered in a civilian hospital. But I had to pay out of pocket for my ultrasounds because that wasn't covered unless there was a medical necessity.

But you are of course at the mercy of the whims of the system. About five months into my second pregnancy, the doctors group called me to tell me that they were no longer being paid by Tricare. It turned out that a new labor and delivery wing had opened at the local military hospital (about twice as far away as the civilian hospital I'd planned on using) and Tricare had cancelled my non availability statement. They had not, however, told me of this change. In fact, when I called them and complained I was told that they were working their way through the list and would have gotten to me in a few weeks (presumably after I'd had a couple more bills unpaid). I asked by they hadn't sent out a form letter informing everyone affected of the change and potential problem. They said that they hadn't bothered because they didn't think that enough of the addresses were valid (this was the same address list that they'd used to mail out the statements of non-availability in the first place).

Eventually, we did get the non availability statement authorized again, but it took a personal conversation between the head of the ob department at the military hospital and the fleet surgeon on the staff my husband was on. I dread to think of how many other families had the rug jerked out from under them, several months along in a pregnancy. My husband was a mid-grade officer on a fleet staff and I would consider myself to be educated and very confident. Yet I ended each of the phone conversations with the Tricare staff shaking with anger at the cavalier way I was treated. I dread to think of the way that they spoke to younger wives of more junior sailors.

The practice that my midwife was part of, which was one of the larger and more popular practices in the area, with several doctors and two nurses, decided about a month into the go-around with Tricare that they would no longer accept new Tricare patients. When my oldest son was born, it was the incredible ability of their on call doctor whom I credit with making the difference between a live delivery and a still birth. He used a proceedure that he'd used over his then 20+ year career as an OB. But it was so uncommon that every other doctor and nurse on the floor were in the room to see how the equipment worked. If we moved back to that duty station, care through this group would be out of reach for me, because the practice is still not accepting new Tricare patients.

I could go on and on about the contradictions in care. Ultrasounds no authorized for patients with a statement of non-availability but my friend who was being seen at a military facility receiving one at every other visit. A pregnancy a few years later in another city were non-availability statements weren't authorized at all because of how many beds the labor facilities at the military hospitals had - except when this same friend went into labor on a full night and was refused admission and had to go find a civilian hospital with doctors she did not know (she had to look up the nearest hospital in the phone book during labor). Or the ultrasound nearly insisted upon in the first trimester (for delivery prediction purposes) but refused after five months when it would have had more diagnostic use. Or the other friend who was scolded by a doctor when he objected to his jaundiced son to a bili light that was over a year out of periodicity in its certification (He was told that when he'd been in the military a few years, he'd understand that this was the way things were done - ie a junior officer not questioning a slightly senior officer. Unfortunately for that doctor, my friend was prior enlisted with almost twenty years of service and he ended up with a meeting with the head of the hospital before he was done.)

This isn't to imply that I don't like military doctors. I have actually had very good service from most of the doctors that I've encountered in the military system. But getting to them or trying to figure out the way that payment works if I go outside or fixing a problem if something is entered incorrectly is no better than in any other large health provider. This is not to say that the proposal working its way through Congress would impose a Tricare like system on the whole country.

It is to say that people are people everywhere; some are sensitive and polite and others are pushy and harried. It is to say that while one beauracracy might be trying to make money, another is most certainly trying to save it at every turn. And if patients or patients' families get caught in the grinder, that is just the way the system works. It would be foolish to think that just because the government is in charge that everything would be smooth and trouble-free.

Under the free enterprise system of competition, one practice has a pressure to take care of its patients or they (and their friends) will become the customers of some other practice. Under a government controlled system, you do not have a pressure to keep paying customers. Instead you have the Feres Doctrine and the idea that you can't sue for malpractice because they will provide health care after they make a mistake.

The Power of a Name

One of the loveliest side effects of doing the Outdoor Challenges from Handbook of Nature Study is that I have sharpened my skill at noticing the living things around me. DH says that I now get a certain look on my face when I am looking at a bird. I see the grass along the sidewalk, not as a featureless expanse of green but as clusters of various little plants, here a long grass, here a clover, there a moss, there a tassleflower.

In Reviving the Lost Art of Naming, Carol Kaesuk Yoon looks at the nature of naming and mentally categorizing life that is at the heart of taxonomy.

I see this urge in my kids. They group stuffed animals or trading cards or toy cars in ways that make sense to them. Makes you wonder what Adam was really up to when he was naming the animals. In some pictures this comes off as Adam exerting dominion over the animals. In others it is shown as a futile quest for a helpmate. Maybe it is in part an exercise of some very basic part of what makes us human, and is a reflection of God's image in us.

BTW, don't miss the quiz to see if you can pick out the bird names from the fish names in a language you don't know.

Second Earthquake in 48 Hours

This one was shorter, but felt a bit more intense. It was a lower magnitude but closer.
Seems like maybe we'll be doing and earthquake unit study this week. And making sure that we have bug out bags ready to grab.

Can You Write Laws Better than You Write Surveys?

My congressional representative, Glenn Nye*, has a survey on his website about healthcare. The very first question asks

What do you think Congress should do to solve the health care crisis? *

Pass health care reform that reduces costs, invests in preventive care, and includes a public insurance option along with private insurers

Enact new rules for private insurance companies, but do not include a public insurance option

Keep the current system exactly as it is

The asterix after the question indicates that this is a required field. You can't submit the survey unless you pick one of the three options indicated. But it seems to me that the survey writers left a few possible responses out.

- Pass laws broadening the use of individually selected and funded health insurance such as Health Savings Accounts by giving individuals, not covered by an employer health insurance, plan the tax deductions for premium payments.

- Pass tort reform to limit the costs of malpractice insurance that is driving many health care providers out of practice.

- Eliminate the tax benefits of employer health insurance in order to de-link employment and insurance.

- Encourage the expansion of health care charity such as those that founded many of the hospitals in the US in the last century by providing an extra tax deduction for charitable giving to the organizations that support them.

I actually don't like the way that the tax code is designed to reward certain behavior, but I probably have to resign myself to the fact that it is so designed and will remain that way. Many hospitals in the past were founded by religious organizations, especially by the Catholic church, so I'm sure that some would object to anything that involved them. But if we're writing a survey to find out what constituents are thinking about, then lets get creative.

I'll also point out that the last question in the four question survey allows multiple answers, so more options in the first question should have been possible. The way that the survey is presented, there is no room for people who think that the health care system might be improved but don't see a vast public system or more restrictive rules for private insurers as the main answer.

The biggest missing option is anything that would restore free-market functions to the health care system. Food is not government funded, but I still have lots of options, that can support nearly any foodie whim or diet or religious dietary restriction. I don't see that giving the government expansive control over the way health care is provided is going to give us some great result at lower cost than if someone with a profit motive does it.

*I'm not trying to gripe too much against Congressman Nye. He isn't of my party of preference, but I appreciate the way that he has voted on several issues, including not always voting on the party line (especially when the bill wasn't finalized in a timely manner so that it could be read before it was voted on). I suspect that this survey is one that was provided to a wide range of the representatives from his party. I hope that he puts his critical thinking skills to work on this issue and remembers that he does represents the men and women of his district, not the leaders of his party.

Red Hair and Pain

The last trip to the dentist included a couple fillings and ten shots of pain killer. The dentist kept giving me shots. I could feel my heart racing and could still feel the drill.

Maybe I had a reason for this. It seems that people with red hair have a tendency to a greater sensitivity to pain and often require more anesthetic. I waver between blond and reddish, with a lot of freckles.

On the other hand I did my last labor and deliver almost without painkiller at all, despite its being an induction. Maybe having teeth drilled doesn't deliver the same natural excitement of childbirth.

On Sorting Books

I've been going through bookshelves and trying to triage our books. This is the second or third swipe through. I gave up on the first attack on the books in Rutabaga's room, where most of the kids' books are that aren't in use for school. It was just too much and I needed to get school going.

So that's were I am again. I'm packing up books that we'll use again when Artichoke is older. And I'm trying to just get rid of books that we don't need to keep. I've been posting a bunch of them on Paperback Swap.

I'm having conflicting emotions. On the one hand, it feels good to purge. On the other, it feels like it contradicts the Use It Up, Make It Do, Do Without mentality that I've been trying to foster.

There was a time when I bought any homeschool book that caught my eye, just because I could. After all, even a hefty book budget was less than private school for two or three kids. That has left me with incredible depth of resources, especially in science and history. But sometimes the depth is honestly overwhelming. What good do all the books do if we don't get around to reading them? But then, some of these were probably unwise purchases at the get go and will go forever unused. That goes double if they are getting in the way of my noticing (or finding) other books that I would like to use.

So if I can turn them into credit for something else, even if it is of fleeting interest, then that seems worthwhile.