My US Representative told the Star Tribune that in the future he would listen to our military leaders when formulating his opinion on matters relating to the war in Iraq. This is new but hardly encouraging. It is only days ago that he ignored our military leaders, General Petraeus in particular, in voting against  the reinforcement of our soldiers in Iraq, defying our President who had expressly asked for the support of his party in this crisis. He joined 16 other Republicans. Since Senator Coleman did something similar in the Senate I am left unrepresented in my State.
    Ramstad had been mostly silent on matters relating to the war. He rarely seeks the spotlight and this has been one of his strengths. His reputation for hard work is very likely well earned. I have voted for him every time almost reflexively. His previous primary challenges have given him virtually no discomfort and the State Republican Party discourages challenges. Ramstad is a "made man".
    I emailed him before the vote was cast on the non-binding resolution. He did not respond though my email was not provocative in tone or content. I fully expect his mailings to continue. But seriously, on what basis does he expect my vote again. I cannot, will not cast a vote his way again. I will return all his solicitations with comments appropriate to the moment. Representative Ramstad is not the kind of man I deserve. He ought to be opposed vigorously and the State Party ought to begin laying out some markers that suggest that a challenge like this is good for the Party, rather than forming ranks in defense of the indefensible. In time of war this man deserted his President. In a symbolic vote of no confidence which can only give aid and comfort to our enemies he buckled to the anticipated bad news for him in future polls. This is a cowardly act, not an indication of deep conviction. A man opposed to the war opposes it with all his mettle. Paul Wellstone was such a man though I never agreed with his positions I always admired the display of courage with his convictions. Wellstone, though in my view wrong on most things was a man. He is missed because his kind are so rare. Politics is no longer the ground where courage signifies anything constructive at all. God help us when the point of our spear is broken, when we can no longer find men and women ready to stand against mujahideen combatants in the alleys of Fallujah. Today we still have such men. They must be encouraged to prevail, not abandoned. Representative Ramstad's vote of no confidence was wrong. It tells me something important about him. Something I will not forget. 

    The bureaucratic mind controls an empty chest, sucking out all courage, fortitude, resilience and leaves one capable only of grasping for advantage over others. Power is its objective and in these times opinion polls matter most. The bureaucratic mind renders one hollow. Pretty people abound, people with keen instincts about camera angles and opportunity. Sadly, this group is experiencing growth in numbers. These people are everywhere and rising to the top of every institution. There seems to be no credible counterpoint that can restrain this growth. Left unchecked they doom us. Our enemies know well how to tickle their fancy with the rub of lust, not carnal but fawning. These people are addicted.They hunger for attention and our enemies stroke them. Yes, we have enemies. Lethal enemies.

    Perhaps, we are undecided whether this war we are waging is real. Perhaps, failed communication is a cause which might be reversed and help some. I doubt it. I see too many hollow men abounding. 

    This is a crucial moment. General Petreaus must be a warrior first. Only his ability to deploy his forces in the most dangerous areas with lethal force will serve the moment. This is war for soldiers regardless of what diplomats (pragmatists) would have us understand. These soldiers cannot be engaged in peace-keeping, nation building, or other ventures until the enemies will to resist is crushed and/or the source of funds that feeds them is stopped. Since we dare not confront directly the funding sources we must destroy the people who wield the weapons. This is soldiers work. It is time to turn them loose.

    Otherwise they become targets while politician's discuss the terms of disengagement. If that is the de facto position we have slipped into then we will discover sooner than later that the consequences for us and our civilization have become dreadful. This point of departure has consequences, serious consequences. Hollow men are unlikely to grasp this and they abound.

     Senator Coleman responded promptly and thoughtfully to my emailed encouragement to support President Bush. My response to his response keeps coming back as undeliverable. Being tech illiterate I have trouble thinking through the cause, so forget about it.

    The Honorable Senator Coleman has one point of dispute with the President and General Petraeus. Senator Coleman thinks deploying our soldiers to Bagdad is not a good idea. We disagree. I took some pains and time to explain myself. Let me try here to share these thoughts since the cyber post office seems incapable of delivering his mail from me. I know there is probably a way I can hit a few keystrokes and paste my email into this space but again I respect the wonder of this stuff by am not inclined to ever master it. I will just transcribe my answer to Senator Coleman from the hard copy I printed for myself.

    Tuesday, January 30, 2007 8:23 AM

        Thank you for your response. As I read it I am persuaded we differ on only one point. Your determination to vote against President Bush in this "symbolic" no confidence measure is pegged to the disagreement you have with deploying our soldiers into the  Bagdad operational area. This most dangerous area must be secured by those least capable of securing it as a first step. On all other points you can support President Bush and his Generals.
        With due respect this is unreasonable. On both practical and "symbolic" grounds we must deploy the best to the biggest point of danger and crush their will to defy the forces of goodwill arrayed agianst them. We must, by our continued willingness to shed our blood with our Iraqi allies, prosecute this conflict with the greatest hope for securing an enduring end to hostilities in this area. To sit on the outside rooting for them will not remove our soldiers from danger, it will just prolong the period that they will face danger.
        As we confronted the result of American resolve failing in Viet Nam we continued to face danger. What made it most excruciating is that we were denied relief in the form of a robust ability to strike back with all our combined forces. We bled but had to endure while the pragmatists in Paris discussed the shape of the table.
        Your calibration serves only your hope of securing a reputation of independence in the State of Minnesota where this war is so unpopular. I understand your dilemma. I cannot find it in me to give you a pass on this point. You, like so many others, seem to have calculated that the outcome is so gloomy that victory on the ground, in Bagdad, is impossible. Yet, the new General says otherwise. By frustrating this operation you aid and abet its enemies both foreign and domestic and make the General's task much more difficult. What I fear most is that this General is not the warrior we need just now but rather a man determined to do his own calibrating and thereby desert his commander-in chief when we all need him most.
        Your refusal to lend an ounce of support to the forces mounting against the President will distinguish you espeacially in light of your public anguish over this matter. Soldiers understand warfare and our soldiers have the advantage of being volunteers. They cannot understand and come quickly to despise politician's of all parties. Today we need our soldiers on task and reinforced more than our politician's calibrating (there's that word again) their next election.
        I will resort to prayer, that you do what is right in this matter.

    I will try to mail this again. Perhaps his mailbox is stuffed and overflowing with letters form constituents. I pray that these are mostly pleas for him to buck-up, to stand up, consequences be... whatever.

     This blogging experience has been interrupted for many reasons. My life is hard and time is precious and being so boneweary so often I fear these printed remarks will embarrass me and mine one day. But these are terrible times for many. Just now I have finished signing a pledge to withhold financial support to any Republican who fails to support President Bush as he reinforces our soldiers in Iraq. I have begun contacting them. I pray for the President and our gallant warriors who ought to be turned loose to wage war.

    President Kennedy motivated my enlistment in the Army. My brother enlisted in the Marines. We both arrived near Hue in February 1968. The TET offensive demoralized Walter Cronkite such that he turned the nation around. He spoke eloquently of his disdain for the warmakers in the government, Nixon more than Johnson and the Senators of that day began preparing for our defeat in the field. The rules of engagemment, always a problem, became more so. We went through the motions with increasing certainty that our leaders were deserting us and so it went until total defeat in 1975. Kennedy moved me with words alone.

    We were attacked for years before 9/11. We are at war. We must pursue victory. We must give our soldiers the confidence that they risk all for a purpose greater than finding an accomodation with loathesome regimes. The greater powers that finance our opponents are carefully calculating and calibrating just how far they can go. Only we can stand against these forces and if we acquiese to the pressure of the moment and withdraw we will find that truly dreadful consequences await us. These are terrible times. Courage and fortitude are needed. Our soldiers have that. Our politicians may not.

     Post election analysis is terribly tedious for me. Hatch lost. This makes me happy. He must be kept far away from power of any kind. Let him pretend to write legal briefs for some obscure law firm,that's all.

    President Bush has apparently consulted dad. Not a good sign in this case. I feel a sickness rising in my gut. Jim Baker is an answer to nothing. Pragmatists and war are a lethal combination. If we have no will to fight over there we must come home now. Not another funeral please.

    It is hard to ingest the truth that bin Laden was correct about us. We have no warriors at the top. Just men who wish they were as they send proxies into harms way in order to feel tough. Please God save us from these empty men.

    I am resigned to just work. One day last week I worked more than 24 hours straight, taking food and beverage on the fly. A bag of nuts and a Mountain Dew for caffeine. I do not recommend this but it is my life. It leaves almost no time for blogs or keeping up, or seeing my wife and daughter let alone visiting with them. It is my life, decisions I have made have reduced me to this. I am clawing back to a point where just perhaps my name will be restored to where it once was. 

    And someone wants me to make a call about bedsores. I am being encouraged to tell my story yet again. This party may have an interest. He is caring for a family member who is at risk for bedsores and is able to afford doing something about it. Nothing tires me more than this. Hard labor for long hours is downright exhilarating compared to the thought that I would recount this story yet again. And that is because I could not survive my hopes being raised again. I have this story to tell, this earthshaking story to tell, yet only empty suits prevail where something might be done about it. Who am I against these empty suits? Just a guy reduced to common labor in order to take care of his own against such long odds.

    But then maybe this is just the right thing after-all. There is more to my story after this episode runs its course. My behavior while enduring is the key. It's the key for us all.

    If there is anybody out there an email would be welcome.

    

    SunMicroSystems could lead health care reform by wiring the nursing stations with fiber optics and an array of wirless technologies. A large health care provider would be needed to participate and bedsores would be the first quality outcome to be scrutinized. The ultimate goal would be to get the funds available routed to the places where the superior outcomes were obtained. Intense scrutiny would be given those locations in the provider system where outcomes were deficient. Relevant data would surge at the speed of light to all  entities, from nurses and aides to virtual charts residing at various junctures in the system. Those with a need to know could have access and data crunchers would be able to analyize what supported the successes and what led to the failures.

    Ultimately a Skin Integrity Quotient SIQ would be developed. This could also be called  Systems Integrated Quality. It would be some numerical value the was comprised of real results. An SIQ of 1 would represent a reasonably credible qualtity outcome obtained. An SIQ of 3.3 would represent poor quality delivered and an SIQ of .65 would denote superior quality delivered. Bedsores, nosocomial infection rates and other pesky aberrations could be used to develop the SIQ value. Marketers would tout the facilities delivering SIQ designations of <1. The public would have better choices. They would understand that low SIQ scores meant something meaningful, more than say the quality of the artwork in the facilities open areas or administrators office.

    The health care insiders will not accept this. They are always resiting reform because they claim uniqueness in every instance. For them their case is always the exception that explains away the problem. For them there are no credible authorities. Each location, indeed each situation is special enough to be granted immunity from scrutiny into quality of care matters. Outcomes cannot be fixed on, only conformance to process is acceptable. 

    Yet, the bedsore is absolutely preventable and for a fraction of the cost currently dedicated to treating them. They are not the inevitable consequence of living longer than we did. They result from capillary occlusion-period.

    What are the odds someone from SunMicro Systems is reading this? What are the odds anyone is? About the same I fear. It is nonetheless a great service TownHall.com provides. My rants are theraputic. I have something of value to say. It only really matters that I persist for the rest of my days. Ed Lord compells me. Ed, like Christopher Reeve, died of his bedsores. To move on, to forget about what I know is unacceptable. Though I can do very little, this blog only, it is something and I will persist.   

    Another election cycle finds me fairly gagging on the politician's appeal for health care reform. Democrats want single payor guaranteed and Republicans want to free the market. None of them are serious. They treat us all like fools. We are, actually, when all is said and done. We do not hold them in enough contempt. We do not demand a better way.

    A while back I attended an "End of Lifecare" symposium sponsored by the Minnesota Department of Health when Jan Malcomb was the Commissioner of Health for Governor Ventura. You remember him perhaps, as the guy who said his administration would be different. In many respects it was. In important ones it was not.

    At one of these sessions a prominent leader, an executive of a very good hospital, remarked that she worried sometimes about the public's learning too much about how poorly they were doing. She said she visualized being strung up by an angry mob. She was not looking for laughs. 

    Then that same morning in small group breakout sessions we discussed how to get some things accomplished with respect to end of lifecare issues. The term "thinking outside the box" was often heard. Conversationally these best and brightest were eloquent, impassioned, dare I say bold. But it was all wind, gas, it so quickly dissipated into thin air.  My followups about outcomes, specifically bedsore outcomes were ignored.
Behind the gaze one suspected some measure of fear and an acknowledgement that someone was calling them out, reminding them about their earlier zealousness with respect to necessary reforms. They did not want to do, or risk anything. So what does thinking outside the box get us but a catered lunch, and a very fine lunch it was too.

    The papers in Minnesota are full of the news that Dr. McGuire is stepping down from United Healthcare. He had to back date some options so that his cash could break the billion dollar barrier. A darling of wall street, an innovator par excellence and so far removed from reality one just looses hope that anyone matters anymore. We are on a declining glideslope in health care. Cash generation, names and reputation, data crunched and packaged for the slugs in the public, you and me, to swill. 

    Consider the bedsore. If they exist in any numbers, something directly proportional can be known about the facility and the quality of care delivered. A small incidence/prevalence of bedsores signifies good quality of care delivered. The greater the number of bedsores the poorer the quality. Treating existing bedsores is very costly but conventional medical wisdom states that this is the very best that we can do. They are inevitable, don't you see, all these titans and insiders say. They are wrong.

    Establish no bedsores as the desired outcome, absolute prevention, then sit back and watch a breathtaking result unfold. Health care costs will decline as quality of care delivered improves: a quantum paradox. It can be done. But it takes men and women with chests to do it. These sadly are nearing extinction. The hollow men abound. They are paid very well for these hollow characteristics. We enable them. We are in awe of them. They deserve much less than that.

     I am a very fortunate man. This is something I have long known but am just beginning to appreciate. I work seven days a week for W-2 income. My wife does as well. This allows us to meet our obligations. We are able to save just the tiniest fraction of this. Having lost the savings we once had we are climbing out of debt. That mountains summit is in sight.

    In between the seventy hours I work each week I am studying a new skill as an apprentice to a master of a high demand service. This will hopefully allow me to transition from one or both of the W-2 incomes. Additionally, a home based business opportunity is showing promise. This blog allows me vent for the healthcare reform I know is God's special gift to me. He led me to the bedsore and showed me its solution. In time my circumstances will be such that I am able to dedicate sufficient time to pressing this point ever more relentlessly, though hollow men and women abound. How can I be sure of this. Let me tell you.

    Yesterday, after finishing a 10 hour shift I apprenticed for four hours, then I did four hours of additional W-2 labor, then I had a precious 30 minute visit with my wife and daughter, then I fell into a deep sleep. The entire day was blessed and my steps were graced and I was in a place I have rarely known. I should have been otherwise by the world's reckoning, perhaps even a bit cranky. Only God knows if my tiny insight into the big healthcare problem that is the bedsore will one day matter. I just thank Him for the opportunity He has given me. I am truly blessed.

     Our health care delivery system is broken at the microcosmic space between the nursing station and the bedside. All the energy and attention has drifted up and away from patients. Nursing intuition has given way to adapting to ever more complex process. All the money is siphoned off into committees and facilities and ever more impressive technology. The health care enterprize is thoroughly bureaucratic and virtually no one operating within it is satisfied. They adapt or leave. Compassion fatigue runs rampant, its consequences can be dreadful.

    Managing process is futile. Nothing good comes of it, it just wears out the participants. A better way would be a focus on outcomes delivered. Let the money flow to where the outcomes delivered are superior. 

    This does not happen now because the health care insiders have lost confidence in their ability to deliver credible health care outcomes. One senior executive of my acquaintance told me that her hospital delivered the national average with respect to bedsores. As the person responsible for quality she thought that this was an achievement. National average results an achievement? She too, stopped taking my calls.

    If bedsores were an outcome to be avoided rather than an inevitability we might begin to approach a solution to the problem of rising cost that has seemed to defy solution since 1965. Who knows it might even save Medicare. I contend that the bedsore is at the center of a solution to this seemingly intractable problem. Getting a responsible party to sit still long enough to think it through has been my seemingly intractable problem.

    In my mind's eye I visualize the day when a collaboration with someone like SunMicroSystems will lead to a quantum leap forward in health care delivery. When we can begin to see quality outcomes guaranteed, starting with bedsores, we can add other outcomes that will be equally beneficial. I believe that bedsores prevented for less cost than we presently expend for treatment is demonstrable. It could be guaranteed. Finding courageous people with the adequate vision to see the implications of such a first step seems to be the impossible task. Yet not one person has, after examining the case, refuted me in any respect. They just go silent. It is this quality in our best and brightest that is killing us.

    

     Yesterday two people inguired about the availability of Bazooka beds. This broke months and months of silence. What can it mean?

    Well, one inquiry was from my Pastor whose father is in hospice care. He asked about the cost of a device seeking to bring comfort to father as he passes from this world to a far, far better place. The second inquiry was from a brother-in-law who wonders about the availability of the device. He asks, "Are you able to restore your relationship with the patent holder?

    This represents the two sides of the conundrum. My Pastor trusts that the Bazooka device is all I have represented it to be and wants to comfort his father. At the individual human level, the microcosm where modern health care has broken down, he is anxious to apply a better remedy than that system is prepared to deliver his dad. And, at the other end, my brother-in-law is earnest about solving a big problem by encouraging someone he knows to take a hard look at the issue of bedsores in America. His friend, a successful entrepreneur now retired, has rededicated his life to a foundation that seeks to help the paralyzed.

    Today I anticipate their calls with no clear idea of what to say. I asked each for 24 hours to think it through. The patented medical device Bazooka is capable of imploding the wound care industry by drying up the bedsores that feed it. It is this power that has rallied all of the various interested parties against it. As long as I remain alone in this cause they prevail without much trouble at all. My present circumstances mean I am unable to dedicate time or money, I have none of either, to this mission. I will blog as often as I can, between jobs and sleep and precious family time broken into increments of minutes only; the occasional meal, passing my daughter or wife in the hallway, a sentence or two between us.

    Why God? These two inquiries in one day. And what am I going to say?

    Today's news reveals that the Federal government will begin funding a study of why senior citizens are falling. I wish I were more hopeful that this meant that something constructive might result. It seems AARP has a hand in sponsoring this effort and I wish too that this meant that they were serious about a constructive outcome.

    But I am not hopeful. Parties unknown will secure tax dollars distributed by politicians all too eager for headlines and campaign contributions but seniors will still be subject to the indignities of our all too expensive American way of health. They might even conclude a secret protocol that insists that it's the ever growing numbers of these seniors that is the problem. Why can't they just realize, these pesky seniors that is, that they ought to do the right thing by arranging a peaceful transition out of this world. I am quite certain our health care professionals would aid and abet that decision. After all Tom Brokaw has informed us these old codgers are a courageous generation. It's the numbers of them stupid. We must have fewer numbers of them.

    My cynicism offends me. It was born of struggle for a better way. The right honorable Senator Bill Frist wrote a letter on my behalf to a Mr. Tom Scully who headed the appropriate Federal bureaucracy. Mr. Tom Scully told me he would look into the matter.
I was looking for a rule change that would allow prevention of bedsores rather than all the funding going to treatment of inevitable bedsores. Mr. Scully told me to call Ms. Ballantine, the appropriate staff person. She was at least honest. What she told me was enough for me to cease and desist my hope of scratching the federal hog. I tried letters to Frist, to his brother who heads-up the family health care conglomerate and a few others.

    But why, you might be inquiring, did I need a rule change in order to get into the federal feeding trough myself? Why couldn't I just take my story to individual providers? It is because they have lost the will to do the right thing on behalf of these frailest of our loved ones. They have fought their last battle years ago. They have suffered themselves for trying to do what their caregivers heart has told them is proper. The decisions are no longer made by people who see patients. The medical professional is now a bureaucrat. If he plays by the rules good things happen to him. If he doesn't the bad things descend.

    The last health care reformer I encountered who couldn't be called hollow was destroyed by this federal health care monster. I will tell you about that encounter another day. For now I am reeling with the news that we are going to be docked millions more to determine what we know. I could solve your problem Senator Milkulski. I just cannot afford a single dollar for your campaign. And of course my solution would kill the golden goose that are bedsores for countless firms that depend on them.

 

    When enterprising minds discovered that nurses had lost their way and bedsores were a result they engineered a vast array of products and devices designed to fill this vacuum. That few of these items delivered any material benefit was beside the point. Nurses needed help and reached out to embrace the salesmen's promised outcomes. And since bedsores were prevalent in such great numbers and were so horrifically severe the regulators had little to say about redirecting funding in order to reimburse the providers who deployed these items.

    One of the marvels of engineering that paved the way was the air-fluidized specialty bed. This technology is presently owned by Hill Rom a division of Hillenbrand Industries but they did not invent it. As I heard the story an engineer created it after experiencing a personal sorrow over a loved one suffering from serious burns. This was in the late 1960's. The technology consists of a bathtub like basin filled with tiny spherical ceramic beads that are activated by a powerful compressor. This creates a fluid-like medium which supports the body while equalizing the pressure on the body. It is as close as one can get to floating in a pool of water. Its purpose was to relieve the suffering of burn victims. It also was discovered to facilitate the healing of serious bedsores. It soon became the device of choice for bedsores.

    However, it weighs about a ton, consumes lot's of electricity and is described by patients as intimidating; noisy, hot etc.. The regulators began reimbursing acute care hospitals >$400/day for its use. Other manufacturers saw this goldmine and rushed their engineering teams to design something comparable. The trouble was that a patent existed and this secured its holder against anything comparable. To this day air-fluidized technology exist only in the Hill Rom line. But here's the rub. The regulator buckles under pressure and expands the definition in the code in order to admit other devices that are made up of deep cushions and calls this air-fluidized. This of course creates the competition that starts bringing the costs down. From >$450/day in the 1970's to about $125/day today. These specialty beds still weigh about a ton, consume lot's of electricity and are described as uncomfortable by patients but they have the virtue of facilitating tissue healing.

    The regulator then responded to yet other manufacturers inquiries and the nursing profession joined the fray. No one claimed that prevention was practical but perhaps the regulator should warrant a range of reimbursement rates for lesser effective devices so that they could feel better along the way from intact healthy skin through the stages of bedsore development. The regulator acquiesced and there are now literally thousands of products and devices on the market. This is very big business and baby boom demographics insure lots to go around for all the players. 

    A relative peace exists. As long as a prospective player understands the established rules of engagement they are allowed in. Bedsores are inevitable (a cash generating bonanza for all) and treatment is the only reasonable thing that we can do. Anyone that claims that prevention might be possible is an enemy. Anyone that claims that prevention could cost less than treatment is painted as a fool. And yet not one of the many dozens of insiders that I have confronted with my finding has disputed it in any way. Mostly they get very silent and the look is revealing. They no longer take my calls. I no longer make them. My nest egg long depleted I must work at hard labor in order to eat.  

    The July 1974 issue of the American Journal of Nursing features a most disturbing article; not just because of the photographs of bedsores, though these took my breath away. I have mentioned earlier that I engaged in a literature review of professional medical journals in order to learn all I could about the bedsore (pressure sore) problem that gave rise to a growth industry in medical devices and products. I had by this time seen my share of disturbing photographs but these were somehow more than I was prepared for. To this day I keep them with me to show people who think that bedsores are bad rashes. No, the disturbing quality of this article lay in the title and the message. It proved for me that I was on to something important if I could just get someone responsible, and as it turns out, courageous to listen and respond.

    The nurses in the article were speaking of the benefits of using Karya Seals for severe bedsores. They were in awe of its "magic" properties. Karya seals are O-rings that are used to protect the intentional wounds needed to facilitate ostomy procedures. These nurses used them and Saran wrap to cover bedsores and were amazed when the wounds healed. 

    Prior to this article there were not many success stories. More and more there was a tone of desperation from caregivers asked to comment on the increasing numbers of bedsores and their severity. After this article appeared more products were advertised and the race was on. It was as though someone reviewing these journals had an "aha" moment and cried, "The nurses have lost their grip." 

    Indeed, if you read the article carefully one important fact emerges and it is absolutely contrary to what the nurses report. In order for the Karya seals to work beneficially they must be changed frequently, the wounds irragated and the patient repositioned. It was the nursing care, not the Kaya seal that made the differance.

    Nurses lost their way and have yet to recover it. A vacuum was created in the early 1970's when nurses were compelled by there leadership to pursue baccalaureate degrees in the science of nursing. When they returned to the bedside they expected, understanably, to do less menial work and receive more compensation. Patients suffered and bedsores in huge numbers and severity are the evidence of it. Manufacturers of products and devices seized this moment to flood the market with a vast array of items designed specifically to bridge the gap. None of them can replace nursing care rendered, absolutely none of them.

     Nurses in the majority see me as an enemy. They see me antagonistic to their profession. Nothing could be further from the truth. My mission in this is to see them recover the ground they forsook as modern health care delivery morphed into the bizarre and monstrous entity it has become. Perhaps, only nurses can help solve the riddle but not without learning something important about the wrong turn they took. When they effectively left the bedside and picked up their charts the sheets were changed by others too few and too distracted to care. The mean sheets need changing. The paradox is in the microcosm. Quality of care delivered is on a human scale not a technological one. We must recover that truth. Solving the bedsore problem is a first step of giant proportions.

     Why am I fixated on bedsores? You haven't asked but others have. Even when I explain it the looks are telling. Poor thing they seem to say. I get this especially from the parents of my daughters friends. She attends a private Christian school and many of her friends are affluent. One girls mother asked my wife when I intended to get a proper job. Seeing me in a crowd finds some of them steering away from me in hopes of avoiding a casual conversation. All my conversations lead, in the end, to bedsores. Who can blame them.

    Since I have lost nearly everything material in this quest for the bedsore solution I have had to get two jobs, both considered menial and somehow "improper" in order to sustain my daughter in this school. My wife has too. We each work very hard, seven days a week for less than I used to make in my very "proper" job alone. Restoring the nest egg does not seem humanly possible but retiring our debt is a worthy enough goal. My work is physically demanding, 50 hours of it anyway. Boneweariness is a companion of mine. Sleep is a luxury.  Yet this blog creeps into existence; I cannot help it. But why bedsores?

    Because dear reader you must hear this and respond. Not to me but to your heart. If I cannot move you in the heart with this story I will pray for you. Bedsores are killing our frailest in great numbers. Bedsores are leaching precious dollars from health care delivery system at a rate that is unbelievable. Bedsores are depleting health care professionals of the compassion necessary to maintain the caregivers heart. Most importantly, bedsores provide a clue into real meaningful solutions to what ails this system. One needs not have great intelligence to grasp it. It is simple to understand. But one must have a heart that is big enough to care. The hollow man is deficient in his heart. 

    The solution to what ails healthcare today is in that microcosm that is the distance between the nursing station and the bedside where "the mean sheets" need changing. A quantum paradox exists in this space. If only someone at Sun Microsystems cared enough to think it through with me I could demonstrate the first steps to reordering the delivery of healthcare in America such that quality would improve as cost declined. The key is in an understanding of the bedsore problem. Far from being inevitable they are blot on our soul. 

    In the posts that follow I will try to stick to this point. At least until someone responds or news breaks that triggers something. But even other news will be tied back to the inevitable bedsore. It is that kind of thing with me. Being on to something is the only thing that penetrates my boneweariness. I thank God for it. 

Mike Hatch advised me to try the new Pawlenty Administration rather than trouble him anymore. I did of course. They were polite but equally uninterested in what I had discovered about the Bedsore Industry. I think Democrats are unresponsive because they see an assault on one of their big constituencies, the nursing profession. I think Republicans are unmoved to respond because they see me as antagonistic to managed healthcare. They are correct in sensing my criticism of both but both are worthy of scorn in this regard. The bedsore problem is perverse.

Hatch seems such a small man when you examine him closely. His every action is for some political effect. Even his championing the cause of Casey who allegedly died of his wounds (bedsores) was not really about Casey. Hatch was after an out of state health care provider. He loves limelight. He loves taking on organizations he senses will give him favor with the public. He wants me to think he is genuine, bold, principled. He is none of these.

Health care providers from an out of state organization, according to Mike Hatch killed Casey by neglecting him to such an extent that bedsores weakened him to the point of death. I have knowledge that Mr. Hatch would have benefited from if he were real. My 30 minute visit with the staff attorney who was handling the case convinced me that she was moved and very grateful for my offering. She told me she would bring the matter to Mike. Then she went into hiding. After pestering Hatch for a while he send the nasty-gram advising me to try those pesky Republicans. I only wanted to help. Casey deserved better than Hatch. There are far too many Casey's out there. The hollow men could care less.