The Pixieford Files

While the cleaning at home is nearly done, I've also been cleaning at work.  Every project I was supposed to be working on, or could be working on right now, is on hold.  I mentioned this to Howie last week.

"Clean your desk," came his reply.  Beg pardon?  "Clean your desk," he repeated.  "Clean everything, archive everything that needs to go into storage, file everything, get rid of it all; make a clean slate ready for new work.  Get ready for the next project."

Now, upon hearing that, the wintermint freshness of panic seeped into my colon.  'Clean your desk' has a creepy connotation of late, what with all the layoffs.  However, Howie was serious.  He cleared me to bill cleaning my desk to a general overhead billing code, so I went forth to get my clean on.  What does it say about the state of my desk that I literally spent all of Thursday and Friday cleaning it, and still have another 2-3 hours to do on it?  It says that I'm a messy trollop, that's what.  But my desk is pretty damn clean.

Jann saw me archiving files and product samples for MHRC, and she mentioned she had some files to go through to include in those archive boxes.  I offered to do the sorting for her, and she gladly took me up on it.  Her desk was at least as scary as mine, if not worse.  Hence, I've been helping her for the past day and a half, sorting and filing papers for a variety of projects.  On the one hand, it feels weird to just file and clean and wipe counters down with Clorox Clean-Up cloths.  On the other hand, I haven't felt this productive in a long-ass time.

So, I'm cleaning at work, and I'm cleaning at home.  Guy and I did a real scrub job on the place last night, and Guy even took some newspaper to all the mirrors and glass tabletops in our modern-ass house.  The place is glowing.  Mies would be proud.  The house is ready for Kitty and then Guy's mouth-breathing friends to visit, so I'm going to quit cleaning.  I'm done.  At home, anyway.

Cleaning house, but not in a barfight-kind of way

Today was grey and misty/rainy in Denver, which made it a good day for Guy to take a nap while I cleaned.  I managed to scrub the grout in the bathroom tile floor, mostly clean my shower and toilet, swiff most of the house, clean the kitchen counters and the ceramic stove cooktop, wipe up around the litter boxes and clean the litter box walkoff pads, wash up a bunch of large dishes, and do some paper-and-magazine cleanup and throw-away.  Granted, my sister doesn't care how my house looks, and the guys that are coming next weekend will hardly care how tidy everything is, it's just time to do some cleaning.  There's something to be said for living in a nice, clean space, where things are relatively organized and things are mostly sanitary.  Once Kitty gets here and picks over my closet, I'll then do a cleaning of my wardrobe.  But for now, I'm getting rid of paper clutter and dirt/funk.

When Guy awoke to see what I'd accomplished in about 90 minutes' time, he promptly took me to one of our favorite nearby Mexican joints for linner as a reward.  He did a little cleaning after we returned, but now we're girthing in front of the TV, and more cleaning will take place tomorrow.  Hence, I have no interesting pictures or articles for you today.  

But my house is almost clean.  Almost.

Okay, I'll say it again: can we PLEASE get a national health care policy in place?

A new report from The Advisory Board shows that nonurgent ED (emergency department) visits are a source of bad debt.  The article says "Hospitals are not only seeing record growth in the use of ED resources by nonurgent patients but also finding that many nonurgent patients ultimately are written off as bad debt. Given this reality, many hospitals have begun to explore ideas for encouraging more appropriate ED utilization for patients with nonurgent needs. "
 
Here's an idea: let's run nonurgent needs through an outpatient clinic, like we're supposed to!  The ED is for emergencies, not nonurgent care.
 
I've heard a developer and a finance guy each cast aspersions at a national health care plan, saying it would mess up/foul up the healthcare design and construction industry.  I'm having a hard time seeing how.  If suddenly, 41+million Americans (with Social Security numbers, I might add) had health care, wouldn't you need a hell of a lot more treatment spaces for those people?  If the funding came to provide that care, instead of becoming the black hole that is nonurgent-indigent-care-at-the-ED, hospitals might have more cash to pay nursing staff to extend hours of treatment and/or build or remodel those treatment spaces.
 
Do we have any healthcare providers in the crowd interested in sounding off on this?

In honor of Dad's 62nd birthday, or, Invasion of the Biscuit-and-Gravy Pod People

Today would have been my dad's 62nd birthday.  On this day, I try to do something fun to celebrate Dad's birthday that I think he would enjoy, too.  Guy had to go into the office this afternoon, so I decided to make a proper Southern breakfast to fuel him for the day.  I broached the subject last night as Guy tucked me into bed.  (He stays up later than I do, and I get up earlier than I do.  Hence, he tucks me in and kisses me goodnight, and I kiss him good morning when his alarm goes off and I've already had a workout and a shower.)

Pixie: So, tomorrow is Dad's 62nd birthday, and I wanna make breakfast in his honor.

Guy: Oh, okay.  Sounds yummy.

Pixie: Oooh!  I know just what I'm gonna make, too!

Guy: What?

Pixie: I'm gonna make biscuits, country ham, eggs, and get some sliced cheese, and--

Guy: You know what's missing from those biscuits?  Some gr--

Pixie: [nearly leaping out of bed]  No!  Fuck your gravy!

Guy: [falling over laughing on the bed]  "Fuck my gravy"?

Pixie: You need to think of your stupid gravy box!  I was gonna suggest making breakfast biscuit sammitches with the ham and eggs and cheese, but you want to drown everything in some damn gravy!

Guy: [still chuckling]  Look, I'm sorry, but you need gravy with biscuits.

Pixie: Well I'm sorry, but you need therapy.  Biscuits don't always need gravy.  I'm talking about breakfast biscuits, like we get at McDonald's.

Guy: You get biscuits at McDonald's.  I get an Egg McMuffin or a breakfast burrito.  I don't need some flavorless bread as part of my breakfast.

Pixie: [sighing] Fine, tomorrow, in honor of my deceased father, I will take some tasty meat, tasty egg, and tasty cheese, and I will sandwich them in between two pieces of homemade buttermilk cardboard, and you will like it.

Guy: [kissing Pixie's forehead]  Yes, dear.

So, this morning, I made biscuits.  And I mean homemade buttermilk biscuits.

Flour, baking soda, and salt with butter.  Mix/cut the butter into the flour mixture with two knives or your hands until it looks like coarse meal.

Then, pour in a cup of milk and mix until all the dry stuff is evenly moistened.  You can use buttermilk, or as I do, you can add one tablespoon of lemon juice or vinegar to the cup of regular milk, because it helps "curdle" the milk properly.

Scatter the flour on the countertop (oh, soft heavenly flour!) and turn out the dough on the counter.  The less you work (knead) the dough, the more tender your biscuits are.  Pat it to about 3/4" thick, then cut the biscuits and put them on a lightly greased cookie sheet.

Spacing them close together allows them to "steam" on each other while they bake.  Pop 'em in the oven at 450 for 10 to 15 minutes, depending on weather, elevation, flour type, etc.  I use Hungarian high altitude flour.  

I baked these for 12 minutes, which was about the top end of their baking time.  They ended up a tad brown for my tastes, but they were still nice and soft inside and they had a little dusting of flour on top.  Again, NOM.

Lawd, honeh.  Them's good.

I made two biscuit sandwiches for me and let Guy make his two.  I polished mine off in short order while drinking coffee and reading the funnies.  Guy ate, then got up and started dong laundry before he went to work, and left this at his place at the table.

Um, excuse me?  Did someone leave some biscuit, ham, and egg on his plate?

I confronted Guy on his apparent lack of interest in my Southern culinary masterpiece.  He countered by saying he had too much to eat and got full.  After some back and forth, it turns out that Guy managed to eat the two largest biscuits and most of the ham.  So, this time, I'll give him a pass on not finishing his biscuit.

But we still have dinner tonight.  And three more biscuits to eat.

However, the problem remains that Guy loves gravy with his biscuits, and I, raised fully and utterly in Georgia, have never had gravy pass my lips on a perfectly good biscuit.  It's sacrilege, says Miss Kitty and I.  Amongst my friends and coworkers, the biscuits + jam/butter/honey versus biscuits + gravy camps are evenly divided.  Kellye likes biscuits and gravy, while his wife (from the same part of St. Louis as Kellye) prefers biscuits and jam/butter/honey.  Norman would take either, and Elliot nearly fell out of his chair at the thought that Guy would snub my biscuits just because they lacked gravy.  Derek was part of the jam/butter/honey camp, but he would enjoy gravy just as well, no big whoop.  

So, WAD readers, sound off: gravy or jam/butter/honey?  Both?  Neither?  And say where you're from when you weigh in--I want to know if this is geographical, cultural, or an alien invasion that makes people want gravy on a perfectly good biscuit that never did anything bad to them in the first place.

Happy birthday, Daddy.  Your son-in-law is a good man, despite his biscuit ig'nance.

The greatest health threat we're STILL not treating

A recent report by The Advisory Board titled "Future of Neurosciences" reveals that, while behavioral/mental health cases dwarf other admits by volume (in 2006, 10.1 million behavioral health cases versus 3 million cerebrovascular cases, the next largest neuroscience inpatient or outpatient admit in Advisory's study pool), it is not profitable ($1,759 profit per behavioral health case vs. $3,223 profit per cerebrovascular case).  Over 50% of psychiatric admits are through the emergency department, which totally blows for hospitals because a) ED staff aren't usually trained to deal with psych cases, and b) psych admits occupy profitable inpatient beds up to twice as long as average inpatient admits from the ED (like heart attacks, trauma/accidents, etc.).  Psych admits are unprofitable because most major mental illnesses, like schizophrenia, see their major onset during a patient's 20s, and the diseases leave the patient unable to hold down a job which ensures that they'll end up on Medicare/Medicaid or charity/self pay, which means you're not getting a lot of cashola for dealing with them.

Psychiatric/behavioral health treatment is also labor-intensive.  For an inpatient psych wing, you need a couple of psych nurses at all times, plus a couple of caseworkers, several therapists, group therapy leaders, psychiatrists (who, unlike psychologists, are able to prescribe meds, which is bullshit because psychologists get better training, really), specialists for different problems (depression, eating disorders, PTSD/trauma, PTSD/military, drug and alcohol addiction, etc)...and you need these people available on a 24-hour basis.  Most med-surg (your typical) inpatient hospital beds require much lower staff-per-patient ratios, and sometimes only about 1 or 2 nurses at night for 24-30 patients.  And labor in the US is what costs us so much.  Drugs are (relatively) cheap, but it costs a lot to pay a well-trained nurse to settle someone down and get a knife from the cafeteria out of their hands.

Again, I ask:  What.  The.  Fuck?

How can we not fund the care of a problem that costs us so much?  Think about the hidden costs of not caring for behavioral health issues: lost time from work, both in terms of the patient not getting paid and being out sick, plus the employer who loses effort and time and productivity from this illness; the worn-out staff that misdiagnoses other illnesses in the ED; the true emergency cases that have to wait and get even worse because the staff is handling out-of-control walk-ins that shouldn't be there.

And there's the other random lives that are touched when mental illness spills out and hurts others, like when a gunman storms a playground or restaurant.  Or the not-so-random lives, like when my uncle shot my dad and himself.

I should also add that building an inpatient psych wing costs.  You need special hardware that keeps people from hurting or isolating themselves, light fixtures and finishes (walls, paint, etc) that people can't beat up or hurt themselves on.  And if we as a culture would fund the care of the mentally ill--who often seem pretty normal most of the time--I could build the psych hospital that I was supposed to build over a year ago and why I started this blog in the first place, and it would give our office something to do and keep us from having to lay off yet more people.

Scene: Friday afternoon, Pixie's and coworkers' cubicle area

[Pixie searches online for something, Norman checks shop drawings, Derek reads an email, Elliot redlines drawings for an intern, Ingrid draws on Revit]

Pixie:       Sweet!

Derek:     Find some good news?

Pixie:       Hell yeah!  The King Soopers pharmacy near my house is open 'til 9 tonight.

Norman:   What, are you picking up some Ritalin for a rave tonight or something?

Pixie:       [laughing] Noo, I gotta get Maddy's chemo prescription and I haven't been able to get over there before 6 all week.

Derek:     So Kitty starts chemo, huh?

Pixie:       Yeah, I hope it helps her out.

Ingrid:       [standing up very slowly]  Does she just get chemo?  'Cuz if she gets Vicodin, I could use it for the vertebrae I cracked on Tuesday when that chick ran over me on my bike.

Elliot:       [not looking up from drawing]  If you'da been in a bar instead of riding your bike "for your health", that shit wouldn'tve happen to you.

Derek:     Ooh, you could be our dealer if you're picking up things "for Maddy"!

Pixie:     [laughing harder, holding hand like a phone to her ear] 'Yes, King Soopers pharmacy?  My cat really needs some Xanax, and some Vicodin, and even some Valium.  She's really stressed out about this chemo.'

Norman:   [flipping pages on shop drawing]  '...and she needs some methadone.  Her DTs are so bad she's breaking furniture.'

[everyone laughs]

Norman:   Isn't that what heroin addicts use to get off heroin?

Pixie:       Yeah, methadone.

Derek:     Is it kinda like heroin or something?

Pixie:     Well, yes and no.  It has some of the benefits wi--

Norman:   Benefits?

Elliot: Benefits?!  Pixie, you don't need to go to a pharmacy.

Derek: Somebody needs some rehab.

Ingrid: [singing] "They tried to make Pix go to rehab, she said, noooo, noo, no!"

Pixie: [laughing so hard she's crying]  It's--I'm--It's not me I'm going to the pharmacy for! It's--"

All: Suuuuuuure.

[Pixie collapses into desk chair, laughing]

Learning to love the fallout

The past week/ten days have been a little weird.  First off, our friends and former coworkers are emailing us all, asking for photos and details (square footage, program, date of completion) of projects they worked on while at DA.  Added to this is the pressure to be productive on whatever it is that you may still have to work on--folks are trying their damndest to be useful and efficient.  Ethel nearly drove me crazy on Friday with a constant stream of emails about whether or not she should include the potential new employer's address on the cover letter or this or that on the resume, even blind copying me on emails she sent these potential new employers.  She barraged Jacqueline with emails as well: please look at my resume, I need info on this and that and the other projects, I need it today.  It was the "I need it today" that bothered both Jacqueline and me.  If any of y'all wanted to send out resumes on Friday, and you wanted some of your friends and former colleagues to review your resume and give you information on projects you worked on, you'd send that request before late Thursday afternoon, wouldn't you?  Please say yes.  Jacqueline made some comments on Ethel's resume that were pretty sharp and that I wish I'd noticed--things like deleting the "objective" on a resume.  How 80s.  And frankly, everyone knows you want a job, that's the point.  She also suggested that she reorganize the info on the resume because it was looking a bit congested and dense.  It was only after Jacqueline's email to Ethel saying a) you need to clean up your resume and b) I can't get you all this info today as I have a deadline, Ethel finally stopped carpet-bombing us.

I was stunned as I recounted all this to Guy as we went to dinner for a late birthday celebration.  "Why is she even asking me for resume and cover letter help?"  I asked Guy.  "I've only ever had to interview for two jobs in my life, and I've never been laid off.  She's been laid off before; she's got to know how to get a job, for the love of Frank Gehry. It feels like she's giving her power away."

"She's in panic mode," replied Guy.  "I talked to Sarge yesterday, and I advised him to take some time to make a good, clean resume and project sheet.  I mean, yeah, everyone and their mom is applying for a job right now, so the least you can do is make a clean, good-looking resume so it catches everyone's eye."

What happened at DA last week has a lot of us thinking, even Norman, who is an associate with DA.  Several of us have begun tuning up our resumes and getting the images we need in order to make good project image sheets, just in case.  None of us who are left want to have to call someone if the ax should fall our way.

Meanwhile, Kellye and I have been waxing philosophical during a few lunches in one of the upstairs conference rooms.  It's cheap--you bring your own lunch--and it's still kinda relaxing--you get away from your desk but don't have to tip anyone for sitting in their tables.  Yogic and Buddhist philosophy have a concept called "sitting with the discomfort," which entails not fighting or avoiding or trying to 'fix' whatever's 'wrong'.  While in some instances this is obviously bad advice, it's a different way of looking at the kind of uncertainty and instability that DA's layoffs bring.  Kellye posited the theory that the present climate--layoffs, bailout bill in Congress, elections, the whole lot--may be about to bring about a revolution.  Not necessarily one with blood and pitchforks that someone will just have to write a musical about, but one where people wake up and go, "Hey, this isn't right, and here's what I/we really need and want!"  The lack of work to do, the layoffs, everything is part of a pendulum swing, and this too shall pass.  Just breathe.  Eventually there will be work to be done.  Eventually something will come along, or you'll go somewhere else and something will come along.  Either way, whatever moment in front of you, happy or sad, isn't permanent.  So just breathe.

Not that it's easy.  We're giving this viewpoint a shot because it seems to lead to less drinking-NyQuil-straight-from-the-bottle types of activity.