Later On

A blog written for those whose interests more or less match mine.

Archive for April 5th, 2021

The health-care industry doesn’t want to talk about this single word

leave a comment »

A clear example of the extent of systemic racism in the United States is offered in a Washington Post column by Ron Wyatt, co-chairof the Institute for Healthcare Improvement’s equity advisory group and faculty for the IHI Pursuing Equity Initiative. Wyatt was the first Black chief medical resident at the Saint Louis University School of Medicine. He writes:

When I write about health policy or speak with medical colleagues about barriers to care, there is one word — and one word only — that evokes a wide range of responses. Some respond with silence; others with avoidance. Some respond with anger and defensiveness.

The word appeared at the top of a paper I submitted to the Journal of the American Medical Association in 2015 with David R. Williams, a professor of public health and African American studies at Harvard University. The title: “Racism in Health and Healthcare: Challenges and Opportunities.”

The editor of the journal at that time, Howard Bauchner, advised us that the word could not be published and that “racial bias” would be substituted into the title before publication. Using “racism,” he said, would result in “losing readers.” As authors and scientists, we compromised. We agreed to the change, and the article was published.

Just a few weeks ago, six years after that decision to compromise, Bauchner and I spoke by phone. He apologized, saying that progress has been made since then.

Has progress been made? JAMA recently announced that following controversial comments on racism in medicine made by a deputy editor, Bauchner was placed on administrative leave on March 25 while an independent investigation is completed.

Entrenched systemic racism — and the deliberate omission of the word in patient safety circles — is the cause of an astonishing level of preventable harm and death among communities of color that have been devalued and discounted for more than 400 years.

The covid-19 pandemic has laid bare the racial inequities of the U.S. health-care system. Too many health-care executives still perpetuate the ahistoric perspective that our country’s model provides safe and equal care for all. Yet the disproportionate number of deaths to covid-19 among racial and ethnic minority groups exposes the systemic and lethal barriers to care.

Last month, a major health-care trade magazine accepted another article that I contributed to with three colleagues, once again with “racism” in the title. When our editor sent us the final authors’ agreement, we noticed the word had been removed from the title and replaced with “intolerance.” This time, we were not willing to compromise. Our editor later informed us that the article would not be published in the May/June issue as scheduled. We were not given a reason.

I have worked all over the United States and internationally as a champion of addressing health inequity. I can say without hesitation — both as a doctor and a citizen — that racism in the United States is a public health crisis.

Having lived in rural Alabama, my family experienced these inequities personally. When my great uncle, who was like a father to me, fell ill, he was taken to a clinic that was segregated by skin color, and was subsequently admitted to a hospital in Selma in 1973. He died one day later. In 2015, I learned he had a ruptured appendix and was never seen by a physician.

I have advised and worked with large, complex health-care systems in the United States, Britain, Australia and Africa. I have collaborated with organizations such as the American Medical Association, the American Hospital Association and the Joint Commission. I have even discussed race as a risk factor for death with White health leaders, such as former president of the Institute for Healthcare Improvement Don Berwick.

Yet, I still sometimes feel that survival mechanism kick in to compromise and veil the truth that structural and systemic racism is a root cause of preventable harm and death across U.S. health care. I have been warned that if I did not continue to compromise, I would be labeled an “angry Black man” and that colleagues would distance themselves from me.

The days of compromise are over.

Solving systemic racism in public health must start with naming it. We must publish the word. We must say the word. If health-care providers are to be competent in caring for communities that have been marginalized and oppressed for centuries, then they must understand the role racism plays in poor health. This includes . . .

Continue reading.

Racists don’t like it when you point out their racism.

Written by LeisureGuy

5 April 2021 at 5:51 pm

Spring is definitely here

leave a comment »

This is another view of the trees that front the building, taken from the other angle and in sunshine. (Note absence of clouds.)

Written by LeisureGuy

5 April 2021 at 3:50 pm

Posted in Daily life

‘We found a baby on the subway – now he’s our son’

leave a comment »

Be ready for a surge of emotion as you read the BBC report by Lucy Wallis that begins:

It was around eight o’clock on 28 August 2000, just past the frenzy of the New York rush hour when a subway train rattled down the track into 14th Street station, in the Chelsea district of Manhattan. Danny Stewart, 34, was late for dinner with his partner, Pete Mercurio, 32.

The couple had met three years earlier through a friend in Pete’s softball team. Later Danny had moved in with Pete and his flatmate, but on this summer evening he had been back to his sublet apartment in Harlem to pick up the post.

As Danny was hurrying out of the station something caught his eye.

“I noticed on the floor tucked up against the wall, what I thought was a baby doll,” he says.

He was puzzled – why would a child leave a doll on the ground? – but he continued up the stairs to the exit.

“I glanced back one more time, and that’s when I noticed his legs moved.”

He ran back down the stairs and realised that the doll was in fact a baby boy, wrapped in a dark sweatshirt, with his tiny legs sticking out.

“He didn’t have any clothes on, he was just wrapped up in this sweatshirt. His umbilical cord was still partially intact, so I could tell he was a newborn. I was thinking maybe a day or so old,” he says.

Danny could hardly believe what he was seeing. He couldn’t understand how a baby had been left on the floor, or who could have left it.

The little boy was very quiet, and yet also alert, with big, wide eyes.

“He did look up and I stroked his head and then he whimpered a little bit. It seemed really unreal, the whole situation, and at that point I was trying to alert people to what was happening, but I couldn’t get anybody’s attention.”

Danny yelled out, “Please, call the police,” but almost everyone ignored him.

“I did get the attention of one woman, but she didn’t speak English, so she didn’t really understand what I was saying, even when I was trying to point to the baby,” Danny says. “I think she probably thought I may have been a little deranged.”

This was before the time when everyone had a mobile phone and Danny was afraid to pick up the baby in case he was hurt. So Danny ran up the stairs to the street to a payphone and called 911.

“I found a baby,” he blurted out. Then he told the police where he was located and ran back to check the baby was still OK. He waited for what seemed like ages. . .

Continue reading for the whole story.

Written by LeisureGuy

5 April 2021 at 3:00 pm

Posted in Daily life

Lazy day

leave a comment »

Along with my usual tangerine, pear, and apple, I decided that with my tea (Storm Watcher by Murchie’s, though rather than storm we have a brilliant clear day), I’d have a dragon fruit, which has a pleasant mild taste and is easily scooped from the shell with a spoon, the shell serving as bowl.

I wrote this yesterday, but it was such a lazy day I didn’t get around to posting it. I posting it now with the thought that some readers who have not tried a dragon fruit might be encouraged by the post to give it a go.

One reason it was a lazy day is that I’m all caught up on cooking for a few days, with the refrigerator well stocked with cooked vegetables, greens, beans, and grain, plus makings for a salad if I feel like it.

Written by LeisureGuy

5 April 2021 at 12:45 pm

Posted in Daily life

Why Are Stents Still Used If They Don’t Work?

leave a comment »

Written by LeisureGuy

5 April 2021 at 9:34 am

People “know” a lot of things that are not true — example: the lockdowns caused a rise in suicides

leave a comment »

Written by LeisureGuy

5 April 2021 at 9:21 am

Yaqi’s “cashmere” knot with Love Bombs and the Stealth

with one comment

I think the fragrance name is intended as an adjective modifying a plural noun, but my ear-mind connection keeps construing as a sentence with a singular subject — as in “People say love solves things, but often love bombs.”

Be that as it may, the lather is excellent in composition (it’s the CK-6 formula) and fragrance (Dark Chocolate, Rose, Rosewood, Bergamot, Tea, Orange, Lemon, Black Pepper, Ginger, Palo Santo, Vetiver, Cedar, Tobacco & Rose Absolute). Unfortunately, this was a limited-run soap and it is no longer listed on the Phoenix Artisan website, though perhaps some vendors might have some stock on hand.

The brush is interesting. It’s a 22mm knot (the bunny/Easter-egg brush I used Saturday had a 19mm knot), but feels a bit smaller because the bristles are so very fine. It’s an unusually fine and soft brush, though with reasonable resilience. I would say that the difference in feel between a silvertip badger and a Plissoft knot is about the same as the difference between a Plissoft knot and this knot. 

In terms of actual performance, it does a fine job: it loads easily and works up the lather well. But I’m certain that many men will say that it’s too soft on the face (speaking of the feel of the brush and not the resilience of the knot). I like it, though I like it in the context of enjoying variety and having many other choices available. I think it’s worth noting that Yaqi titles their catalog entry as “Yaqi 22mm Soft Cashmere Synthetic Hair” (emphasis added).

I have other brushes with a gentle feel from having a fluffy (and resilient knot) — the Mühle silvertip, my G.B. Kent BK4, the custom brush with the snakewood handle, the Fine Classic — but this brush is not the same: the knot is not fluffy but reasonably dense. It’s simply that the bristles are so very fine that it is soft, but with the density the knot doesn’t have the quick give, the immediate yielding that the gentle knots have. This knot stands up to pressure more than do those.

If you like variety, it’s certainly a brush worth getting, and it will define one extreme.

The shave itself was excellent. This time I particularly noticed presence of the pre-shave on the second pass, but the entire shave went well — two-day stubble, good prep, and the Stealth pretty much guaranteed that.

A splash of Love Bombs, and the week’s underway.

Written by LeisureGuy

5 April 2021 at 9:08 am

Posted in Shaving

<span>%d</span> bloggers like this: