Philadelphia Freedom

Posted on 25 April 2015 | No responses

With a dram of Glenmorangie at hand and a cat on my lap, gather ’round, kiddies, cuz grandpa’s gonna tell you about his last few weeks.

National Quality Summit

Wednesday through Friday, I attended the National Quality Summit sponsored by the National Association for Healthcare Quality. The event, held at Penn’s Landing in downtown Philadelphia, focused on transitions in care. Credit to the NAHQ planning team: The event packed a lot of good information shared by top industry experts like Dr. Eric Coleman and Cheri Lattimer. The more intimate venue — the Summit replaced the longstanding general conference this year — gave in-person and virtual attendees more time to network and more time to think through the QI implications of managing a whole person across every setting where clinical services get rendered.

Health care, as an industry in the U.S., really sucks at transitions; the subject is probably the next big area of improvement on a national scale. Glad to see NAHQ taking a leadership role in setting the agenda.

While I was there, I enjoyed the chance to re-connect with colleagues I’ve gotten to know over the years, because of the small-group lunches, the general reception and the invite-only president’s reception. I met new colleagues, too, thanks in part to a focus group with Abbott Nutrition (and what a learning experience that was — we too rarely include dieticians in our care-planning teams despite the effect of nutrition on readmissions and complications).

The only downside? I wish I would have planned to do some sightseeing. Looks like a lot of fun things to check out in Philly, but I didn’t allot myself enough time to take it all in.

Planning for The 3288 Review

Last week Friday, John, Elyse and I met at John’s charming front porch to start our detailed planning for The 3288 Review, the forthcoming literary journal sponsored by Caffeinated Press. John’s obvious enthusiasm for the project is infectious, and Elyse’s practical wisdom keeps our ambitions on the straight-and-narrow. We’re targeting a mid-August release. Next planning meeting is this coming Monday; I expect (ahem!) Alaric to grace us with his presence.

The Merry Widow

Last Sunday, I trekked to the East Side of the Mitten for a full day of merriment with April. We did brunch at the oh-so-tasty Pantry then drove to downtown Detroit to catch The Merry Widow, an opera featuring famed soprano Deborah Voigt and tenor Roger Honeywell, conducted by Gerald Steichen. We had excellent seats (close enough to peer into the orchestra pit!). The excursion marked my first, but surely not my last, visit to the storied Michigan Opera House.

Funny aside: After the mid-afternoon event, I took April home, but we stopped at American Grand Coney for a quick, informal dinner before I dropped her off. I wore grey dress slacks, a burgundy shawl-collar sweater and white shirt with a burgundy paisley tie (same shade as the sweater, mind you). She wore a stunning black-and-white dress. We sat down in the restaurant and the waitress said something to the effect that she’s never seen such well-dressed customers before, a compliment that made my hot dogs extra tasty.

Célébration au manoir Dimondale

But before the opera, I spent the evening with Tony, Jen, Joe, PPQ and The Good Doctor at Dimondale Manor. We first dined at a local roadhouse, then retired to the palatial estate in the sticks for an evening of snacks, Tony-style mixology and darts. The revelry continued until after 3 a.m., but the chance to spend time with such amazing people was well worth suffering through my 7 a.m. alarm. And although I was displaced from The Blue Room, the air mattress in Jen’s office was astonishingly comfortable.

The Community Welcome

On April 6, the board of directors and a few of our anthology authors enjoyed a “community welcome” sponsored by Schuler Books and Music. We had more than 40 attendees and Schuler sold more than half the stock they purchased. The enthusiasm of the SBM team and the way our guests were so engaged with our presentation and the Q&A session really inspired me. We done did good — and my mom and my nephew even made an appearance!

Sic Transit

Seasons change, and people too. I learned of one workplace transition on my way to Philly. Just before that, I learned that my primary section editor at Demand Media Studios was departing. I wish both of them the very best as their careers take exciting new turns — even as I weep to myself over all the forthcoming changes.

Cards Against Humanity … With Thy Family

On the 3rd, I dined with Jen, Dave and Tawnya as we settled up on our arrangements for our forthcoming diving trip to Bonaire later this spring. It’s going to happen! So that was fun. But on my way from Lowell, my brother texted me. That day was his birthday, and he and my sister-in-law and my mother were at mom’s house, enjoying snacks and beer and playing Cards Against Humanity.

I showed up, and had fun — but wow. You learn a lot about people by playing that game. :)

… And With Thy Friends

But at the infamous “sushi night” at Steve and Brittany’s — wherein the Lady of the House learned that guzzling an entire bottle of wine on an empty stomach makes for a poor life choice — we also played the game. With a table full of gamers, only one of whom was a paragon of virtue.

Anyway. A quiet(er) week awaits.

A Better Person, or a Happy Person?

Posted on 11 April 2015 | No responses

While working this morning on a blog post for Caffeinated Press, I had included a throw-away line (since deleted) about how the breadth, not necessarily depth, of someone’s reading history made for a more well-rounded writer.

That segment and its implications have been percolating ‘twixt my earholes for the last few hours. I think I originally intended the idea to mean that exposure to many different genres makes for a better author, insofar as writers benefit from engagement with different rhetorical devices, modes of writing and standards of literary excellence. In short: “Diversity makes you stronger.”

But I’m not sure I really believe the diversity argument. After all, it’s not exactly rare for the D-word to get tossed out as some sort of MacGuffin, a trinket to be prized for its own sake, when really, what we’re talking about with D-word euphemisms is some other subject we’d prefer to avoid discussing plainly.

When I visited prison inmates during my time volunteering for the Catholic diocese and the Michigan Department of Corrections, one of the slogans I frequently heard was: “What doesn’t kill you, makes you stronger.” The inmates believed, based on their own experiences, that life’s a hard teacher, but if you pay attention and at least get a passing grade, you’ll survive. Put differently, it’s not the exposure, but the engagement that counts; you can’t just drive past 8 Mile, you need to walk the block, too.

In a literary sense, a stronger writer is one who engaged in the struggle rather than merely observed it. For example, an author’s voice and rhetorical approach for a story about a young woman contemplating abortion will differ significantly depending on whether the author has had an abortion, protests against them, or is utterly ambivalent to the issue. Your depth of experience (laying on the table waiting for a surgical D&C, vs. studying the laws and stats and joining prayer chains, vs. not caring a whit but writing anyway on a work-for-hire assignment) matters more than how widely studied you are about the procedure. Right?

Maybe. But maybe not. The activist knows the subject, but not necessarily all the context on the margins that lead to a more sound interpretation of that subject. Perhaps an ethicist or a physician can speak more soundly about abortion, in toto, than the activist who undergoes the procedure or the cleric who wages spiritual warfare against it.

The better question is: From the perspective of a writer, is it more advantageous to master the niche but forego context, or to have lots of context but no real depth? There’s no good answer to that one, I’m afraid, but it’s a valuable paradigm for assessing how well a given story works.

In the context of an author’s reading habits, though, I think “the struggle” manifests itself in tackling hard material simply for the pleasure and the challenge of doing so. Too many writers of my acquaintance content themselves to reading the things they like while avoiding the things they dislike. Although at first blush such a sentiment may elicit a self-evident “Duh,” the problem lies in the Venn diagram of what I like vs. everything else. A sci-fi author who only reads sci-fi will have a solid heartbeat on the genre, but he hamstrings himself from the perspective of the totality of his art as a penmonkey.

Distilled, I think it’s a comfort question. We read what we like and we like what we read because it’s more enjoyable to read for entertainment than to read for self-improvement. The fantasy fan who consumes nothing but fantasy surely profits in her own mental world. Yet can we not say that the person who reads challenging things — histories, the classics, autobiographies — encounters new things in new ways that leaves her better off than if she had played it safe?

A recent re-read of The Meditations by Marcus Aurelius reinforced for me the value of using every action as a learning moment, even actions intended as leisure. So perhaps a different way of phrasing the “reading for fun” question is, Is it preferable to read to become a better person, or to read to become a happier person? For the two prospects, although they occasionally overlap, aren’t exactly synonymous.

Do I read The Brothers Karamazov because I should, knowing that I’d gain new insight about the human condition but also dreading the book’s length and density? Do I grab the latest Nicholas Sparks throw-away pulp just to pass the time?

These are tough questions. It’s hard to begrudge a reader the right of escape. But for an author? I think an author’s reading list needs to be less comfortable, more challenging. We owe our readers that much.

On Bakeries, Pizza Shops, Florists and Same-Sex Nuptials

Posted on 5 April 2015 | No responses

Dismay.

I can’t think of any other word to describe my impression of the brouhaha sweeping the country about the collision of same-sex marriage and the religious beliefs of small-business owners.

Off the bat, I’ll declaim what I believe to be self-evidently true: The radical monoculture of the Totalitarian Left tears at our shared social fabric. I could go on at length about the subject, but there’s not much I can add to what’s already been published by conservative commentators the last few weeks. Even for conservatives like me, who are supportive of gay rights, it’s difficult to be allies when the most prominent spokespeople of the Left have gone Full Alinsky on us, adopting hate-filled rhetoric and violent intimidation along the You Will Be Made To Care axis of “argumentation.”

That said, I am skeptical that a plain and faithful reading of Scripture justifies a small-business owner refusing to supply a same-sex wedding. There’s plenty in both Scripture and Tradition to bar a faithful Christian from being one of the spouses in a same-sex marriage … but serving as a contractor? One could, I suppose, elucidate a fairly subtle theological argument to justify non-engagement with a same-sex wedding in any capacity, including as a vendor, but it’s an argument — an interpretation of religious norms, not a plain-text reading of one. And the nature of many of these arguments I’ve encountered recently suggest that there’s not much theological nuance there; the arguments have all the superficiality of a post-hoc rationalization, a thin veneer disguising overt discrimination.

In other words: I throw the bullshit card on the idea that there’s a specifically religious reason compelling enough to justify the denial of service to same-sex clients. Especially when the very folks who argue their religious rights are violated by acting as vendors for a same-sex wedding also argue that those weddings are invalid in the eyes of God. So what’s the religious problem, then, in catering a make-believe wedding? The only way the religious-exemption logic holds is if the objector conceded that same-sex marriage (even civil marriage) is divinely sanctioned — but then, divine sanction erases the claim for a religious exemption. The mind boggles at the irrationality of it all.

To be sure, many Christians profess significant problems with homosexuality and the expansion of marriage to same-sex partners. Those problems are rooted in valid readings of Christian theology. I believe very strongly that Christians should not be targeted or persecuted for adhering to those beliefs. I also believe very strongly that gays and lesbians should not be ostentatiously refused public accommodation by businesses, through the self-serving and open-ended assertion of religious liberty.

These Christians are also Americans. The civil law has recently opened a gulf between what’s legally permissible and what many Christians view as being morally permissible, regarding the institution of marriage. Squaring the circle between private faith and the public Constitutional order isn’t easy, but there are ways beyond public foot-stomping to remain true to your faith while fully participating in even today’s more permissible social climate.

In fact, the real problem here is the perfect storm of a brand of Evangelical conservative Christians who want to make a stand, and be seen making a stand, for their disapprobation of gay rights — in opposition to far-Left ideologues eager to pick a fight with the “bitter clingers.” So we’re left with the rank idiocy of the Indiana and Arkansas RFRA bills but also uncharitable lawsuits against bakers and florists who prefer not to celebrate that which they morally oppose. The veiled threats of the far-right blogosphere contributes, too, with its denunciations of the “caving” by Indiana Gov. Mike Pence, while far-left activists delight in vitriolic denunciations of alleged intolerance that are untethered to reality. All of this drama constitutes a self-inflicted injury for Christian conservatives.

Let’s look at this from the perspective of a devoutly Christian baker, caterer, florist or wedding planner. You’re behind the counter, conducting your trade in peace. You go to church on Sunday, you tithe, you pray. And then Adam and Steve sashay into your storefront, ready to place an order for a sheet cake for their upcoming wedding. What do you do?

When you walk the Path of Martyrs, eager to be seen as making a stand for Jesus, you tell Adam and Steve that you can’t support them because you’re a Christian and won’t be a party to their sin. Cue the raging public shitstorm. (And, in a sense, the religious hypocrisy — viz Matthew 6:5.)

In a more reasonable world, when Adam and Steve cross your threshold, you smile at them, congratulate them on their engagement, ask friendly questions about their color choices, and enquire about the date of their ceremony. Then you appear crestfallen when you say that you can’t accommodate that date because you’re already booked solid that weekend, but you’d be happy to refer Adam and Steve to Jane’s Bakery across the street. And wouldn’t you know it, Jane just came back from a confectioner’s conference and she has some really great designs for contemporary his-and-his cakes!

Better yet, you mark that date on your calendar and genuinely take it off as a day of prayer, thus protecting you from the accusation of lying while deepening your relationship with Jesus. Sure, you’ll lose some revenue, but consider it as an investment in your treasure in Heaven. Net result: Happy customers, happy proprietors. You have rendered on to Caesar that which is Caesar’s, and onto God that which is God’s.

The cynic view, of which I’m increasingly persuaded, is that all of this drama has very little to do with gay marriage. If Adam and Steve want to get married, fine; you’d think they’d find vendors who support them, instead of compelling vendors who don’t. Human decency, and all that. And you’d also think that small-business owners would recognize that baking a cake isn’t a sin, even if you don’t like your customer.

What we’re seeing is, I think, less a genuine question of gay rights or religious freedom, and more a paradigmatic question of whose orthodoxy will govern the terms of engagement in the naked public square. So in a sense, all of this drama is small-small potatoes skirmishing in a much larger and more significant cultural war, a conflict wherein certain modes of thinking that contradict the Authoritarian Left must be rooted out, suppressed, denounced — while certain practices that conservative activists despise must be de-legitimized in the name of “freedom.”

Don’t be distracted. None of this is really about a nuanced view of Christianity, or about gay marriage. Rather, it’s about competing claims to the power to coerce normative values on the larger body politic.

Hence, dismay.

Catch-Up Day

Posted on 31 March 2015 | No responses

I took a vacation day today. The last few weekends were packed with agenda items, and the evenings have been larded with sundry activities that leave me wishing for a few extra hours each night. Now I need to do a little catch-up, which is harder to do when you’re sitting in your office chair with a tasty cup of coffee and a cat gently snoring on your lap.

Updates follow.

Workplace Transitions

Life in the office has been interesting. My department — Quality Improvement Analytics — is now simply called Clinical Analytics, because the QI function has been pulled from my boss and given to a different leader in the organization. So instead of having a subject (QI) and a competency (analytics), we are now simply a competency. I lost two current staff members in the transition, but I am hiring a new senior analyst right now and can hire a new entry-level analyst in July.

The upside? I can still do QI, but subsumed under the larger umbrella of care-model transformation. If we play the cards right, my boss and co-manager and I will re-shape our shop into a clinical analytics center of excellence. I mildly grieved for the loss of the “quality” designation, but in the long run, this transition may free us to do more work of greater significance than when we were boxed into the QI space.

Caffeinated Press Launch

Our first publication — the Brewed Awakenings anthology — has already turned a small profit after its March 2 launch … despite not yet even being widely available on the Ingram catalog. So we’re pretty happy about that. If you haven’t yet purchased your copy, go here. :)

On April 6 at 7 p.m., we’re holding an event co-sponsored by Schuler Books and Music, the area’s largest independent bookseller. All are welcome to join us at the 28th Street store. We’re planning a roughly 90-minute session targeted mostly to writers. We’ll also have a book-signing table.

And our literary journal, The 3288 Review, is starting to get a masthead. Yay for that. John has done yeoman’s work in researching the current state of the literary-mag universe.

Travel

Spring has sprung, and with it, my travel schedule begins to blossom. In about three weeks, I’ll be looking forward to dinner with Tony/Jen and PPQ/GoodDoctor at Dimondale Manor, followed by an afternoon at the opera in Detroit, with April. I’ll be in Philadelphia for a few nights, the week after that, and plan to be in Bonaire over Memorial Day week for a diving trip with Tawnya, Dave and Jen.

In theory, I have the 360Vegas Vacation II in mid June, but I’m not sure whether I can attend given other priorities stacking up around the same time. Then Seattle in early August for the Joint Statistical Meetings and likely the VIMFP in mid October in Las Vegas. Somewhere in the middle of all that is an overnight trek to Chicago, too. Mid-May, I think.

And lest I forget: I have an invite for an autumn visit to see Jared and Sarah in Abu Dhabi.

Fitness

The Bonaire diving trip reminds me that strapping a steel cylinder to your back and plunging 100 feet into the ocean is a much more pleasant experience when you’ve got adequate cardiopulmonary function. I’ve been hitting the exercise bike several times each week. I’ve discovered that my normal evening routine of “cigar + cocktail + news” actually has one element that’s truly important to me: the news. And hey, guess what? I can read the news whilst cycling away the pounds. Burning 800 calories is preferable to consuming 300 calories, I guess.

It’s actually pretty easy, now that I have a new routine locked. I can log 25 or so miles in about an hour on the bike and not even think about it, given how my attention is focused on the content scrolling across my tablet. I shall not be “that guy” on the dive team who forces everyone to the surface because he’s sucking down the nitrox like it’s candy.

What I’ve Been Reading & Watching

I rarely watch television. I cut the cord with Comcast in late December and haven’t looked back. On Netflix, though, I did catch the 13 or so episodes of the first season of Helix. Interesting program.

Books, though? I’ve resumed reading more than just the day’s headlines, usually grabbing a book while enjoying dinner. In the last few weeks, I’ve finished Roll the Bones by Dr. David G. Schwartz. “Dr. Dave” is a leading academic expert about casino gaming, from UNLV; I purchased a copy of his book from him in 2013. He even autographed it for me. Anyway, I’m done with it. Fascinating historical survey of gambling, from pre-history to today. And last night I finished a re-read of The Meditations of Marcus Aurelius.

Oh, and I also wrapped up Political Order and Political Decay by Francis Fukuyama. Fascinating theoretical construct there. I am, I think, largely persuaded that the biggest political challenge in the contemporary United States isn’t “partisan gridlock” or “ideological warfare,” but rather elite repatrimonialization of state institutions by conflicting groups of elites. If you enjoy political theory — and who doesn’t? — I recommend this book, plus the first volume of the two, The Origins of Political Order.

Sundry Observations

And for your grab-bag of short takes:

  1. Looks like our friends from Denton, Dallas & Beyond will be a headliner at the 2015 VIMFP! :)
  2. Tony and I had an unrecoverable glitch that affected two of the podcasts we recorded in late February, but now we’re back on track.
  3. The Michigan Republican State Convention went well. It was held in February in Lansing. I was pleased that Dave Agema doesn’t seem to be a mainstream character. Now, if only he’d resign or get removed ….
  4. Much of my free time has been spent on CafPress stuff, but I’ve had the chance to do some fun things, including hang out with Scott and Jeremy at Logan’s Alley for the KBS tapping a few weeks ago, and visit Tony and his wife at their new palatial estate in Dimondale, Michigan. Also got to enjoy a premium cigar with Matt at Tuttle’s and crash the “bestie date” with Brittany and April for South Pacific a couple Fridays ago. (I really should attend more performances at the Civic.)
  5. The 50-year-old Grand Rapids Press building is now tumbling down. A once-iconic brand is now outsourced to MLive Media Group, thus guaranteeing that we really don’t have a newspaper anymore in this town. It’s sad, really.
  6. Still planning — I hope — to do a weekend backpacking hike with my brother this season.
  7. Easter is coming. Already. I had some aspirations for Lent, but tempus fugit.
  8. I’m trying to write more. And partially succeeding at it.

— 30 —

A Thoughtful Gift!

Posted on 16 March 2015 | No responses

A Thoughtful Gift!

via Tumblr http://ift.tt/1GVLOPt

Like to Read? Then Have I Got a Book for You ….

Posted on 14 February 2015 | No responses

We’re launching Brewed Awakenings, the house anthology of Caffeinated Press, on March 1. The inaugural volume of the anthology features eight novelettes written by West Michigan writers.

Not only did I write a story, but I edited the volume and managed the production of the title. Buttload of work, not all of which is completely wrapped up as of this post.

Copies are now available for order; they’ll ship on March 2. But why wait? BUY NOW. BUY, I SAY.

What a Month!

Posted on 1 February 2015 | No responses

January is already a memory. Wow. Let’s recap some highlights.

Auto-Mania

Around Thanksgiving, I started my GMC Jimmy one morning and heard a bit of a squeal and smelled an odd aroma reminiscent of a mix of oil, burning rubber and ozone. It came, it went, life went on. But Jimmy started to act a little funny — eventually, I’d experience intermittent periods where the charging system would fail. Then it would come back to life, as if by magic.

Over my Christmas vacation, I vowed to fix the problem myself, if I could. I popped the hood and voila! — it was immediately obvious that the pulley on the belt tensioner was broken. As in, chewed to pieces. The entire serpentine belt was chafing and parts, like the alternator, weren’t being properly driven.

“I can fix that!” I said to the cats. So I did. I bought a replacement pulley from AutoZone (1.04 miles from my house by foot) and replaced the damaged part. In single-digit temperatures. Outdoors. Without gloves. Woohoo. So I got that part replaced and what happened? You guessed it — sitting for a few days, in the cold, after having had intermittent charging, left the already worn battery too weak to soldier on. So on one of the snowiest days of early January, I trudged to AutoZone on foot, bought a replacement battery, carried it home through drifts as high as two feet — and, after I installed it, thought, “Geez, why didn’t I just call a cab?”

Battery worked. But still no charge. Damn it.

So back to AutoZone for a replacement alternator. When the weather got a little nicer — as in, the upper 20s — I swapped alternators. Only hard part about that process was getting the bolts aligned on the new unit. So I fired up the ol’ girl and watched the voltmeter go from 11 volts to about 14 over the course of a minute. Then I flipped on the defroster and the system immediately dialed to 11, never to recover.

By that point, any other fixes would be guesses, because I lacked the tools and expertise to diagnose what might have been an odd fault somewhere. I took Jimmy to Community Automotive, whereupon I was informed that the problem was that the alternator wasn’t putting out a charge. Translation: They said AutoZone sold me a defective replacement part.

They also told me that the tensioner was screwed up and the serpentine belt was super worn. So I said, “Fine. Replace the entire tensioner assembly and the belt. I’ll deal with AutoZone on my own.”

I picked up Jimmy from the shop — and lo and behold, the charging system works. I’ve been driving it for a week and my voltmeter is fine and I’m clearly not driving on the battery alone.

My guess? Community Automotive determined a bad charge on the alternator with a misaligned belt. After the belt was replaced and the tensioner re-aligned, the alternator was good to go. But I’m still keeping my eyes peeled for a while for signs of charging-system faults.

Food Deserts, Public Transportation and Good Health

While Jimmy was undergoing repairs, I opted to play it safe and keep it parked until I knew the problems were fixed. That left me to find alternative transportation to work. Daily cab fare runs $50 between my house downtown and the office on the far northeast side of the city. But, I live near a bus stop, and there’s a stop about an eighth of a mile from the office. So, problem solved — for $3/day, I can just Ride the Rapid.

I don’t mind the bus. The Rapid buses are clean and run mostly on time. My biggest gripe with the system is that the metro area consists of an urban core surrounded by inner-ring suburbs that aren’t well connected to each other. The transit system uses a hub-and-spoke model that routes most buses through the downtown Central Station; there are just a handful of crosstown routes that don’t connect through Central. In a practical sense, then, getting most places takes longer than it needs to. My drive from home to office is about 15 minutes; my bus commute, door to door, takes a full hour. We really need more ring routes and crosstown routes to connect disparate parts of the metro area without having to head downtown so frequently.

(I think a shuttle service between Standale Meijer and the Grandville Library is essential, as is a park-and-ride lot at Plainfield and the Beltline where Route 11 extends all the way to the Beltline, then a crosstown route connects that lot with Knapps Corner, Meijer Gardens and then Woodland Mall. If the Rapid folks were super clever, they’d run a two-way square ring route starting at Leonard and Alpine, proceeding on Leonard to Plymouth, south to Franklin, west to Godfrey/Market, then follow Wealthy to Straight, Seward and back to Alpine — thus crossing a whopping 19 routes without actually putting in at Central Station, a potential time-saver for folks who just want to get from one part of the periphery to another. But I digress.)

My location, in the South Hill neighborhood, puts me within reasonable walking distance of a small Family Dollar and the small Wealthy Market. Neither establishment stocks an assortment of healthful foods. Family Dollar, for example, offers no fresh fruits or vegetables and the freezer section consists of pizzas, burritos, ice cream and such. Were I to aim for healthy eating, my only real option is to trudge a few blocks to a bus stop, head to the Kalamazoo Ave. Meijer, buy groceries, then trudge back. That’s a lot of time and effort — moreso than most would undertake.

I’m not a huge activist for Michelle Obama’s “food desert” propaganda, but I do note in passing that if I were permanently confined to public transportation, I’d either need to radically re-think my daily routines or acquiesce to less healthful foods. Puts the “chronic co-morbidities” question into a different lens, methinks.

Caffeinated Press

I’ve mentioned it before, but perhaps not in adequate detail. So here goes.

In mid 2014, a group of colleagues and I established Caffeinated Press, Inc., a for-profit S corporation organized in Michigan. Our mission as a small independent publisher is to connect authors and readers in the West Michigan market. I serve as chairman of the board and chief executive officer; in that capacity, I also oversee the acquisitions and editorial processes. The company includes five board members and several outstanding associates who are working hard to build the company.

I’m putting the final touches on Brewed Awakenings, the first of what we intend to be an annual house anthology. Production has been labor-intensive. I’ve had to proofread roughly 85k words, manage layout, design the cover, develop the front matter, etc. Takes a lot of time — indeed, the bulk of my month has been spent on anthology production. Eight local authors contributed novelettes to the anthology; I’m in it too, with “Providence,” a story set on Lake Michigan. Our very loose theme was “all goes dark,” but the work we’re publishing includes some humor, some gore, some romance, some speculative fiction. Good stuff. We’re producing the anthology in both paper and e-book formats; the paper version will appear in the Ingram catalog and the e-book versions on Amazon, Barnes & Noble, Overdrive, etc.

The board recently authorized the production of a quarterly literary journal, called The 3288 Review. More details on that, later.

Health Data Analytics; State Leaders Team

I’ve wrapped up most of my work on the Health Data Analytics project for the National Association for Healthcare Quality. With my colleague Tricia, executive director of outcomes for an Illinois hospital, we led a team of health quality practitioners from across the country on an exercise to define the emerging competencies necessary for the next generation of practitioners. Our charge focused on health data analytics — i.e., Quality pros who specialize in analytics. Interesting work. Our report goes next to the NAHQ board of directors.

And on the subject of NAHQ, this year’s president asked me to move my cheese a bit. Instead of rotating into the second-year lead role for the Special Interest Group team, she asked me to begin a new two-year cycle as co-lead of the State Leaders team. That puts me and my new colleague, Andrew, in front of the presidents and presidents-elect of the various state-level health care quality associations across the country. Andrew is a top-notch fellow and our assigned staffer at NAHQ and our board liaison are very easy to work with. Looking forward to this new opportunity.

Surgical Site Infections

With one of our physician medical directors, I recently authored an internal white paper about the costs associated with surgical site infections for patients who are fully embraced within a particular accountable-care organization. The numbers were low — but we recognized that part of the problem was identifying SSIs correctly amid a paucity of accurate physician documentation that works its way into an administrative claim record. Looks like this early report will fuel a broader review of how healthcare acquired infections are managed within our ACO. Potentially publishable research!

Texas, Ho!

Still on track, in a few weeks, for a brief excursion to Texas. My plan is to drive from Grand Rapids to Shreveport, LA, and spend the night at a casino there. Then, drop of my friend Duane’s stuff in East Texas, then push through to the Dallas Metroplex to catch some of the Thinline Film Festival shenanigans. I’ll head back to The Mitten by means of Oklahoma City, so I can catch some prominent casinos along the way. Basically, killing three birds with one minivan.

Miscellaneous Updates

Some other tidbits of interest —

  • Enjoyed a lovely podcasting marathon yesterday with Tony. We had sushi at Maru, enjoyed some Japanese whiskey and cigars at Grand River Cigar, and then retreated to my dining room to push out four episodes. The cigars came to us courtesy of Famous Smoke Shop, an online retailer, that’s partnering with our podcast.
  • I get to hire a new intern and a new senior analyst this fiscal year. Yay!
  • One of my contract clients had a change of leadership in my area; the upshot is that I’m being invited to do more management stuff, as a contractor, that had formerly been the sole domain of company personnel.
  • We’ve got a severe winter warning right now. As I write this, I see heavy, blowing snow creating white-out conditions at a quarter mile. Beautiful. If only I had thought to buy firewood so I could have a fire tonight.
  • Looking forward to the county convention next week, in anticipation of the 2015 Michigan Republican state convention.
  • My next writing project might be a textbook about health care quality.
  • Fleshing out my author page on Goodreads reminds me of how little time I have to actually read. That said, I’m about 60 percent done with Francis Fukuyama’s Political Order and Political Decay, the second of two volumes dedicated to revisiting and extending the groundbreaking research of Samuel Huntington into the origin and evolution of political institutions.
  • I cut the cord. After paying Comcast $220 per month for years for TV I rarely watched, a phone I never used and Internet that sometimes crawled to a halt, I gave them the boot and now rely on AT&T DSL for $40 per month. I still have Netflix and Hulu Plus, and Skype and my cell phone, so … yeah.

Hoist Upon Chait’s Petard

Some concluding thoughts about this week’s pundit nerdfight over Jonathan Chait’s essay, “Not a Very P.C. Thing to Say.”

The back-and-forth over whether Chait makes a good point or whether he is some sort of hypocrite or whether he is locked in his own view of privilege — well, it’s all already been said. The most fitting coda, I think, is merely to observe that the dour puritanism of today’s Left will, perhaps inevitably, engender a systemic backlash from within the Left itself.

The human mind enjoys a finite capability to accept cognitive dissonance, let alone the doublethink that lets people hold mutually inconsistent assertions to be true without it even triggering that dissonance. Indeed, the New Soviet Man was a creature of this doublethink. But even with relentless propaganda, nuclear missiles and Kalashnikovs, the spark of truth couldn’t ever really be repressed. The events of 1989 bore that out. Yet the Left today is increasingly reliant on authoritarian systems of psychosocial control that require doublethink to avoid cognitive dissonance. At some point, the average Man of the Left will ask: Is this really what I believe? And when that happens, the bottom will fall out.

There’s something odd, for example, in holding that the concept of a gender construct is sufficient to change reality. Were I to announce that I identify as female and henceforth want to be known as Jane, most on the Left will applaud my bravery, call me Jane and use “she” as a pronoun. All that, despite inconvenient reality of my XX chromosomes (and sexual organs). One would think the “science is settled” about biological sex at least as strongly as it’s allegedly settled about climate change, but ….

So, again — the mind’s ability to square the cognitively dissonant circle isn’t without limit. Regardless what you think of Chait, or his arguments, the Thermidor he points to may dawn more swiftly than some expect.

Out with 2014; In with 2015 — A Reflection

Posted on 4 January 2015 | No responses

We are now a full 1 percent finished with 2015. Can you believe it? Tempus fugit. Lots of good stuff occurred this past year, including —

  • Earning promotion to management at work
  • Executing successfully our state healthcare-quality conference in Traverse City
  • Finishing my gear-out for scuba diving and getting back under the water
  • Trekking to Boston, Chicago, Nashville and Las Vegas — plus the Detroit/Windsor casino excursion from February
  • Receiving the Rising Quality Star honor from NAHQ
  • Establishing Caffeinated Press, Inc., and pulling together our first product, an eight-story anthology
  • Sponsoring my friend Rob into the Catholic Church
  • Maintaining a perfect track record for our weekly Vice Lounge Online podcasts
  • “Winning” NaNoWriMo with Aiden’s Wager
  • Ending the year about a pound lighter than I started it
  • Seeing my 403(b) account increase more than 6 percent from last year

As I survey the legacy of 2014, certain lessons have presented themselves:

  1. I’m more likely to get things done and to prioritize effectively when I have a lot on my plate. Conversely, the more I have pending, the more likely that fairly routine tasks will be set aside in service to the crisis du jore. Among those routine tasks are the basic “wellness” activities that too often get trumped by an external deadline.
  2. Unlike the heady days of my early-to-mid 20s, nowadays I need regular downtime to recharge. If I burn the candle from both ends for too long, as soon as a free day comes, I just collapse. That sprint-then-stop pace isn’t healthy in the long run. I’ve been tinkering with my normal to-do list to isolate Sundays. I am going to try to make Sundays a day of full and complete rest — no work, no chores, just tranquility. Maybe some reading or Netflixing or walking in the park, but nothing I have to do.
  3. The things that are important and the things that are urgent, rarely overlap.
  4. The older I get, the less I can pretend that bad habits don’t matter.
  5. Having aggressive goals does matter.

I’m not a fan of new-year resolutions — they reek of “lost cause” — but I have identified some goals for the coming year. I need to replace my vehicle and my desktop PC. I’m planning on trips this year to the Dallas metroplex, Philadelphia, Seattle and Las Vegas, as well as a return trek to Isle Royale (weather permitting). I want to learn Python and R, launch a quarterly literary journal through Caffeinated Press, upgrade my radio license to General class, earn SSI’s “master diver” rank by the end of the summer, and publish a textbook about clinical quality improvement. Later this month, discussions will commence about a possible dive trip with the Gang of Four and about a possible visit to see my friend Jared in Abu Dhabi (perhaps, twinning the UAE trip with a side excursion to Bangalore, India). I’d really, really like to try the Metro Health Marathon in October. And despite bobbing around the diocese, including extended sojourns to the cathedral and to St. Robert, I think I’d feel more at home with a return to St. Anthony.

Today is the final day of Grand Staycation IV. I got a lot done, but much remains to be finished. I’m looking forward to 2015, mostly because I have a better sense than last year of the things that are worth pursuing, versus the things I have either always done, or allowed myself to be talked into. So I think the watchwords for the coming year are “triage and consolidation” — i.e., fixing what’s not optimal and doubling down on what’s important.

Best wishes for a safe, happy and healthy new year!

On the Proactive Avoidance of Relationship Regret

Posted on 28 December 2014 | No responses

Posted on my Roadmap is my one-sentence mission: “I will be a contented and healthy man who, upon his 70th birthday, can look himself in the mirror free of the sting of regret.” Easier written than done, perhaps, but thinking about the question 32 years early opens the door for opportunities to avoid incurring regret in the first place.

I’m sometimes asked whether I get depressed about not having married and “settled down” with a brood of crumb-crunchers and a little suburban house with a white picket fence and a used minivan and a slightly dopey golden retriever. Usually well-intentioned, the question nevertheless is curious, insofar as it rests on two rickety assumptions: First, that marriage and family are normative, from which deviation signifies loss or defect; and second, that I am ignorant of what I’m missing so therefore I should pine for it.

As to the first assumption, I can only say that I’ve seen many people marry and remain happy together for a very long time. I’ve also seen friends younger than I who have already divorced. I am aware, through my own family’s experience, of what divorce does to family dynamics. A few years ago, when I more actively searched for a partner, I was dismayed to discover just how many women in the 25-to-35 age cohort are either single or divorced … but with at least one small child. Marriage isn’t the institution it used to be, and most families I know have so absorbed the individualist Gestalt that “family” is perhaps more meaningful as a tribal affiliation than as blood-kin identification.

I am not unaware of the benefits of marriage and child-rearing. Should the right situation arise, I’d get married. But I’m not drawn to the institution and I don’t feel incomplete because I live in an apartment with no one except my feline overlords. I’ve seen too many elderly people in the hospital who bet on a spouse and children or grandchildren to look after them in their dotage — and then see those bets fail. No one is guaranteed a loving family surrounding you on your deathbed when you’re in your late 90s. People die; they grow apart, they feud, they have different priorities. When I did pastoral care rounds in the hospital, years ago, it wasn’t all that rare for the older patients to want me to stick around. To talk. Sure, they had families — but, you know, they were busy. Seems odd to structure a life, beginning in your 20s, on the gamble of what you’ll need or want in your twilight years. Yet that’s the message, fundamentally, of family: They’re the ones who will take care of you when you’re back in diapers. Good luck with that.

Life is a series of trade-offs. There’s no such thing as a perfect existence — just a never-ending churn of decisions balanced against each individual person’s proprietary blend of needs and wants. With marriage and kids, you get better income stability, regular affection, family bonding, life milestones. Without marriage and kids, though, I retain the freedom to make major life choices without getting them approved by someone else — I can come and go as I wish, buy or save as I wish, avoid having to live with the inevitable compromises that come with marriage, and if I needed to take care of my mom when she gets old, I’m not subject to the whim of a spouse who may resist or resent it. And certainly not least, if I were to retire to a sailboat and see parts of the world, no one will try to stop me.

The other argument for marriage and family follows from a basic human need for companionship. To which, all I can say is that I do not want for friends. I have a long-term stable core, a middle-ring network that comes and goes, and a large flock of friendly acquaintances. I occasionally have weeks where I think to myself: Self, you need to start declining some social invitations so you can get some work done. So I’m not exactly a lonely recluse.

The second assumption — that I should pine or grieve for what I lack — flows from the first. When you accept the normativity of marriage and procreation, then not having it becomes an emotional struggle, a challenge of self-worth, a grave problem requiring resolution. I think there’s a fairly strong Christian Reformed, West-Michigan-culture thing at play, there, too: If you’re not married by a certain age, then there’s something wrong with you. I know quite a few people who unduly stress out over their lack of a spouse. Anyone who’s spoken to the aspiring MRS candidates at Cornerstone University or Kuyper College or even Calvin College knows the fairytale: You wait for your prince or princess then live happily upper-middle-class forever and ever, amen. Lots of those women end up, several years after their graduation and their weddings, with OKCupid profiles that feature them with their infants. I know; I’ve dated some of them. That toxic culture has wreaked incalculable chaos on the lives of the young and the innocent thanks to the tyranny of impossible expectations.

But I digress.

My biggest frustration with friends who do lust after marriage is that the longer they search in vain, the more out-of-whack their thinking becomes. It’s as if there’s some magical ratchet in their heads that, as the months and years slip away, creates ever-more-unreasonable demands for what they expect in a mate — until they come to obsess after an idealized spouse who could not possibly exist in the real world. In a sense, that ratchet is a defense mechanism, with a twofold task of protecting them having to engage in serious self-examination while precluding relationships that might be “good enough” but are nevertheless avoided because they won’t be perfect. The fairytale always trumps, but the drama never ends.

As for me, I guess I have nothing to pine over because there’s not much related to interpersonal intimacy that I haven’t experienced. I’ve loved people. I’ve woken up smiling with someone else’s head beside mine on the pillow. I’ve known the thrill of a first date, the pain of a break-up, the emptiness of a drunken bar hookup and the joy of bonding with someone over drinks. My closest friends have been with me for going on two decades. If I ever woke up at 2 a.m. with a crisis, I can think of at least five numbers to call off the top of my head where the person on the other end of the line wouldn’t hesitate to leap to my assistance.

I am content. So, having weighed the merits and elected my current path, all I can say is — I think I’ve avoided incurring a regret that would otherwise haunt me in late 2046.

What Would Impel You to Murder?

Posted on 27 December 2014 | 1 response

Statutes recognize several distinct grades of legal culpability when one human kills another. Deaths resulting from the acts of a perpetrator who didn’t intend to kill and had no ill will for the decedents — i.e., the crime lacked intent and malice — may end up with a manslaughter charge, whereas a death arising from the perpetrator’s failure to exercise due care might be charged as a negligent homicide. When a death occurs because of the willful act of the perpetrator, then the charge becomes murder and falls into one of three degrees. Many crimes of passion get charged as second-degree murder. Premeditated killings earn a first-degree murder charge. Layered into the mix are a host of defenses — insanity, self-defense, accident, impairment, victim retaliation, etc. — that attempt to minimize the mix of intent and malice that lead to specific charges and specific sentences.

The law’s judgment, however, imperfectly squares with moral judgment. To many ethicists, killing in reasonable self-defense — including during combat — and killing that follows from an unforeseeable accident, both carry minimal moral culpability. A person’s moral burden increases when a death results from an avoidable set of circumstances, like intoxication or reckless driving. It increases further when a killing that might legally be justified nevertheless could have been avoided with non-lethal approaches to conflict resolution. It increases still further when the perpetrator put himself into an environment where there was a known and avoidable risk of violence, like when an angry husband returns home to confront a cheating wife. When you cross into the threshold of first-degree murder, an ethical distinction follows from the reason for the crime; this reason may appear in sentencing memoranda but usually not in the charge. In general, the more the act of murder depersonalizes the victim, the higher the level of ethical censure.

Let’s shift gears. I’ve been doing a lot of editing of short stories for the Brewed Awakenings anthology. As part of my prep, I’ve visited libraries and bookstores to browse recently published novels and anthologies, to get a better feel for how certain plot devices unfold or how other authors manage the flow of dialogue and contextual information within a scene. What I’ve taken away from that exercise is that for many writers — although, to my satisfaction, none in our anthology — killing is something that just seems to happen, often without malice or intent. Murder becomes a plot device that’s divorced from any real grasp of what the crime actually entails in the real world. (It’s curious how many contemporary novels rely on killing and rape as staple plot conventions, despite near-universal condemnation of the practices. Perhaps there’s something significant in that.)

For an average person, the innate prohibition against murder is so strong that the only realistic way he’d kill another is by accident or through avoidable impairment. So when authors craft tales about premeditated murder, the killer rarely works when he’s an archetype of Joe Sixpack. Premeditated murder by a psychologically competent offender occurs for only a small number of reasons:

  • Financial or reputational gain (contract hit men, insurance windfalls, gang violence, failed drug deals, prison murders)
  • Revenge (grudges and other personal animosities against a known victim, honor killings, failed marriages)
  • Jealousy (knocking off a rival for someone’s affections, envy over the good fortune of another, killing a scorning lover)
  • Service to a cause (ideology, religion, sociocultural tribal codes)
  • To avoid exposure (cover up other crimes, silence whistleblowers)
  • To gain exposure (school shootings, serial killing, police-assisted suicide)
  • Bias (hatred of known or unknown others who exhibit a disfavored characteristic, tribal initiations, out-of-control bullying)
  • Thrill (killing for fun by a person not psychologically compromised, BDSM snuff activity)

Of course, reasons for premeditated murder by the psychologically incompetent run the gamut — “the voices made me do it,” etc. — but that class of perpetrator is less interesting because they’re acting out on disordered compulsions, so their actions are rarely voluntary in the sense they rationally consider their motive, means and opportunity to kill another absent any legal justification for doing so. In this sense, although some serial killers are impaired, certain diagnoses within the DSM-V don’t rise to the level of acute psychological disorder that removes moral culpability. A person with antisocial personality disorder, for example, has a diagnosis that may well be admissible at trial, but all but the most severely afflicted can still function normally and make rational choices about first-degree murder.

All of the above having been established, the question for authors is straightforward: Can you explain why a rational person willingly ended the life of another? The cultural and even instinctive taboo against unjustified homicide runs deep. A person rarely just wakes up one day and snaps into Murder One (that’s what Murder Two is for); the sequence of events leading to the pulling of the trigger or the wielding of the knife take weeks, months or years to develop. Introducing a premeditated murder at random makes for a thin plot.

But the larger question rolls beyond authors and includes everyone. What stops us from killing? For some, it’s that pre-rational inhibition rooted in culture, religion or instinct. For others, it flows from a panhumanist love for all living things. And don’t forget the fear of arrest, trial and incarceration and the deep loss of friends, family and freedom that follow. Or about the physical difficulty that comes from subduing another and the exposure to blood and internal organs that may dissuade the squeamish. Authors rarely seek recourse to the rich literature on ethical paradigms; if they did, they’d realize that certain ethical frameworks justify the don’t-murder injunction using starkly different logic models. (Consequentialists, I think, have the hardest time with this problem.)

There’s no such thing as a random killing. Each murder has a reason for its commission that outweighs the relative risk of its consequences. For authors, there’s probably some wisdom in avoiding the rape-and-murder trope unless you can paint a compelling character sketch of the perpetrator — why did he do it, and why didn’t the fear of consequences deter him?

For everyone else, it’s a useful exercise to consider the circumstances that could lead you to cold-blooded murder. And if you find that you cannot list any, then follow up with the question: Am I deceiving myself?

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