"The Diving Bell And The Butterfly" by Jean-Dominique Bauby

 

My wife Candice and I just finished reading this fine little book by Jean-Dominique Bauby in the manner in which we have been reading books regularly for several years now.  While Candice washes our breakfast dishes, I read aloud from whatever book we are reading at the time.  When she finishes washing the dishes, I stop reading and rinse them.  I put them away later.  We alternate who chooses the next book we read, and this one was her choice.  Our previous book which I chose was "Band Of Angels", a novel by Robert Penn Warren which I wrote about at this link.  For us, this book is personal.  Bauby was the editor of "Elle", the French fashion magazine, when he suddenly, and apparently without any warning, suffered a severe stroke in his early forties which left him with "Locked In Syndrome".  Locked In Syndrome is a condition due to a stroke or other form of brain damage which leaves the patient completely paralyzed, unable to move or speak, and without any realistic hope of recovery.  Usually, the patients mind is working perfectly well inside a completely dysfunctional body.  Sometimes, as in Bauby's case, the patient is able to blink one or both eyes which is utilized to facilitate a form of communication.  Bauby, his friends, family, and providers were trained to use an alphabet system with the letters of the alphabet arranged in order according to their frequency of use in French, his native language.  The person communicating with such a patient is required to read the letters one at a time, wait until the patient blinks in response to a letter, write that letter down, and repeat the process until a word is spelled.  Then a sentence, and thus a conversation.  Bauby and a young female employee of his publisher utilized the system for him to write this book which is, understandably, only 132 short pages of about 175 words each for a total of approximately 23,000 words. Admittedly, that is a small word total for most adult non-fiction books.  But for a book which was produced using the method described above, it is a phenomenal piece of work for both Bauby and his publisher's employee.  

 

For my wife and I, the book is a personal matter for two reasons: 1) my wife has been in a wheelchair for about 26 years, and in a power chair for about 5 years due to a rare genetic disorder; 2) when I was an undergraduate at Morehead State University, I had a professor whose husband, a retired psychiatrist, suffered a massive stroke which left him with "Locked In Syndrome".  On one occasion, my former professor told me the story of her husband's stroke and eventual death.  They utilized some such system of eye blinking to discuss his condition, absolutely devastating prognosis, and their possible options in the matter.  Admittedly, they were a couple who were unusually prepared by their professional lives to deal with such an issue in their private lives.  Her husband was a retired medical doctor and psychiatrist who had run a large state operated mental health treatment system.  His wife was a doctoral level professor of social work who had also worked in mental health setting in the past.  But, as she told me the story, it was obvious that she was still totally devastated by the decision they had reached in his case.  They had discussed their problem and their options, as I described above, and her husband chose to be disconnected from life support and to die rather than to linger for whatever time the health care system could have kept him alive.  Admittedly, my wife and I have a very unique perspective from which to assess Bauby's incredible little book.  

 

The book is written in very short chapters, very little pages, and is an incredible read both for its brevity and its breadth in how much information it contains.  Bauby says little until almost the end of the book about the actual event of his stroke.  It moves from short segments about his life in a state government operated system for very difficult neurological cases in France to segments about his life before his stroke to other segments about how he spends his time when he is alone in his hospital bed.  He discusses his creation of fantasies about what had previously been his goals and dreams, his life with his young children and wife, and his professional life as the editor of a major French fashion magazine.  This is a book which a good reader can finish in a single sitting.  But it is also a book which can require some time between sittings for the reader to absorb and process the information it contains.  This is an incredible book and well worth reading by every reader  

Every American Voter Should Read One Of These Books Before November 5, 2024!

 

“These are the times that try men's souls. The summer soldier and the sunshine patriot will, in this crisis, shrink from the service of their country; but he that stands it now, deserves the love and thanks of man and woman." Thomas Paine  

 

I first began posting these book lists sometime shortly after it became apparent to most intelligent, politically aware people in America that TRAITOR Trump was just that, a TRAITOR, nothing more, nothing less.  He was that long before I ever posted one of these reading lists.  He is still a TRAITOR today.  He will still be a TRAITOR on the day he dies and finally leaves America and Americans to live in peace after he has destroyed everything he can on the way.  It is imperative, if America is to remain a democracy, that TRAITOR Trump must never be allowed anywhere near the White House or any other active component of government in this country.  He is unfit to hold any position of public trust at any level, all the way down to dogcatcher and constable in a small, poverty stricken district.  Do both yourself and the country a much needed favor and read at least one of these books on this list before you vote on November 5, 2024.  This is an election between Good and Evil, Patriotism and TREASON, Peace and Total Destruction of Everything Valuable in America.   

 

On Democracy by Timothy Snyder  This is Timothy Snyder's latest book, just having been releases a short while ago.  Like everything Snyder writes, it is described as being a book which "will allow us to design a government in which we and future generations can flourish."  It is a continuation of Snyder's deep concerns and fears for America and American Democracy if the voters of this country allow TRAITOR Trump to return to another TREASONOUS occupation of the White House.  In my opinion, Snyder is the greatest historian and historical writer in America today.  He is a professor of history at Yale University in an endowed chair and still manages to write at least one important book a year or more.  This is the link to his official website.  Anything which Snyder writes is a must read for any citizen of America who wishes to see our Democracy survive.  I will add a couple of his other books below with less commentary about them.  Just assume if he wrote it, you need to read it. 

 

The Dangerous Case Of Donald Trump Edited by Bandy Lee, M. D. I reviewed this book here.  This is one of those books that every reasonably intelligent citizen of this country should read.  I have been promoting this book ever since the day the initial publicity campaign began when it was released.  This book was written in individual articles by 27 of the best, best known, most experienced, most respected psychiatrists in the country and edited by Dr. Bandy X. Lee, M. D. who is a psychiatrist and professor at Yale University.  Her credentials are incredible and so is this book.  Just as the letter to the senate from 2,400 law professors should have put an end to the legal career of Brett Kavanaugh, this book should have put an end to the public life of TRAITOR Trump.  Read this book even if you do not choose to read another book on this list or another book of any kind for the rest of your life. Do not let the fact that it is written by a bevy of psychiatrists deter you from reading it.  When you are done you will have a far better understanding of the serious and danger mental illness of TRAITOR Trump. 

 

The Road To Unfreedom by Timothy Snyder  This is Snyder's most recent book excluding the release last month of his latest, On Freedom.  The Road To Unfreedom is an excellent and well documented study of how Fascism has been spread by Russia and other countries in Eastern Europe.  It discusses Putin's dream of putting together a Russian empire extending all the way from Vladivostok to Lisbon covering most of Eastern Europe and Northern Asia.  Do not for a minute believe TRAITOR Trump when he tells you that he could "stop the war in Ukraine before" he took office if he should actually win an American election for the first time in his life.  Putin has expressed this plan for quite a few years in magazine and newspaper articles published under his name, in public speeches, and in all forms of media.  His attempt to subjugate Ukraine is geared toward giving Russia an open door to proceed further in this plan.  If he is allowed to overpower Ukraine, Poland will be next.  World War 3 will have begun and Putin will proceed until he is forcefully stopped, if that is even possible at that point.  

 

On Call by Anthony Fauci, M. D.  is the recently published memoir of Dr. Fauci who recently retired as the Director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health.  He was also the public face of the scientific fight against Covid and was daily defamed, insulted, minimized, and abused by TRAITOR Trump who is not now and never was fit to be a pimple on Dr. Fauci's ass.   More than 1million innocent American victims of Covid died because TRAITOR Trump refused to do anything to stop the pandemic after being informed by the intelligence and healthcare communities in January and February 2020 that the pandemic was coming and could destroy the country.  If NIH and the CDC had been allowed to fully do their jobs in early 2020, Covid would have been far less destructive and would have been confronted and dealt with successfully far sooner if TRAITOR Trump had not attempted to hamper every effort the scientific community made to do their jobs.  How do I know this?  For 5 years in the middle to late 1990's I spent many days at NIH.  My wife was a patient there during that period and we traveled there 2 or 3 times a year for a week at a time during that 5 year period.  So did my father-in-law.  I have never met Dr. Fauci, but I have met one other chair of an institute there.  I know NIH.  I have known people there at every level of employment from grounds keepers, food service workers, nurses, research staff, doctors, and one director of an institute.  Every one of them is a hero working daily in their own unique ways to help save the world.  If you don't read another word of Dr. Fauci's book read the section on Covid 19 and the pandemic which is only 67 pages long and will show you exactly what a TRAITOR TRAITOR Trump is and exactly what heroes the men and women of NIH  are.  It will also give you a great deal of insight into how greatly TRAITOR Trump has damaged this country morally and ethically over the last 10 years.

 

 Fascism by Madeleine Albright  Former Secretary of State Albright's book has been postively reviewed by most of the media people who have read it.  Secretary Albright was born in Czechoslovakia and immigrated to the US to become our first female Secretary of State and one of our best.  This is her description of a Fascist: "A Fascist is someone who claims to speak for a whole nation or group, is utterly unconcerned with the rights of others, and is willing to use violence and whatever other means are necessary to achieve the goals he or she might have.”  There is no more accurate description of TRAITOR Trump.  Read this book and if you finish it before I do send me an e-mail or a comment on this blog post.

 

  
Trump/Russia by Seth Hettena  This book provides an excellently researched timeline of the more than 30 year history of interactions between TRAITOR Trump and Russia.  Hettena's reputation as a reporter, researcher, and writer are excellent.  He is a graduate of Johns Hopkins University and that, in itself, is a recommendation of his mind and ability to function successfully in a high pressure environment.

 

 

The Restless Wave by John McCain  "Worse misfits have not been seen in a White House since William Taft got stuck in his bathtub."  (John McCain, p. 327)  When I read that sentence in John McCain's last book, I laughed out loud.  I have not reviewed this book yet, and have a few pages left to read before I finish it but this book is the most pleasant surprise I have had in a book in quite some time.  I began reading it since McCain has recently died and he had up put some level of public resistance to TRAITOR Trump.  However, in 2016, he had failed to go the full mile and endorse Hillary Clinton for president instead of just refusing to endorse TRAITOR Trump. Yet this book is far more positive about Hillary Clinton and President Barack Obama than toward TRAITOR Trump.  I had begun the book expecting to hear a pretty standard espousal of fairly Right Wing Repugnican politics and a play by play of McCain's career.  But the book is often very honest about McCain's serious misgivings, distrust, and opposition to TRAITOR Trump.  But once again, he fell short of taking the full step and calling a spade a spade.  But the book is very well worth reading.   

 

The Plot To Destroy America by Malcolm Nance Malcolm Nance is a career US Navy man and the author of several books on counter terrorism, intelligence, national security, and Islamic extremism.  He is a trained intelligence expert and cryptologist.  His unique perspective and ability to write about what he knows without endangering his security clearance or his reputation is remarkable.  Malcolm Nance is the kind of person you could expect someday to be a national security adviser to the next duly elected, legitimate administration to occupy the White House.

Russian Roulette by Michael Issikoff & David Corn  These two authors are writers for Yahoo News and Mother Jones Magazine respectively.  This book is another examination of the Russian interference in the 2016 election.  While I consider Mother Jones to be a far more reputable source of news than Yahoo, these two authors also have excellent reputations and their work is well respected.

Fear by Bob Woodward Bob Woodward needs no introductions anywhere in the world.  He is one of the two men who broke the story of the Watergate Conspiracy and eventually could be said to have helped bring about the resignation of Richard Nixon.  His reputation is flawless and he has steadily written political works since the 1970's.  Nearly all his books, more than a dozen, have been best sellers and above average works.  His ability to develop sources deep within sheltered organizations was first seen in the information he and his co-author Carl Bernstein obtained from Deep Throat who eventually revealed himself as a Deputy Director of The FBI.  This might be the first book some of you read or may have already read.  Tell me about it if you have.

The Apprentice: Trump, Russia and the Subversion of American Democracy by Greg Miller This book was written by Pulitzer Prize winning Washington Post reporter Greg Miller.  No author should ever need to have their resume bolstered after having been employed at the best newspaper in the nation and winning a Pulitzer Prize.  Place this book high on your list of works to be read as I have.  I can't wait to get to it and neither should you. 

Everything Trump Touches Dies: A Republican Strategist Gets Real About the Worst President Ever by Rick Wilson  Numerous reputable Republicans who desire to keep their reputations intact have spoken out over the last three years about the crimes and ignorance of TRAITOR Trump.  Many have left the Republican Party over his actions.  The rest should do the same.  Rick Wilson has a more than thirty year career as a Republican political operative and worked in the Department of Defense under Dick Cheney.  His resume and his political roots make this book worth examining. 

House of Trump, House of Putin: The Untold Story of Donald Trump and the Russian Mafia by Craig Unger Craig Unger has a Harvard education and a growing list of books written primarily about connections between Republican politicians and less than desirable partners. This book examines the long history between TRAITOR Trump and the Russian Mafia whose upper echelon members own many of the apartments in Trump Tower.  Nothing more need be said about that connection when you look at the list of business deals and money laundering schemes which have been perpetrated between these prinicpals. This book seems to be worth the time to read it.  Let me know what you think if you get to it before I do. 

 

 

Collusion Secret Meetings, Dirty Money And How Russia Helped Donald Trump Win by Luke Harding  I have reviewed this book here.  This is the first historical book that I read about the crimes of the TRAITOR Trump. It was well worth the experience and has often guided me in my choices about other subsequent reading.  Luke Harding is a writer for The Guardian and is a tremendous writer, researcher, and fact finder in the very dangerous world of international politics.  He and his colleagues are on that list of journalists whom every American citizen should read regularly.  This book goes a very long way to explain and corroborate the information contained in the Steele Dossier which literally began the revelations about the crimes of TRAITOR Trump.  This book also does a great job of putting the timeline of the crimes of TRAITOR Trump into a logical frame for the less aware reader.  This book "reads like a spy novel" is what my friend and follower of this blog Steve Sargent said about it.  My response to that was "it is a spy novel". However, it is also the farthest thing in the world from fiction.  

Facts And Fears by James Clapper This book continues James Clapper's public denunciation of the crimes of TRAITOR Trump.  I have reviewed it here.  The one glaring shortcoming in the book is the use of acronyms for literally dozens of branches of the federal government and international agencies which Mr. Clapper worked with or for during his lifetime of public service.  For the person not well versed in the federal bureaucracy, this use of hundreds of acronyms is confusing and irritating in spite of the insertion of a list of full names in the back of the book.  But this book is one of the first on the list that I would suggest that you read.  It is a fine historical perspective on American intelligence efforts over the last forty years and brutally honest, especially so about the Russian collusion and hacking of our 2016 election.   

A Higher Loyalty Truth Lies And Leadership by James Comey  First and foremost, I want to say that this book is about James Comey and his life of public service much more than it is about his firing and public victimization by TRAITOR Trump.  I have reviewed it here.  This book, just as is true of James Clapper's is much more about facts and history than it is about any emotion the author might feel toward the current illegal occupant of the White House.  It is an excellent piece of work which I do not believe would have ever been written if Mr. Comey had not felt that it was his duty as a patriot and lifetime public servant to do so because of the criminality of TRAITOR Trump.  Read it!  Learn from it!  Familiarize yourself with and utilize the truths it contains. 

 

United States Constitution The US Constitution and individual rights will be under attack from the first second the Republicans take control of the US government.  Donald Trump has already, on numerous occasions, stated a desire to restrict freedom of the press, freedom of speech, and all rights of Muslim citizens and immigrants in general.  Every citizen should have a solid understanding of the Constitution, Bill of Rights, and the Declaration of Independence.  Every citizen should also be willing to stand up and speak out in defense of these basic principles of American Democracy at any time Trump or his generally uneducated, ignorant, and unprincipled followers make attacks on these concepts.  The Capitol Net publishes pocket copies of the Constitution and many other important American political documents which are cheap and easily ordered from their web site.   Capitol Net will actually send you a free pocket copy of the Constitution upon request. Get a copy, read it, study it, understand it, carry it with you wherever you go, and be prepared to confront ignorance about the foundations of American Democracy wherever you encounter it. 

The Federalist Papers by Alexander Hamilton, James Madison, and John Jay Do not ever listen to and accept the opinion of another about what the Founding Fathers thought, intended, or wanted.  Read what they said for yourself and form your own opinion.  

"Mein Kampf" by Adolph Hitler Donald Trump's campaign was a carbon copy of the campaign Hitler used to gain power in Germany.  One of Trump's ex-wives has stated that he kept a copy of Hitler's speeches by his bed.  Many of the same techniques Adolph Hitler and Vladimir Putin have used to gain and maintain power are the same being used by Donald Trump today and that use is not accidental. The Big Lie is being used every day by TRAITOR Trump just as it was used by Adolph Hitler.  It is deliberate emulation of Adolph Hitler. 

Black Earth The Holocaust As History And Warning by Timothy Snyder One of the most cogent quotations from history comes from the philosopher George Santayana:  "Those who cannot remember the past are condemned to repeat it."  Donald Trump is backed by a coalition of extremist groups ranging from the Ku Klux Klan to the American Nazi Party.  Trump has consistently refused to condemn them, their ideologies, or their actions.  Here is a link to a great story from Mother Jones about those groups.  Most of the followers of these groups are psychologically very similar to the German citizens who became Hitler's Brown Shirts and SS Troopers.  And the most important thing to remember about the Germans who carried out Adolph Hitler's crimes against humanity is that before Adolph Hitler rose to power those people were considered to be ordinary German citizens just as most of Trump's followers would have us believe they are ordinary American citizens.  This book by Timothy Snyder looks at the Holocaust both as a historical event and as an event that could be repeated if the people of today do not heed the warnings provided by the Holocaust.  This is one of the most important books to have been written in the last 25 years. 

Stubborn Twig: Three Generations In The Life Of A Japanese American Family For those of you who do not believe that anything remotely resembling the crimes of the Holocaust could happen in America, this book is a must read as Donald Trump rises to power after having preached disrespect, disregard, and unconstitutional labeling of groups in America such as the media, Muslims and immigrants.  It details the life of a very successful and patriotic Japanese American family which had their land and property seized during World War II and were sent off to interment camps simply because of their ethnicity.  Yes, it can happen in America and it already has under the administration of one of the greatest American Presidents, Franklin D. Roosevelt.  

The Cherokee Removal A Brief History With Documents edited by Theda Perdue & Michael Green  For those of you who have read "Stubborn Twig..." and still find yourselves saying it couldn't happen here, it already has...twice, once to the Japanese Americans and once to the Cherokee.  In many ways, the disrespect that Trump shows to Muslims and immigrants is a lot like the attitude which Andrew Jackson showed the Native Americans.  

The United States Of Appalachia How Southern Mountaineers Brought Independence, Culture, and Enlightenment To America by Jeff Biggers  This book will teach you a great deal about the birth of American Democracy, especially for those of you who have never heard of the State Of Franklin.  Jeff Biggers will also show you a lot about how a few dedicated citizens can change a country for the better. 

A Nation Defiant Polish Resistance To The German Occupation Of Poland by Richard S. Fuegner  The only way the country will be able to successfully resist, confront, and stop the destruction of American Democracy by Traitor Trump and his henchmen will be by utilizing a committed, determined, and well organized populist resistance.  Such a resistance is forming in America and can win this battle in the long run but that resistance must learn techniques which have been successful in other periods and other places.  This is an excellent book about the Polish resistance and will teach you a lot.

When Even Angels Wept by Lately Thomas During 1954, Senator Joseph McCarthy of Wisconsin led an effort known as the Communist Witch Hunts which destroyed the lives and careers of many thousand falsely accused Americans.  Senator McCarthy, another classic megalomaniac, led a senate investigation into alleged communism in the country and dragged hundreds and thousands of innocent socially active people in front of the committee where they were pilloried, denigrated, and defamed with little to no evidence in most cases.  Many of these people spent the rest of their lives unemployed, defamed, and in poverty.  But Senator McCarthy was confronted and stopped before he could completely destroy the country and American Democracy.  This is a great book to learn about one of the most shameful episodes in the history of the country and to utilize that knowledge to prevent TRAITOR Trump and his henchmen from perpetrating another such crime.  

I hope every person who reads this post will go on to read at least one of the listed works, especially the United States Constitution, which will be under attack for the next four years by the Republican Party whether or not Donald Trump is successfully prosecuted for treason.  

 

Surviving An Endarterectomy, Or A Little Knife Fight I Won!

 

About 4  years ago, I discovered that I had a blockage of about 70+ percent in my right carotid artery which I managed to handle with diet changes, exercise, and a little medication for something like 4 1/4 years.  But annual scans showed that the blockage was steadily increasing despite marked decreases in my serum cholesterol, blood pressure, weight, etc.  So a few months ago, I made the decision to have the blockage removed via the endarterectomy process which laymen sometimes describe as a "rotorooter" on the artery.  This involves making a fairly major incision through the skin and muscles of the neck to expose the artery, clamping the blood flow at both ends of the artery area to be cleared, and, as I understand it, literally scraping the accumulated cholesterol plaque out of the exposed inner surface of the artery.  This is not a surgery to be taken lightly.  But, due to the way I had generally behaved since the blockage was first diagnosed, my doctors conceded that I was in generally better physical condition than the great majority of patients who have such a surgery.  I also trusted my surgical team at the University of Kentucky Hospital absolutely and, if I had not, I would never have consented to allow them to play among my arteries.  

 

My decision was not taken lightly since my wife has been in a wheelchair for more than twenty years and, in the event I had any kind of major catastrophic outcome from the surgery, either my wife alone or both of us together would most likely spend the rest of our lives in a nursing home which is a fate to which no one I know aspires. This issue was further complicated by the fact that I would have to spend at least one night in the hospital if all went according to plan and would have about two weeks of limited physical activity which would make it impossible for me to provide my wife the care she must have on a daily basis.  But her sister, who lives in Sheboygan Falls, Wisconsin, volunteered to come and stay with her/us for a little over two weeks if the surgery could be postponed until after her twelve year old son was out of school for the summer.  My doctor, David Minion, M. D., agreed to the plan and we scheduled my admission and surgery for June 14, 2022, which gave us a few days for my sister-in-law and her son to arrive here and for me to train her in the usage of a Hoyer Lift and the other issues of assisting my wife in and out of bed, shower, toilet, etc.  She adjusted smoothly to the task and I felt safe in leaving Candice at home alone.  

On June 14, 2022, I was admitted to UK Hospital at about 5:30am and the surgery was over by about noon, lasting roughly four hours in the operating room.  The next twenty four hours I had a lot of pain involved in my neck and throat but I was released from the hospital the afternoon of June 15.  I got home uneventfully with massive swelling in my incision area, went to bed as usual about 10pm but couldn't get to sleep.  About 11:30pm, I got up, looked in a mirror, and saw even more swelling in my neck, and came to the conclusion that I had a minor leak from the artery.  Since I couldn't drive at that point, it would have been necessary to have my sister-in-law drive me to the hospital I preferred in Morehead, Kentucky, thirty miles away.  Candice didn't feel safe being left at home in bed when it was impossible to get out and asked me to take an ambulance to the local ARH Hospital in West Liberty where I have not trusted the medical providers and management for several years now.  Against my better judgment, I agreed to go there by ambulance.  I called 911, an ambulance arrived, and I was transported to ARH-ER shortly before midnight June 15, 2022.  ARH has adopted a policy quite some time in the past to contract their ER doctors from some national medical service.  Additionally, about 3 years ago, they ran off the three best prescribing professionals working in that institution, closed the Home Care Store which my wife had used regularly for years, and replaced the medical providers with providers with less experience, credentials, and, in my opinion, at far less pay and benefits which I believe was the primary object of all these actions.  I was admitted, put on an ER bed, hooked to monitors, and left in the room for quite an extended period of time before I was even seen by a doctor.  That doctor finally came in, stood at the foot of my bed looking at me for about 15 seconds, stepped beside the bed and touched my neck, said "that's wonderful surgery", and walked out without saying another word or introducing himself.  Shortly after I arrived, my blood pressure began jumping up and down much like Roy Acuff's yoyo, and little to nothing was done about it.  Finally, after some extended period the doctor came into the room again, looked at me for a few seconds, and left without saying a word.  I was eventually seen by the nurse manager in the ER that night and the next day and she told me that they were seeking a bed for me at UK.  They gave me one or two injections of some short term blood pressure medication which only lowered my blood pressure briefly before it spiked again.  I spent the night in the ER in that cycle with my blood pressure sometimes reaching levels of 190/90 and going as low as 130/60.  Nothing ever came of the alleged referral to UK.  Finally about noon on June 16, I had an exchange with the nurse manager in which I told her I had no faith in the doctor of the upper level management of the hospital and I was considering leaving AMA, Against Medical Advice, since nothing seemed to be happening to improve my condition.  She and the doctor came in at some point for his third encounter with me and I confronted him in her presence about the fact that he had done little or nothing to help me which he denied, stated "you're not going to die", and claimed that the machines could do a far better job of watching my condition than people.  I made a phone call to the Nurse Manager of the vascular surgery team at UK to see if she could facilitate my transfer and she stated she could do nothing.  I then called the office of my primary care provider at Saint Claire Clinic in Sandy Hook, Kentucky, to ask if I could be seen there and she stated, through her nurse, that I should go to UK ER.  At that point, I made up my mind that I was leaving AMA and called my cousin Jack Terry in Louisa, Kentucky, to ask if he could transport me to UK which he agreed to do.  I got out of bed at about 3pm, disconnected my electrodes from my body, walked to the nurses station and asked to have my IV removed, and signed the AMA papers.  I walked out of the ARH-ER after 16 hours of absolutely useless time and traveled to Lexington to the UK ER.  

I signed in there at about 6pm, since it took Jack quite a while to arrive from his house.  The ER at UK is in a major expansion and part of the building is unfinished but in use with patient cubicles on the ground floor with blue tarpaulins for doors and exposed ceilings showing concrete beams, copper pipes, HVAC pipes, no cell phone service in that area, etc.  But the UK-ER team is doing a helluva job in rough circumstances and I respect them a great deal.  They retested every test which had ever been done on me, consulted with the vascular surgery team, and finally I was admitted to a room in the hospital about 4:30am after about 9 hours on site.  They immediately put me on IV antibiotics, and medication to lower my blood pressure.  The nursing staff, lab staff, food service staff, and the members of the vascular surgery team are all wonderful practitioners each of their own personal profession.  They took great care of me, got my blood pressure under control in just a few hours, kept me at least part of four days, and discharged me on June 19, 2022, to return to home.  During the time of my stay at UK, I was told by three different members of the vascular surgery team that I had "done the right thing" by leaving ARH against medical advise.  That is a rare occurrence in health care today to ever hear any member of a medical profession state that other members of their profession have delivered less than exemplary care to a patient.  I really do believe I would have been likely to die if I had remained at ARH and unless I have absolutely no choice, I will never darken their doors again.  What is really sad about this whole situation is that a few years ago, I would have just as strongly defended ARH and their practitioners against all criticism.  But those practitioners are no longer there and most of them left against their will leaving hundreds, probably a few thousand, patients without the quality of medical care they had been receiving from those providers.  I do still have several providers in that hospital in other departments whose work I respect.  But, I have little doubt that they also are on thin ice if they are being paid what they are worth.

This entire episode is an example of how healthcare has often failed in Appalachia.  In this region, we often are served by providers who do not understand our culture, our people, how we think, believe, and live our lives.  Many small regional hospitals in our area are understaffed, underfunded, under governed, and unsafe.  In many ways, large numbers of these hospitals are similar to what was once said by Ralph Nader about the Chevrolet Corvair.  They are "unsafe at any speed".  It is also sad that in the early history of what later became the ARH hospital chain, they were actually owned and operated by the United Mine Workers of America and were shining examples of how health care should be delivered to a depressed area. In explanation of my willingness to openly criticize so large and powerful a corporation, I would point my readers to these two articles on the website of the American Counseling Association which I co-authored with Dr. Heather Ambrose, Ph. D., both of which are rooted primarily in my own work in graduate school.  One of  these articles we delivered at the 2005 National Conference of The American Counseling Association and it is included as a chapter in a book from the ACA on cutting edge advances in counseling.  The other is about culturally appropriate supervision of counselors in Appalachia and is on the ACA permanent website for professionals.  Both articles are frequently cited and quoted in professional articles, books, and graduate school dissertations.  I know whereof I speak both from a personal and a professional viewpoint when I discuss healthcare in Appalachia. 

Return The Historic Window To Leslie County Kentucky

 In recent weeks, the board of directors of what is now the Frontier Nursing University which was originally, and for nearly a century, known as The Frontier Nursing Service, have removed a historic 15th century stained glass window from the original chapel of the Frontier Nursing Service campus in Leslie County Kentucky and stated their intentions to install in the new campus of the Frontier Nursing University in Versailles Kentucky more than a hundred and thirty miles from the spot which Mary Breckinridge had placed it and stated her intentions for it to remain in perpetuity.  The citizens of Leslie County are deeply troubled by this theft of a priceless artifact of the county's history and are fighting the board of directors to force the return of the window.  I fully support their efforts and so should you.  Please go to the link I have provided below and sign the petition.  Also please consider calling the offices of the Frontier  Nursing University and state your support for the citizens of Leslie County.  That telephone number is (859) 251-4700.  Also please share the petition in all forms of your social media and by e-mail.  Please support the citizens of Leslie County.  

Mary Breckinridge, Founder of The Frontier Nursing Service.

Here is an edited link to the peitition by the citizens of Leslie County Kentucky demanding that Frontier Nursing University return a historic 15th century stained glass window to the chapel on the original campus of the Frontier Nursing Service which was started by Mary Breckinridge as an agency dedicated to direct health care services to the citizens of the area. The current board of directors have abandoned the mission along with Leslie County, all of Eastern Kentucky, and Appalachia in order to become a lower tier nursing school in Versailles Kentucky the heart of the Bluegrass and well outside Appalachia. Please consider signing the petition and demanding that this historic window be returned to Leslie County where it was intended to stay for all eternity by Mary Breckinridge herself.

Mary Breckinridge began the Frontier Nursing Service in 1925 in order to work with mothers and young children primarily to lower the rates of infant mortality, still births, and the deaths of mothers in child birth.  In the 1920's, Leslie County was one of the most remote and isolated areas in all of Appalachia and health care was minimal at best.  The nurses of the Frontier Nursing Service road on horse back in rain, sleet, snow, hail, lighting, thunder, and dark of night to provide health care to natives of Central Appalachia.  The Frontier Nursing Service School of Midwifery and Family Nursing was established in 1939 in order to train nurses and midwives and eventually became the longest continually operating nurse-midwife educational program in the country.  Leslie County was in the heart of the Kentucky coal fields and as coal companies came to the area and coal camps proliferated, the Frontier Nursing Service provided care in all the gaps which the coal companies refused to operate.  They were the first line of defense against death, disease, and epidemics in the area around Hyden and Leslie County.  They fought the polio epidemic of the early twentieth century along with providing basic health care to anyone who asked.  

But over the course of time, the area acquired roads such as the Daniel Boone Parkway, more doctors and hospitals arrived, and the mission of the Frontier Nursing Service became much more focused on educating nurses and midwives.  In recent years, the board has changed hands and become dominated by individuals who have little or interest in serving or being loyal to Leslie County and its citizens. Hence the crisis of the stained glass window has arisen in the wake of the board having decided to abandon Leslie County for the rolling fields of the Bluegrass in Woodford County.  They moved their headquarters and decided to cart the historic and priceless window off with them.  Without notifying the community, essentially in the dead of night, they removed the window from the original chapel of the Frontier Nursing Service Campus and now want to mollify the residents of Leslie County by giving them a "facsimile" or "replica" of the priceless window which was actually a gift from Mary Breckinridge to the county.  This has just become one more chapter in the rape and rapine of Appalachia.  I beg of each of you who reads this to join the fight with the citizens of Leslie County and never give up until that window is back where it belongs. 

In Memory Of 100,000 Innocent Dead American Victims Of Covid 19

Wreath Photo by Pinterest

It seems appropriate since this is Memorial Day weekend to write a blog post in memory of the roughly 100,000 innocent, dead American victims of the Corona Virus or Covid 19 whichever you prefer.  At this point, I have not known any of the victims although I do  have a great niece in Indiana who is battling the virus after contracting it in a nursing home which reportedly has an 80% positive rate among the staff and clients.  What is truly sad about that is that it is not terribly unusual in the nursing home industry.  The virus has killed astounding numbers of people, both clients and staff, in nursing and long term care facilities.  I know of another nursing home in a very rural county in Eastern Kentucky which has similar infection rates with several deaths including one staff person.  But the truly horrible aspect of this whole pandemic is that the great majority of these deaths were preventable if any appropriate actions had been taken by the federal government in January and February after the White House was notified that the pandemic was coming and could destroy the county.  For two months in January and February 2020, not one thing was done to stop the virus until we actually had cases and deaths and at that point it was far too late to act with any hope of stopping the spread.  It is highly likely that we will hit 150,000 US deaths by the end of June 2020 and the total number of deaths may well reach a quarter million before the pandemic runs its course or a fully tested, ethically produced vaccine can be created, manufactured in large enough numbers, and administered to those of us who are lucky enough to have survived to that point.  And at this point, the TRAITOR who illegally occupies the White House is unethically, irrationally, and indefensibly fast tracking some choice vaccine efforts in which he may well have a vested interest just as he has attempted to promote Hydroxychloroquine in spite of its well documented ineffectivness against Covid 19 and its equally well documented risks of heart disease and increased deaths.  In fact, hydrosychloroquine is no more effective against the Corona Virus than is the combination of injected disinfectants this TRAITOR also promoted.  This TRAITOR fired the entire pandemic response team more than two years ago simply because the team had been created by President Obama.  Nothing he has ever done has been rational, ethical, or in the best interests of the country, the world, or the human race.  He has totally ignored, belittled, verbally abused, and vilified the best scientist alive while claiming to know a great deal when in fact he knows nothing, cares nothing, accepts no personal responsibility for his TREASON, assorted other crimes, and ignorance in general.  Every one of these 100,000 deaths from Covid 19 to date are on his head and his hands.  Let's remember each of these 100,000 innocent victims and all those victims still to come until this TRAITOR can be removed the scene of his nearly four year crime spree to date.  These innocent victims deserve to be honored, remembered, defended, and their final sacrifice must be dealt with by the American justice system against the perpetrator of this disaster.  

I Got Tested For Covid 19! So Should You!

On Tuesday, May 19, 2020, my wife and I traveled to Saint Claire Medical Center in Morehead Kentucky to participate in a free, drive through Corona Virus test.  I hear people talking all the time about how they will not participate in testing, will not wear a mask in public, and think that all the promotions about staying safe against the spread of the most dangerous virus in the world is all "a hoax", or useless, or crazy, or whatever asinine excuse they can come up with to avoid being tested.  The entire procedure from the time we drove into the parking lot to the completion of testing and driving away was about fifteen minutes.  Isn't it worth fifteen minutes of your time to avoid becoming an asymptomatic carrier, infecting dozens of people, and possibly causing the deaths of some of them?  The test itself is a bit unpleasant.  The nurse, in full personal protective equipment (PPE) walked up each window of our vehicle, asked a few identifying questions, entered them into a laptop, and returned with a long handled swab which was probably six inches long.  I honestly cannot tell you whether the handle portion of the swab was plastic or twisted paper like a stick for a child's sucker.  The cotton tip of the swab was then inserted up each of our nostrils all the way to the back of our throats which takes less than ten seconds but is a bit unpleasant.  I had to sneeze into my mask a couple of times shortly after the test was performed.  My wife did not and seemed to dislike the procedure less than me.  This morning, two days later, I went on the patient portal at Saint Claire and checked our results which were both negative as we expected.  My wife, due to serious complicating health problems has not gone into a public setting in over two months.  I do the chores and always wear a mask and gloves.  You should also always wear a mask and gloves.  There are no valid reasons for not wearing a mask in public.  There are no valid reasons for not wearing gloves in public.  There are no valid reasons for not being tested.  There are only excuses.  If you allow your irrational fears of testing or your ignorant justifications for not wearing a mask and gloves to prevent you from helping in the fight to stop the spread of this virus will you be willing to step up and take responsibility for the potential dozens of infections and deaths your refusals led to?  I doubt it.  You should be tested and you should wear a mask and gloves in public.  You are simply assisting in the spread of the deadliest disease to hit the world in many years if you do not.  This virus has already killed 95,000 innocent American victims as of today, May 21, 2020, and will kill more than 100,000 before June 1, 2020.  It is also likely to kill 150,000 before July 1, 2020.  Are you going to help it in its work or are you going to help the country fight it? 

Will You Allow TRAITOR Trump To Murder You?

As the death toll from the Corona Virus pandemic has crossed the 30,000 mark in the USA, as of this writing on April 16, 2020, TRAITOR Trump continues to run his mouth, spout ignorant propaganda, and attempt to reopen the United States long before the pandemic is likely to have run its course and well before most of the governors in the country agree on a reasonable date to loosen pandemic restrictions.  So the question becomes "Are you willing to bet your life on decisions being made by the worst TRAITOR in the history of the world?  Will you allow TRAITOR Trump to murder you?"  I realize the use of the word murder is strong.  But none of these deaths had to happen if the TRAITOR had simply done the job he was never elected to do.  But since he has always acted against the best interests of the United States ever since the day he illegally and TREASONOUSLY waltzed into the White House at the urging and due to the assistance of Vladimir Putin, TRAITOR Trump wants to ignore all aspects of science and medicine and tell the American people to take their lives in their own hands and go back to living life as if there is not a deadly virus wreaking the worst havoc in this country since at least the polio epidemic of the early twentieth century.

At least eleven governors in the United States and the mayor of the Washington, DC, know better and have updated their stay at home orders to at least May 15, 2020, which is still a decidedly optimistic time frame to reopen the country when the virus has killed at least 6,000 people in nursing homes, 33,000 nationwide and is now equal to 50% of the total US deaths during the Viet Nam War and rapidly approaching the total of all US deaths during the Korean War.  Just today we learned that the largest nursing home in New Jersey was just caught storing 17 bodies in a morgue intended for a maximum of 4 in an apparent attempt to delay or cover up knowledge of all those deaths since that facility had recently received the lowest possible state inspection rating which would allow them to remain open.  Even in decidedly rural Jackson County Kentucky, a county in which I worked for 2+ years as a mental health therapist in a juvenile facility, a nursing home is fighting a major outbreak with multiple cases and multiple deaths. Refrigerated trucks are in use as morgues in New York and New Jersey.  Funeral homes in both those states are overloaded and the unclaimed dead are being buried in trenches in a pauper's field in New York.  An official of the Centers For Disease Control has just publicly stated that the publicly accepted death toll of 33,000 as of this writing is probably "just the tip of the iceberg" and that actual number are probably much higher due to the criminally inadequate testing numbers nation wide due to the a lack of testing equipment and laboratories. The overall testing issue is also exacerbated by inaccurate, overdue, and undone reporting by many private labs. In his daily propaganda spiel on this date, TRAITOR Trump backed off his TREASONOUS disputation of the US Constitution that he has "total power" and admitted that the calls to reopen states must come from the governors.  But he is still the most dangerous man in the world and working daily to destroy the country.

Yet, in the face of all these governors and their actions, we are saddled with the TREASONOUS occupant of the White House blatantly and daily insisting that the most important aspect of this pandemic is the question of when the restrictions will be lifted and the country reopened.  This recipient of the electoral espionage and manipulation of Russia and Vladimir Putin does not care one iota about you, the reader, or any other citizen, state, city, or other jurisdiction in the country.  He does not care if you live or die and he is willing to allow all of us to die in order to get his way and avoid responsibility for his TREASONOUS inaction for two months from January until March as the virus was spreading all over this nation.  I repeat myself, WILL YOU ALLOW TRAITOR Trump TO MURDER YOU?

A Tale Of Two Press Conferences And The Corona Virus!

Every day between 5pm and 7pm, two press conferences are televised in Kentucky.  One of those press conferences is also televised nationwide and that is a damn shame!  In Kentucky, at 5pm on every major television station in the state we see press conference by our Governor Andy Beshear.  It usually lasts for about an hour and is a shining example of what a press conference by an elected official working in a crisis should be.

Governor Andy Beshear of Kentucky

Governor Beshear is professional, strong, well informed, honest, accurate, compassionate, and everything a people in crisis should expect and receive from a leader at one of the worst times in the history of the state and nation.  This press conference has been taking place on a daily basis for about two weeks since Kentucky developed its first cases of Corona Virus in Jefferson and Fayette counties, the two truly urban counties in the state.  At the time these press conferences began, we had two cases in the state as I recall.  Today, March 28, 2020, we have roughly 300 cases statewide in at least 45 of the 120 counties.  The virus is spreading rapidly and randomly across the state just as it is across the nation.  Citizens are hoarding food, avoiding social contact, living in irrational fear, and doing both many good things and an equal number of ignorant, misinformed, and irrational things.   But Andy Beshear and his team of staff walk into the capitol press room each day cool, calm, collected, prepared with facts and information which is needed by every citizen of the state.  He begins the conferences these days with an affirmation and actually asks the audience to repeat it with him: "We Will Get Through This!  We Will Get Through This Together!"  Andy Beshear is everything a leader should be.  He has assembled the best team of the most talented people that the state can offer.  They deliver facts in a calm, supportive, professional, ethical manner and every citizen of Kentucky is better because of it.  

At about the time Andy Beshear's press conference is ending, the TRAITOR who illegally occupies the White House based on his TREASON with Russia also begins a daily press conference which is everything the press conferences of Governor Beshear's are not.  This TRAITOR is ignorant, uninformed, divisive, abrasive, uneducated, unintelligent, dishonest, amoral, and without one iota of compassion as he has always been.  He spits, sputters, foments greater fears among the populace because of his thousands of flaws, lies, and deceptions.  He does anything he can to avoid taking the appropriate blame for having, on a daily basis, increased the danger to every citizen of this country.  He blames others.  He lies repeatedly.  He attacks the press, the governors of many states, and at times even the victims of the Corona Virus.  He is an idiot, a pathological liar, an international and a domestic terrorist, and the personification of evil in the world.  He refuses to heed the advice of communicable disease, national security, health care, and government experts.  He uses the one actual professional on his team, Dr. Anthony Fauci, as a shield and a scapegoat.  He is a waste of time to every American who watches him and further endangers the lives of every resident of the United States and the world.  His rants have progressed to the point that the three major television networks usually cut away from his "press conferences" at or near 6:30pm and go on the air with the national news just as they did in the days when the Corona Virus was unknown in the world.  The television networks and their reporters recognize this TRAITOR for exactly what he is and this is as close to nothing as a living, breathing human can sink.  America is in the worst health care disaster since the polio epidemic of the early twentieth century and we have no leader at the top.  Instead we are saddled with a TRAITOR who does not care one iota bout the country or its citizens.  What do you as a citizen in what used to be the greatest democracy in the world going to do about this?  

Thank God For Governors Like Andy Beshear!

 As the Corona Virus crisis deepens, cases and deaths increase, and the economy becomes steadily worse, many people all over the country and the world are panicking and becoming more and more bizarre in their actions both in public and private.  A man in Nelson County Kentucky has tested positive for the corona virus, refused to self quarantine, and

Kentucky Governor Andy Beshear--Photo by Twitter.com

Governor Andy Beshear has been forced to place deputy sheriffs outside the man's house to keep him from infecting the general public.  Now the man denies he was ever tested for the virus and has approached several media outlets to make claims that he does not have the virus and is being held against his will.  So the natural question becomes 'whom do you believe'?  I believe Governor Andy Beshear and the health care workers and sheriff's deputies in Nelson County Kentucky and so should you.  I watch Governor Beshear's daily press conferences about the corona virus on most days.  I am consistently impressed with his calm, professional, ethical, and compassionate attitude every minute of every press conference. I can assure you that, in the middle of the worst health care crisis in this country since the polio outbreak of the early twentieth century, he has more things on his mind than having police officers holding an innocent idiot against his will.  

Most of the news outlets which have run stories from this man and his wife are marginal in their professionalism and veracity.  The Washington Post did run a story one day ago, on March 17, 2020, with the headline "Don’t want to self-quarantine? The sheriff could send armed guards to your house."  I must insist that the headline is a bit garish for the usual professional standards of the Washington post.  But the story states in the second paragraph that "He recently checked himself out of a University of Louisville hospital against his doctors’ advice and told the local health department he would not comply with an order to isolate himself from others."  You can bet your butt that the newspaper which has won 47 Pulitzer Prizes knows how to verify any statement made by any reporter in any story and would not make such a statement as a lead paragraph in a story if it had not been substantiated by the governor's office, the hospital, and the Nelson county health department.  Andy Beshear has already served one term as the attorney general of Kentucky and his law degree is from the University of Virginia which is one of the best law schools in the country other than those in the Ivy League.  He did not take this step lightly and he did not take this step without justification.  People like the man in question are willing to endanger their family, friends, and neighbors simply because they are ignorant, uncaring, and anti-social to the core.  At this time, when the great majority of Americans are doing their duty and staying at home to protect the rest of the human race, idiots like this are a major part of the reason the Corona Virus is spreading like wildfire all across the country. We should also remember that any person who has tested positive can transmit the virus whether or not they are showing symptoms.  I do not know the particular circumstances of another case nearly as well as I know those of the Nelson County case but a family in New Jersey has had three deaths, six other members hospitalized, and five of those in critical condition, with pending tests for nineteen others in the family.  Their story is a clear indication of just how dangerous it is for an infected person like the man in Nelson County to traipse lightly through an unsuspecting community.  If you or any other member of your family is infected, whether or not they are showing symptoms, insist that they remain in isolation for whatever period the local authorities require which is generally two weeks to be followed with two negative Corona Virus tests taken at least twenty-four hours apart.  Do your part!  Obey the standards established by the Centers For Disease Control to the letter!  Do not become an uncaring carrier whose actions contribute to the infections and deaths of other innocent victims!  And join me in thanking Kentucky Governor Andy Beshear for doing an excellent job in a horrible time!  #TeamKentucky  #togetherKY 

Keys To The Kentucky Election 2019

On Tuesday, November 5, 2019, the Kentucky General Election will take place with all statewide constitutional offices up for election including governor, lieutenant governor, secretary of state, state auditor, attorney general, and commissioner of agriculture.  In my opinion, this is the most important election in Kentucky in many years, perhaps even all time.  There has never been a more clear cut separation of the parties and candidates in Kentucky election history.  The future of the entire state government system and the long term well being of most of the citizens of the state hangs in the balance.  The next four years in Kentucky can be either among the best in state history or literally the four worst and most damaging years in the history of the state.  

For the past four years, Kentucky has been saddled with the most unpopular and most destructive governor in all fifty states, Repugnican Matt Bevin, who actually isn't even from Kentucky.  Over the last few years, the Repugnican party has also managed to gain majority control in both houses of the state legislature.  We have been attacked by the governor and his Right Wing Radical Repugnican supporters in a multitude of ways.  They have passed right to work legislation which  is always a lie and a direct attack on the working class anytime, anywhere it is proposed or passed.  They have passed radical and ignorant changes to Kentucky gun laws which now allow anyone who can legally own a gun to carry that gun in concealment without any permit or oversight from any form of government.  They have attempted to destroy the pension systems for Kentucky teachers and other retirees.  The governor and his Right Wing Radical Repugnican co-conspirators have only been prevented from destroying the state by virtue of the fact that we have had a highly qualified, morally solid attorney general in Andy Beshear who is now the only qualified candidate for the governorship.  The Right Wing Radical Repugnican candidate for attorney general has never really practiced law and his only claim to fame is that he assisted the TRAITOR who illegally occupies the White House to appoint a sexual predator to the US Supreme Court.  If Matt Bevin is reelected and he has a Right Wing Radical Repugnican attorney general to assist him in his crime spree along with the morally corrupt state legislature, they will literally destroy public education, health care, social justice, and many other departments of Kentucky state government in the next four years.  They must be stopped!  Kentucky voters must vote straight Democratic in order to protect this state not just for the next four years but for all time.  The amount of damage that would be done by the group of Right Wing Repugnican Radicals over the next four years would do damage that might be irreversible for decades.  

The keys to the election will be voter turnout especially by teachers and public employees and retirees; solidarity among the aforementioned voting blocks; and, the level of political knowledge among those voting blocks.  Literally, this election lies in the hands of Kentucky teachers, public employees and retirees of all occupations, and liberal leaning voters.  In any election in recent memory in Kentucky, teachers and those they should have been able to influence to vote in a rational manner could have provided the most crucial blocks of votes and prevented the disastrous election of Matt Bevin and his Right Wing Radical co-conspirators in the legislature.  Teachers and those they could have been expected to be able to influence could have saved the state from the last four deeply damaging years and they can definitely save the state for the next four years by voting straight Democratic and putting Matt Bevin out of office.  Teachers and all other public employees must go to the polls en masse, must influence every relative to vote with them, and must vote in their own best interest and the best interest of the entire state.  Kentucky public education, public health, and social welfare programs have been under constant attack by Matt Bevin for four solid years.  He must be stopped and the only way to do that is to vote for Andy Beshear and the entire Democratic ticket on Tuesday, November 5, 2019. 

"Public Health In Appalachia Essays From The Clinic And The Field" Edited by Wendy Welch--Book Review

Welch, Wendy, Editor: Public Health In Appalachia Essays From The Clinic And The Field (Jefferson, North Carolina, McFarland And Company, 2014)

This book is one work in a series of books from McFarland and Company in Jefferson, North Carolina, called the Contributions To Southern Appalachian Studies series which in the last twenty years has produced roughly forty books.  It is a book I should have read and written about promptly after it was published in 2014 since one article in the book quotes substantially from an article which I co-authored in 2005 with Dr. Heather Ambrose, Ph.D. on the topic of "Culturally Appropriate Counseling and Human Services in Appalachia: The Need and How to Address It" which was published online by the American Counseling Association and which we delivered in a presentation at the 2005 National Conference of the ACA.  However, that quotation and citation is not the best reason for me or anyone else to read this book.  The real reason you should read it is that it is a compilation of ten very cogent and informative essays written by more than a dozen human services and/or education professionals in the Central and Southern Appalachian region.  The subtitle, "Essays From The Clinic And The Field", explains very aptly why I consider this book to be a fine resource for human services and education professionals working in the region.  It is taken directly from the mouths of more a dozen of the "horses" who have been pulling the load in some very tough professions in the region and who clearly demonstrate their professional skills and cultural competence in their writing.  

In the opening paragraph of the Foreword, John Dreyzehner addresses one of my pet peeves for nearly all my life which I have always confronted in the header to this blog.  Mr. Dreyzehner has begun his introduction to the book by saying: 

"Many years ago a young college student from Chicago signed up for a brief Catholic mission experience deep in rural Appalachia.  One of the first things the ignorant young man noticed was that the locals and the host clergy didn't pronounce "Appalachia" right.  What they said sounded more like "apple-AT-cha".  Fortunately, he did not try to correct them, nor they, more kindly, he in saying "app-a-LAY-cha".  That was the beginning of an education in cultural sensitivity and cultural literacy.  There was a lot to learn." (Dreyzehner, Public Health In Appalachia Essays from the Clinic and the Field, p. 1)

I cannot think of a finer way for any non-native resident of Appalachia to begin a discussion of the region.  My own aforementioned header to this blog uses nearly identical words to address the same topic:

"An ever growing site of non-fiction,flotsam, fiction,memoir,autobiography,literature,history, ethnography, and book reviews about Appalachia, Appalachian Culture, and how to keep it alive!!! Also,how to pronounce the word: Ap-uh-latch-uh. Billy Ed Wheeler said that his mother always said,"Billy, if you don't quit, I'm going to throw this APPLE AT CHA" Those two ways are correct. All The Others Are Wrong." (Roger D. Hicks, see above)

This book makes a meritorious attempt in several of the articles to address that need for cultural competency and the same article which quotes my work, written by Bob Franko, also quotes and cites  the work of my friend and mentor Loyal Jones from his book "Appalachian Values" on which I have based much of my writings about the need for cultural competence in writing about or working in Central and Southern Appalachia.  It was quite refreshing to see anyone directly addressing the widespread and deliberate mispronunciation of the name of our homeland.  One of my very early blog posts,  and I am proud to say one of the most frequently read on this blog, directly addressed this issue.  I also frequently mention the excellent, early Appal Shop movie "Strangers and Kin: A History of the Hillbilly Image", which is one of finest attempts ever made to address the negative attacks on Appalachia and Appalachians.  Those of us who have fought this battle for most of our lives can truly appreciate the effort by Franko and Dreyzehner.

But there are numerous other reasons to appreciate this book and the greater series from McFarland and Company.  Nearly every article in the book has direct applications for both professionals working in the region and native Appalachian who simply want to be understood by the greater America around us as an unappreciated and frequently maligned minority which are generally denied minority status.  The first section of the book contains four articles which address a quartet of the most serious problems facing the region today: cancer, diabetes, drug addiction, and inadequate dental care. The second section is comprised of three articles about culturally appropriate health care delivery systems.  All three of these articles are well written by individuals who understand exactly what they are talking about.  Steve North, M. D. wrote a very good article about telehealth in Appalachia.  But I must take offense with the general need for telehealth in Appalachia or anywhere else in a country which mistakenly claims to be the most advanced in the world.  I am still offended that in America we have reached a time where it is necessary for people in any part of the country to participate in telehealth in order to participate in the health care system.  I also take offense when I am seen at one of the best hospitals in the entire southeast and I am unable to see a person who is actually a medical doctor.  I have worked with and know several highly qualified nurse practitioners and physicians assistants but I will never believe that this country could not, if politicians and health care administrators would allow it, produce a health care system in which every patient would meet with a physician at the moment of initial contact.  Such a system would require us, as a nation, to actually create new systems of taxation, education, and healthcare delivery. Such a system would allow every qualified applicant to be accepted into a medical school without fear of losing their future freedom of choice because of paying off education loans.  Other countries with far less average gross domestic product pay for a college education for every qualified applicant.  We should also.  If those applicants choose to become nurse practitioners or physicians assistants instead of becoming doctors, we should support them just the same.  A free public college education for every qualified applicant in America would vastly increase our gross domestic product, average income, and general effectiveness as a nation.  But for the time being, I do admit that the current system of using medical practitioners who are less qualified than full medical doctors does give us the ability to delivery minimally effective health care to the greatest number of patients especially in remote areas of Appalachia, the Deep South, and the far west.  But it should never be accepted as the best or most widely used system. 

The third section of the book contains three articles on cultural theory and clinical policy.  One of those articles written by Tauna Gulley, RN, on fatalism and its effects on Appalachian youth.  Fatalism is one of the old topics which has been repeatedly used as a club with which to beat Appalachia and Appalachians.  In my opinion, this article could have been left on the cutting room floor and the overall book would have been better.  Fatalism is an easy place to fall back on if an author is attempting to continue the denigration, defamation, and defeat of Appalachia.  It is not nearly as prevalent or important as some people believe. At the time of publication of this book, Ms Gulley was a professor of nursing at the University of Virginia College at Wise.  Today, she is the coordinator of a nursing program at the University of Pikeville and apparently now holds a doctoral degree.  I do not know her or her educational or personal background.  But it has generally been my experience that the topics of fatalism, familism, and internecine squabbles, when used in reference to Appalachia are most generally used by non-natives of the region as a way to justify  what they mistakenly believe to be our shortcomings as a people and a region. 

Do not allow the couple of negative assessments I have made of individual articles to overly color your opinions of this book.  The strengths of the work strongly overcome any weaknesses a couple of articles may exhibit.  Read the book and benefit from it.  Read it with a critical eye and use the parts of it you are willing to accept at face value.  Use the parts with which you disagree to broaden your own knowledge base about how to overcome or counterbalance the alleged weaknesses those authors may discuss.  And realize that the opinions of any particular author may well not represent those of the editor or the other authors.  This is a book from which to learn. It is a tool.  Use it wisely!