Monday, August 31, 2009

Something Nice to Look At


It's looking like a busy news week so here is something from my picture file to remind us that there is more to this life than the daily grind...

More on MAST

The Kansas City City Council introduced late last week, when they thought no one was paying attention, a resolution to create a new "ambulance department" separate from the fire department and change the way MAST is run. Earlier today, Citizens to Save MAST (the group gathering signatures for a vote) held a news conference/rally. I didn't go, and except for a report from KMBZ, there has not been a lot of media on it yet. Basically, the council is trying to get the job done, with an end run around the possibility of a citizen's vote. Some more example of incompetent city government trying to fix what is not broken, all for some political reason (fire fighters' union?)

Yael Abouhalkah has a nice take on this on his KC Star blogpage, including this bon mot:

Sharp's ordinance is just the latest example of how slipshod this entire takeover has been, starting with the very idea that any major change in who ran ambulance service was necessary at all.
(But of course it was, because the fire union said it was....)


And as usual, Tony's Kansas City is right on top of it; he posted this morning.

Oy veh. (smack forehead with hand)

Saturday, August 29, 2009

Hurricane Katrina, Four Years Later

I laughed when I read a fellow blogger's note that she left her best stuff in the comment sections of other people's blogs, but yesterday I did this myself. I left my best writing in the comment section of the New York Times. The article, to run in the magazine section Sunday, August 30th is about the events occurring in a flooded hospital in New Orleans.

Your link to the article, "Strained by Katrina, a Hospital Faced Deadly Choices" in the August 30th New York Times.

293.
EDITORS' SELECTIONS (what's this?)

Kansas City, MO
August 28th, 2009
7:01 pm
As a nurse and former EMT, I read this article with increasing sorrow and trepidation. You could see it coming, like an oncoming freight train. Lines were going to be crossed and things were going to happen. It's like a vise closed on them, and the thinking got narrower and narrower...

A few words about triage. There may be nine systems of triage but there are two essential ways to do triage. One way is when the most critical and close to death are treated first, then the less critical, then the "walking wounded". This is the typical form of triage in your local ED. People with gun shot wounds and heart attacks skip to the front of the line because delaying their care will cause death or permanent injury. Those with non life threatening illnesses or injuries wait. The second way to do triage is to defer care for many of those whose injuries/illnesses are life threatening and will require a lot of resources to be stabilized. Those with lesser problems are treated first. This form of triage is used when resources are limited, and the idea is to do the most good for the most people. It must be noted that you cannot use these two philosophies of triage at the same time. The next thing to know about triage is that it is very difficult. On the face of it, it may look easy, but it's not. For the triage nurse in the ED, she/he must take the data and evaluate the patient in a very short time. Mistakes are easy to make. There are courses in how to do this well and as accurately as possible.

And now a few words about D.N.R. orders: D.N.R. does not mean D.N.T.--do not treat. It means only that if the heart is to stop, the patient does not want someone jumping on their chest with CPR, does not want to have a breathing tube placed, and does not want drugs, external pacemakers or other tools of Advanced Cardiovascular Life Support applied to them. It does mean that if they have an illness that is amenable to treatment, such as an infection or a condition correctable by surgery, that they would like to have those things.

For a few of the patients in Memorial/LifeCare during Katrina a cascade of issues resulted in the awful outcome related in this article. Poor disaster planning (I now hope every hospital in the US has considered how their generators and electric systems would fair in the disasters endemic to their areas.),structural issues (two flights of stairs outside and a three foot hole to reach the helipad?) failure of evacuation, poor triage decision making, and some bad judgements and decisions during the event caused the perfect storm (pardon the expression) of failure. I particularly think of Mr. Everett, who fell victim to several kinds of failure.

I'm sure that the events surrounding Katrina have been used to change plans and improve mass casualty and disaster response. Let's hope so, so that this horrible outcome is never repeated. And talk is cheap. Don't be afraid to practice these things in drills and such.

I have trouble with what the doctor and the nurses did. I don't like it, and I suspect if I were on the scene I would be looking for another way, any other way. I'm not sure what prosecuting them would have done for anyone. Let's focus on prevention and planning, so that it never comes down to this again.

Consider the difference one working elevator would have made...


Natch, I'm pretty proud that my little opus made the editor's choice list. I always feel that when I read medical articles that the general public may not have the whole picture due to lack of information. So when I venture into comment land, I feel a need to explain in a little detail what's going on. So there's not a lot of opinion sometimes. Here's some opinion for you. I do believe that people were killed, using morphine and Versed, some because they were indeed ill, and some because they presented, to the people present an unsolvable and unpleasant problem. Serious triage mistakes were made due to confabulating Do Not Resuscitate with Do Not Treat. Not to mention that triage needs to be rethought just a little here. In addition to medical condition, resources and outcome, we almost need to add mobility. Mr. Everett would have lived if we could have gotten him down from the seventh floor. When the flood waters were creeping up and electric service was known to be in peril, that would have been the time to get this immobile but otherwise stable patient downstairs.

Now, I hear all the comments saying, "But you weren't there." Indeed I was not, and I have no perfect idea of how I would have reacted. I think, knowing myself, I would have kept busy helping patients. I do not think I would have accepted the drugging/overdose/euthanasia idea if it had been presented to me. I don't think I could have injected the cats! It's interesting to me that the doctor and nurses operated as isolated as they did. The doc took the lead, got "permission" (or at least, no resistance or command to stop), and they did it together. To me, the crucial thing lacking was forethought and planning ahead. Clearly, whatever planning and drilling were done at Memorial and in New Orleans as a whole (including the sorry performances of the local, state and federal governments) was not sufficient. Not enough. Not even close.

In 1984, the Amtrak Montrealer, which at that time, ran through Vermont, derailed in Williston after crossing over a washed out area of track. 7 people died and over 70 were injured. This was a big deal for Vermont. However, Vermont had a tradition of practicing disasters, complete with real patients, taken by real ambulances to real hospitals. Moulage, the whole thing. And debriefings afterwards. Vermont's EMS was hailed as having done a superior job at handling this mass casualty situation. Part of the credit has to go to the drills. When you practice something, the pathways can be established, bugs washed out and plans reviewed as needed.

Were circumstances in New Orleans so extraordinary that any plan would have fallen short? Maybe. But if you have a good plan, you have something to hang on to, and something to innovate from. What was the command structure at Memorial? Who was in charge? What were the goals? Who would make decisions about resources? Who could suppress rouge elements and deal with conflict? Why was the LifeCare institution not included in the Memorial plans as matter of course? (I sure hope the Kansas City version of LifeCare, Select Specialty, is included in the plans of Research Medical Center and Overland Park Regional...) Did they ever practice these things, even as an exercise around a table? These questions cannot be answered in the midst of the disaster. There's too much pressure and too much at stake. There is no substitute for preparation. You can't prepare during the situation. You must prepare beforehand. If you have good preparation, then you can innovate as things progress (or decay). You are more able to think freely and broadly. Applying this to Memorial, the solution of euthanasia does not have an appeal because there are good sound alternatives that are brought to the table. Perhaps time does not become such a pressure (clearly, the application of a time deadline by people outside the hospital influenced and hastened the decision process), because someone can stand up and say, "Give us 12 more hours. Get us some help." and it has meaning and weight.

There is no substitute in a disaster for preparation. And no substitute for practice.

Friday, August 28, 2009

It's Friday and I'm Tired...

Has it been a long week for you? I feel like it's been a long week. Two community meetings along with the usual activities of daily living. Persistent low pressure weather. Ugh.

Let' see what else. Ted Kennedy died. I'm not a big fan, although I am very impressed how he cleaned up his act with alcohol over the last 10-15 years of his life. Two of my favorite bloggers are having a blog fight. Guys, back to your corners. MAST situation has changed yet again, will citizens still get to vote? A blogger was unmasked due to her immoderate words by Google, then turns around and sues Google. Dennis Moore, third district Kansas rep continues to demonstrate his total lack of 'nads. Girl is recovered after decades of captivity with serious nut job in California.

OK, that's a wrap. It's supposed to be a nice weekend; enjoy it everyone.

Longbranch car cruise, here I come!

Thursday, August 27, 2009

An Interesting Evening...

The International House of Prayer had the first of their two informational meetings for the people of Grandview and south Kansas City. The auditorium at Grandview High School was 75% full with concerned and interested citizens. A couple from my own street was there. I'd say that 90% of the audience was white, and most were older. There was a smattering of black folks there as well, generally a little younger then the white folks. Pastor Mike Bickle was there along with nine other people representing IHOP leadership and concerns; this included Diane Bickle who runs Glad Heart Reality. IHOP was recording and filming the proceedings and will be putting the meeting on their website www.ihop.org .

I wasn't sure what to expect from this meeting. Would people be hostile spiritually, either resenting IHOP's Christianity or believing that IHOP is a cult? Would people be more concerned with more secular issues such as economic impact and development, and housing and real estate issues? As the questions emerged, it was truly a mixed bag, swinging from economic to spiritual to accountabilty to housing and quality of life. A few things that stick in my memory as I look back at the evening...

A lady reported she had a IHOP house near her with 17 people living in it for an extended period over the winter. My neighbor relayed concern that he has no real knowledge of who owns one of the homes on our block occupied by IHOP related people. Others related stories of houses being altered for non related folks living together, and one gave a story of having to call out the code folks on someone building an extension to a home without proper permits.

Someone asked outright if IHOP was a cult. Mike Bickle basically did some teaching on the marks of a cult. The teaching was sound, right in line with cult experts such as Walter Martin. Basically some of the marks of a cult are closing the person off to family, friends and the greater culture, shunning and condemning if the person leaves, nonbiblical or extrabiblical doctrine that cannot be questioned, the barring of having personal money and property, leadership without openness and accountability, inappropriate sexual relationships between leadership and select people. IHOP portrays itself as being very deliberate about teaching the marks of a cult and on the watch for cult-type behaviour. If you google IHOP you will find some anti-IHOP websites and if you look at them, they basically accuse IHOP of being a cult or even worse. 1 John 4 tells Christians to discern the spirits.

One lady got up, talked about Grandview's diversity, then noted her interracial marriage to an Asian man, who is a Buddhist. She wanted it in writing that there would be no evangelizing. Mike Bickle restated that IHOP was unabashedly Christian, preaching the saving grace of Jesus Christ. She was not pleased and stated, " I will hold you to the law."

Bickle and several of the others on the stage were very "grieved" (their word) over the problems with some of the houses. They felt maybe that some of these issues of families and students boarding and renting in a multifamily way were from lack of oversight.

One person expressed concern about the ministry falling or failing either due to moral lapse and/or financial problems. "It would be a disaster for us." if this happened. There were just a few questions about IHOP's financial basis, where the money came from and how the accounting was monitored. IHOP reported that their books were open to be looked at at any time.

An interesting note came up about development on Martha Truman Road, that the land had been stripped and readied for building, then everything stopped, with some erosion and other environmental concerns. The lady who raised the issue said she heard it stopped because IHOP was bankrupt. IHOP people stated they did not own this land, a guy from MN owned it, and development was stopped due to the economy, and no one was bankrupt. The questioner stated there was "a challenge" to the development. Through what I wonder? Zoning board? Environmental board? Just as long as there is never a through road to Martha Truman from Red Bridge, especially Norby Road or Cleveland Avenue. Such a thing would ruin the Terrace Lake neighborhood.

Other issues and questions: education of children moving in, the fate of leased space at the Briarwood center, the timeline for Grandview Plaza construction (they hope to have IHOP U in by fall 2010,) and the timeline for the big project in Grandview.

Mike Bickle gave his testimony which took him from bars at 12 to a Christian sports camp at 15 to church at Colonial Presbyterian. He was vague about his education; stated he was going to go into medicine then decided to go in to the ministry. He said something about seven years of school in St. Louis. A lady I talked to after said he dropped out of Mizzou to take care of a family member.

Afterwards, there were still people stewing about the housing issue. Many were perturbed by the murky ownership records of the homes near theirs, and the problems with extra people and cars.

Well that's about it. Impression? Not really sure about what the people thought in general of IHOP--hard to read. I think most did not believe IHOP to be a cult. However, there were multiple secular quality of life concerns, and I am not sure IHOP resolved all those issues. It will be interesting to follow this along. A second meeting is scheduled for early next week. Stay tuned.

Wednesday, August 26, 2009

Wayside Waifs Wednesday

Meet the Captain (left) and Tenielle (right) two nice bicolor cats. They came to Wayside Waifs together, and would like to find their new home together. They are about 9 years old. Tenielle, the black and white, is more laid back but friendly. Captain, the orange and white, is playful and verbal. They sleep together and play together. Two cats keep each other occupied and keep the owner from being the target of aggressive play.
These two pleading "Take us home." are both Belgian Malinois mixed one year old sisters named Demi (the darker muzzle) and Diem (more white). Belgian Malinois are a smart trainable breed often used in law enforcement. These girls are friendly, trainable and ready to be a part of a active household. Two is always better than one!

Wayside Waifs is located at 3901 Martha Truman Road in Kansas City, MO. The phone number is 816-761-8151. The hours are Wednesday-Friday 2 p.m.-8 p.m. and Saturday and Sunday 12 noon to 6 p.m. The Shelter is closed on Mondays and Tuesdays. The website, which has listings for all adoptable pets, including photos, is http://www.waysidewaifs.org/

Don't litter, have your pet spayed or neutered!

Double Infrastructure Fail

Water main break at Norby Road and Red Bridge Road, with water flowing down Norby...
...to pool in the street due to the storm drain that isn't draining.

Some Follow up and a Few Good Links

The health care forum at the Church of the Resurrection was very good. An excellent primer on the problems, and glimpses of some ideas for solutions. Tomorrow they will have transcripted the proceedings and you will be able to buy a DVD of the program. If you have an interest in health care reform and would like to increase your basic knowledge of the issue, it is definitely worth pursuing. On the Web: http://www.cor.org/.

Following up two items from last Thursday's post--note the flap about Michelle's shorts has disappeared without a trace. (I had to be careful how I said that: it wasn't the First Lady's shorts that disappeared...) The South African runner, Caster Semenya, the tests on her gender are not back yet. She has received a hero's welcome in her country, and is enjoying her gold medal. We'll keep following. The Afghani elections proceeded but there were reports of fraud, violence and intimidation. There were reports of women who voted having their ink stained fingers cut off by the local Muslim clergy. Per reports, a preliminary result may be made public in a few days. The current president, Hamid Karzai and his challenger, Abdullah Abdullah are neck and neck per new stories. Pray for Afghanistan.

You may have heard of the humor web site http://www.icanhazcheezburger.com/ . Time magazine has an interesting article about its owner and the fact the site makes money. Amusingly, there's a link in the article that says that the site is overrated, and proof of the fall of western civilization. Sometimes the arrogance and judgemental attitude of the mainstream media is not to be believed. Your link to the Time article.

Oh, by the way, check out the site http://www.lovelylisting.com/ for hysterical real estate ads and pictures. The way some people decorate their homes! And they leave them that way when they go to sell the house. Sometimes the site is sad because you see what happens to houses (that were once homes) abandoned in foreclosure. But most times, it's funny. It's the newest part of the cheezburger empire.

Strange Survivalist/Christian (???) group in my family's small town in Vermont are in a kerfuffle with the town about a road and a gate. The link from WCAX TV. I didn't know exactly where this was, so I mapquested and googled, and found the road dead ends at what looks like a settlement (barns, houses, etc.). So I'm pretty positive the town fathers can figure this out. By the way, the James Jones interviewed in the video piece was in my high school class.

Tuesday, August 25, 2009

A Week and a Day of Blogging

Well, a whole eight days of blog entries...and my respect for the top tier bloggers has gone up 500%. To do this right, especially if you do it as a side activity/job, is not as easy as it looks. You have to have material, it needs to be well thought out, and you have to get it on the computer in a timely, orderly manner. Even if all you do is throw up a bunch of links or post photos, it has to be done correctly, so the links work and the photos look good. I haven't written so much computer code (my ventures into Html) since seventh grade. Also proof reading and spell checking (so I don't drive my friend Janice nuts).

Well, about to go to the health care forum at the Church of the Resurrection.

Here is a link to a nice article in the New York Times about a town hall attendee. Fair and balanced in the Old Grey Lady.

C.S. Lewis Has Something to Say

From Mere Christianity:

The first thing to get clear about Christian morality between man and man is that in this department, Christ did not come to preach any brand new morality. The Golden Rule of the New Testament (Do as you would be done by) is a summing up of what everyone, at bottom, had always known to be right....

...The second thing to get clear is that Christianity has not, and does not profess to have, a detailed political programme for applying 'Do as you would be done by; to a particular society at a particular moment...

....All the same, the New Testament, without going into details, gives us a pretty clear hint of what a fully Christian society would be like. Perhaps it gives us more than we can take. It tells us that here are to be no passengers or parasites: if a man does not work, he ought not to eat. Everyone is to work with his own hands, and what is more, every one's work is to produce something good: there will be no manufacture of silly luxuries and then of sillier advertisements to persuade us to buy them. And there is to be no 'swank' or 'side', no putting on airs. To that extent a Christian society would be what we call Leftist. On the other hand, it is always insisting on obedience--obedience (and outward marks of respect) from all of us to properly appointed magistrates, form children to parents, and (I'm afraid this is going to be very unpopular) from wives to husbands. Thirdly, it is to be a cheerful society: full of singing and rejoicing, and regarding worry or anxiety as wrong. Courtesy is one of the Christian virtues; and the New Testament hates what it calls 'busybodies.'
If there was such a society in existence and you or I visited it, I think we should come away with a curious impression. We should feel that its economic life was very socialistic and, in that sense 'advanced', but that its family life and its code of manners were rather old fashioned...Each of us would like some bits of it, but I'm afraid very few of us would like the whole thing. That is just what one would expect if Christianity is the total plan for the human machine. We have all departed from that total plan in different ways, and each of us wants to make out that his own modification of the original plan is the plan itself: You will find this again and again about anything that is really Christian: everyone is attracted by bits of it and wants to pick out those bits and leave the rest....

...Charity--giving to the poor--is an essential part of Christian morality: in the frightening parable of the sheep and the goats it seems to be the point on which everything turns. Some people nowadays say that charity ought to be unnecessary and that instead of giving to the poor we ought to be producing a society in which there were no poor to give to. They may be quite right in saying that we ought to produce this kind of society. But if anyone thinks that, as a consequence, you can stop giving in the meantime, then he has parted company with all Christian morality...

And now, before I end, I am going to venture on a guess as to how this section has affected any who have read it. My guess is that there are some Leftist people among them who are very angry that it has not gone further in that direction, and some people of an opposite sort who are angry because they think it has gone much too far...

...A Christian society is not going to arrive until most of us really want it: and we are not going to want it until we become fully Christian. I may repeat 'Do as you would be done by' till I am black in the face, but I cannot really carry it out till I love my neighbour as myself: and I cannot learn to love my neighbour as myself till I learn to love God: and I cannot learn to love God except by learning to obey Him. And so, as I warned you, we are driven on to something more inward--driven on from social matters to religious matters. For the longest way round is the shortest way home.

Something to consider during the Great Healthcare Debate...

Monday, August 24, 2009

Tackling Health Care Part One

OK, going to tackle health care now...big complex issue, divisive, gives rise to great emotion and some irrational behaviour. My friend John, the BikeHiker is involved in an initiative called Forty Days for Health Care. This initiative apparently got a mention on Fox News and John's email and comment portals were inundated with rude and inappropriate emails. This makes it a little bit personal for me, as John is a friend. We need to be free to discuss without concern for our safety or being slammed on the Internet. In addition, three forums are coming up this week, for information and exchange of ideas. Here are the details:

Health Care Forums

Claire McCaskill will have a health forum today at 4:30 pm at Swinney Recreation Center on the UMKC campus. You had better be reading this on your BlackBerry, Palm or iPhone 'cause if you ain't there now, you ain't gonna get in. Senator McCaskill is the only democrat with any brass around here. She has not been shy about having forums and getting down and dirty with the people. I probably agree with her about 5% of the time, but I like her; she has integrity and guts.


Church of the Resurrection, 13720 Roe Avenue, Leawood KS
Tuesday, August 25, 7 pm, Sanctuary
Live webstreaming at live.cor.org
Join us for the opportunity to listen in as a panel of professionals discuss the challenges faced by people who cannot afford health care and the issue of health care reform. Panel participants are:
Sam Turner, CEO, Shawnee Mission Medical Center
Myra Christopher, President and CEO, The Center for Practical BioEthics
Keith Wisdom, CFO, United Health Care Midwest
Rick Kahle, President, Employee Benefits, Lockton Insurance
Hilda Fuentes, CEO, Samuel Rodgers Health Center
Dr. Ritch Richardson, Emergency Room Physician, Johnson CountyEMS Director
Dr. Bill Reed, chair of the department of cardiovascular disease and a member of the Kansas Health Authority board will be helping to craft the questions for the discussion.


On Thursday, August 27, KMBZ radio will be putting on a forum at Rockhurst College. I hope. There's a graphic on the web site but no info.


Two more things to stick here before we proceed. One is a link to a story that Tony's Kansas City found about a doc right here in KC metro. The story is from a British paper, The Guardian.
The second is this essay on socialism that I found on World Net Daily. It's really interesting and I think right on the button, from PoliticalAffairs.net. Pretty dense stuff but worth the read. Print it off and mark it up.



If you read the Political Affairs article, you will see how our governance is a combination of private and public or collective. Companies make private decisions that help their profit picture and benefit stakeholders, but often conduct business under collective government rules. Rules about pay, worker safety and accident compensation; rules like health department inspections of restaurants, gas mileage for the cars our car companies build, standards for construction contractors to adhere to, that kind of thing. Our corporate entities are not totally free to do whatever they want. Then there are fully public organizations or services who are supervised in full by elected officials (our representatives, senators and president) or their proxies; things like Medicare, the VA system, police and fire departments, water services and so on. It's a real mixture: private contractors sometimes perform public/socialist/collective services, and there are hybrids, like GM and Chrysler in their current configuration. I think it is important to understand what we are talking about when we sling around words like "socialism."



So with that groundwork, here is the first question I want to start with: What's wrong , if anything, with the current system?

First, yes, there is stuff wrong with the current system.

It costs too much. I mean everything about it costs too much. Insurance costs too much. Hospital room rates are too high. Acetaminophen and band aids cost too much. X-rays and MRIs cost too much.

We spend way too much money on treatments at the end of a person's life. I know this sentence will get me in lots of trouble. But people should not be treated to within the last minutes of their life, when its obvious to everyone that the illness will lead to imminent death.

The insurance system needs a lot of help. Preexisting condition rules need to be looked at. The rules concerning interstate sales are too restrictive. And, as noted above, it costs too much.

Tax rules are overly restrictive. How about deductions for the majority of medical bills, rather than starting at a certain threshold. Also, more tax advantages for health savings accounts.

We need to evaluate the tort system. Doctors practice defensive medicine all the time. I have heard experienced ER doctors fret about letting patients go, and having that patient get worse somehow, and then suing them, so patients are admitted "just in case, to CYA".

Doctor availability has become an issue. Doctors have been funneling patients to the ER for evaluation, which is expensive and inefficient.

Well, that is a short list, that if you unpack it reveals a lot of complexity. The health care system is complex. So this blogger is going to attack it piecemeal. If you have an addition to "What's wrong with the current system?" feel free to use the comment portal supplied below.

Saturday, August 22, 2009

MAST meeting, continued...

More musings on the MAST meeting concerning ourselves with the coverage in various venues in the city. If you do not live in MAST's service area, or a area of mutual aid (Grandview, pay attention) just think of it as large lessons on city government. Just put on your hip waders, because it might get deep around here.

First, media coverage. KMBC did a nice video piece; my only gripe with it was the lack of speakers of color on it. Maybe it's because white women hollar louder. KSHB also had a nice video piece, and featured a feisty black lady. On internet scan, (I am not watching TV at this time) WDAF and KCTV did not have either a text or video story on their internet sites.

The Kansas City Star had no coverage on their Internet site or the dead tree version. Very disappointing, and the reader's rep is going to have an earful from me.

Tony's Kansas City, as usual, does a terrific job. His tipsters are awesome. It's so good, that I'll let you all read it right here, as well as providing a link.

LACK OF DIVERSITY THWARTS LOCAL 42 AND FIREFIGHTERS AT KANSAS CITY COMMUNITY MEETING!!!

The biggest Friday Night Fight in Kansas City Community politics took place Southeast Community Center and Local 42 represented by a few thuggish firefighters lost.Here's why:A BUNCH OF WHITE GUY FIREFIGHTERS YELLING IN THE MINORITY COMMUNITY ABOUT THE BENEFITS OF THE HOSTILE MAST TAKEOVER HAVE NO CREDIBILITY!!!For years the lack of diversity in Kansas City's Fire Department has been lamented and now it looks as if Local 42 is going to pay the price for that neglect.Here are the heretofore unpublished highlights from the Meeting that KICKASS TKC TIPSTERS have provided:
White dude firefighters who probably all live up North seemed out of place at Southeast Community Center.
They sat together and took video and did their best to shout down all opposition in typical Union thug fashion . . . Which is kinda sad because TKC is mostly pro-Union when power-grabs aren't involved.
MAST supporters collected DOZENS OF SIGNATURES for their petition intended to stop the hostile takeover. Word is their signature gathering drive is going well.
To be fair, a bunch of white people supporting MAST showed up as well . . . Local 42 fired back with arguments that mostly involved empty threats. The overriding theme of the meeting was clear . . . NOBODY TRUSTS KANSAS CITY LOCAL GOVERNMENT TO MANAGE HEALTHCARE!!! But all of these points are really civic issues that don't interest TKC much . . .On the funny side, Local 42 quickly used the "Hero Card" in order to make arguments for a City Hall takeover that would quickly put MAST under Fire Department control. . . Unfortunately, because they lack a diverse perspective . . . Firefighters at the meeting might not remember that a recent death of 7 year-old student hit by a fire truck that was subsequently BLAMED ON THE VICTIM was perceived as less than heroic behavior by a great many in Kansas City's minority communities.And here's the most important part:FIREFIGHTERS AND LOCAL 42 HAVE BEEN OUTMANEUVERED IN KANSAS CITY'S DIVERSE COMMUNITIES BECAUSE OF THEIR OVERALL LACK OF REPRESENTATION!!!The leaders of this petition movement are all females and Firefighters look less than heroic when using their bully tactics against a bunch of women.More importantly, while I'm sure KC's Fire Departments meet quota . . . The lack of real diversity in the department guarantees that whenever Local 42 shows up in a minority community they're going to come off as nothing more than a bunch of angry white guys giving orders.Now, the KC Unions and Firefighters could take TKC advice and strenghten their commitment toward diversity which is pretty much non-existent . . . But what's most likely is that they'll just go recruit some sellouts and continue making empty threats.In the meantime . . . The initial stages of the petition effort will be successful because only around 4k signatures are needed and Union folks without diverse community representation have no credibility in a great many parts of Kansas City.

The tipsters and Tony are absolutely right: the union guys looked completely out of place and even uncomfortable. As well, there was a black guy who identified himself as a firefighter who spoke in support of the KCFD takeover of MAST, who did seem like a sell out. There was something about him that was just as slimy as the identified union guys. It's a slightly different perspective from my own, but interesting we came to the same conclusion: no one trusts the city's ability to manage anything, the change is for no good reason, and creates a high risk that ambulance service will be mismanaged. Which just doesn't cut it for the bottom line: Emergency services should be above politics as much as possible, and left to their business of saving lives.

OK, enough blogging for one day. It's beautiful outside. I'm going cruisin' in Belton. Hope to see you there.

Friday, August 21, 2009

Oh, and One Last Thing...

Just one more bit on the MAST meeting: the actual running of the most vital services in a city must be above politics. The union guys kept saying, well, you all say fire is a good service, you like the FD and firefighters, why not merge MAST into the fire department? Well why merge MAST if it's working and you can't/won't demonstrate really good reasons for the changing of the command structure? Other than politics and power. Fire, Police and EMS must be above the political fray, to the very best of their ability. That's how come the people of the city have a higher regard for the PD, FD and MAST than most city departments and services. If politics is driving this move to merge, then it is wrong and should not be done. For example, will the new structure continue mobile posting (posting ambulances at various places in the city)? If not, what will they do? How will that affect response time? How many ambulances will be out on the street? How many at 7 a.m? 2 p.m? 10 p.m? 3 a.m? Right now, MAST can vary the number and be very flexible.

A lot to chew on tonight. Let the people know what's going on. Let's have an informed and open vote of the people. Readers, sign the petition when it's presented to you. There will be more meetings and opportunities to sign. Don't miss out.

Report from the MAST meeting


Hey, just got back from the MAST meeting... Close to 50 people were there at the meeting at 4201 E 63rd St. Most were from the immediate neighborhood. I wish I had asked the folks how it was they came to hear about the meeting. They could have heard about it on TV, and I am still on my TV fast, so I wouldn't have heard that way. They did not exactly fit the demographic of your average blogger! There were a few people with current or past affiliation with MAST there, three local 42 union reps, and a couple of community organizers. When I entered the room, there were 3 video cameras set up, including a guy in a KCFD tee shirt. Check it out. (It turned out camera dude was from KSHB)



The first bit of news was that the current head of MAST, Gil Glass, resigned in the afternoon. From the reaction of people, I don't think it was an expected move. The main presenters were Susan, Lisa, and Yancy Davis. Ms. Davis is a community organizer who worked with the Obama campaign, and Susan and Lisa have MAST connections. There was also a gentleman whose name I didn't catch who spoke, who had been doing EMS in Kansas City so long he worked for Community Ambulance (Sidetrack: He named all the ambulance companies doing business in KC before MAST came into being. One was called Acme Ambulance. Honest. The Wiley E. Coyote ambulance company...sorry, ADD moment.) Information was presented on MAST; call volume of about 87K per year, one of the best response times and code blue save (cardiac arrest-- sneaky medical lingo!!) rates in the country, trained dispatchers, community service in the schools, car seat checks, etc. Letters from two doctors, Dr. Gary Gaddis, from UMKC School of Medicine and St. Luke's Hospital and Dr. Richard Rosenthal, chair of the ED at Research Medical Center, were summarized and copies made available to the audience. To make a long story short, both docs had multiple concerns about the changeover. Dr. Rosenthal was at Providence Medical Center when KCK changed over from MAST to a Fire Department model, and he reported a decline in the level of care and unexpected expense during the transition. Dr. Gaddis was concerned about management issues, and medical control. His letter is three pages long and quite technical.


(above left, participant with question [middle], camera dude, union guy. Right, below, the crowd there)

I think the plan was more of an informational meeting, and not a real open question-answer meeting. Ms. Davis had the best line during the presentations: "This is backdoor political dealing at its finest." However, you know how it is about best laid plans: sometimes, you have to blow them up. So the floor was opened to questions and statements from the audience. And as the questions were asked, the immediate tone of total distrust of the city's management became apparent. The Gloria settlement was mentioned. Bulky item pick-up was mentioned. Mayor Funkhouser was mentioned. It also became immediately clear that the structure of the merged organization was a complete unknown. One of the three union 42 guys described possible "back room service" savings such as merged building maintainace contracts, and saving on the separate broad band/phone service for dispatch. He also related savings from having just one command structure for both the fire service and EMS service. But I am not sure the audience was buying: why mess with what is not broken? A few other items show up on the notepad on my Black Berry: "Pension issue. Distrust city running service. What does the city gain from this? Louie Wright to support Funky?...Goal to take jobs to FD." Both the power playing and the consequences to MAST employees were also discussed. Many people felt that it was a power grab and not done for any particularly good reason. I got my two cents worth, first talking about the mobile post system, where MAST parks ambulances in strategic parts of the city to make getting good response times easy, second talking about firefighters, third why change, city management is bad and finally told the story of the church lady I took care of at the VA. The system worked from beginning to end for her, let's not mess it up! (She had cardiac arrest at her church; we were the nearest hospital, fire and MAST were perfect! She was stabilized and transferred to RMC, where she did really well. High fives all around.)

(right, two other guys from local 42. The guy in the dark shirt did a lot of talking. The guy in the light shirt had a video camera; at one point, he had to be told several times to stop taping when a participant--a MAST employee--was speaking and requested that he not be taped.) I just don't think the crowd was completely buying what the union and others in favor of merging were selling. Savings were too vague--they might have convinced a few with a well done handout of all the savings and a diagram of the new command structure. But they had no such information. So the question of "why?" lingered in the air, and the stench of the playing of power from local 42, and the upcoming mayor's race just would not go away. Many just could not see a really good reason to make this change.
There are basically two models of control for EMS. One is for EMS to be under the control of the local fire department and they have the ambulances and medics under their control. The second is for EMS to be a separate entity, with its own command structure. They may have a tie in with the local hospitals and doctors. MAST is separate. Raytown EMS is not part of the fire department in that city. Lee's Summit and Grandview Fire Departments do the EMS for their respective cities. Each has its pluses and minuses, but all things being equal, I would rather keep the entities separate. Fire's primary responsibility is to put out fires. EMS becomes a step child, especially in areas where historically EMS and fire have been separate. I would vote for MAST staying separate. The only exception would be if it could be thoroughly documented that service would not suffer and there was really economic savings. Even then, I might say MAST should stay separate. Because the smell of power lust and manipulation is just too strong.

Cruisin' Around on a Friday...

Keeping up with the car theme, tomorrow is the fourth Saturday of the month. (Odd calender this month!) The South 71 cruisers big monthly cruise is tomorrow, August 22, 4 pm to 9 pm in downtown Belton, MO. The weather forecast is for some great weather. Last month there was outstanding weather, with the result of a turnout of over 700 antique, classic and specialty cars--there were cars everywhere! So come on down, and check it out.



For your Friday cruise warm up, come on out to the Longbranch on the northeast corner of 91st street and Metcalf Ave in Overland Park, KS around about 6 pm. A DJ and relaxed atmosphere have made this weekly cruise a must attend for classic/antique car owners and enthusiasts.

MAST petition gathering tonight. We'll be reporting back on what we see and hear..

Nice SKC neighbor story...the odds of this happening, especially across racial lines, are unbelievably high. Check it in the Kansas City Star.

More good SKC news, as reported by Alonzo Washington...from his blog on myspace--check the blog list for the link. Stark Ave murderer caught!

KC,I have been pushing for people to give tips in the recent spate of murders in this hell hole. It looks like someone heard me. One homicide may be solved. However, we need to solve many more. Keep the tips coming. If the news was not so negative they would build on this story. They would cover the need for people to come forward & use this story for a example of how murders can be solved if someone speaks up. Although, most of them would rather keep covering the bad things instead of the good things that take place in the hood. Read this & if you have a tip in another case give me a call.Peace,Alonzo Washington(913) 321-6764
Charges filed in weekend KC homicide
From Bob Cronkleton: The Jackson County prosecutor has charged Kris L. Ruff, 38, of Kansas City with murder in connection with a fatal shooting Sunday evening. Ruff was charged with second-degree murder and armed criminal action. He is accused of shooting Anthony Melson, 42, of Kansas City at a residence in the 10700 block of Stark Avenue.


From the Jackson County Advocate this week...International House of Prayer to Purchase Grandview Plaza....IHOP will be using the facility as a stopgap until their big complex is built...See the Advocate for a nifty map of all the property IHOP is involved in in SKC and GV...there will be community meetings with IHOP August 27th 7 pm at Grandview High School 2300 High Grove in Grandview and September 1st at 7 pm at the Hillcrest Community Center, 10401 Hillcrest Rd, KCMO. Also in the Advocate, news on bulky item pick up, and school progress. Shameless plug alert: The Jackson County Advocate is the kind of newspaper that is still flourishing in the Internet age; small weekly papers are the ones doing the best. If you are not already getting the Advocate through your home owner's associate, subscribe or pick one up at the store.

Blog at you later about the MAST meeting!

Thursday, August 20, 2009

Well, I Did It...

Well, I finally did it. I got someone's undies in a bunch on the Internets. I was commenting on comments posted on one of Tony's Kansas City's entries on MAST and Local 42, the KCFD union. I noted that many of the comments were posted anonymously, and said more or less that that says more about Louie and Local 42 than I ever wanted to know. In other words, people are posting anonymously because they are concerned about their health and well being. Someone (anonymously, natch!) took me to task because my blogger name, Observer, is rather vague and anonymous, and what's it to me to be commenting about anonymous commenters. Well, I explained myself a little bit, noted that I am not completely anonymous (blog's right here folks) and was reminded that when issues are red hot, and everyone gets a little "het up", that subtlety is missed. Just come right out and say it--the commenters are anonymous because they are concerned for their safety!!

Thursday Afternoon Potpourri

I was going to post a nice picture of Michelle Obama getting off Air Force One in a nice pair of shorts, and discuss the minor kerfluffle that has come up about it, but the picture won't post, even though I talked really nicely to my computer. Oh, well, here's a link instead. As you can see she looks good--really. She's not a waif, she's a woman. Here's the discussion part: I have no problem with it in this context. She is on vacation. She isn't meeting anyone, or doing official business. I think some of the flap is from conservatives who will criticize anything the Obamas do. I think some of it is generational. Our generation (I am 10 months older than the president) is much less formal. We are more willing to dress down. If you want to see an example of the change, check out some of the older sports photos. Everyone is dressed up. You dressed up to see your sports team play. Now, you might dress up, but certainly not in a coat and tie!

Elections are taking place in Afghanistan today and so far, there has been minor violence and per msnbc 26 deaths but not the chaos the Taliban were threatening. The people there are very discouraged by the results of their last election, and have been threatened, so it will be interesting to see the turnout. So far, the turnout is reported to be "millions". The area is so riven by centuries old conflicts and has so many cultures within it, and is so backwards--I mean stuck in the 18th and 19th centuries when I say this--that it is just about impossible to centrally govern. Pray for the people of Afghanistan, that they will find their way out of the darkness of unmerciful, un-graceful Islam.

A young woman by the name of Castor Semenya from the Republic of South Africa has won the 800 meters race at the World Track and Field Championships. She'll receive her medal, but they are going to test her genetic gender. This takes a little while to process, she gets to keep her medal until a problem is demonstrated. Here's a link, so you can see her photo. To me, she looks like a female in the head and neck--no prominent Adam's Apple, feminine facial features--and like a guy in the body. She doesn't appear to have external genitalia of a man (can't hide much while wearing those tight track shorts). This is more complicated than it looks: She could be female and 1) doping--injecting testosterone 2) have abnormal hormone levels naturally. She could be male and have been born with weird abnormal genitals, and the doctors cut them off, and her family raised her female. So we'll follow along with you, and await the results.

I am planning an entry on what cars people may be collecting in the future. I was thinking of it when cash for clunkers started. Oh, it just hurts my car loving soul that engines are being deliberately destroyed by this program. I wince every time I think about it. So, reader, any cars of the past 20-30 years you can think of that could generate enough passion that folks would collect them?

Future classic?

Wednesday, August 19, 2009

Wayside Waifs Wednesday

The SKC Observer will be posting every Wednesday some photos and info about wonderful adoptable pets at Wayside Waifs, the animal shelter here in the south part of town. Wayside Waifs has been in operation since 1944, and now has this gorgeous facility to help care for the animals. Way back in 1990, I adopted a wonderful cat from these folks. Buddy passed away in 2007; this is one way I can both celebrate his successful life and give back a little bit. So here goes...

Meet Sam, an "older" cat gentleman. Sam was given up by his owner when she could not care for him any more. Sam is 12 years old. He's not much for small, rambunctious children, or other felines, but he is interactive, playful and very talkative and responsive to people. As you can see, he is an orange tabby with white on his chest and paws. He has "freckles" on his nose and lips, not uncommon on orange cats. Cats can live to their upper teens and even to twenty, so Sam has plenty of good years left.



These handsome dudes in this terrible picture (animals are always so cooperative about picture taking!) are Cole (L) and Duke (R) They are both about 4 years old, and grew up together. They were found, with a note, tethered to the door at Belton Animal Control. I doubt the owner was cruel or mean, just in a tight spot. The dogs were well fed and healthy, and the note contained all kinds of helpful info for perspective adopters. Cole and Duke are housebroken,
know how to use a doggy door, leash trained, and good with kids. They are friendly and interactive when you approach them. Cole is part lab, all black (a little grey around the muzzle), with a lab type coat. Duke looks for all the world like a very small Bernise Mountain Dog, with waves of hair on his back, orange "eye brows" and a white tip on his feathery tail. They are both probably 60 lbs, not small dogs but not huge either. They'd do well with a family, or active couple. Cole seems the less active of the two, but it can be hard to discern personality at the shelter sometimes. You just have to come see them yourself!

Wayside Waifs is located at 3901 Martha Truman Road in Kansas City, MO. The phone number is 816-761-8151. The hours are Wednesday-Friday 2 p.m.-8 p.m. and Saturday and Sunday 12 noon to 6 p.m. The Shelter is closed on Mondays and Tuesdays. The website, which has listings for all adoptable pets, including photos, is http://www.waysidewaifs.org/

Consider adopting a pet--they'll love you forever.

Save MAST!

I have to admit, I was wondering where we were at with the possible city take over of the ambulance service MAST. And there is TKC fearlessly supplying the answer! (Yes, that is a shameless plug.) This is more than a passing issue to me. As an RN in the ER, what happens out in the field is very important to me; it might make the difference between receiving a live patient in the ER verses receiving a dead one. I think very highly of the service MAST gives, and have been very impressed at the high level of care that is given, often under very difficult conditions.

The most important thing I want to get across to everyone is this:

Local physicians, MAST employees, community leaders, local politicians and petition organizers will be on hand gathering 4300 signatures of registered Kansas City voters required to put the issue on the ballot in February and providing more information about the MAST takeover at the Southeast Community Center located in the Multi-purpose Conference Room at 4201 E. 63rd St. Kansas City, MO 64130 from 6:30pm to 8:30pm on Friday, August 21, 2009. Light Refreshments will be served. Space is very limited.

Go and sign the petition, Kansas City voters!

Tuesday, August 18, 2009

The Endlessly Fascinating Weather

I have always found the weather just fascinating to watch. You can place the blame on two old time TV weather dudes: Tex (don't remember his last name) on channel 7 eyewitness news in New York and Stewart Hall of WCAX channel 3 in Burlington. After 20 (!?!) years in K.C., the weather has only gotten more interesting to me. You will notice two weather blogs in the blog list, one for K.C. and one for Vermont. I read them pretty regularly, along with the resources on the web site Weather Underground.

This summer has been one for the books, with Seattle heatwave, late Vermont heat, and cool Midwest Summers, with the second coolest July on record here in K.C. Sometimes, I think "normal" is merely an invention by someone with a really bad sense of humor.

With the wonder of cell phone cameras, you can photograph the weather "as it happens" so I am, hopefully, with this new toy, going to let you all see some really neat shots I took as I drove into a small squall of rain earlier this summer. In the pictures I am driving east on I-435, with the setting sun at my back. Note the rainbow to the left, and on the early shots, you can still make out shadows from the other cars on the road.

Well, it's obvious this picture placement stuff is going to take some practice! I had to edit in Html to get them in a logical spot but they are posted in the right order, the earliest on top and to the left and the last at the bottom. Read'em left to right, and I think that will get the order right. I'm going to leave the Html gobblygook as I don't want the pictures to disappear! Sorry about that, call it growing pains.



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Thanks to everyone who has read and commented so far!

Observations From the Observer

A few quick posts on this cloudy Tuesday...

Brett Favre has signed with the Vikings...frankly, surprised the heck out of me. I really thought he was done. It is anticipated he will take snaps against the Chiefs later on this week. The story will be all over the place, here's one link.

980 KMBZ will be having a Town Hall Forum on Health Care on August 27th at 7 pm at Rockhurst University. They are hoping they can get Congressman Cleaver or Congressman Moore to come, among others. The lack of intestinal fortitude on the part of our left leaning congressmen is a subject for another entry, but it sure would be a better Forum with one (or both--dare I dream?) of these guys. Check KMBZ's website for further details.

If you follow any of the KC blogs, you no doubt have seen the flap doodle between Alonzo Washington and a blog called the Bovine Comedy, as highlighted on Alonzo's blog and on Tony's Kansas City. My two cents: leave Alonzo alone please. The way he dresses, the way he talks, the way he writes on his blog--all secondary to the issue of crime in this town. It's easy to speak fluff crap when it's not you and yours that's getting shot at, robbed, burgled and whatnot. Even from my neighborhood, while we got troubles, it would be easy to blow off Alonzo as unprofessional, etc. But he has his ears on the 'hoods with trouble, and folks find him comfortable to talk to. When you have to solve a problem, you use all resources--including the ones that are outside your comfort zone. So let the man do his work! Links to Tony and Alonzo here.

That's about all for now; I have a whole yellow pad of ideas for the blog.

Monday, August 17, 2009

Welcome to my Blog

Friends, family, hangers on--I've started a blog! My blog will be a place where you'll find observations on the world around me. I'll also wax philosophical and theological at times. Other times, the pithy words found here will be news and event driven. As I get more comfortable with formats and links and the other toys, the blog will include more. I want it to be interesting and fun!

Now, I know the blogosphere can be ruthless and mean, with dualing entries, flame attacks and ridicule, but truly I am here to have a little fun, to have a place to opine, to bring things to people's attention, to perhaps teach, to perhaps be used by God, and to make folks laugh. So if a spelling mistake, or typo makes it into print, or I wade into some current controversy (people, leave Alonzo Washington ALONE!), and I get some "eh" feedback, that's just part of the game.

So let the blogging commence!