We interrupt this blog because......

well....because I'm going to be traveling for the next seven weeks or so. Off to Dallas and then to New York for most of July and August where I'll be spending seven weeks in New York this summer. Seven weeks learning (and acquiring a certificate) to teach non-English speaking people to speak English (with a Southern accent, I imagine. But....that can't be helped.)

I've been admitted. I've found an apartment to sublet. I've orderd most of the texts. I've done most everything except convince myself that I'm actually going to do it! I mean, it's been years since I've been in school (as a student or as a teacher).

Yet, why do I feel so excited about it? Why am I not scared and anxious? Why am I actually moving forward -- step by step? Have I lost my mind? (I don't really need that last question answered....)

Momentum......

Don't you just love it when things work out like they were just meant to be?

Have you ever had a goal in mind that, somehow, waaaaaay in the back of your mind, you knew you would reach if you just took that first step? And that certainty that it would actually happen scared the poo out of you and kept you from taking the first step?

Well, a few months ago, I took the first step toward something that I just knew would come about if I acted upon it. And....bless pat, it seems to be becoming a reality. And....I'm scared. No. That's not true. I'm calm, confident -- yet excited. And that scares me because I feel I should be scared.

I know this post makes little sense, but -- in a couple of days, maybe I can be clearer.

VERY long article, but interesting read......

Maybe it's because I've been so close to the aftermath of a true disaster, but so many things I read cause me to see signs of what may be ahead for so many of us with the changes in our weather cycle, terrorism....you name it. I still don't think many people get what happened in New Orleans, and that it really could happen to anyone of us. Our world could be changed in the blink of an eye -- even if we're attractive, smell nice, and are insured. Yes, ma'am, if a disaster happens (and you truly learn the definition of disaster -- not the definition that includes Starbucks discontinuing your favorite coffee) I think many may understand why the term survivor is used in Katrina Suvivor.

The following is an article from The Times-Picayune, and I think it shows how, after a true disaster, things don't just go back as they were before. If you don't read the entire article, just read this one paragraph from a doctor and her husband (also a doctor) who are moving from New York to New Orleans. As, I think, the doctor's statement shows, New Orleans is a place that many people just won't get unless and until they actually come down and let it soak into your blood -- okay, I hear those "blood alcohol level" jokes. Naughty! Naughty! That's not what I'm talking about. ;)


Here's the paragraph (and the article follows):

"We had a lot of reservations initially," Velu said about coming to New Orleans. "What we see in the media is what everyone else sees. It is a little intimidating at times. When we went down there, what we saw ourselves is that there is so much potential. I can't imagine a city like New Orleans not getting itself back together."



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Grants aim to cure exodus of doctors
Posted by sstokes June 10, 2007 9:10PM
By Kate Moran
staff writer


Ellis Lucia / Times-Picayune

Mordecai Potash was paying down his medical school debt by picking up evening shifts at the Veterans Affairs Medical Center in downtown New Orleans -- before Hurricane Katrina destroyed it.

But Potash's student loans survived the storm just fine.

Doctors like Potash who earned solid -- and often enviable -- incomes before Katrina have watched their prospects dim since the storm. Practices flooded, hospitals closed, and the population of uninsured patients has ballooned. Doctors are working under greater stress but making less money for their troubles.

To stanch an outmigration of doctors eyeing greener pastures and to lure recruits to Louisiana, the state has developed the Greater New Orleans Health Service Corps, a program that offers incentives of up to $110,000, including student loan repayment and income guarantees, to doctors, dentists and other medical professionals willing to work in post-disaster conditions.

In exchange, qualifying medical workers must agree to work in the metro area for at least three years and dedicate one-third of their practice to treating patients with Medicaid, Medicare or no insurance at all.

The federal government this year provided $15 million to finance the program, and the state already has made 81 awards to primary care doctors, gynecologists, psychiatrists, dentists and a handful of nurses and counselors.

The secretary of the U.S. Department of Health and Human Services announced last month that the federal agency would provide another $35 million to help the state recruit and retain health care workers. The state will use this latest infusion to target nurses, who can receive up to $55,000, and pharmacists, who can receive $50,000, in addition to doctors, dentists and medical school faculty.

'A huge financial incentive'

Doctors such as Potash, who received a grant to pay off his medical school loans, say the money helps to counteract the hardships of practicing in New Orleans. He had been commuting to the veterans clinic in Baton Rouge after the downtown hospital closed, but with the grant he can practice full time in New Orleans, where his psychiatric services are sorely needed.

"It provides a huge financial incentive to stay in the area and continue my work," said Potash, a clinical assistant professor at Tulane University. "As a doctor, I am not worried about surviving. I have a small house in a nice neighborhood. It is meeting the financial obligations of going to medical school that has been the struggle."

Doctors say maintaining a practice in the New Orleans area has become more trying as colleagues have decamped for the north shore and for other states, leaving behind patients who are clamoring for a new doctor. Some doctors have tried to expand, only to run into a wall in trying to recruit a partner.

Ricardo Febry, who specializes in providing general care for hospitalized patients and is the president of the Orleans Parish Medical Society, said he has been on the hunt for a partner for almost a year. Though he has not advertised in national publications, he said recruitment is tough these days because local medical schools have produced a smaller crop of residents since Katrina.

Adding to the challenge of reeling in recruits from other parts of the country are the high cost of business and malpractice insurance and the large population of uninsured patients. Whereas indigent patients once relied on Charity Hospital for low-cost care, they are now showing up in private emergency rooms, where doctors usually have to swallow the cost of treating them.

"You are doing the work, you are taking care of the patient, you are not getting paid, and you are exposing yourself to the risk that the patient will turn around and sue you for bad outcomes," Febry said. "If you are a young doctor deciding where you want to settle down and develop a practice, and you have that set of circumstances offered to you in New Orleans, then it is easy to decide not to come here."

Diagnosing limitations

David Myers, a Metairie internist who has been seeking a partner for five months, sees serious limitations to the incentives dangled by the state. He thinks the requirement that doctors devote one-third of their practice to care for uninsured, Medicaid and Medicare patients will dissuade many possible recruits from applying for grants.

But patients are having trouble finding a doctor these days, regardless of their insurance status. At Myers' office, the next available appointment for a new patient is July 25. With that bad a bottleneck, the state should not impose such stiff rules about how much time doctors are required to devote to patients who cannot pay them, he said.

"The most disappointing thing about the way the state and the feds have approached the health care crisis is that they have focused only on the fact that there are a lot of people without insurance," Myers said. "There are also people with insurance who cannot find services quickly... .

"You start seeing these (uninsured) patients, and at the end of three years, you have this patient base you are taking care of who can't afford to pay you. Who wants to come here and establish that practice?"

The state thinks enough primary care doctors are in the area to treat patients with private insurance, but 54 doctor recruits are needed to see the uninsured. Kristy Nichols, director of primary care and rural health for the Department of Health and Hospitals, said the state is on the way to closing that gap with the incentive program.

Monir Shalaby, medical director of the Excelth clinic in Algiers and a grant beneficiary, saw a large volume of uninsured patients before Katrina. But he said the clinic, which charges patients based on their income, has become a de facto Charity Hospital since the downtown institution closed after Katrina. These days as many as 80 percent of his patients lack insurance.

Shalaby said he has considered leaving New Orleans because he feels endlessly frustrated by the inadequate safety net for poor people who need advanced medical treatment or hospitalization. He recently saw a patient with an apple-size tumor on her neck. When he referred her to the charity hospital in Baton Rouge, the woman was told she would have to wait seven months for an appointment.

"It is very frustrating to work in a place where you do not know how to help your patients," Shalaby said. "You have in your heart the mission to serve. It would be much easier to work in Florida or Alabama or Texas, where you have everything in place. I feel very fortunate that the state is doing something to help physicians stay in the area."

Serving the underserved

Douglas Cross, a dentist, also received an income guarantee after losing his private practice in eastern New Orleans to the storm. He now works full time for the city Health Department, where he sees elderly and uninsured patients. He said the state's grant program is helping disadvantaged patients by keeping providers in the area.

"A lot of people cannot afford dental care at this point. Their living expenses have increased, and they do not have a lot of disposable income," Cross said. "It is extremely important for the Health Department to have these clinics because other options for low-cost dental care are gone."

Though many local doctors said conditions in New Orleans are tough, at least one doctor who accepted a grant to relocate sees opportunity here.

Priya Velu is moving from New York to practice family medicine on the faculty of Louisiana State University. She said most grants designed to lure doctors to underserved areas require them to practice in a rural setting. She said she and her husband, an orthopedist, wanted an urban practice.

"We had a lot of reservations initially," Velu said about coming to New Orleans. "What we see in the media is what everyone else sees. It is a little intimidating at times. When we went down there, what we saw ourselves is that there is so much potential. I can't imagine a city like New Orleans not getting itself back together."

Health professionals can learn more about the health service corps by visiting www.pcrh.dhh.la.gov.

Kate Moran can be reached at kmoran@timespicayune.com or (504) 826-3491.

Things I wonder about......

I wonder why: when the cleaners gives you a ticket saying you can pick up your clothes on Wednesday -- why the ticket (or the person working there) doesn't say Wednesday, after five pm!

I wonder why: after shopping, making your way to the checkout, where you stand in line for over ten minutes, until the manager finally notices that the checkout lines are snaking to the back of the frickin store, and she calls for extra workers to open more registers -- why it's always the shoppers who are just walking up to the checkouts that get the choice of the newly opened registers.

I wonder why: every store I go in (including my bank), I'm met by an employee who says -- hello, I'm new and have no idea what I'm doing so I'll double check everything I do with my manager, which means it's gonna take three times as long to get anything done.

I wonder why: this city I live in won't wake up, smell the coffee and realize the storm's changed where we live, so for gawd sake -- GROW UP! Quit making people carry you kickin' and screamin' into reality.

I wonder why: I continue to live in a place that's hotter than hell -- or, as I heard someone put it today, "It's Africa hot outside."

Can you tell I didn't have a good day? sniff! sniff!

Do you have your neti pot?

I saw this on Oprah and had to order one. The first three or four times I used it, I swallowed so much salt water I felt as if I were swimming in the ocean. But.... all of a sudden I discovered the perfect angle to tilt my head and -- WOW! -- I think the thing really works.

It looks kind of yucky, doesn't it? If it helps me live with Cassie the Shedding Cat it will be well worth the yuck factor.

Cemeteries

I don't know why, but I am fascinated with cemeteries. I can wander around in one, reading the engravings on the stones, and concoct stories about who lies underneath. Sometimes the engraved words tell the life story of those who lie below -- sometimes the words seem to tell the story of those left behind. Somtimes the engraved words bring a tear, sometimes a laugh. Sometimes curiosity gets the best of me and I find myself wanting to know more about the person I'm standing over -- reading the words that define their life.

Now, I don't necessarily go out of my way to visit cemeteries -- unless we're in a new city and I can persuade J. to mosey through one with me. He thinks it's kind of weird and eerie. The only graves he wants to visit are his mom's and his grandparents. He also feels honor bound to visit my parents gravesites. That's why, last week, while in Alabama, I visited two cemeteries. Two quite different cemeteries.

J.'s mom and grandparents are buried in the small cemetery in the small town he was born and grew up in. He visits their graves everytime he's there. It takes all of fifteen/twenty minutes to pay a respectful visit. Drive in the cemetery. Drive to the gravesite. Walk ten steps to the grave -- and there you are. Get back in the car. Drive two minutes (or don't even bother with the car -- walk) to the next location. There you are. It's a different scenario when we visit my family's resting places.

My parents, in fact generations of my family are buried in a much larger cemetery, in the much larger city I was born and grew up in. I, unlike my husband, feel no compulsion to visit anyone's gravesite. I don't admire this about myself and wonder if I should be bringing flowers, tending the graves, planting things as J. does. Maybe I would visit more often if it didn't turn into such an ordeal each time we go.

First, you need to be sure which exit to take. If you're wrong, you could end up wending your way through parts of the city where you really, really don't want to be. That's what we did Saturday. J. doesn't think anything about driving through certain parts of the city. J. didn't grow up there. I totally freak out.

Finally, we find the cemetery (after me having an anxiety attack and swearing I'm filing for divorce) whereupon, instead of stopping at the office for a map, we proceed to spend 45 minutes driving around lost as a goose. Then we go back to square one (which would be the office), tell the people there whose graves we're looking for, and they print us out nice clear maps. Using the maps cuts our time being lost (once again) in about half.

Finding the cemetery is only the beginning of my dilemma. Once J. drags me there I don't know whose graves to visit. There are so many -- and I care about them all. And.....they are buried all over the large cemetery. I may not initially want to go, but once there I want to see everybody! J. does not. He thinks we should pay our respects to my parents, and that's it. He comes from a very small family -- three graves to visit -- and doesn't get it. Saturday, besides my mom and dad, I visited my maternal grandparents and my maiden aunt.

I looked for my uncle's wife's grave. At my dad's funeral my uncle walked me to his wife's gravesite (also his future resting place) to show me how it was just across the street from my parents. My uncle (a true penny pincher) had wanted my dad to buy the two plots behind his so they could half the price of the head stone (my uncle and his wife's dates and stuff engraved on one side, and my mom and dad's info on the other). My dad said -- no thanks. Daddy later told me that he didn't like the idea of being so close to Uncle J. for eternity -- he liked my uncle, but in small doses.

For the life of me I couldn't find my uncle's plots (he's still alive and kicking BTW). I think it was because J. was hurrying me so. But, wandering around the old section where my grandparents are buried, and the newer section where my parents are buried, and hunting for my uncle's plots, I managed to browse many headstones. That day I was struck by the simplicity of some of the epitaphs:


Mother

Our own sweet dear

My love

Navy Wife

The Family of ___ ________

Gone


I wanted to visit the Bear's grave, but J. was worn out from visiting so many of my kin and we still had to drive back to Baton Rouge. So the coach will have to wait till next time. It should be easier to find his grave because "Since his death, the gravesite has attracted so many visitors that cemetery personnel, weary of giving directions, finally painted a crimson line from the entrance gates to his Block 30 grave." I did emit a reverent "Roll Tide!" as we drove past Block 31. That should count for something.

Heartbreak

9:30 PM Sunday night, barking dogs brought a local woman to her front door where she found Army officials waiting outside. This woman had two sons serving in Iraq so she knew something had happened. She asked what had happened. The officers told her they couldn't tell her until her husband arrived home. She called her husband. She asked which son it was. The officers wouldn't tell her anything until her husband arrived.

Thirty minutes later, thirty minutes later, thirty minutes later, when her husband finally sped up the drive, the mom and step-dad were told which son had been killed.

The army said that both mom and step-dad were on the next-of-kin to notify list and they decided to wait until both parents were present for moral support.

As with the Virginia Tech massacre, I have no words to express my feelings.

Truck Stops

I agree that I should be embarrassed by the amount of expertise I possess in certain areas -- truck stop food being one of them. But, hey. You are what you are....

This knowledge was gained by the years J., son #3, and I spent pulling a 5th wheel around this great country while J. was a contractor. Being a contractor meant he worked wherever, for whoever, for as long as it took to get the job done. During those years we ate at our fair share of truck stops. And, surprisingly, the food was pretty durn good.

Those of you unfamiliar with life on the road may not know that modern day truck stops can be a surprising piece of work -- Internet access, private showers, tv/reading rooms, some even offer family areas with shower/dressing room/kiddie play area. Now I have never showered at a truck stop, but as far as I could see, these areas looked bright and clean.

All the above spiel is to justify tell you all about where J. and I stopped to eat Saturday on the way home from Alabama. Yes, we spent a week in Bama working on that darn house! But that's beside the point. (As is almost everything else in this post.) You see, the last few years going to and from AL, we have been stopping at a place called Red Hot. It was a truck stop many years ago, but now it is a restaurant with pretty good southern-style food. The same cooks have worked there for many years turning out good old-fashioned veggies, cobblers, burgers -- you name it. And their breakfasts! Hunny hush.

(In the spirit of full disclosure -- Red Hot was bought a year or so ago and its new name is now Checker Board. But....we still refer to it as Red Hot.)

Well....Saturday we were all prepared for our Red Hot-pit stop. As we left B'ham. we started talking about what we were going to eat. I was going to get a veggie plate. J. is always tempted by their burgers, but can never decide until he looks at the menu. By the time we got to Meridian, Mississippi (home to Red Hot) our tummies were ready and grumbling. And, of course, wouldn't you know it, Red Hot was closed. WTF!

That's how we ended up at Queen City Truck Stop's Magnolia Restaurant. If we have the truck we usually fuel up at Queen City because they generally have the best prices. The restaurant is always bustling but we've never tried it. So, we wondered, should we or shouldn't we -- eat there. Now I've gotta tell you, if we didn't know a little about truck stops (blush!) we probably would never have stepped foot inside the door. But, being seasoned roadies, we decided to give it a try. And I'm glad we did.

There seemed to be about as many locals eating there as truckers and passers-through (like us). The sweet tea was good and strong (as was the coffee), the service was competent, friendly and polite, and the food arrived quickly, was warm, spicy, and filling, and the rolls were homemade and melt in your mouth. The chef could even be seen in the back -- complete with his big ol white chef's hat. (Okay, truth be told, I think I only had one slice of banana in my banana pudding, but....)

What really impressed me was the the fact that most of the menu offerings were healthy and the portions were just the correct sizes (according to WeightWatchers). Not bad for a truck stop in the middle of Mississippi.