Saturday, March 15, 2008
Bad Movie Physics: A Report Card
Bad Movie Physics: A Report Card
Apollo 13 and the Right Stuff scored the best...
Worth1000.com | Photoshop Contests | Are you Worthy™ | contest
Photoshoped modern items inserted into vintage ads - check them out; pretty cool.
Worth1000.com | Photoshop Contests | Are you Worthy™ | contest
Restored Houdini movies features a fight with the first ever robot in a motion picture - Boing Boing
Sweded remake of Star Wars - Boing Boing
Sweded remake of Star Wars - Boing Boing
This Sweded Star Wars remake features enthusiastic young people with KFC buckets on their heads reenacting key scenes from Episode 4: A New Hope while humming the theme music. Gold. Link, Link to production sketches (via IZ Reloaded)
Fingertip biometrics at Disney turnstiles: the Mouse does its bit for the police state - Boing Boing
Fingertip biometrics at Disney turnstiles: the Mouse does its bit for the police state - Boing Boing
" What these readers are effective at is conditioning kids to accept surveillance and routine searches and identity checks without particularized suspcion..."
Friday, March 14, 2008
House Democrats reject telecom amnesty, warrantless surveillance - Glenn Greenwald - Salon.com
House Democrats reject telecom amnesty, warrantless surveillance - Glenn Greenwald - Salon.com: "As impressive as the House vote itself was, more impressive still was the floor debate which preceded it. I can't recall ever watching a debate on the floor of either House of Congress that I found even remotely impressive -- until today. One Democrat after the next -- of all stripes -- delivered impassioned, defiant speeches in defense of the rule of law, oversight on presidential eavesdropping, and safeguards on government spying. They swatted away the GOP's fear-mongering claims with the dismissive contempt such tactics deserve, rejecting the principle that has predominated political debate in this country since 9/11: that the threat of the Terrorists means we must live under the rule of an omnipotent President and a dismantled constitutional framework."
Cassini probe failed to 'taste' moon's geysers in flyby - space - 14 March 2008 - New Scientist Space
Cassini probe failed to 'taste' moon's geysers in flyby - space - 14 March 2008 - New Scientist Space: "As Cassini flew over the small moon on 12 March, passing only 200 kilometres from the base of the plume, an 'unexplained software hiccup' prevented the spacecraft's Cosmic Dust Analyzer (CDA) from transmitting data to the onboard computer."
Andersen attorney on RIAA suit: "They can't run now"
Andersen attorney on RIAA suit: "They can't run now"
"...The amended complaint and subsequent discovery will also focus on what Lybeck calls the "flawed nature" of the RIAA's investigations. "We know [the RIAA] cannot identify individuals," he says in response to a question on false positives. "We want to know how many dolphins the RIAA is catching," referring to a former RIAA spokesperson's 2003 comment about accidentally catching a few dolphins when fishing with a net.
The RIAA is likely to fight the discovery process tooth and nail, however, as the information that is unearthed could prove to be extremely embarrassing, if not problematic. "They've operated in this zone of secrecy for five years now, and we hope to put a stop to that," Lybeck stated emphatically, "because it will become obvious that their conduct is illegal an their whole scheme is flawed at its basic core."
he judge has barred further motions for dismissal, so unless the RIAA decides to settle—a move Lybeck believes is in the group's best interest—the case will proceed through discovery and to trial. Unlike the thousands of lawsuits filed so far, the RIAA does not have the luxury of walking away from this case if there's a real chance of embarrassing information being released. "Once discovery happens in the cases the RIAA brings, they run," Lybeck says. "This is our case now, and they can't run...."
Secure USB sticks cracked - heise Security UK
Secure USB sticks cracked - heise Security UK
Manufacturers of USB sticks and cards with fingerprint readers promise us that their data safes can only be opened with the right fingerprint. It turns out that an easy-to-find tool allows nosy parties to get around the protection in some products.
"...All you need to do is use the PLscsi tool to send a single USB command – Command Descriptor Block – to the stick for access to the public partition to be replaced by access to the protected one. At first, this flaw seemed to be an undocumented back door, but some sniffing with a USB monitor tool revealed it to be a major design flaw: the controller on the stick does not decide whether to provide access to the partition; the software running on Windows does. The software on the PC uses another command to decide whether read-only write access is possible..."
"...You can find out whether your USB stick can also be "opened" without authentication by using the open source tool PLscsi. A precompiled command line version for in Windows is available; Linux users will have to compile the tool themselves. The command plscsi -w specifies USB drive as a variable. Keep in mind that the fingerprint sticks register two drives on the system when connected to the PC: a virtual CD-ROM and the normal drive..."
"...The fingerprint sensors in the products mentioned above apparently only serve one purpose: they mislead interested buyers. They do not provide any significant level of protection..."
FBI Tried to Cover Patriot Act Abuses With Flawed, Retroactive Subpoenas, Audit Finds | Threat Level from Wired.com
FBI Tried to Cover Patriot Act Abuses With Flawed, Retroactive Subpoenas, Audit Finds | Threat Level from Wired.com: "FBI headquarters officials sought to cover their informal and possibly illegal acquisition of phone records on thousands of Americans from 2003 to 2005 by issuing 11 improper, retroactive 'blanket' administrative subpoenas in 2006 to three phone companies that are under contract to the FBI, according to an audit released Thursday.
Top officials at the FBI's counter-terrorism division signed the blanket subpoenas 'retroactively to justify the FBI's acquisition of data through the exigent letters or or other informal requests,' the Justice Department's Inspector General Glenn Fine found."
U.S. faces severe recession: NBER's Feldstein | Reuters
U.S. faces severe recession: NBER's Feldstein | Reuters: "The United States is in a recession that could be 'substantially more severe' than recent ones, National Bureau of Economic Research President Martin Feldstein said on Friday.
'The situation is very bad, the situation is getting worse, and the risks are that it could get very bad,' Feldstein said in a speech at the Futures Industry Association meeting in Boca Raton, Florida."
Fed comes to Bear Stearns' rescue; shares dive | Reuters
Fed comes to Bear Stearns' rescue; shares dive | Reuters: "Bear Stearns, slammed by a sudden cash crunch, hammered out an emergency funding deal with the Federal Reserve and JPMorgan Chase, intensifying fears the global credit crisis will claim more victims and driving Bear's shares down by as much as half.
It was the Federal Reserve's first rescue of a broker since the Great Depression and its latest effort to soothe financial markets roiled by fallout from rising mortgage defaults."
Eliot’s Mess Greg Palast
Eliot’s Mess Greg Palast: "While New York Governor Eliot Spitzer was paying an ‘escort’ $4,300 in a hotel room in Washington, just down the road, George Bush’s new Federal Reserve Board Chairman, Ben Bernanke, was secretly handing over $200 billion in a tryst with mortgage bank industry speculators.
Both acts were wanton, wicked and lewd. But there’s a BIG difference. The Governor was using his own checkbook. Bush’s man Bernanke was using ours."
Clinton role in health program disputed - The Boston Globe
Clinton role in health program disputed - The Boston Globe: "Hillary Clinton, who has frequently described herself on the campaign trail as playing a pivotal role in forging a children's health insurance plan, had little to do with crafting the landmark legislation or ushering it through Congress, according to several lawmakers, staffers, and healthcare advocates involved in the issue."
The Gavel » Blog Archive » House Passes FISA Amendments Act
The Gavel » Blog Archive » House Passes FISA Amendments Act: "the House bill does not provide retroactive immunity for telecom companies but allows the courts to determine whether lawsuits should proceed."
American Civil Liberties Union : Watch List Counter
American Civil Liberties Union : Watch List Counter
So far there are over 928,000 people on the watch list.
Why are there so many names on the U.S. government's terrorist list?
In September 2007, the Inspector General of the Justice Department reported that the Terrorist Screening Center (the FBI-administered organization that consolidates terrorist watch list information in the United States) had over 700,000 names in its database as of April 2007 - and that the list was growing by an average of over 20,000 records per month.1
At that rate, our list will have a million names on it by July. If there were really that many terrorists running around, we'd all be dead.
China sends in troops to quell monks' peaceful protests - Boing Boing
China sends in troops to quell monks' peaceful protests - Boing Boing: "Among the many reports today, this sad and symbolic story: two of the protesting monks from Drepung are in critical condition after stabbing their wrists and chests as a form of protest.
The two monks were identified as Kalsang and Damchoe, both originally from Kirti monastery in Sichuan province and now resident at Drepung monastery. Sources said the men had stabbed themselves in the chest, hands, and wrists. Both refused to be moved to hospital but were taken instead to the monastery clinic, the sources said.
'There are many other monks who hurt themselves in desperation, and protests are going on inside the monastery as of March 12 and 13,' one source said. Another source described the two monks' condition as critical and said they were not expected to survive."
Wednesday, March 12, 2008
How an information system helped nail Eliot Spitzer and a prostitution ring | Between the Lines | ZDNet.com
The Gmail password hijacking incident: When so-called helpful apps hurt | Zero Day | ZDNet.com
The Gmail password hijacking incident: When so-called helpful apps hurt | Zero Day | ZDNet.com
An application dubbed G-Archiver backs up your Gmail account to a hard drive with a not-so-nice twist: It swipes your user name and password.
Monday, March 10, 2008
Digg Users Are Doing Their Best To Kill An Acquisition
Digg users are getting worked up over something that is not going to happen...
Digg Users Are Doing Their Best To Kill An Acquisition
A Facebook Application To Find Blood Donors Fast
In search of blood...
A Facebook Application To Find Blood Donors Fast
The Best Things In Life May Be Free, But It Cost $400 Million To Get The Beatles On iTunes
$400 Million get us the Beatles on Itunes...
The Best Things In Life May Be Free, But It Cost $400 Million To Get The Beatles On iTunes
Gmail Scam Signal Of A Much Bigger Security Issue
Gmail Scam Signal Of A Much Bigger Security Issue
...NEVER give you credentials to any 3rd party software!
Justice Scalia's Two-Front War | The American Prospect
Justice Scalia's Two-Front War | The American Prospect: "Despite lip service to 'judicial restraint' Scalia has been waging a war against consumer product regulation as well as protections for workers, at both the state and federal level."
wcbstv.com - Sources: Spitzer Resignation Expected
wcbstv.com - Sources: Spitzer Resignation Expected: "Gov. Eliot Spitzer was not expected to continue as governor and may resign sometime Monday evening, sources told CBS 2 shortly after it was reported that he was linked to a prostitution ring.
Reliable sources told CBS 2 Political Reporter Marcia Kramer that Lt. Gov. David Paterson could be sworn in as governor as early as 7 p.m. Monday.
The news sets off one of the largest scandals in modern New York state political history."
Obama ridicules notion of VP slot - Yahoo! News
Obama ridicules notion of VP slot - Yahoo! News: "'I don't know how somebody who is in second place is offering the vice presidency to the person who is first place,' Obama said, drawing cheers and a long standing ovation from about 1,700 people in Columbus, Miss."
Daily Kos: Obama's "bad" week
Update: It was even better for Obama last week. The final certified vote in California swung four votes Obama's direction. So officially, Obama gained four delegates last week, unofficially (including that Wyoming unpledged delegate), it was five.
Update II: And there were two new super delegate endorsements for Obama on Saturday -- NV State Party Vice Chairwoman Teresa Benitez-Thompson and Rep. Nick Rahall (D-WV).
That makes it a +6 delegate week for Obama officially, +7 unofficially.
Update III: And another super delegates signed up last Tuesday as well -- Georgia Democratic Party chairwoman Jane Kidd.
So make that +7 officially, +8 unofficially.
Criminal Health Care: My Experience in Insurance Company Hell | Health and Wellness | AlterNet
Criminal Health Care: My Experience in Insurance Company Hell | Health and Wellness | AlterNet
By Eric Stoner, AlterNet
Posted on March 10, 2008, Printed on March 10, 2008
http://www.alternet.org/story/79226/
Health care has become the top domestic issue for most Americans this electoral season -- and for good reason. By nearly any measure, the system simply does not work. Heart-wrenching stories of its shortcomings can be read ad infinitum. And while they rightly evoke feelings of empathy and anger, experiencing the system's brokenness first-hand -- as I recently did -- gave me a new understanding of its horror.
I have cystic fibrosis (CF), a serious genetic disease that primarily affects the digestive and respiratory systems. My lungs create excess mucus that is thicker than it should be. This means I am more susceptible to everyday lung infections -- such as the flu or pneumonia -- which can, in turn, be life-threatening.
Despite amazing advances in medical research over the last couple decades, the average person with the disease still does not live to see his or her 40th birthday. The best we can do is stick to long, arduous treatment regimens -- and trust, often in vain, that the U.S. medical system will help us do that.
Cystic fibrosis is a rare ailment; there are only about 30,000 cases in the United States. In business terms, this means that medicines used to treat CF are developed for a very limited market. And since insurance and pharmaceutical companies need to make their billions, the costs of the various drugs that I must take on a daily basis are insanely expensive. (Last spring, I calculated that my prescriptions cost more than $60,000 annually.)
That makes me a life-long cash cow for the drug companies and, paradoxically, an enormous liability for any insurance company -- one that ideally should be expunged as quickly as possible. Indeed, I'm the worst kind of member to have on the rolls: someone with a chronic illness whose medical expenses, as long as a cure remains elusive, will always be exorbitant. I show no profit potential.
Not surprisingly, then, navigating the health care system has never been easy for me. Even when the system is working as smoothly as it can, I have had to jump through countless hoops. Those are an unavoidable and exhausting part of this tortuous circus. But my experience in insurance company hell reached a new low last year. Last November, I spent weeks politely jostling my inept doctor's office and insurance provider to get one of my prescriptions filled. Nobody seemed to take me seriously or put any priority on my case, even as I stressed that I was quickly running out of my medicine. To my disbelief, I began to realize that I did not have intrinsic value in their eyes, but had effectively been reduced to a "member number" and data on their seemingly endless medical forms. And when your needs become too expensive -- since the price of life apparently can now be calculated -- the companies find every possible way to dodge their obligation, playing the role of absentee landlord or deadbeat dad to perfection.
The system's labyrinthine bureaucracy serves to diffuse responsibility for those who must do the dirty work and to demoralize those forced to navigate it. People who are caring and decent in their personal lives dispassionately read the scripted reasons why they are denying medicines -- which, for you, may literally mean the difference between life and death -- over the phone.
"That drug is not on our list," she says.
"We need more clinical proof that you need this medicine."
"The review can take up to 72 hours."
"I'm sorry, but that is our policy."
Armed with excuses, the barricades are erected. The refrain sung. Never mind that you have a valid prescription from a doctor on their plan. Never mind that he called to authorize it and filled out the requisite "medical necessity form." Never mind that you've been on that particular medicine your entire life. That is our policy.
At one point I was on the phone from the moment I woke up until the company's office closed for four days straight. I paid close attention to their complicated explanations for the hold up and tried my hardest to follow their instructions. Once one obstacle was cleared, new ones faithfully arose. Even making the financial argument that if I didn't get the treatment I would have to go to the hospital, which would be vastly more expensive for the insurance company, seemed to have no effect.
"I guess you should go to the emergency room then," I was callously advised more than once. Did they realize that they were talking to a real person about his health and not some trivial matter? Did they get what an utter waste of taxpayer dollars that would be?
Completely desperate, I spoke with a friend who is a lawyer. He was eager to take action. "I'm always ready for a good fight," he reassured. "We can send them a nastygram," he explained, which would put pressure on the company to resolve this before it gets ugly. His confidence and support put me at ease.
The following afternoon, an insurance representative called to say that the medical director had finally approved my treatment. There was no explanation. The extensive documentation that they had been demanding was, in the end, unnecessary, as I suspected. I rushed to the pharmacy. But by the time I was able to fill the prescription, I had already gone three days without it.
My fragile health was put at risk because some faceless suit wanted to save a buck and was testing to see how much of a fight I would put up. (I was told more than once by people who had their own horror stories with health insurance that companies hope you'll just give up. Whether it's true or not, that is definitely how it feels.) It was an emotionally exhausting process that I hoped I would never have to endure again.
Unfortunately the fight wasn't over. A couple weeks later, the insurance company rejected another medicine. It was dรฉjร vu, except this time I was weary. I did not know if I had the stamina for another protracted fight. But when it comes to your health, you have little choice. I was forced to pick up the phone and make the exasperating calls all over again. After nearly two weeks of pleading -- with little to show for it -- I was at my wit's end.
In talking with a friend who is an expert on New York's different public health insurance programs, he said that he believed the company was technically in violation of the law. This was the final straw. With the confidence of someone who has nothing left to lose, I called the company and demanded an answer by the end of the day.
"I have spoken with a lawyer," I told them, "and I am ready to take action." Those magic words worked wonders. They snapped to attention and immediately began to work on my case. I even started receiving periodic updates by phone about their progress. It was as if I were talking to an entirely different company, one that actually cared about its customers. The about-face was striking. By the end of the day, I received a call from the representative I had been dealing with. "Go pick up your medicine," he said. "It has been approved."
My crisis was resolved, but what about the people who don't have my advantages? What about the immigrant, whose first language is not English? What about the mother who works two jobs while raising children? As a writer, I can generally make my own work hours. As an activist, I am accustomed to long battles and challenging the powers that be. I have important resources, including legal help, at my fingertips. But because the majority of people in need of government-assisted health care are poor, they rarely have such backgrounds or support networks. That leaves insurers in positions of complete power, able to ignore the cries of the poor with little fear of repercussions.
It could be different. Several years ago, while living and studying in Spain, I experienced one alternative. To get my medicines, I filled out paperwork for twenty minutes at a hospital in Valencia. Without further hassle, I was able to pick up the same name brand prescriptions that I take in the United States, at one-tenth of their cost. Even though I was not a citizen and did not pay taxes, the Spanish government graciously footed the rest of the bill. They simply have different priorities, one being taking care of whoever happens to live there.
With our great ingenuity, a better, more humane system is not out of reach. Health care should not be subject to the whims of profit-hungry corporations. It must be recognized as a universal human right. To put people through such tumultuous trials for a basic necessity is criminal. Life is difficult enough.
Eric Stoner is a writer based in New York, whose articles have appeared in The Nation, Huffington Post and a variety of newspapers.
© 2008 Independent Media Institute. All rights reserved.
View this story online at: http://www.alternet.org/story/79226/
Candidates' Focus on Mandates Hinders Health Care Reform | Health and Wellness | AlterNet
Candidates' Focus on Mandates Hinders Health Care Reform | Health and Wellness | AlterNet: "Clinton and Obama should stop fixating on the individual mandate and focus on what really matters: affordable and accessible health insurance."
The Empowered Patient: Protect Yourself from Hospital Errors | Health and Wellness | AlterNet
The Empowered Patient: Protect Yourself from Hospital Errors | Health and Wellness | AlterNet
By Maggie Mahar, Health Beat
Posted on March 10, 2008, Printed on March 10, 2008
http://www.alternet.org/story/79043/
Julia Hallisy recently sent me her book, The Empowered Patient (PatientsafetyCA.org, 2008). It is at once one of the most pragmatic and one of the most moving health care books that I have ever read.
Hallisy's daughter, Kate, was diagnosed with an aggressive eye cancer when she was five months old. Over the next decade, she went through radiation, chemo, reconstructive surgery, an operation to remove her right eye, a hospital-acquired infection that led to toxic-shock syndrome and an above-the-knee amputation. Kate died in 2000. She was eleven years old.
Remarkably, The Empowered Patient is not an angry book. It is not maudlin. To her great credit, Hallisy manages to keep her tone matter-of-fact as she tells her reader what every patient and every patient's advocate needs to know about how to stay safe in a hospital.
First she reminds us of the mind-boggling number of errors that occur in our hospitals every year. "As many as 95,000 people die annually" as a result of adverse events ranging from infections to fatal drug reactions. It's hard to grasp just how many people are dying until Hallisy gives us what she calls "a tragic reference point." The number of lives lost to medical error is roughly equivalent to a World Trade Center attack occurring every two weeks during the year.
Hallisy's 300-page book is eminently readable, and filled with enormously useful detail. As she points out "the media and the government do try to warn us against the dangers we are up against with admonitions such as, 'Make sure all your healthcare providers wash their hands before touching you,' or 'Don't sign blanket consent forms,' or 'Check your medication ... '
"Good advice," writes Hallisy, "but what exactly are you supposed to do to ensure that these things actually happen? Many of you reading this right now don't know that you have a right to customize your consent form."
I certainly didn't.
Hallisy and her husband learned how to keep their daughter safe the hard way. Although Kate was treated in some of the finest hospitals in the San Francisco area, "During all those years of interacting with physicians and hospitals, I encountered virtually every problem a patient and their loved ones can face ... My husband and I became more savvy and educated the longer my daughter's illness went on. As we progressed, we slowly came to realize that the quality of healthcare she was receiving, as mediocre as it sometimes was, was actually far superior to the care other families around us in the hospital were receiving. They began to notice this discrepancy as well, and they wanted to know how we knew the things we did and who had given us such valuable 'inside' information. We had to explain to them that we had come across everything we knew ... by watching our daughter suffer through medical errors, misdiagnoses and inexperienced medical providers, and investigating the mistakes and taking steps to make sure they didn't occur again."
Begin with the consent form. It turns out that if you want to be certain that you know who will be caring for you while you are in the hospital, you should look carefully at the "Terms and Conditions of Service" on your consent form. It may well say:
"Attending physicians may be assisted by medical students, interns, residents and postgraduate fellows during the care of each patient. The patient agrees to treatment by these persons while under the direction or supervision of the attending physician."
Hallisy explains that "direction" and "supervision" have distinct meanings. If the attending physician is "directing" that only requires that he be available for questions. When "supervising," by contrast, he should be physically present and personally overseeing the proceedings.
Of course residents need to practice on someone. Hallisy is not recommending that you "refuse all outright care by medical residents." But she is suggesting that you "not give away blanket permission for inexperienced or unsupervised medical personnel to take care of your health care when a lot is at stake." [my emphasis]
Instead, she advises altering the form to read: "Patient agrees to treatment by residents and interns on an individual basis on an informed consent basis. Patient expects such persons to be under the direct and daily supervision of attending physician." Then be sure to initial the change.
The first sentence ensures that you will meet the residents "who will be writing orders and making health care decision -- sometimes behind the scenes. This gives you a chance to find out a little about his or her level of expertise and to judge whether this person seems competent to treat your condition."
Hallisy points out that if you or a loved one are going in for surgery, and you want to make sure that your surgeon is actually performing the procedure -- or at least that he or she will be in the room -- you need to take a close look at the "Authorization for Surgery' portion of the consent form.
She offers a disturbing example of what can happen if you don't. At one point, her daughter's oncologist wanted to rule out a possible metastasis of the cancer to her other leg. "Kate was scheduled for a biopsy on her left femur, and we were immediately referred to a particular physician because he was a specialist in pediatric bone tumors." After the biopsy was completed, that surgeon appeared in the doorway of the waiting room. He was dressed in scrubs, his hair and shoes were dressed in the protective paper coverings used in the OR, holding up a specimen jar with a piece of bone floating in a clear preservative liquid. He assured Hallisy and her husband that "this is not cancer. I know what osteosarcoma looks like, and I don't feel that this is what it is."
Months later, they discovered that he had not operated on their daughter. "Two residents had cut into my child," says Hallisy, recalling her rage when she discovered that they had been deceived. Given how sick Kate was, and how important the surgery was, I sympathize completely.
The Hallisys had no legal recourse because they had not looked carefully at the line in the consent form which said: "I authorize ____________________M.D. and any other physicians he/she may designate ... "
"Remember," Hallisy points out, "residents and interns are physicians. If you want a particular surgeon, you should cross out 'other physicians' or 'associates' and insert 'only' in front of your surgeon's name."
In some cases, of course, you may not mind if an associate performs the surgery. A few years ago, my husband snapped his Achilles tendon while playing tennis. He went to a NYC hospital with a world-class sports injury clinic. The doctor he chose for the surgery operates on the New York Giants when they are injured. It was only after the procedure was over that my husband found out that a resident working with the doctor actually did the job. The famous surgeon was in a different room, operating on someone else.
My husband was miffed. No doubt someone should have told him that an associate would be doing the operation. But the truth is that he was disappointed because he liked the idea of telling people that his surgeon was the team physician for the Giants!
Because my husband is in excellent health, and the surgery was not life-threatening, I wasn't terribly upset. He was probably better off having a resident chosen and trained by a world-class surgeon than a more experienced, but mediocre physician. In any case, he came out of the surgery without even a hint of a limp. So it's worth keeping in mind that the students of a great physician may be better than the average physician. Still, you should be told who will be operating on you. And you should ask how many similar operations they have done.
If you do decide to customize your consent form, make sure that when you sign it, you insert "with alterations" to "I have read, understood and agreed." And then inform the hospital staff that you have made changes. Your alterations are effective only if the hospital staff is aware of them.
Hallisy acknowledges that "It is entirely possible that a hospital will find your alterations to a consent form unusual, but never forget that you are allowed to do it. It can end up being the impetus for a meaningful communication between you and your doctor."
She adds that you should talk to your doctor about your concerns and any plans to alter the form well before the surgery. "Have a frank discussion with your physician to lay out your expectations if you want him or her to be present for, and personally direct, all aspects of the surgery. Ask outright if a resident will be performing any part of your surgery and what the experience level of the resident is."
Generally, Hallisy stresses: "There is very real power in having, and stating, expectations." You don't want to become involved in confrontations after-the-fact.You do not want to be labeled a "difficult patient." But you do want to make your concerns known before something happens.
For example, when talking about how to guard against picking up an infection in the hospital, Hallisy writes: "don't wait for staff to members to breach protocol and then jump on them. Avoid awkward situations by announcing your concerns to staff well in advance of the start of the procedure ... I always found it helpful to put the onus on myself by saying something like 'I just don't feel comfortable unless everyone wears gloves.'" A practicing dentist, Hallisy understands how dangerous infections can be, and how important it is that caregivers follow protocol down to the detail.
Sometimes technicians need to un-glove, she points out -- to feel for a vein, for example. But make sure they take the time to prep their hands again before inserting a needle into your flesh.
One might assume that nurses and hospital staff will be good about constantly washing their hands -- after all, we have known for more than a century that this is key to hospital safety. But the fact is that even very good hospitals often are understaffed and nurses are rushed. Studies show that at teaching hospitals, as few as a third of physicians and nurses may be complying with hand-washing standards. Yet Hallisy notes, "patients are hesitant to say anything because they don't want to seem to be suggesting that hospital staff aren't 'clean.'"
She offers a simple solution: "When our daughter was ill, we taped an eye-catching, easy-to-read sign to the door of her room. Using colored paper, we wrote 'PLEASE WASH YOUR HANDS AND WEAR GLOVES AS APPROPRIATE' in large, black letters ... The increase in compliance was so immediate and so dramatic that the infection control specialist made her own signs and placed them on the doors to all of the rooms in the pediatric oncology unit."
Urinary catheters -- which drain urine from the bladder -- are another common source of serious infections. People who pick up urinary tract infections are far more likely to incur kidney or blood stream infections. "Too often, inserting a catheter is looked upon as a routine procedure," Hallisy warns, "but it should be seen as a last resort if the patient is conscious and able to the walk to the bathroom unassisted." If a catheter must be used, try to make sure that it is removed as soon as possible. Studies show that doctors often forget that their patients are catherized, and so don't write timely orders to have them removed. It's up to you, or your patient advocate, to remind someone that you no longer need the catheter.
If you have any serious concerns about your care, Hallisy advises reading your chart so that you know whether your doctors are on the same page. In one case, an orthopedic surgeon failed, for five days, to diagnose and treat a raging abscess in Kate's biopsy site. He insisted that the site was not infected -- and not the cause of a larger infection that had become life-threatening.
Only later, when the Hallisy's read Kate's records, did they discover that some of the other doctors were as alarmed as they were. "The other doctors were extremely reticent about coming forward with their own concerns," she explains. "If we had looked at their notes in the chart, we would have known immediately which doctors shared our opinion and we could have pressed them to take a stand." (Hallisy also explains how she later went to the hospital's Patients Relations Department to receive permission to review medical records as they were being written.)
These are just a few of the hundreds of pieces of practical advice that Hallisy offers about how to stay safe in a hospital.
Let me be clear: Hallisy is not "anti-doctor" or "anti-nurse." She understands how easily errors can occur and is particularly sympathetic to "the unrelenting fatigue, stress and chaos experienced by new doctors." She also praises first-year residents who "to their credit, seem well aware of their lack of experience and do not regard the fact that they may need more guidance as a personal or professional failure."
As an example, she points out that "in 1998, the residents at a major San Francisco medical center negotiated to postpone their pediatric oncology rotation until their second year of residency. A resident I spoke to stated that they simply weren't confident that they were ready to handle the complexities of medical oncology case management. After their complaints, the pediatric oncology rotation became part of the second-year curriculum, not the first year. We should applaud these beginners who ... were not willing to put their own careers ahead of public safety."
This book is not an expose. But ultimately, The Empowered Patient frankly acknowledges that U.S. hospitals have become hectic, potentially dangerous places. And you do have a right to feel safe. As Hallisy puts it: "Your need to feel safe is not self-indulgent. You have a right to expect a reasonable degree of safety. In fact, where else should you expect to be safer than in a hospital?"
Maggie Mahar is a fellow at The Century Foundation and the author of Money-Driven Medicine: The Real Reason Health Care Costs So Much (Harper/Collins 2006).
© 2008 Health Beat All rights reserved.
View this story online at: http://www.alternet.org/story/79043/
Michael Pollan: Don't Eat Anything That Doesn't Rot | Health and Wellness | AlterNet
Michael Pollan: Don't Eat Anything That Doesn't Rot | Health and Wellness | AlterNet
Consumers are getting duped by the food industry, paying the price with their health.
Pundit Review » Blog Archive » Schadenfreude Alert: Elliot Spitzer Is Linked to Prostitution Ring
Pundit Review » Blog Archive » Schadenfreude Alert: Elliot Spitzer Is Linked to Prostitution Ring: "Spitzer has built his political legacy on stamping out corruption, including several headline-making battles with Wall Street while serving as attorney general. He stormed into the governor’s office in 2006 with a historic share of the vote, vowing to continue his no-nonsense approach to fixing one of the nation’s worst governments.
Time magazine had named him “Crusader of the Year” when he was attorney general and the tabloids proclaimed him “Eliot Ness.”"
CrunchGear » Archive » McCartney finally cashes in
CrunchGear » Archive » McCartney finally cashes in
The Beatles are going to be available on Itunes.....finally
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