Thursday, November 5, 2009

Annotation image and questions

1. The history of medicare
2. The cost of health insurance for the elderly
3. Home doctor visits vs. going to the doctors
4. Are the elderly being treated fairly
5. Elderly health care services (gerontology/geriatrics)
6. Nursing homes verse staying with loved ones

Sources:
Time for Senior Citizens to Review Medicare Drug Coverage
The Gerontological Society of America
Doctors Visits Are Getting Short Shrift in Tight Economy
Designing Health Insurance for the Elderly
Nursing Home vs. Home Care - Is There Really Any Question?
Ageism Is Pervasive In Health Care?

Monday, November 2, 2009

Welcome to Cancerland...

In her article, Barbara Ehrenreich discusses her personal experience with being diagnosed with breast cancer and the journey it put her on, both emotionally and spiritually. Physically speaking, Barbara experienced what we all know to be the painful affects of being diagnosed with breast cancer but on other levels she was rocked worse. Initially receiving her diagnosis after a routine mammogram that her health insurance company recommends to all women after reaching the age of 50, Barbara’s world was suddenly turned upside down. She instantly went from a life of normalcy; running errands and having the confidence of knowing what each day held to being a member of support meetings, maintaining a positive attitude, donning pink ribbons and feeling anger for her situation but disguising it as acceptance. She talks about the frustration and fear people are subjected to with regard to the mammogram machine and the painful experience of having one’s breast squished for an excruciatingly long period of time while it’s being examined. The fear she went through when the radiologist will not answer any questions about what they may or may not have seen on her mammogram results was apparent and the length of time she had to wait to get her mammogram results bothered Barbara as well. While most of us are privy to the information we might see on a television special about breast cancer or what we see at a pink ribbon rally, Barbara tells of the experiences that she faces when one is diagnosed with this incurable cancer that most people, especially those with the disease, rarely discuss. Barbara writes about the “unmentionable” in her article, honestly sharing her feelings on how awful it is to be diagnosed. She quickly discovers it is inappropriate and taboo to discuss breast cancer in a self-defeating way and rather it is more accepted to remain upbeat, happy and feeling beautiful.
To date, there are 2.2 million women in America going through various stages of breast cancer. Of these people diagnosed Barbara explains, each is supposed to think of their cancer cells as “the enemy.” Always told to remain positive and keep a positive attitude, Barbara discusses her inability to keep such a happy facade during her time of diagnosis and during the chemotherapy and terrible medications that followed. There is already a mapped out plan for treatment for each women diagnosed, Barbara explains. While she might have been able to decide whether or not she wanted a lumpectomy or a mastectomy, because of the results, Barbara and most women prefer the first anyway. “The pressure is on, from doctors and loved ones, to do something right away—kill it, get it out now,” she says. A breast cancer cure is not in existence so regardless of which path Barbara chose to take with regard to her surgery, she was painfully aware that the death rate for people who have breast cancer has changed little in the last seventy years. There is also still no decisive determination on what causes it. Alternative methods for treatment are available; numerous celebrities like Suzanne Somers have also published books discussing their success with alternative medicine in destroying cancer. Studies have shown that alternative methods have proven unsuccessful in most of these cases, however, so Barbara chose to put her faith in science and take the chemotherapy route.
Numerous organizations exist to support people who have been diagnosed with breast cancer that were not available thirty years ago. Barbara discovered hundreds of websites dedicated to the issue, breast cancer pamphlets, several books cited within the article, a monthly magazine called Mamm, and she also found out that there are four, nationally supported breast cancer organizations that financially support many programs geared toward breast cancer awareness and funding for a cure. One of the more well known organizations is The Susan G. Komen Foundation. Barbara admits that while most of these “Race for a Cure” marathons and “Pink Ribbon” events held by such companies spend more on decorations than they make on donation funds, she believes there is a comfort in the discovery that no one has to go through dealing with breast cancer alone. Hesitant to use the word, “victims,” Barbara and other women joined together as “survivors,” learning through the battle stories each one would share and rejoicing in their victory. Counting the days that they have lived through since each was first told they had breast cancer. Barbara and her peers remember the people who had succumbed to the disease with candle light vigils. Also referred to as those people who have “lost their battle” with breast cancer. Barbara and others like her struggle to accept the survivor’s guilt they feel for still being alive yet remain optimistic because for the time being, at least, they are ahead of the disease for which there is still no cure.

Thursday, October 15, 2009

Cheers

“You want to go where everybody knows the troubles are all the same, you want to go where everybody knows your name…” I heard those lyrics to the television show, Cheers, a lot growing up because my parents used to watch the show every week. While the show itself and the Cheers bar are based on a location in Boston, the characters in the show and the atmosphere of the bar itself, is a microcosm of any bar in America. I found this out about 5 years ago when I started going to a bar that a friend introduced me to in Rhode Island and discovered very quickly that there are other Cliffs, Rebecca’s and Sam Malone’s in the world besides the actors who played them in the television series. They come in all different shapes and sizes and can be referred to within society as anything from a customer, to a social drinker, to a bar fly to an alcoholic. The atmosphere of this bar in Rhode Island in particular, has amused me for years based on my Cheers theory. My friends and I meet there for drinks one night a week and over the years I have become more familiarized with and able to gather a lot of observations about this bar and the people who are the regulars, that go there. While I will not reveal the true identity of the bar to protect the patrons that frequent it, for the purpose of this essay I will call it The Bar and I have also changed the names of the people I wrote about to protect their identities.

At first pass it’s easy to miss the entrance to the parking lot that runs adjacent to The Bar. Only a small off-white, rectangular sign no larger than 2 feet by 1 foot and held up by a wooden mailbox post with the name, The Bar, written across the front in brown paint alerts the passerby that it’s even there. From the street the building appears anonymous and boring; it only has windows along two sides and the structure itself is relatively small. There are only a few signs on the windows that face the parking lot indicating an establishment is inside. One telling of the latest imported beer that has been up now for about 2 years and another asking that you wear a shirt and shoes or you won’t get served. It’s at this point, at least, that you know you are entering a drinking establishment but if not for the signs, you wouldn’t know until you entered and saw the large bar itself that takes up the entire left side of the space. Upon entering, the delicious smells of French fries and popcorn mixed with the scents of sizzling hamburger patties and steak and onion sandwiches fill your nostrils and immediately make you hungry. The bar is along the left wall and to the right are barstool tables and then beyond those are about a dozen larger tables for families or those who are with a large group of people. In the back is a smaller bar with an area that has a few arcade games and two pool tables. The walls are made of a beautiful, dark wood and it’s evident that the d├ęcor is that of a sports bar. There are numerous autographed photographs of the Celtics and Patriots players who have visited the bar hanging along the walls. Among them, a few worn out and yellowed newspaper articles, dating back to almost thirty years ago, report on events like the day when Sullivan Stadium was re-named Foxboro Stadium or when The Bar originally opened. Large, flat-screened plasma televisions that arrived only a year ago and have increased the viewing pleasure of whatever sporting game happens to be on are bolted securely onto each wall at various places around the three large, connecting and open rooms that make up The Bar. Their perfect positioning high up on the walls makes it so that at whatever seat you sit, you have a perfect view of a television. The overhead lighting is on at a low enough brightness that it makes it seem as if the lights are hidden among the ceiling and you are surrounded by natural light.

The glass door entrance to The Bar is never shut for long as it is always opening to reveal a new character or a regular coming in to quench their thirst. Whether they be a lone businessmen just passing through town or people getting together to share a laugh that are on a first name basis with the bartender, The Bar is a busy place whichever night of the week you go. Busy but quaint enough that it’s not overwhelming and you feel crowded. I sit in the first section as you walk in where the bar stool tables are and because there are only 8 of these tables in this section, I have come to recognize and get to know the people who frequent The Bar over the years. With the faces have since come first names and stories; my own Cheers, complete with a cast of characters all its’ own that I occasionally talk to or overhear, just located in a different bar and in a different state. The “Cliff” of the group, or the character that always appears sad and beaten down, is a man in his forties named Sal who owns a pizzeria in Warwick. He comes in every Wednesday night after he closes up his restaurant, arrives at 10:45 and is always sweaty and wearing a white chefs shirt and black pants and sneakers. It looks as if he has never showered or seen a razor but as I found out years later, he has to leave his house by 5 am for work so he does shave and shower but come nighttime it just looks as if he hasn’t. The bad 5 o’clock shadow runs in his family he once told me in a serious and defeating tone, “It’s because we’re Italian.” He talks about every aspect of himself and his life out loud like he’s reciting a play and the more he drinks the more boisterous his voice gets and the more animated his hand gestures become. Sal also dislikes his parents, regrets buying a pizzeria and thinks little of himself. Despite anyone saying otherwise, Sal thinks he is a loser. Multiply that by 4 years and I now also know that Sal is gay and the man who he would always sit next to at the bar that I just thought was his good friend, is actually his lover but no one is supposed to know. I’ve also discovered that Sal’s mother, Lisa, whom I’ve never met but know a lot about, is an angry old woman who prefers her children to be straight and lives in a nursing home that Sal pays for.

The Bar’s version of “Rebecca” or the incredibly high-strung and ditzy character is a woman named Alice who is dating the bartender of The Bar, whose name is George. Alice, a twice divorced mother of two adult sons works for a phone company and usually pulls in anywhere from 60-65 hours a week. She comes to the bar to spend time with her boyfriend George that she moved in with last summer and with whom she wishes she had more time to spend. She walks as if she’s trying to make up for lost time, with a hurry that would be more appropriate for a person exercising than just casually walking around. Her face always carries a look that screams exasperated and when she talks to you it’s so quick you feel like you need to replay the conversation three times to catch what she said. Alice is very nice but always in a rush or having a problem, similar to Sal but she is just more frantic about it. The nights she comes in she sits at the very last seat at the bar and sips water and eats chicken wings. Alice is 54 years old but looks like she could be 60 because the lines around her face are hard and her hair is almost grey. She wears her hair in a short and simple cut, has brown square glasses and dresses in simple clothing. Someday she hopes to retire but because of financial difficulties accrued during her disastrous first marriage and her second husband ruining her credit, Alice doesn’t think she’ll ever be able to do it. In the five years I have known her, this is all Alice really focuses on.

George, on the other hand, is one of the most laid back people I’ve ever met and is the Sam Malone character in my Cheers philosophy. He’s just so cool and has been since the first night I went to The Bar. George makes everyone that walks into the bar feel like they’re old friends. He’s quick to give you a menu, offer advice or refill your drink. George has a sixth sense about who needs what and his tips are evidence of his popularity among the customers. The customer base is always larger on the nights that George works and I only go to The Bar on the nights that he’s there. Compared to most bartenders that work there or other places I’ve been, George is the equivalent of Tom Cruise in Cocktail. Not only can he flip liquor bottles into the air and catch them but his advice is good, he always has a joke to tell and my friends and I get discounts on our bill because we’re regulars and he likes us. George is an attractive, middle-aged man with fiery red hair and freckles. He always wears dark jeans and a dark blue work polo. He collects nice watches, specifically Rolex, and he is always wearing a different gold watch each night. Bartending is George’s second job, one he has more “to pay for the gas in his cars” than anything else. His main bill-paying job is as a realtor and he has been very successful at that for over ten years now. He picked this part-time job up more for the social aspect it affords him than for the paycheck. All of George’s friends come in and see him when he works at the bar so working at The Bar for George has always been more like serving his friends and getting paid for it.

At quarter to one every morning, the bouncer or one of the waiters will turn the lights up and shut off the music to signal last call. No matter how many times you go through it or prepare for it, the moment when the serene natural light and soft music turns into a bright fluorescent glare and silence, your good time lessens slightly. Their method for getting patrons out is very successful, you don’t want to hang out in there anymore when the lights come on; the magic is gone. The Bar is only a plain structure from the outside view but once you go inside and truly experience the atmosphere and the people, it suddenly transforms itself into a familiar place with personality and people full of charm. I don’t know Sal or Alice or George’s last names and we don’t socialize outside of the bar but they are an important part of my experience there and when I go, I look forward to what they might tell me that day and hope that each shows up. When I first went to The Bar I thought that people who knew the bartender by name or who knew the personal details of the people around them were bar flies or alcoholics. Cheers, was only a television show created by someone but not based on anyone, a figment of some writer’s imagination. Now I think that Cheers can be any bar, anywhere. It’s not just problem drinkers that hang out at bars, some people like Alice go to bars and don’t even drink alcohol. Others like Sal go to feel accepted and let it all out so they can get up the next morning and do it all over again. George is the man who brings them all in; the lone businessman who stops by The Bar on the way to his hotel for a quick drink or a group of woman who get together for a girl’s night out. No matter what the reason they come, the customers do come…to share a laugh or a cry. “You want to go where everybody knows the troubles are all the same, you want to go where everybody knows your name…”

Friday, September 25, 2009

The San Francisco International Airport

It was on a Tuesday that I made the decision to fly out to California with my boyfriend, Carter, for a flight that was leaving on Thursday of the same week. We had only been dating for a few weeks but he had decided months before meeting me that he wanted to attend the Champ Car, preseason races, at Laguna Seca in Long Beach, California, so I, having never been to California before and really wanting to get away with him on our first vacation together, agreed extremely last minute to book a flight and go as well. As the fates would have it, the flight Carter was taking was full so I had to book another leaving virtually around the same time but flying direct versus his flight having one stop-over, putting me into California almost one hour earlier. The inconvenience of not being able to fly on the same plane with my boyfriend, on our first vacation together no less was a bummer. Waiting around the airport for an hour for him also wasn’t too appealing. Under normal circumstances it would not have been worth it for me to spend the money on the ticket and fly out there. The flight was 6 hours and I knew next to nothing about Champ Car, I had only knowledge of NASCAR but didn’t even watch that. Everything told me not to go but because I really liked this guy and he really liked Champ Car, I was determined to go and try and like Champ Car, too. I was sucking up the fact that I would have to sit alone on the plane or get stuck talking to a stranger for hours and hours. Rhode Island to California is a long trip and I wasn’t used to going places like that alone but despite that, I was going and at least we were both flying home on the same flight together.

My 5 hour and 40 minute flight from Providence to San Francisco went pretty smoothly. I was looking forward to visiting California and getting to experience one of Carter’s favorite hobbies. After landing at the airport and getting off the plane, California time was 8 pm so while there was much passenger activity to and from airplane gates, there was little open in the way of magazine stores or restaurants. I had to find a place to sit out of the way of foot traffic and settled on a bottle of Pepsi and crackers from a vending machine. I hadn’t eaten dinner before leaving for the trip so with little else to eat on the plane but a bag of pretzels, I was hungry. After glancing around my surroundings and realizing that the airport had shut everything down but the gates, I figured I would wait until Carter got there and we’d pick something up once we left. I moved to a better location where I could spread out my stuff and nearer to the wall where there was an electrical plug so I could charge my cell phone because the battery was acting funny. There was a clock overhead so I was glad I would be able to keep track of the time while my phone was off charging but behind me in a sectioned off area there was construction going on and I found that noise annoying. I looked at my phone and was thankful I only had about 35 more minutes to deal with this and then Carter and I would be leaving.

First, I thought his flight was just delayed landing on the tarmac. I had waited until five minutes past nine to phone him giving his flight a few extra minutes to unload and giving him a few minutes to get his cell phone turned back on. No answer. The electric saw started up again behind me and I couldn’t even hear myself so I had to move down the escalator to step outside and tried calling him again from the curb. I missed hearing the low battery beep that warns you of little battery power left. No answer. I pulled out my last cigarette, smoked it faster than most people take 5 regular breaths, dialed his number again and heard his voicemail message. It’s one thing to be stood up in your hometown or local surroundings but 6,000 miles away at 9 at night when I was out of cigarettes with no way to get to our hotel was wrong. I was scared but I couldn’t lose it now, I had to hold it together and figure out what was going on. Carter wouldn’t just leave me here, something logical must have happened. I went back up the escalator and resumed my position against the wall near the construction and plugged my phone back in. It dawned on me the phone wasn’t charging. No sooner did I plug the phone in and have the thought that it rang and showed Carter’s number. Thank God! Just as soon as my joy went up at anticipating his arrival any minute, it came crashing down when he told me his plane had technical problems in Chicago and due to the delay of their replacement plane, hadn’t even taken off yet on the last leg to California. His best guess was that it would be another 6 hours until he landed in San Francisco. 6 hours until I would be able to eat some real food…6 hours until I could see my cute boyfriend…6 hours until I could buy more cigarettes…6 hours until I recognized a friendly face in this endless, busy mob of strange faces…6 hours.

There’s no way I can do this I thought to myself, if I hear that electric saw or those construction workers talking to each other in a language I don’t understand for one more minute, I’m going to lose my mind. My stomach was so empty at this point I could feel it turning on and eating itself. It was grumbling so loudly it sounded like I was hiding a starving child in my carry-on bag. My cell phone battery dilemma seemed more like a devastating crisis. I felt completely deflated and hopeless, like the universe was punishing me for something I was unaware I had done. I hated California, I hated Champ Car (even though I still didn’t know what it was) and I really hated myself for making such a last-minute, sporadic decision that I was obviously paying for now. To add insult to injury, it was sometime after Carter and I hung up with each other, about 6 minutes into my crying rant on the phone with my mother who was trying to comfort me and sort of starting to, that my cell phone died. The tears started rolling down my cheeks and while I was busy catching everyone with my fist so people walking by wouldn’t notice and scolding myself for having been so stupid as to have a broken cell phone, no cigarettes, no hotel name, no boyfriend for so many more hours and no way to get food, I heard a little boy walking by with his family yell, smile. I looked up as he was yelling it again to see a tiny blonde haired boy with a bright red Florida sweatshirt and tan shorts take a picture of his parents, who obeyed and were smiling. The irony of it all, I thought, this family so happy and all together and me, so upset and feeling so alone.

The clock above my head read the same time it had when I had first arrived at my spot against the wall so I realized it wasn’t working and when I heard the electric saw start up for the millionth time I figured it must have been shut off for the construction. I wasn’t wearing a watch and my cell phone was dead so I had no way of telling time. Moments after the boy in the red sweatshirt went by I got up and went back down the escalator, outside to the waiting area on the curb to ask someone for the time. Everyone I asked, which was a total of 6 people, couldn’t be 100% on the time so between all their answers, I guesstimated what time I thought it must be. It was still hours to go until Carter landed but I decided instead of focusing on the negatives about it, I would instead start to view this fiasco as an adventure. I looked around. It was then that I noticed the comfortable looking metal benches lined up along the curbside for waiting passengers to sit down and take a load off. I also noticed the temperature was really nice, a lot warmer than the 36 degrees I left behind back in Rhode Island in January, so I took off my top shirt and sat down. I took a deep breath, maybe I could do this. A proper looking businessman approached me while I was sitting outside and asked if I had a light. I pulled the lighter out of my pocket and as he was handing it back to me I asked him if he had an extra cigarette I could have. He said yes and gave me one and all of a sudden I noticed that things were starting to look up, just a little. Maybe San Francisco wasn’t so bad after all and just maybe I could do this.

The obnoxious construction had the power off in the entire section of the San Francisco airport where my plane flew into. There was no working screen to show which flights had arrived and which ones were departing. The restaurants weren’t just closed for the night; they were closed for the restoration. So on the floor against the wall I sat and I waited and I sat and I waited and I watched the area where Carter would be coming out of. Finally, after thousands of different faces and glasses and baseball caps and flowers and endless styles of carry-on bags, I recognized the face that appeared out of the crowd and remembered seeing the red and black carry-on bag in his closet…it was Carter. He smiled and I smiled and I ran to him from where I was, covering a distance of about forty feet in less than a second. The electric saw began again in the background and I wasn’t even bothered by the grating sound, I was hugging Carter. We were together, he was finally in San Francisco, we were leaving together to feed us and get my cigarettes, and our first vacation was officially beginning. I had survived a difficult, exhausting, stressful, endlessly never-ending disaster of events from the moment I exited the gate on Thursday until Friday, early morning when Carter arrived yet if asked today what vacations really stand out, San Francisco is one of them, for Laguna Seca and for the airport.

Monday, September 21, 2009

Personal essay experience

The process I used to generate ideas was talking to my boyfriend. After searching tirelessly through diaries and old vacation photos and racking my brain for ideas only to hit a wall in an effort to think of something to write, my boyfriend ended up being my best source for my inspiration. He suggested that he say things aloud to me that he and I had done or experienced together and if something stuck with me then we would expand on it further to see just how much I could write. This process took about a week or so and then once I settled on the idea, I still talked the experience through with him to make sure I could capture it as it had happened, and make sure I detailed the moments I remembered as being important, and why. I struggled with picking a topic, too, because I wanted to make sure it was appropriate for the audience and not anything too personal to share. It had to be a topic that would have enough "meat" in it to cover a couple of pages and most of those times have been personal experiences I didn't want to share so it was difficult to choose one that would include a lot of detail and experience without giving away too much, yet still complete that part of the assignment that has a universal topic most people could somehow relate with.