Consent to Die

Dying is natural.  So is the desire to avoid death.  The desire to live is a basal instinct, one which usually continues long after mental capabilities, such as judgement and decision making, have declined.  

Today, most old people die of one of 5 causes: cancer, heart disease, lung disease, stroke, and dementia.  Before antibiotics and modern medicine, most people died of infection, usually within 3 days.

If an old person today dies of infection, their care is judged to be substandard.  Infections are relatively easy to treat.  Cancer, heart disease, lung disease, stroke, and senile dementia - those are hard to treat.  Hard to treat - and expensive and time consuming to treat.

Why would we want to let old people die from easy-to-treat causes?  Why would an old person choose to die of easy to treat causes?  How can an old person with dementia choose to die of an easily treated cause?

70% of deaths in the US occur upon the removal of a ventilator.

Dementia patients can often still speak their desires (though they can no longer reason) so they can still demand or be persuaded to get treatment for years after they are diagnosed with dementia.

Treatment means the doctors and medical establishment get paid.

Treatment means our society is spending its resources keeping alive those who have little benefit left to society.

A bladder infection in an old person is an indication of declining health and much greater probability of dying in the next  months.

As smoking declines, fewer cancer, lung disease, heart disease and stroke deaths might well mean more deaths by dementia.

The predicted epidemic in Alzheimer's is expected to be very costly to the developed world.

What if we were to let seniors with dementia die of infections, such as bladder infections?  What changes would we need to make to our medical system to allow such deaths?  What changes would we need to make so consent given by a person of sound mind could control that person's destiny years later when the mind is no longer sound enough to reason, but is still sound enough to speak? To speak the basal truth that all of us want to continue living?

Learning math facts

We here in the US do a poor job of teaching our children math - starting right off with teaching the elementary addition, subtraction, multiplication and division facts.  This was brought home to me again when I visited my granddaughter's school for a curriculum meeting for parents.  Most of the education administrators in the room admitted they were not very good at math.  None of them used the word "proof" when trying to say they didn't understand (and were not taught to understand) what they learned in math in their school days.

They all agreed, though, that children need to struggle to figure out the answers on their own.  They, as teachers, shouldn't help them or "give them the answer".

My granddaughter doesn't know her basic addition facts.  She is certainly smart enough to learn them, and she understands what they are and mean.  She just doesn't practice them and she has no fluency in them.

I remember the terror of  math work sheets.  All those math facts - incomplete - for me  to complete, sometimes incorrectly, to be graded by the teacher. Never do I remember being shown a sheet of completed math facts for me to learn from.

People learn best when there is very little pressure.  To reduce the pressure have the children first see the
math fact completed. 1+1=2.  Post the math fact around the classroom.  Make it the bulletin board of the week.   Then ask the children to say and write out the complete math fact.  Have the children practice the math fact in games, such as with dice and on the computer.  Only once the children know the math fact should they be confronted with it on a math worksheet.  That way, the worksheets won't be intimidating. More American students would get mastery of their math facts, feel competent at math, become competent at math, enjoy math, and enjoy teaching math.

Oh, I love the snow!  I've cross-country skied at least once in eight out of the last nine days.  Though many people I meet complain of the snow and cold, I wake up to a blanket of new-fallen snow with sheer delight.  Too deep to drive through?  Good, then I'll just ski over to do my daily visit to the nursing home where my parents reside.  Roads cleared, sidewalks shoveled?  Time to visit the Metroparks.  I don't get to the golf courses when the golfers use them.  Only when there is a thick coating of snow do I venture on those lovely "greens".  And the bridle trails are so scenic as they thread through the snowy woods, often close to the iced-over river.  I can explore places I never go. I can cross great unbroken fields.  I can break trail  through thick powder, or exalt in the long glides of packed and iced trails made by others days ago.

Often people say it is a work out or great exercise I'm getting, as though skiing requires an intimidating amount of effort.  I reassure them I ski like a little old lady.  Just like walking, it is possible to ski fast or slow, look at the scenery or focus on making time.  A stroll in the park is as enjoyable as a jog through the park.  So it is with skiing.  A leisurely ski through the park leaves me warm, happy, and exhilarated.

Huge cave system under Manitoulin Island

While watching the Great Lakes surface temperatures (site currently unavailable due to government shutdown) this past summer, I noticed the surface water temperatures of Lake Huron just south of the western end of Manitoulin Island had several jets of surface water colder than the surface waters in any of the lakes except Lake Superior.  Where did that cold water come from?  It must flow up from lower, hence colder levels of Lake Huron or originate in Lake Superior - or both.  Flowing up from more southerly, lower levels doesn't make sense. If that were happening at the south shore of Manitoulin Island, why not at the the northern shore of all of the Great Lakes?

What is special about Manitoulin Island that it would have these jets of cold water pouring into Lake Huron?

As part of the Niagara Escarpment, Manitoulin Island is limestone.  Limestone easily erodes in water.  Often cave systems are formed.  The Mammoth Cave system in Kentucky was formed by water flowing from the north through a porous limestone escarpment.

I propose the same thing is happening now at the north end of the Niagara Escarpment, draining the deeper waters of Lake Superior and Georgian Bay into Lake Huron.  The caverns must be vast, and the flow rate torrential enough that the deep cold water displaces even the warm surface water where the jets empty into Lake Huron.

The Demise of the Ruling Class - White People

While helping my dad mow the lawn today, he, in faded shirt and jeans, approached me slowly and stiffly from under a shady tree.  I noticed him when the stepped into a brilliantly sunny spot under the tree, making him look very white in my peripheral vision.  For a moment I didn't recognize him - he just looked very old and very white.

He is very White: WASPish, wealthy and well educated. Age has turned his hair, what little there is of it, white, too. Sadly but inevitably, age has also diminished his power, strength, wealth, mobility and even his reasoning powers.  The next generation, of which I am a part, has not replicated his power, wealth, or knowledge. 

Today I heard the Census Bureau announcement that the majority of children born in the US last year were not white. My granddaughter, who was born last year, is half Asian. Even before she reaches adulthood, I think "White" will connote "old".

health care - If you need it, we will fire you!

Today, April 24, 2012, I went to new (seasonal) employee employment orientation.   I was told about an accident/injury report form I am to fill out every time I am injured or hurt on the job.   Johnna reassured us there was told there was no reason to not fill out the form.  For that matter, if we didn't fill out the form at the time of injury, and later claimed an on the job injury, we might be denied coverage.  She explained she was in the process of denying coverage to an employee injured 6 weeks ago who did not fill out the form at the time of the accident.

I have never seen the form and very much doubt it would be anywhere near the water where I actually work, usually on weekends.  To fill out the form would require me to wait until Monday, then go to some building miles from where I actually work, and fill it out. 

After  Johnna stopped talking to us, the woman from Human Resources who was hosting the orientation  returned to the podium.  The subject was misconduct and reasons for termination.  The second slide, right there on the bottom left, said that if we caused ourselves or others harm, even accidentally, it could be reason for a reprimand or even termination.

Let me get this straight.  In our country, health insurance comes with employment.  Not, however, if you are a temporary or part-time worker.  Because I am older - and more expensive to insure - and it is an employers' market, I can't get anything but a part-time or temporary job.  No health insurance benefits included. If I am accidentally hurt on my job, say by slipping on an algae-covered boat ramp, my employer could deny me coverage because 1) I am a part-time, seasonal employee, 2) I didn't fill out the (unavailable) form at the time of the accident, and 3) I was (perhaps) the cause of the unsafe conditions - say, not wearing appropriate footwear. 

Every company tries to keep employment costs low.  Finding ways to deny employees medical and accident coverage helps their bottom line.  They don't have the employee's benefit in mind.  So why does our health system put individual's health care in the hands of employers?



In China, children who get sick or hurt are punished.  It's a blame the victim culture.  I thought we didn't do that here. 

Thoughts on Zambian Sex Practices

I spoke with Rachel (aka Summer) today. She is in Zambia working with a British charity and the Zambian government to bring AIDS and HIV awareness to students in rural Zambia. Rachel is in a mining town, 45 minutes by bus outside of Lusaka. There she lives with her Zamibian co-volunteer, Deborah, in a thatched roof hut 12 feet in diameter. Ten feet away is the girls dormitory, where 35 of her students live.

There isn't much room - certainly no spare bedrooms- for privacy in Zambia. So Rachel asked her students where they "do it". The answer - in trees! And in bushes. Well, I guess if you can't do it in the back seat of a car...

Rachel wants to do it with Eugene in a tree when he goes to visit in month or so.

Rachel has polled her students if they have fun having sex. Not one answered an unequivocal yes. They kiss, and then they fit the pieces together. No oral sex. No foreplay. No discussions like "which do you like better, this or this?" They go right from first base to home base. Rachel thinks this would make it very uncomfortable, if not outright painful. No wonder no one thinks it is fun. She, of course, is out to tell them about foreplay and making sex fun.

I think Playboy and Cosmopolitan and such magazines had a huge influence on our culture in bringing the common person's understanding of sex from a primal urge to an enjoyable pastime.

Rachel, the free-love missionary to Zambia. Rachel, the Cosmopolitan cultural ambassador.

But how does one do foreplay in a tree? The missionary position would be impossible. Maybe all those branches are put to good use. Guess if there are enough branches, you can find some of suitable height and separation for any couple. Makes me think of the great apes having sex in trees.

I'm looking forward to a report about sex in a tree. Wonder if I will get one from Rachel? Or Eugene?

Then there is the issue of condoms. "You can't eat a sweet in the wrapper" is the refrain she hears constantly. Rachel discussed the prevalence of AIDs (was it greater than 50% of all pregnant women tested at the nearby clinic?) and the perceived prevalence (the mine clinic just down the road doesn't know the prevalence of AIDS, but supposes it is 5%). She says, "Now are you more likely to have unprotected sex if you think the prevalence is 50% or 5%?"

And have her students had sex? She thinks more than half have. About half of those tried it once at about 13, and it was painful and not fun and they are currently abstaining. The other half continue to have sex. They are mostly "the girls who have sex for money". Who apparently also find it painful, and not fun, but lucrative. The mines are a source of customers.

Rachel does not call her students prostitutes.

So, what about condom use? Rachel explained that there is a division of labor in American culture. It is the guy's job to provide the condom; it is the girl's job to ask for the condom and to put off sex until the guy provides it. Guys get the hint.

But her girls don't ask for a condom. And they believe condoms don't work most of the time. Rachel points out that with regular condom use, only 1% of couples get pregant in a year. 95% of couples who don't use a condom get pregnant in a year. And condoms provide both pregnancy and AIDS protection.

Rachel, the statistician, persuading the Zambians to use condoms.

How does a couple put on a condom in a tree? And where you put it when you are done with it?