Author Archives: gonzo66

On responsibility and fun

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From a close friend:

You’ve heard this before, but never took it seriously.In my twenties I never aspired to live beyond 30. Life beyond 30 has turned out exactly as I envisioned back then. I can honestly say I’ve not had one day of pure fun since turning 30. At 30 I accepted responsibility; pure fun thereafter is not possible. My epitaph will read “Died at 80 after enjoying his first 30 years and enduring his last 50.”

My reply:

Your concept of persistent fun is faulty, I think. Both of us had a full measure of fun back in the day, Piedmont I think was the high point. Our time at Georgia was OK but the ominous specter of it ending was obvious. Then it evolved from fun to discovery of where what we would be as functioning adults. There was never any possibility of fun as we knew it at Piedmont again, but the translation and evolution to fulfillment had the potential to make up for it. In Vietnam, we discovered our goals, we pursued them and we both were wildly successful beyond any expectation. You discovered the meaning of your life and you became exceptionally good at it. You had a stellar Marine experience, rising to a high rank and a phenomenal career. Worth of a book of your life. Then you parlayed it to a post-retirement career at Clemson commanding responsibility, respect and making the world a safer place. By a combination of dumb luck and an absolute refusal to quit despite impossible odds, I did the same. I ascended to a career that I never in my wildest dreams thought was possible. I have been all over the world speaking at medical meetings, writing papers and books, taking care of sick people competently and teaching youngsters the art. There simply isn’t anything left I haven’t done. It transcends “fun”. It’s “fulfillment” and is better than fun. It generates good for the world, growth and good for our psyches. It is/was impossible to sustain fun. Those that try die trying or go mad. Sooner or later “fun” MUST transition to something with a foundation that matters on different levels, careers, wives, mortgages, kids and responsibility. Maybe even Puerto Rican pussy on the side. Fun was a transition state we needed to have because it filled a need to be irresponsible early so we would have something to measure responsibility against when it became inevitable. That said, because we have expertly ordered our careers to insure plenty of funds to support us when we inevitably choose to stop working, the two of us have a RARE opportunity to sneak back into a part time fun mode under the radar. We can collect classic Porsches, classic Triumphs and we can see the world (again) as we like to do it. We can have many of the same things we loved in our youth and enjoy it just as much or more. So my advice is not to fret about fun. Both of us should be brim full of joy at how our lives turned out. The best deal we were ever going to get was fulfillment. We could look back at fun but you know most people can’t go back there. We dumb lucked out.

“Divergent” (2014): Anatomy of bad film

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Directed by Neil Burger (“The Illusionist,”), this adaptation of Veronica Roth’s novel is a variation on the current theme of young girls living and surviving in a post-apocalyptic wasteland (“The Hunger Games”). A society in which everyone is divided into five groups matching their personality (basically: smart, brave, honest, selfless, or kind) based on a psychological test.

Most young people choose what their parents are but they don’t have to. The groups are segregated and members and choose an occupation commensurate with that faction, lawyers and judges in the Candor group, teachers and scientists in the Erudite group and so on

The heroine, Beatrice (a very Katniss-like Shailene Woodley) discovers she’s “divergent,” she doesn’t fit into any discreet category, making her unpredictable in a society that thrives on predictability. This puts her at risk from being killed by cold-blooded utopians like Kate Winslet (a throw-away role). She survives using the same dangerous qualities that can kill her if discovered.

Here’s what makes a BAD QUALITY FILM and “Divergent” qualifies:

1. Films made from good books rarely succeed. It is extremely difficult if not impossible to translate the intricacies of a book to a two-hour film. The classic crash and burn was the film version of “Catch-22” (1970) that flopped despite an all-star cast, a ton of money and a Director fresh from his success in “The Graduate” (1968). Even “The Godfather” book was much more intense.

2. Beware messages about the evils of conformity wrapped in big budget packages. A script marked by pre-digested, post-adolescent wish fulfillment trite in a nonsense futurist premise is what it is, too busy warning us about the dangers of conformity to develop a unique persona of its own.

3. Jumping on the bandwagons of similar films that came before rarely succeed. Plucky, post-adolescent heroines learning to adapt to unfamiliar circumstances has been done. That the public embraced “The Hunger Games” is no guarantee they will embrace a similar concept with look-alike stars.

4. The story line isn’t even by a stretch possible or believable in real life. It’s silly and contrived especially for the film’s plot. Further, it doesn’t adequately inform the audience to the basic premise it’s built on, making it unwieldy and repetitive. The audience gets lost as they are forced to fill in the blanks, then they get perplexed and then bored.

5. Interjecting an obligatory and ever-so-brief sex scene into an otherwise austere story line doesn’t work except as a thinly veiled contrivance to be sure guys in the audience don’t get too bored. It’s as out of place as yarmulkes on biker gangs.

6. The film is too long. There is little or no sense of story progression in a two and a half hour film that could have adequately explored the premise in 2/3 the time. The story line bogs down, usually to extend CGI pyrotechnics that get overwhelming quickly.

7. If the producers desire a sequel (said to be in the works), leave some twists at the end to build on. This film comes to a climax that seems pretty much self-contained. Any sequel will not continue the model and so will be a totally different production, using the same characters to work an unrelated plot.

For all the above reasons, this film is not recommended by me. Watching a poodle recite Tennyson would be more interesting. Definitely don’t pay to see it.

Unrated.

Film Review: “House of Cards” (Netflix- 2013 – 2014)

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“House of Cards” was an astonishing risk for film streaming outfit “Netflix”, who six months earlier was in deep financial trouble, teetering on the brink. Netflix literally pushed the few chips they had to the center of the table and bet the farm on a hastily accumulated political drama starring a very expensive Kevin Spacey and relatively overlooked Robin Wright. A new concept of viewing, the entire season out in one big chunk for series gluttons. They succeeded beyond their expectations.

Francis Underwood (Kevin Spacey) schemes way through convoluted shenanigans as the (very) Southern Democratic Senate majority whip out to get revenge on a new administration that promised him a cabinet position, then reneges. His reptilian wife Claire (Robin Wright) aids and abets from a different perspective. House of Cards portrays the protocol of political power differently than “The West Wing”. The Byzantine plots are a much more complex chess game in which progress is planned five moves ahead and the baroque parliamentary gerrymandering is fierce to the point of brutality. Francis chillingly mentions to one of the characters: “Generosity is its own form of power.” Remember that the next time someone does you a favor.”

Underwood and his wife share a spooky relationship in which much of their communication is unspoken, but between the two of them, they relentlessly decide the fates of others with Machiavellian cunning. Their interaction with victims is meticulously crafted to gently facilitate their self-destruction. Those investigative journalists ferreting out the couple’s guilt fall into artful traps that brutally assure their own destruction. The result is a masterpiece of intrigue with a minimum of suspense. The viewer always knows where the path leads, and the series takes its time getting there, wringing out the intricate details along the way.

Kevin Spacey pauses along the way to step out of character and wink at the camera, offering up snarky quips: “I love that woman. I love her more than sharks love blood”.

“House of Cards is an unexpectedly brilliant masterpiece that probably single handedly pulled Netflix out of receivership. Spacey’s delivery of menacing charisma is the freshest character on TV. Wife Clare’s emotional link marinated with ruthlessness augment the series’ magnetism. The other characters are perfectly placed.

Best part: Frank’s to-the-camera quips: It’s so “Refreshing to work with someone who’ll throw a saddle on a gift horse rather than look it in the mouth”.

Inferior part: If you choose to absorb this series, you MUST begin with Chapter 1 of Season 1. The story line is entirely too complex to pick it up in the middle. At the end of Season 2 there are now 26 one-hour chapters so this will be a long haul.

I give it 4 of 5 sneers. Highly recommended if you have the time and attention capability.

A quick tour of the USS Midway in San Francisco

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While in San Diego for a CODES gig, I got a chance to tour the USS Midway, a simply enormous aircraft carrier sitting in the bay. This thing is a small city, laid down in the year of my birth,1943 and after many years of service, towed to San Diego as a historical exhibit.

After some refurbishing, a modernized Midway began service in the South China Sea during the Laotian Crisis of spring of 1961. In1965, she flew strikes against military and logistics installations in North and South Vietnam. On 17 June 1965, aviators of Midway’s Attack Carrier Wing 2, VF-21 downed the first two MiGs credited to U.S. forces in Southeast Asia.

On 12 January 1973 an aircraft from Midway made the last air-to-air kill of the Vietnam War. For her service in Vietnam from 30 April 1972, to 9 February 1973, the USS Midway and her crew received the Presidential Unit Citation from Richard Nixon.

Only twenty bucks to tour, this paltry fee offsets the half million dollars it cost to tow it to San Diego.  The Navy requires another half million in the bank from the promoters in case the exhibit goes bankrupt to finance the cost to tow it elsewhere.

One can walk all over the ship with recorded headphone remarks. It could easily take a full day to see it all. Most interesting part was the deck side lectures on taking off from- and landing on the Midway, given by retired fighter pilots mainly in the Vietnam era.  Both saw combat action.

Taking off from a catapult involved racing from standing still to 165 miles per hour (265 KPH) in two seconds over about 250 feet. Pilots pull 2.5 G’s. The steam driven catapult beneath deck weighs about three tons and while travelling 165 mph at the end of the flight deck it’s stopped cold in five feet by a water trap (shakes the entire ship).

The deck personnel wear color-coded jackets to delineate who is responsible for what and they communicate by a series of elaborate hand gestures. All are junior commissioned officers. Hands over head for pilots and hands under waist for other deck crew. When everything is set and the pilot is ready, he or she salutes, the lunch officer returns the salute and the switch is flipped. Just like in “Top Gun”.

The landing lecture was given by another retired pilot and was equally fascinating. The landing area is about 300 feet. The approaching aircraft drops a tail-hook (below the wheels) and on touchdown (at 150 mph) the hook has a grab at one of four wrist thick wires a few feet apart. This is usually successful, bringing the aircraft to a dead stop in 2 seconds with about the same G force as takeoff, except from the opposite direction.

Landing Signal Officers guide the plane in through radio communication as well as a collection of lights on the deck. The pilot will see different lights depending on the plane’s angle of approach. If the plane is right on target, the pilot will see an amber light, dubbed the “meatball,” in line with a row of green lights. If the amber light appears above the green lights, the plane is coming in too high; if the amber light appears below the green lights, the plane is coming in too low. This system is especially interesting at night where the pilot sees only the meatball bobbing up and down with the motion of the ship.

http://gizmodo.com/night-vs-day-aircraft-carrier-landings-in-one-harrowin-979263050

Accidents are infrequent but can be dramatic. Former Presidential candidate John McCain is said to have been sitting in the cockpit of his aircraft on the deck of the USS Forrestal stationed off the coast of North Vietnam, conducting combat operations. A rocket accidentally exploded on another plane, causing a chain reaction of dangerous fireworks. Hundreds of sailors were injured or killed in the melee. McCain is said to have ejected from his stationary aircraft. He was not significantly injured.

This is an incredible tour- highly recommended by me if you find yourself in sunny San Diego.

Here are the brief collections of photos by me. Remember these are high def. and you can increase the size of the screen by the appropriate YouTube icon.

Stress, physicians and age

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Physician “burnout” is defined as loss of enthusiasm for work, feelings of cynicism, low sense of personal accomplishment.

I think the factors involved are infinitely complex. I will also hazard a guess that the issue of burnout builds on two fronts:  Stress and Age, and the nomenclature for each is radically different.

Front 1– The peak “burnout” in the age group of 36-45 comes on two groups:

Group 1.  Doctors that emerge from the long training grind to find out they’ve bitten off more than they can chew and are having trouble digesting it. Too many responsibilities, too much work load combined with the era of mortgages, spouses, kids and mounting expenses acquiring the creature comforts lacking in the austere training days.

Group 2.  Doctors that emerge from the grind to find out that their reward was a false promise and they really don’t like living with the end product. The difference between training for a career and the nuts/bolts of the career don’t match and they’re miserable locked into the saddle with no escape.

The salvation of group 1 is usually that the personality type that thrives in this environment is selected out during the gauntlet. Those that can’t hack it fall by the wayside during training, like Navy Seals in boot camp that ring the bell when they’ve had enough. I think this is an unusual burnout group.

I think group 2 is much more common and not necessarily amenable to filtering by the gauntlet. By and large, there is a big qualitative difference between trainees and attendings, and the realities of that difference are not necessarily apparent before the fact. Some seemingly high quality trainees go bust quickly in the clinch and vice versa, and as far as I can tell, it’s very difficult to discern which is which before the saddle is cinched.

I’d hazard a guess that this group is at highest risk for becoming functionally incapacitated, call it what you will, and also I might add a risk for suicide if there is no escape valve.

All complain about the following factors, but most realistic physicians understand these factors are identical to working for any major corporation in any career position.

Bureaucratic tasks, Too many hours, Compassion fatigue, Difficult employer, Difficult colleagues, The Affordable Care Act of 20008

I don’t think I have ever met a doctor that burst into tears at the thought of onerous paperwork. I do know some however that started drinking heavily at the thought of the Affordable Health Care Act of 2008. The stark reality is that all these things are the price of admission to medicine highly unlikely to cause significant lack of professional fulfillment for no other reason than they are ubiquitous to nature.

Front 2-  aging physicians are a much more convoluted and textured phenomenon- physicians who have successfully run the gauntlets to arrive at a place of relative safety only to discover seniority is a new liability. Inevitable physical limitations and the duty and obligation to make way for others climbing up the same ladder behind them. A different and much more subtle order of “burnout” from the rest.

The limitations and hassles of old age are not linear. They escalate rapidly after a variable certain age”. At 65 I was doing four night calls a month and bounced back easily. I was racing motorcycles and doing high-speed track days at 66. I thought of myself as limitless.

Then I slowly discovered my concentration on the track at 120 mph was fading and I started crashing, once twice in the same corner. I quit at age 66+ before I hurt myself or someone else. Night call quickly became difficult to maintain concentration and the day-after became more difficult to bounce back. I still had the same knowledge base but not as much concentration ability to apply it under stress.

At age 70, I have the exact same drive and passion to be the best I can as when I was at the top of my game at 36.  The only limiting factor is my physical ability to bring it all to bear as effectively and efficiently in a world of emerging young people with the same fire in their bellies. Thereby burns the age related “burnout” flame- the fear of becoming irrelevant. An absolutely terrifying, life threatening burden.

That will be the burnout issue that I think will require some creative thought on how to rectify, if it’s even possible.

Epitaph on my headstone:

“This is my generation…..

Hope I die before I get old”

Pete Townshend, 1965. (BTW, Pete is 71 this year)

 

 

It happened this week in 1984

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This week marks the showing of the iconic “1984 won’t be like 1984” TV commercial by “Blade Runner’s Ridley Scott introducing the Apple Macintosh personal computer at the ‘84 Super Bowl. The theme was that the dystopian view of the world from the Orwell novel would be diverted because of the Macintosh computer, a device that would signify the fight of individuals against huge, impersonal corporations……. like maybe IBM.

http://www.youtube.com/watch?v=qIUcNLTsyYo

The TV ad was simply galvanizing. Not only did it chronicle Apple as the plucky company fighting a David vs. Goliath battle for individuality and creativity in the face of insipid conformity, it introduced a truly revolutionary device.

The Macintosh obviated the clunky DOS system, the counter-intuitive “C prompt”, introduced graphic interface and the concept of the “desktop” from which objects were mobilized or opened/closed via a “mouse tail”. It was easy to understand by non-technicians and actually did meaningful work such as writing and math. It was a quantum jump in user interface. Literally mind altering.

Steve Jobs is widely reputed as having “stolen” the entire concept from Xerox in their “Office of the future” project in the early 80s, but this is not technically true. Xerox freely introduced Jobs to the nuts and bolts of the entire project because they thought it would never come to anything. Xerox engineers didn’t think there was any need or use for “personal computing” so they let the inquisitive Jobs have a free look at their intellectual property.

It was the “Eureka moment” that Jobs experienced that prompted the foresight of Macintosh as the “computer for the rest of us”. The concept was not stolen; it was created from a vision that the original owners didn’t have any conception of, radically changing the fabric of society, as we know it.

TN Film Review: “True Detective” (HBO, Sunday night)

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HBO’s “True Detective” (Sunday night) is a major step forward in TV excellence. Putting big league actors Matthew McConaughey and Woody Harrelson together with a well-written plot is a masterstroke. The season opener was exceptional, I think can be mentioned in the rarified air of the best TV productions of all time: “The Wire”, “Deadwood”, “The Killing”, “Breaking Bad” and “Homicide: Life on the Street” to name the top five.

“True Detective” is on the short list of game changers not so much because it’s good performance art, but for how it became good. The vision, perseverance and authority of the diminishing supply of writers that created it. David Milch wrote every word of “Deadwood” and his word was absolute law.  Vince Gilligan demanded his vision of “Breaking Bad” be portrayed the way he saw it and accepted the risk and hassle. Kurt Sutter owns “Sons of Anarchy” and lets his vision run completely free.

 Similarly, novelist, screenwriter, and producer Nic Pizzolatto writes each episode of “True Detective” and demands that his vision be interpreted the way he wants it and no other way.  There is no interference allowed from sponsors or network wonks. HBO is famous for staying out of the way of genius. The risk is the occasional flop along the way. There’s no guarantee every production will be a hit. Milch’s next productions “John from Cincinnati” and “Luck” were flops.

 These writers create fewer episodes per season with more energy and creativity packed into each episode. Eight episodes of meat & potatoes versus 22 episodes of massive sponsor advertising. They also elect to quit before the plot gets stale. “Deadwood” went only three seasons as Milch though he had maxed out everything he wanted to do with it and it was time to move on. “Justified” is scheduled to quit after one more season.

Returns from the season opener suggest that “True Detective” is a creative masterpiece and a popular hit. It carries the distinctive mark of creative writing and directing that HBO is committed to. See it this season. The chances of McConaughey and Harrelson signing up for another season is pretty slim. 

 

 

 

Returns from the season opener suggest that “True Detective” is a creative masterpiece and a popular hit. It carries the distinctive mark of creative writing and directing that HBO is committed to. See it this season. The chances of McConaughey and Harrelson signing up for another season is pretty slim. 

 

Film Review: “Lone Survivor” (2014)

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Among other things, this extremely well done film points out the radical differences between the warriors of Vietnam and the new breed of super-warriors of the new millennium.

45 years ago in Vietnam, we were average guys plucked out of our livelihoods for “duty”.  None of us had any choice. If any of us ended up in the upper echelon of soldering (special Forces or Rangers), it was because we exhibited a reckless yearning for adventure we later regretted.  If we acquired any expertise in the strategy and tactics of warfare, it was by attrition.  Learning street smarts by surviving.

The new super-soldiers are volunteers who righteously train to the physical and intellectual limit and beyond.  Their accouterments and resources are beyond anything we comprehended in Vietnam. They are equipped for phenomenal feats, such as the apprehension of Osama bin Laden and the rescue of Captain Phillips from Somalian pirates.

This film bountifully portrays a lot of war drama and male bonding that’s been done endlessly before, but with a bit of a twist. The viewer knows the outcome as the players are trying to figure out how to make the best of a bad situation. The thrill of watching a really crack team of warriors at work is somewhat dulled by the self fulfilling prophesy of bad planning, bad luck and bad communication.

The film is well paced and consummately directed. The actors, especially Mark Wahlberg and Ben Foster are convincing in their roles but little can compensate for the title that accurately forecasts the futility and doom before it happens.

An excellent film if you like the genre.

Best part:  Excellently photographed, perhaps to a fault of being graphically ultra-violent.

Not so best part:  The graphically violent scenes of the solders in contact the Taliban were a little too drawn out.

I give it a solid four of five gory gunshot wounds, with a bullet.

Film Review: “The Killing” (AMC Channel 2011-2013)

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KillingTrolling the cable channels looking for something interesting, I stumbled upon a rough diamond on the AMC Channel worthy of a focused review.

“The Killing” was adapted from a previous Danish TV production. Two seasons, 2011 and 2012 followed by an abbreviated third season on a separate plot ending summer of 2013. I’ll limit my remarks to the first plot, seasons 1 and 2. Season 3 will deserve a separate review.

Relatively unknown French-American actress Mireille Enos is a phenomenon.  As detective Sarah Linden, she specializes in murders of young girls and she becomes so absorbed in investigations she decompensates, fails to sleep or eat and isolates herself from other human contact. After a previous investigation she landed in a psych hospital for a month. She closes her eyes at crime scenes and suffers every vibration of the act. Her intensity and focus burns the screen.

Equally obscure Swedish-American actor Joel Kinnaman as Detective Stephen Holder maintains a deadpan cat-like expression that burns with a breathtaking intensity. Other notable actors include Michelle Forbes (Dr. Julianna Cox- Homicide: Life on the Street) and Brent Saxton (Harry Manning- “Deadwood” and Sherriff Hunter Moseley- “Justified”).

“The Killing” expands the usually jejune format of the police drama, empowering it with greater depth and artistry, devoting a full season to the investigation of a single murder case. The progression of events peels away one day per episode in a “Blade Runner-like” environment of constant rain and dreary landscape.

The search for the killer expands into a visceral stream of consciousness diegesis, bleak and oppressive but so well told that it’s beyond obsessively addicting. The characters come alive in the extreme and the viewer dives in at their peril. The peripheral characters especially the Larsen family are equal in fervency and ferocity.

The series was nominated for several major awards but drew a mixed reception from critics probably because of the burning intensity and convoluted plot requires more focus than “2 Broke Girls”. The series was also felt by some critics to be too derivative of David Lynch’s “Twin Peaks” (1990-1).

A major complaint of the critics was that the writers refused to concoct a pleasing ending for season 1, relying on stellar but isolated performances by the actors. That said, it must be remembered that, in their quest for originality the writers have no particular obligation to please their audience. The greatest TV dramas, “Deadwood”, “The Wire”, “Breaking Bad” all took risks exploring the vehicle in an intrepid, imaginative and inventive mode. The audience is free to find their way if they choose, but they are not the prime mover.

“The Killing” is a slow burning, eerie, multi-dimensional exploration of how a teenage girl’s murder impacts the lives of others in and out of the event circle. Exceptional writing, credible characters and intense performing arts mark the plot. The cinematography is exceptional.

I found “The Killing” one of the most incredible viewing experience in television media I have ever become immersed in. Maybe not for everyone. Give the first episode a watch and you’ll know one way or the other. If you stick with it, you’ll find “The Killing” an absolutely visceral experience, the top of the performing arts heap.

Best part:  The odd-couple detectives. The Larsen family.

Not-so-best part:  Could have been shortened to 10 episodes instead of 13. Some of the emotional wrenching could have been shortened a bit.

I give “The Killing” 5 (yes FIVE) of five dreary Seattle landscapes. You can find it on Netflix and the torrents.

The “new brain death” in 2014

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<http://usnews.nbcnews.com/_news/2013/12/30/22114290-brain-dead-teen-to-remain-on-life-support-pending-appeal-by-family#comments>

We now have a completely different complexion on the brain death = death issue.

Back in antiquity (1968) brain death was defined objectively as death so we could get dead people off ventilators. Organ issues came later.  But 1968 was a different world of “life support” than it is now and many of the fine points were unknown then. We can now maintain “lifelike” cadavers indefinitely.

Brain death = death has never rested on structurally firm ethical ground. Brain death persons maintain some bodily integration and have been maintained for months so they could deliver healthy babies. We just drew a line in the sand and made objective criteria for brain dysfunction as a practical matter. Not every cell in the brain stone dead. Brain dead persons were simply “dead enough”.

We also now live in the age of surrogates that don’t want their relatives to die and we accommodate them by maintaining warm cadavers in a lifelike appearance on “life support”. Increasingly they’re demanding their relatives stay that way because if they give the appearance of life, there is always a possibility of unexpected reanimation.

Getting surrogates to accept the concept of brain death = death has never been easy in the best of worlds. A cadaver in the morgue looks decidedly dead. A brain dead cadaver on a ventilator looks decidedly comfortable, even animated. The only reason we’ve gotten away with selling brain death so far is the preponderance of multidisciplinary certitude to families.

The number of surrogates who demand futile care for near-dead persons is increasing anyway. Because of “life support”, they simply don’t believe our prognostications of doom and gloom. Their eyes and emotions tell them differently. With this case, it’s now escalated to brain dead persons, and this has the potential to change the complexion of organ donation.

Surrogates have figured out that they don’t have to accept medical prognostication they never fully believed anyway, and now enforce it legally. The groundswell for maintaining this warm cadaver is astounding.  An Internet site to raise money for her “life support” maintenance containing at last count US$28,000, all from the grass roots. Pastors of local churches imploring the court to “save this poor innocent’s life”, 60’s style marches chanting “Don’t kill Jahi!”. The child’s uncle declaring on NBC Nightly News that the child’s mother is certain she responds to her.

This is not a fluctuation in the ether. This is a gift that will keep on giving and will grow like a sunflower seed in the noon day sun. An increasing number of surrogates have now figured out they can get their way, any way they want, simply by calling a lawyer. Once it gets into court, the justice system always errs on the side of “life” as the court understands it. Sustenance of vital signs.

This is now a totally new paradigm in organ donation. It’s been a long time coming and it’s now here.

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CCM-L Member Response: An element that you don’t discuss below is the question of reimbursement. According to news reports, her family’s insurance continues to cover her care while hospitalized. If this becomes more of a trend, I suspect that the carriers will quickly stop that sort of “flexibility” around reimbursement.

I say;  Health care insurers understand the reality that hospitals must continue to care for patients whether they get paid or not. So they routinely get away with rationing and conserving at the provider level, not at the level of their insured. They cut payments to providers retrospectively on the basis of paperwork while assuring their clients they are fully insured. This is a political reality.

The truly significant part of this travesty is the groundswell at the grass roots level. People contributing to the on-line fund. The 60’s, Berkeley style marchers carrying placards, just like “End the Vietnam War”. The public media revelation that the mother “feels like the child responds to her”.

All that means that the groundswell here is NOT limited to this particular family as outliers. It’s broken into the mainstream now, and you can bet your sweet bippy it will “go viral” like a youtube video of Britney Spears naked.

As of now, the “law” pertaining to death by neurologic criteria is moot. Anyone that simply doesn’t believe in death by neurologic criteria can trump it quickly and efficiently by getting a lawyer and petitioning the court. Hungry lawyers looking for work will fall all over this. The precedent is set and a significant portion of the public seems to support it. Do you see marchers today with “This is ridiculous” placards?

This has MASSIVE implications for organ donorship.

CCM-L Member Response: Not intending to make a political statement, but I suspect even more strongly that someone covered by Obamacare will find that reimbursement stop even more quickly.

I say: There is no currently convincing evidence that the Affordable Care Act of 2008 will act any differently than any other “private” company, equally as reluctant to face the political firestorm of “saying no” to their insured. Tradition has it that “saying no” to providers is the path of least resistance.

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Update:  (1/1/2014)

The family’s court filings said New Beginnings Community Center in Medford N.Y., is willing to take Jahi and provide 24-hour medical care. The center was founded by a former hair stylist whose father suffered traumatic brain injury after a 2007 motorcycle crash. New Beginnings founder and owner Allyson Scerri shared a statement on her Facebook page Tuesday explaining how her facility “is about preserving life and treating brain-injured patients with care and dignity.” “We do encourage every citizen to take the time to educate themselves more clearly on the issues of what brain death is and what it is not,” the New Beginnings statement read. “This child has been defined as a deceased person, yet she has all the functional attributes of a living person despite her brain injury.”

(Did I mention radical right-to-lifers…….)

On Tuesday, the Terri Schiavo Foundation, named for the Florida woman who provoked a national debate about end-of-life-issues when she was diagnosed as being in a persistent vegetative state, said it had been helping Jahi’s family find a facility that would take the girl.