Bare Necessities

Growing up, I was taught that the necessities of life were food, clothing, and shelter. Going to work, I found those definitions changing. This is another story alluded to in an old post – “a story for another time”. Here we are, in another time.

So what are the bare necessities in my book, and how did I find them? My first full time job was in a restaurant – preparing food for people. My first “career” was in a grocery co-operative – providing basic food via the Willy Street Co-op. I was pretty sure food counted as a basic need.

After 10 years I left the co-op and moved to Northern California, where I was Maintenance Director (then Financial Manager and General Manager) of the Twin Pines Co-operative Community, a community of 79 families that jointly owned an 80-unit low-income housing co-operative (the 80th unit was a rental reserved for an employee and I was the sole renter for part of my time there). I learned that the Silicon Valley was not filled with Yuppies. Before it became the Silicon Valley, the Santa Clara Valley was The Valley of Heart’s Delight, a vast area of fruit orchards. Now I knew why the supply of apricots had dried up back when I was in the grocery biz – the orchards were being ripped out for factories, office buildings, and housing. (The apricot supply has since recovered somewhat.) There were people who worked in those factories and were the secretaries in those offices and who fixed the fancy cars of those over-priced engineers. They were the people I worked for, and they needed a place to live. Yup, housing made my list.

I’d always had a side job or two. While at Willy Street I was a volunteer programmer at WORT-FM, a listener-sponsored community radio station. I was a patient advocate at the Near East Side Community Health Center, and I was the local representative of FLOC (the Farm Labor Organizing Committee, a farmworkers union started in the tomato fields of Ohio – they later merged with the UFW). In California my side job involved co-operative housing in Nicaragua.

In Nicaragua I found that the Matagalpa River (where we cleaned up after a work day) was also where everyone did their laundry and drew their drinking water, as well as where towns discharged their raw sewage. We found a mountain spring, had the water tested, built a dam and a pipeline, and supplied pure water to the houses we were building. (Fred Colgan deserves the lion’s share of the credit for that.) While we weren’t big enough to set up a sewage treatment program, we dug outhouses so sewage from our little community would not go straight to the river.

When my second visa expired I moved to San Francisco and became a plumber (after a side trip for the Mole Poblano tour, o quiere decir La Vuelta de Mole Poblano). It was pretty clear that clean water and sewage treatment made the list of bare necessities, so I made my living doing that. I mostly did residential service work, but also some remodeling and work in bars and restaurants. I used to tell people that my job involved hanging out in gay bars at 9 o’clock in the morning.

Life being what it is (and a story that I probably won’t bother telling here unless shelter in place lasts a really long time), my plumbing career came to an end. I became a college student and then an occupational therapist. Before I became a patient, I had never heard of occupational therapy. My sister (a Speech and Language Pathologist) defined occupational therapists as the people who come up with a simple commonsense solution to a problem; a solution that seems obvious in retrospect. Then she’d realize that she hadn’t though of it. When people ask me what the difference between a physical and an occupational therapist is, I sometimes say the PT’s job is to make sure you can move around, and my job is to make sure you can do all the things you want to move around for. It is a job that varies widely depending on the setting you are working in; and the lines between what I do and what my PT partner does are sometimes pretty blurry. (If you really want to know the gritty details, I have a 13 hour online course for you. Someday I may be able to do it live again.)

I saw firsthand how much access to healthcare depends on money, and how the US, unlike most industrialized countries, lacks a healthcare system. (I work in a hospital that provides care to all regardless of ability to pay – but that doesn’t mean they don’t get billed later, and it clearly affects the care they get after discharge.) Other countries have a healthcare system. We have an insurance system. Healthcare was now clearly on my list of bare necessities.

A common thread running through these, and made clear by our shelter at home situation, is community. I realized I had found my personal definition of the bare necessities: food, housing, water and sewer, healthcare, and community. I hope my list is complete because I’m closer to 70 than to 60 and I probably don’t want to start another career now. I’d like to pretend I had the forethought 50 years ago to build a life based on the necessities and pretend that my life and career trajectory was planned. Never mind, I don’t even want to pretend that. This was a case of going where life led me, then looking back and seeing what the path looks like. Or, as Robert Hunter said:

There is a road, no simple highway, between the dawn and the dark of night…

Le Tour de France/La Vuelta a España/Il Giro d’Italia

The French tour has been postponed and is now scheduled from 29 August to 20 September. The Spanish tour is still scheduled from 14 August to 6 September, but there is talk of moving it to the fall. The Italian tour is being run in a virtual format and the real version may be moved to late fall. The World Championship is also scheduled in the same timeframe as the rescheduled tours.

I think the only answer to scheduling anything right now is “Who knows?” I know of one cycling event scheduled for June that is still scheduled and another in July that has already been canceled.

Stay safe out there…ride alone and enjoy the scenery.

Mole Poblano

A couple years ago I mentioned a story for another time. That time is here, so here is another story from the past, this one in Mexico.

I was working for a low-income housing co-op in Santa Clara, CA. On the side I was the Northern California Director of APSNICA (Architects and Planners in Support of Nicaragua). I quit the co-op job so I could move to Nicaragua and work full time, where we were building housing on cooperatively-owned cattle ranches.

I knew my Spanish was too rusty to live and work there, so I stopped off in Mexico for a refresher course at Cuauhnahuac, where I had studied Spanish several years before. I had three weeks to get up to speed. I brought my APSNICA slideshow along. As a self-imposed final exam I would present my 45 minute program in Spanish to the school. I had done it dozens of times in English, but this would let me know if I was ready to live in another country and work in Spanish. (I passed. Since I made up the exam, I got to grade it.)

The school placed students with families so we would be exposed to the language for more than the 6 hours/day we would spend at school. I was placed with a family with several children. The whole family slept on the living room floor to free up the bedrooms for students. One of the kids had had polio when he was younger. At 14 he wore a metal and leather long leg brace, which he took off to play basketball. A hoop (or maybe it was a literal basket, I don’t recall) was nailed to a pole in the street outside their house. Bad leg and all, he beat me more than once. (He called the game “basket”, as in – ¿Quieres jugar basket? -[“Do you want to play basketball?”]- but when he scored, he yelled – ¡Canasta! -[“basket!”])

I had a roommate, who was soon to start medical school -coincidentally in my home town. He said he wanted to be a family practice doctor and wanted to work with low-income clients who were not native English speakers. He knew that med school would present temptations to go into lucrative specialties and he wanted an experience to anchor him so he could resist those temptations. He would spend a few months volunteering in a clinic in a tiny mountain town in Puebla (home of Mole Poblano). A stint at Cuauhnahuac was first on the agenda, so he could talk to his patients.

We became fast friends. I was initially impressed by the maturity of his plan. I quickly remembered what I was doing at that age and how offensive it was when people were impressed by my maturity. I kept my mouth shut.

I went off to Nicaragua and Ken went off to Zacapoaxtla. We agreed to meet and travel together when I finished work. In those days, the only communication available was snail mail. International mail traveled at a snail’s pace. I wrote to Ken with a plan and date that I could arrive. I didn’t hear back.

I took a series of buses to get to Zacapoaxtla. I was the only gringo around. I found a clinic but no one was around. I found a hotel. When I went into the restaurant across the street for dinner, I was asked if I had come to town to see Ken, there being no other reason they could imagine a gringo being there. I said yes and that I had gone to the clinic but couldn’t find him. She told me he didn’t work in this town, but in the next village up the road, Tatoxcac.

After breakfast the next day I started up a narrow road winding through the mountain. I kept passing others walking up the same road, only to have to pass them again later. I learned that there was a path that left the road at every switchback and cut straight through the woods. The walk back down the mountain was much faster.

I made it to the little clinic. It was open but empty. I wandered through and then back outside and saw someone waving to me. The doctor walked up and asked if I were Steve. She said Ken was out of town and would be back the next day. She asked where I was staying and we made a plan for Ken to meet me for breakfast at the restaurant across from my hotel (the one that already knew who I was).

We had breakfast and hatched a plan to conduct a Mole Poblano tour. We traveled by bus from town to town throughout the state of Puebla, eventually getting to Puebla (the capital) itself. We ate Mole in every town. We ate in restaurants big and small, more and less fancy. We concluded that the best Mole Poblano was in a little village where there was a large open courtyard with big picnic tables. Surrounding the courtyard were individual open-air kitchens under a corrugated tin roof held up by poles. Whichever one you sat nearest fed you. The one we chose had two items on the menu – pechuga (breast) and pierna (leg). Either was served in a clay bowl covered in sauce and accompanied by a stack of tortillas. If you ran out of sauce before you ran out of tortillas, they refilled your bowl (no more chicken, just the sauce – but that was the best part). If I dug out my journal I could probably name the town. I could maybe find that market if I found the town. That’s not the point. The point was that we had a really good time eating a lot of really good food and had a great tour of the state in the process. And if we did it again, we might find the best mole somewhere else.

Ken went on to med school, became a family practice doctor, married another family practice doctor, went to work for a community health center (interestingly, the one which took over the clinic where I had volunteered in the 70s), eventually became Medical Director, and is now the CEO. I think his plan worked.

Fraud

I watched the “One World: Together at Home” concert, with all of the artists recorded at home. I felt like a fraud. Everyone was lauding the heroic frontline healthcare workers risking their very lives. Yes, I’m a frontline healthcare worker. Maybe I’m in the second line. I dress funny nowadays, but mostly I just do my job. I don’t really do anything heroic. Maybe it’s like the old joke about the definition of a Yankee (the closer you get the more specific and nuanced the definition). Or the notion of a “war zone”. In the 1980s, many people in the US considered all of Central America to be a war zone. When you got to Central America, the war zone was in Nicaragua. When you got to Nicaragua, it was the Matalagalpa region. When you got to Matagalpa, it was out near Muy Muy and Matiguás. Where I worked, between Muy Muy and Matiguás, it was over the next ridge. I never saw the war zone.

I’m no hero. But it would be nice if the wall-mounted hand sanitizer dispensers actually had hand sanitizer in them. It would be nice if I hadn’t worn the same single-use mask for three weeks (and counting). It would be nice if I were allowed to wear an N-95 respirator if I saw a COVID-19+ patient – but those are reserved for the ICU and IMC patients. Since I work in an IMC (intermediate care center), I should be careful what I ask for.

Treason

This is not a word to be tossed around lightly. But Our Only President first asserted absolute power, then said that the authority rested in individual state governors, then tweeted LIBERATE MICHIGAN, where he doesn’t like the governor and where a shelter in place order is active. I don’t know about you, but I remember a lot of National Liberation Fronts. The point of that word was to overthrow the existing government. So when Trump tweets that we should “liberate” a state (Michigan isn’t the only one, and your state may be next) at a time when a demonstration has been called in that state (and who is organizing and funding those demonstrations?) we all know what he means. Sure, he can hide behind the words and claim he just wants to ensure our constitutional freedoms, but we all know what that word means.

Think about that. We have a president advocating for the overthrow of government – not the federal government, but individual states. He may not be technically committing treason, since he’s not advocating nor attempting to implement the overthrow of the US government; but he is advocating for the overthrow of governments within this country and there is news that funding is coming from people within his government, if not from him personally. We have a president who claimed absolute authority. Then he realized that absolute authority is accompanied by absolute responsibility. Since he has already said, “I don’t take responsibility at all”, he may have figured out that he didn’t really want that authority, as he has spent his career blaming others for his failings. As soon as he relinquished that authority, he began attacking those who took it on.

I hate being a grownup!

Those who have followed my life since January, 2020 know that I’ve been dealing with some serious shit regarding my health, Worker’s Compensation, and Human Resources (a term that makes me feel like ore). For the rest of you, here’s a quick summation.

I was injured at work. My compensation claim was denied with the declaration of a Pre-existing Condition that I never knew I had, nor had any doctor I’ve seen in my life (and that’s a while). My HR department canceled my health insurance. When I fought back, they reinstated it with an “oops”. Then they canceled my dental insurance. Another “oops”.

The company that administers our FMLA plan told me (on Feb 5) that I had to be back at work by Feb 4 or risk termination. This, despite the fact that my continuing post-op restriction essentially defines my work. Try “no stress or strain to the abdominal or core muscles” while doing direct patient care in a hospital. To extend my leave requires a signed statement from the surgeon. Will he do it? Does he have time? Does he agree with the nurse who revised the restriction from “no lifting >20 pounds” to “no core stress or strain”? Stay tuned.

A big part of me wants to say “Fine. Fire me. It still hurts too much to go back to work.” The grownup part says that my Social Security benefit will be significantly higher if I stay there for 3 more years. That same grownup says that if I quit, give up my health insurance and go on Medicare, I won’t be able to provide insurance to my child until they turn 26, which was my plan; especially if they go to grad school in the fall and leave their job and that insurance. The grownup says: “You’ve stuck it out 20 years. You can live through 3 ½ more.”

See why I hate being a grownup?

Interval training with the Stray Cats

It has been exactly one month that I’ve been off work. To rebuild the endurance to get back to work, I stayed out of the house for half the day yesterday, running errands. It was exhausting. It is time for the next step – interval training.

The Stray Cats were my training partners for the day. With tempos ranging from ~60 bpm to over 100, and a couple of breaks for them to get a drink and between encores, they were a great inspiration and well-paced. I matched their tempo most of the time (hence the intervals). I managed to get my hands in the drops today for the first time – I haven’t been able to bend that far and have been on the bar tops exclusively until today. No fancy Smart Trainer for me; just the one I bought used about 30 years ago to rehab from a prior injury. (Yeah, I have to take it apart and fix it when it gets hot and falls apart – that may be why the original owner sold it – but that gets me another break.)

Health insurance rant

Ten years ago, I had a company paid health insurance plan. It was through an HMO. Everything was covered. Their job was to help me stay healthy. Then everything changed.

Health insurance costs began to rise precipitously. Wisconsin Act 10 banned union activity at my place of employment, so I lost my contract and my union’s protection. The Affordable Care Act set minimum standards, so employers raced to the bottom, choosing to meet the bare minimum.

The result? My health insurance now costs $231/month, I have a co-pay for each doctor visit, I pay 10% co-insurance for everything other than a routine doctor visit (lab tests, x-rays, surgery…). My maximum out of pocket expense is now $13,700/year (not counting premiums). My actual maximum is therefore $16,472, compared with zero dollars ten years ago – in practical terms, a massive pay cut.

Death Ride

Monitor Pass (snow should be gone for the ride), photo from California Alps Cycling

Registration is now open for the Death Ride on Saturday, July 11, 2020. Enjoy beautiful Alpine County, California, climb your choice of 1-5 mountain passes, and ride up to 129 miles (~200 km). For anyone planning to travel out there, a couple of handy options I recommend for sleeping – Turtle Rock Park for those of the camping persuasion, and Sorenson’s Resort for those of the sleeping indoors persuasion. Both are right on the route. Now that my reservations are in, I can tell the rest of you. This will be my return to the scene of the crime after 28 years. We’ll see if my legs and lungs still have it. Registration is also open for the Horribly Hilly Hundreds, the midwest’s answer to the Death Ride. HHH starts at Blue Mound State Park. Camping is available there or at nearby Brigham County Park. Both are great. I have no recommendation for sleeping indoors. HHH entry is by lottery, so get your application in by February 16. The ride is on Saturday, June 20. No, I’m not going to do both.

 A view from the top of Blue Mound.
View from Blue Mound, photo from WI DNR

Winter

If you live in a cold climate, remember your friendly neighborhood botanical garden. My first introduction to summer in the winter was the Mitchell Park Domes in Milwaukee. Today I visited Olbrich Botanical Gardens in Madison, where there is a special orchid display this month. I kicked myself for forgetting my camera with macro lens, so you’ll have to settle for iPhone photos. Check it out:

PSA

One of my jobs is English-to-English translation, as people always seem to have trouble understanding each other.

While I am home recuperating from surgery, I thought I’d explain a few medical terms for your edification.

Public Service Announcement

  • “Minor surgery” – anything done to someone else.
  • “Procedure” – surgery that your insurance won’t fully cover.
  • “Outpatient procedure” – surgery that even Medicare won’t fully cover.
  • “This won’t hurt a bit” – It won’t hurt me to do it to you. I can’t say what it will feel like on the receiving end.
  • “Just a little prick. It’s not really painful.” – The President is just a little prick, too; but he causes plenty of pain.
  • “This may cause a little discomfort.” – Yeah, doc, let me do it to you and then tell me about discomfort.
  • “Deductible” – Don’t even think about using your insurance before you’re broke.
  • “Co-pay” – You think you’re insured, but we think that unless you have a little skin in the game, you’ll actually try to use your insurance. This’ll make you think twice.
  • “Co-insurance” – Ha! After you satisfied the deductible and made the co-pay, you thought insurance would cover the rest – sucker! Now you get to split the rest of the cost with us!
  • “We’ll just run a few tests.” – We bought this new (and really expensive) machine. The only way we can afford it is to use it a lot and bill you for it.
  • Bonus! Want to save on medical expenses? The TSA scanners have an uncanny ability to detect injuries! My most recent scan found a cavity before I went to the dentist. That’s not to mention the other injuries they have found.

Worker’s Compensation

The popular myth about Worker’s Compensation Insurance is that it is there to protect workers from unsafe working conditions. As Paul Harvey would say, here’s the rest of the story: Worker’s Compensation Insurance is (also) there to protect employers from lawsuits by employees. If you are hurt on the job, you can’t sue your employer for damages. You can file an insurance claim and hope the insurance company (which works for the employer, not you) will agree that your injury was caused by your job and pay for your medical care and a portion of your wages while you are unable to work. More likely is that they will dispute your claim, asserting that you had a pre-existing condition or that your injury was caused by something you do in your spare time. To collect the benefits you are owed you may have to hire an attorney to represent you even though you can’t sue.

Another popular myth is that workers fake injuries in order to collect benefits. Since benefits are set at a fraction of your wages, you have to be pretty stupid to get only a portion of your wages (unless you have some other lucrative job you can perform while collecting benefits, a rarity indeed) while living on savings or scrimping to get by. The insurance company may spend more on surveillance (hiring private investigators to follow you around and film your activities) than the cost of compensation for the injury. An article in the Journal of Social Research (Tennyson, 2008) asserts that industry estimates of fraud are grossly exaggerated (by a factor of 10) and that surveillance activities decrease trust and lead to increased fraud.

In The American Journal of Industrial Medicine, Spieler and Burton (2012) cite more than a dozen reasons for under-reporting of work-related injuries and illnesses and cite conclusions from other studies including ” at least 80% of all medical costs caused by occupational diseases were missed by workers’ compensation programs.” (Leigh and Robbins, 2004)

So are workers ripping off the system in large numbers, as popularly believed? Or is the system ripping off workers in large numbers, as the evidence suggests? The evidence suggests that workers fail to report work-related injuries for multiple reasons including fear of retaliation, and that insurance companies fail to pay for work-related injuries for multiple reasons including asserting that doctors can’t prove that the job was the sole cause of the injury or illness. The evidence also suggests that insurers will go to great lengths to discourage claims and to reject those that are filed.

What do others think of US Healthcare?

Most of the world has a healthcare system. The US has an insurance system. Why does it not strike us as odd that we have a “system” centered around an industry that makes its money by withholding care? The more premiums we pay and the fewer services they pay for, the “healthier” the system is. Take a few minutes to watch the video above and hear what people who have a healthcare system say when asked what they think about the cost of care in the US. Our leaders and our media want to convince us that we can’t afford a single-payer system. The rest of the world recognizes that we can’t afford not to have one.

Human Resources

Resources have value based on the cost of extracting them versus the value added to the product. A few years ago, when the fracking boom hit, western Wisconsin was found to have the best frac sand around. A new industry appeared. They blew up fields to mine sand and built new railroad lines to haul the sand to natural gas wells. A few years went by, and they decided sand in Texas was cheaper, closer to the gas deposits, and good enough. The Wisconsin sand mining industry went bust.

If you are a highly skilled widget maker with 20 years of experience and know things, like where to bang on a machine to restart it when it freezes up, and you make great widgets, and you pay attention so that you know stuff that no one else in the company knows, you get paid well. But maybe they do some calculating and decide that a newly-trained widget maker, who gets paid a lot less, will do most of the time. When the machine goes down or they don’t know where to find something, maybe they figure the lost time will be made up for by the lower wages. Now it’s time to get rid of you. Having Security walk you out of the plant may be bad for morale. What to do, what to do?

Maybe they can make it unpleasant enough that you’ll take early retirement to avoid the headaches. What if they suddenly start making mistakes on your payroll? Or maybe change your family health insurance plan to a single plan without telling you? Maybe your pension contributions get messed up. Maybe, if you notice the mistakes and complain, they’ll get fixed eventually. Or maybe you’ll just get fed up and leave, allowing then to bring in a lower-paid worker. Nah, that would never happen, right? But if the cost of extracting your value becomes greater than the value added to the widgets, start watching those paystubs carefully.

Weather and Climate

We’ve talked about weather and climate before. We’ve linked to data on the freeze/thaw cycles of one Wisconsin lake that has been studied for more than 150 years. While this year’s weather should not be mistaken for climate, in October we were ice fishing. In January we could be swimming, though it would be a bit chilly. October’s ice is gone. The lake is liquid again and the temperature is pushing 50. Since 1852, this lake has melted and re-frozen in the same season six times. Five of those have occurred since 1977.

The preview is old. Don’t try to tune in on the date mentioned.

In case you’ve been wondering where we’ve been, we’re around – we just had nothing to say for a while. Now we can’t ride a bike for a while, so…here we are! Comments welcome. Watching TV is going to get old fast, so let’s talk.

Verklempt Saturday Night Live GIF - Find & Share on GIPHY
Photo credit: John Hart, Wisconsin State Journal 01/07/2020