Friday, October 21, 2016

It Starts With a Bunt

New! Audio broadcast:
https://soundcloud.com/rosemary-schmidt-673577789/schmidthappens20161030


 
Sometimes change starts with a bunt, a small thing, something within reach. Or, at least it did for the Cubs Wednesday night. Things were looking pretty bleak for the Mudville sluggers, as their bats had fallen silent since the first game of the National League Championship Series, a convincing win over the L.A. Dodgers, highlighted by a base-clearing homer in the 8th inning. Clayton Kershaw took the wind out of their sails in Game 2, though the Cubs still kept it to a respectable 1-0 score for the loss. Their drought in hitting continued in Game 3, losing 6-0, and into the start of Game 4. I was starting to wonder if someone had snuck a goat into the Dodgers’ stadium. Irony of ironies, we had just finished watching “It’s The Great Pumpkin, Charlie Brown,” right before the game, and I began to wonder if it was a portent of things to come, that we might be left like Linus once again wailing, “Wait till next year!”

By the time Ben Zobrist went to the plate in the fourth inning, the Cubs had accumulated 21 scoreless innings in a row, and he knew he had to do something different. He bunted. How humble, simple, and selfless of him. No one goes to the Baseball Hall of Fame for bunting. No one gets recognized as the Best Bunter in Baseball, or given the Golden Bunt Award. Everyone focuses on the home run hitters, the Russells and the Rizzos, but I believe it was this simple bunt, this individual sacrifice, that inspired and led his teammates to connect with the ball that inning and send it sailing. Or, as Manager Joe Maddon, was quoted as saying, “It’s contagious.” 


Ben Zobrist's bunt in the 4th inning






Anthony Rizzo after hitting his home run in the top of the 5th
 
Sometimes when you swing for the fence, you miss everything. It’s just too much. Sometimes you have to start with something small, something manageable, something doable.
 
Sometimes you just have to start with a bunt.
 
Final Score Game 4: Cubs 10 – Dodgers 2
Final Score Game 5: Cubs 8 – Dodgers 4


Post Script

It was great watching former Red Sox players Jon Lester pitch for the Cubs in Game 5, and John Lackey in Game 4. All those stories about fried chicken in the Red Sox clubhouse have been left far behind them. Now, everyone thinks it was Theo Epstein’s genius and persuasion that brought them to Chicago, but no, there is a totally different, perfectly logical explanation.

It was the fried chicken.

If you want the best darned fried chicken anywhere, it’s just a few miles down I-55, off exit 267, at the White Fence Farm in Romeoville, Illinois. It is seriously the best fried chicken in the world, plus has the most amazing sides, such as their bean salad, and coleslaw, and my own personal favorite, the corn fritters, perfectly crispy and magically dusted with powdered sugar. Mmm-mmm. You can bet there will be some fried chicken eating in Chicago when the Cubs bring it back to Wrigley Saturday night for Game 6, up 3-2 in the Series.

http://whitefencefarm-il.com/

It is also nice to see Pete Rose gamboling about with the other sportscasters. In a single word: Giddy. He is simply giddy just to be back around the game. It’s a little complicated, and probably a topic for another day, another blog.  

A couple of Roses, exchanging their sports books (2014)
Thanks to everyone who stopped by and took me up on my offer of a free book at last week’s Boston Book Fest. Actually, thank you to everyone who actually even made eye contact or stopped to talk to me. Boston drivers are legendary for their abilities in averting eye contact, to avoid having to let someone into their lane, but I have to tell you the skills are equally honed as pedestrians. Imagine, I’m at a book festival, a place where everyone presumably kind of likes books, and most of the passersby just passed on by.  


Up Next (in the on-deck circle):
Recap of HUBweek 2016


References

Harris, Beth. 2016. Borrowed bat did the trick. The Boston Globe, 21 October 2016.


© 2016 Rosemary A. Schmidt
Rose Schmidt is the author of “Go Forward, Support! The Rugby of Life” (Gainline Press 2004). Use of individual quotes with proper citation and attribution, within the limits of fair use, is permitted. If you would like to request permission to use or reprint any of the content on the site, please contact me.

Saturday, September 24, 2016

HUBweek 2015 Retrospective




HUBweek 2015 Day 1: Faneuil Forum (October 4, 2015)

Here is a quick recap of last year’s HUBweek, now that HUBweek 2016 is about to get underway. After attending De-Stress Boston at MGH, and surviving our stressful driving and parking experiences, we made our way back downtown to attend the Fenway Forum, which had been moved inside to Faneuil Hall, due to weather concerns. By the time we parked and made our way there, we found a line snaking around the building. It turned out that the hall was filled to capacity, but there was a place for overflow viewing at the Millennium Hotel across the street, and we all stampeded over there like a disorganized herd of goats, only to find that the overflow room was packed, and so the overflow from the overflow room were sent to an alcove that had a TV monitor set up, and so that’s where we watched with the huddled masses.

“It’s like Woodstock,” Betsy whispered.



It’s amazing that a philosophy discussion could generate so much interest and draw such a large crowd, but it speaks to both the cerebral nature of the Boston citizenry and the almost-celebrity status of Harvard’s Professor Michael Sandel. The topics moved from the ethics of parking and Uber surge-pricing and privacy issues to big data, genetic engineering, the dance between chance and choice, and smart machines. This last question, whether college test essays should be graded by a machine instead of a human, evoked the most interesting discussion. It brought up the inherent flaws and biases of human grading, such as attention fatigue, as the first essay probably gets more of the professor’s attention than the 50th essay. Yo-Yo Ma reacted most strongly to this statement, believing they should all be given equal attention, asking whether we would think the same of a doctor on the 50th patient.

The reality is that statistically speaking, medical errors do increase as you go through the week, with the lowest on Mondays, higher Wednesday through Friday, and then by the weekend, just forget about it, between skeleton staffing and the fatigue factor. Ditto for radiologist errors in reading MRIs, and being more likely to miss things later in the week. You wouldn’t want a car built on a Friday and for the same reason you might not want a medical procedure on a Friday.

So, one can be shocked, horrified, or even indignant at the thought that everyone does not get equal care or attention, whether it be at the doctor’s office, or getting your essay graded, but the reality is that doctors and teachers are human and it happens. But, even with those flaws, is a human component still better than leaving it all to machines? Maybe there could be a hybrid approach, some combination of smart computing analysis of answers and human analysis.

The biggest problem I saw with automated grading is that it denies the possibility of an original thought, something that has never been thought or said before. Or, as Yo-Yo Ma said, “The idea of the human spirit goes beyond the finite, and we want to look for that in every student.” Yo-Yo Ma described how every musician can play a note the same; but the distance between two notes is unique for every musician. Fascinating!

The last topic had to do with picking the perfect mate. In a taped interview with Conan O’Brien, he cites “accident, fate, and God. Things often go wrong to go right.”

Professor Sandel summed things up this way, postulating that perhaps “accident and happenstance and imperfection” are integral to humanity and the human experience, and that “these debates are not about technology in the end, but about us and how we should negotiate our relationship with the world and each other. We aspire to mastery and control, yet these moments of dominion and control come up short. Does the desire for mastery eclipse our capacity for wonder, to behold the world versus to mold the world?” 

Quite fittingly, the panel discussion ended with a musical performance by Yo-Yo Ma and the Silk Road Ensemble of The Catalonian Song of Freedom, a tribute to the freedom of thought.

 
At the end of the day, it was good, all good, but a little light, and avoided the truly weighty issues of the day – the refugee crisis, the national conversation on immigrants, or climate change. The topics seemed to speak to the problems of the privileged, those who have cars and can afford parking and Uber, versus those who perhaps rely on the MBTA for transportation. Speaking of which, after a couple of stress-inducing drives in and out of the city, I decided to take the T the rest of the week.
 

HUBweek 2015 Day 2: STEM Speed Networking (October 5, 2015)

After navigating my way via the T (bus to Harvard Square, Red Line to MGH), I arrived at the Russell Museum at Mass General for this STEM event, bringing together attendees from both industry and the various organizations that offer STEM activities to the K-12 students. The two most interesting things I learned:

1. Every corporate representative expressed precisely the same purpose in attending this event and promoting STEM education: They need a steady stream of STEM-ready employees. They are facing a workforce skills gap in the talent stream, plus the average age in the workforce currently is 49. The numbers are staggering. As Marcy Reed of National Grid pointed out, “Technology is everywhere now. Even a lineman needs to be computer savvy. Computers are everywhere.” While there has been a lot of discussion about getting women and minorities into STEM, as U.S. Representative Katherine Clark said in her opening remarks: “We can’t afford to leave anyone out of this,” and “we need to attract students from across all demographics.” One person in the audience commented, that “even not having access to technology is a disability in a way.” This brought to mind John Henry’s statements about opportunity inequalities (see “Business & Baseball” blog post, August 10, 2015).

 
2. The organizations promoting STEM to the K-12 students are all completely independent of the public school systems. When I asked other attendees about where the school representatives were, I just about got laughed at. As one attendee put it, waiting for the public school system to foster programs to promote STEM careers is the slow boat. Making change within the educational system is exceedingly slow. Furthermore, it’s imperative to capture the hearts and minds of students, parents and teachers early on. As one panelist said, “By middle school, that ship has already sailed.” The biggest deterrents are often at home and at school, both parents and teachers. Kids need to see STEM as a viable option and it helps for them to see role models. After the panel discussion, we then spent time moving from table to table, allowing corporate representatives and STEM organizations a chance to meet and look for opportunities to work together.

This session made me think about the way the world of work has evolved over the years. Is our economy actually generating jobs that are stimulating, challenging, and attractive to our youth? Ever since the first dawn of the industrial revolution, we’ve been asking this question. How fulfilling were the jobs at the textile mills or on the first car assembly lines in Detroit? At least they saw a tactile, tangible finished product. With each decade, the role of the worker has continued to evolve from craftsperson to automaton. I remember reading the book, Rivethead, in the 1980s, and having these thoughts. Factory work is hard. I remember my Mom’s stories from working in a factory, plus worked factory jobs myself a couple of summers while in college. The lesson engrained in these experiences is that if you want to avoid mind-numbing, grueling factory work, go to college. Of course, now, even those jobs have moved overseas, with corporations lured by lower wages and various tax breaks.

The new economy has spawned a new jobs industry, primarily in the service sector (roughly 80%), but, are they fun? Fulfilling? Recalling Professor Sandel’s talk, are we creating jobs that feed our humanity?

Ironically, even with so much emphasis on STEM, at the end of the day, most jobs still involve working with other people. There was a short article in The Boston Globe back in November 2015, titled “Jobs Abound for Workers with Technology, Math, People Skills,” by Megan Woolhouse, reporting on some research done by Bentley University and Burning Glass Technologies, finding that “positions that require workers to think analytically, and use interpersonal skills as well as use technology paid between $70,000 and $120,000 a year. A person with a liberal arts background and a fluency in database languages fetched earnings of more than $120,000 a year.”

It’s not a question of either/or STEM and humanities, but rather an integration of both. Gloria Larson was quoted in the article, saying “2016 looks to be the year of the hybrid job – and the hybrid employee… The more schools can think about integrating across disciplines and getting students to dive deeper in cross-disciplinary ways is really helpful to breeding this kind of thinking, to developing analytical skills.”

So, employers want it all, both technical and interpersonal skills. Unicorns.


HUBweek 2015 Day 3: Paul Revere (October 6, 2015)

Before making my way over to the Paul Revere House for the talk, I stopped for lunch at a North End eatery, Galleria Umberto, that is open only for lunch. While the pizza was very good, I totally delighted in the potato-shaped pods of mashed potato, with a deep-fried crusty brown exterior, and melty cheese in the middle. This is where the locals eat.  



After lunch, by the time I arrived at the Paul Revere House, I needed use of a comfort station, which I thought they would have there, but, no, I was told by the staff, I would need to go back and use the restroom in the basement of the North Church, three blocks away. Ironic, I grumbled to myself, that the subject of the talk was “Revolutionary Makers: Paul Revere Meets 3D Printing,” when we can’t even solve the seemingly simple problem of public restrooms.

We were treated to a tour of the house, plus a talk that described how Paul Revere was an innovator in his day, a risk-taker in industry. He may not have had the answer in hand, but he had the confidence to say he would figure out a way. We were also introduced to a local firm exploring applications for 3D printing. I had hoped to see the gizmo in operation, but all we got to do was pass around some widgets that had been fabricated by the printer. My mind started wandering back to my mashed potato thing at Galleria Umberto.

Ironically, when I was at the STEM event, I was asked about whether I had any really cool 3D geology models to share with students. I had to explain that while we have models for depicting site geology and structures on our computers, we don’t currently have a program that talks to the 3D printers yet. And so, the coprolite fossil specimen remains the most popular item in our geology talks to students.

Next, I meandered over to the Russell Museum at MGH for the next talk.


HUBweek 2015 Day 3: Driving Ourselves Happy (October 6, 2015)

Dr. Nancy Etcoff, member of both the Harvard Medical School and MGH Department of Psychiatry, gave a talk summing up the history of thought on happiness. Certainly far more research has been done on depression, and rightly so, to alleviate suffering, but it is a relatively recent revelation that the lack of depression does not necessarily equate to happiness. Dr. Etcoff explored a variety of ways we can move the needle, to bump up our happiness level a little bit, ranging from social interaction to self-actualization, flowers, self-kindness, self-compassion, and living in the present.

“We can be in the driver’s seat when it comes to our own happiness.”

This talk was probably the pick of the litter, of all the HUBweek events I attended. I would give it Best In Show. But, why take my word for it? You can (and should) watch the entire talk yourself here on YouTube:

https://www.youtube.com/watch?v=Nh2AFO7ZMas
 

Parting statements by Dr. Etcoff:

-       Be the person you always wanted to have in your life.

-       Give away what you want to have in your life.

 

HUBweek 2015 Day 4: Coping With Climate Change: How Will Boston Adapt? (October 7, 2015)


This event was held at Sanders Theater, in Harvard’s Memorial Hall, a Gothic structure resembling something straight out of a Harry Potter book. There are human heads along the façade.

The panel discussion moved across the topics of infrastructure investment, societal choices, and recovery and resilience. Some of the memorable quotes from this panel discussion follow:

“Evacuating may not be feasible.” (Getting out of town on a Friday afternoon, even on a sunny day, can be difficult when everyone leaves at the same time, I thought to myself.)

 “The trick is to put long-term planning into short-term actions. Otherwise, things happen one permit at a time. We need to translate knowledge into building codes.”

“We fail repeatedly to take the opportunity to rebuild differently after a storm.”

“We tend to underestimate our exposure. No one will have the will to execute it until after we get a taste of just how bad it could be.”

 
At the end of the day, the message seemed to be that if we can’t afford to flood-proof our coasts, then our energy should be spent on building resilience into the post-storm response, such as moving electrical panels upstairs, and keeping a lifeboat and axe in the attic.

Research by Daniel Aldrich, PhD, supports this strategy. Drawing on his own experience surviving Katrina, his subsequent research into post-disaster response has shown how critical resiliency, self-reliance, and social connectedness are to survival and recovery.

 
Or, to put it another way, as said by Skipper (from the movie, The Penguins of Madagascar):

“If anyone’s going to save us, it’s us.”

 
HUBweek 2015 Day 4: Your Brain on Art (October 7, 2015)

I walked a few blocks over to catch this next event, contrasting how an artist and a brain scientist look at art. I was just starting to get a headache at the start of the talk, and it was pounding by the time it ended, and I took the T home.

HUBweek 2015 Day 7: Illuminus (October 10, 2015)

This event, with all it’s clanging and banging, sounded migraine-inducing, compounded by the logistics of heading into town again, and so I stayed home.

Post Script
HUBweek 2016 is slated to run from Sep. 25 – Oct. 1, 2016.
My picks for the week are:
Sun Sep 25 De-Stress Boston (again)
Mon Sep 26 Faneuil Forum
Tue Sep 27 FDA and the Drug Approval Process: Is it Really Broken?
Wed Sep 28 Medical Storytelling

Check it all out at: https://hubweek.org/
 

References
English, Bella. 2015. Providing Insights into Overcoming Disaster. The Boston Globe, 31 August 2015.
https://www.bostonglobe.com/lifestyle/2015/08/31/resilience/u4TXnte3a9JKNs9D2K7AOO/story.html

Hamper, Ben. 1986. Rivethead: Tales From the Assembly Line. New York: Warner Books.

Woolhouse, Megan. 2015. Jobs Abound for Workers with Technology, Math, People Skills. The Boston Globe, 20 November 2015, p. C2.
https://www.bostonglobe.com/business/2015/11/19/employers-seeking-workers-with-broad-range-skills-study-finds/iqTgbTP3UnewOn2vpRavQO/story.html

 
© 2016 Rosemary A. Schmidt
Rose Schmidt is the author of “Go Forward, Support! The Rugby of Life” (Gainline Press 2004). Use of individual quotes with proper citation and attribution, within the limits of fair use, is permitted. If you would like to request permission to use or reprint any of the content on the site, please contact me.

Thursday, May 12, 2016

HUBweek De-Stress Boston Post Script: Why are healthcare workers so stressed?


In the week or so following my last post, a number of stories came out that might help explain why healthcare workers are so stressed, and offer some constructive direction for improving the practice of medicine.

“Medical error – the third leading cause of death in the US.”

http://www.bmj.com/content/353/bmj.i2139

The first story came out on May 3, 2016, and was quickly picked up by STATnews, TV news, CNN, USAToday, etc.  A study by researchers at Johns Hopkins University School of Medicine, published in the BMJ, estimates that approximately 251,000 deaths per year are due to preventable medical errors. This makes medical errors the number three cause of death in the US, behind heart disease and cancer, a far cry from “first do no harm.” The article includes three recommendations: “make errors more visible; respond to error; and make errors less frequent.” Precisely what I was getting at in my prior post. What is lacking currently is a feedback loop for identifying and sharing mistakes so that changes can be made to prevent them from happening again. 
 

“Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011”


This story also came out on May 3, 2016, and was published in the Journal of the American Medical Association. Researchers evaluated antibiotic prescribing practices and based on their analysis of the data (from 2010-2011), they estimated an annual prescription rate of 506 per 1,000 population. Furthermore, of those 506 prescriptions, only 353 were considered likely to be appropriate. In other words, almost one-third of antibiotics prescribed were not warranted. This sounds like one of those medical errors the first article was talking about, and we haven’t even gotten to the topic of Fluoroquinolones yet.

Fluoro-what?

Cipro, Levaquin, and all their generic counterparts: Levofloxacin, etc.  

“Common medication errors to avoid”

The American College of Physicians (ACP) seems to agree that Fluoroquinolones are often a mistake for non-life threatening conditions, given their serious and sometimes permanent side effects. As published on Healio on May 5, 2016, at last week’s ACP Internal Medicine Meeting, doctors were cautioned on their serious side effects, and advised to rethink how they are prescribed.



 
***NEWS FLASH***

And now, even the FDA agrees, issuing a public statement today (May 12, 2016) on their website:
 

“The U.S. Food and Drug Administration is advising that the serious side effects associated with fluoroquinolone antibacterial drugs generally outweigh the benefits for patients with sinusitis, bronchitis, and uncomplicated urinary tract infections who have other treatment options. For patients with these conditions, fluoroquinolone should be reserved for those who do not have alternative treatment options.”

 

“An FDA safety review has shown that fluoroquinolones when used systemically (i.e. tablets, capsules, and injectable) are associated with disabling and potentially permanent serious side effects that can occur together. These side effects can involve the tendons, muscles, joints, nerves, and central nervous system.”

 

“As a result, we are requiring the drug labels and Medication Guides for all fluoroquinolone antibacterial drugs to be updated to reflect this new safety information. We are continuing to investigate safety issues with fluoroquinolones and will update the public with additional information if it becomes available.”

 

“Patients should contact your health care professional immediately if you experience any serious side effects while taking your fluoroquinolone medicine. Some signs and symptoms of serious side effects include tendon, joint and muscle pain, a “pins and needles” tingling or pricking sensation, confusion, and hallucinations. Patients should talk with your health care professional if you have any questions or concerns.”

 

“Health care professionals should stop systemic fluoroquinolone treatment immediately if a patient reports serious side effects, and switch to a non-fluoroquinolone antibacterial drug to complete the patient’s treatment course.”

 

FDA Drug Safety Communication: FDA advises restricting fluoroquinolone antibiotic use for certain uncomplicated infections; warns about disabling side effects that can occur together


 
This is the culmination of years, if not decades, of advocacy work by many groups and individuals, which led to the testimony by impacted patients to the FDA advisory panel in November 2015 (as reported in The Wall Street Journal), and a growing visibility in the media over the past few months.


 
A March 2016 article by Teresa Carr in Consumer Reports also sounded the alarm on the “rampant” over-prescribing of fluoroquinolone antibiotics:
 
“Fluoroquinolones Are Too Risky for Common Infections”


 
Even Dr. Oz offered a caution on fluoroquinolone antibiotics in the April 2016 issue of his magazine, The Good Life, due to their potential serious side effects.




 Much, much more on this a bit later. A few websites to check out in the meantime:

 Advocacy:

 

 

 

Patients:


 

 

 

****************************************

 
Lastly, and perhaps offering a ray of hope, another story came out on May 3, 2016:


“Why one top hospital is going public with its mistakes.”


As reported on STATnews, Brigham and Women’s Hospital in Boston has announced that it is going to share medical errors and lessons learned on its blog site, Safety Matters. Precisely what I had suggested in my prior post!


This is revolutionary in the medical field, where the system barely wants to acknowledge mistakes, let alone air them publicly. Errors are typically close-hold matters because of fears regarding malpractice, lawsuits, and loss of reputation. Without bringing such mistakes into the light of day, there is limited opportunity for improving the state of the practice. Medical errors, in addition to their human toll (deaths, adverse health effects), also exact a heavy price on the cost of medical care, due to both the increased medical care for those adversely affected, and the pass-through costs of litigation and malpractice insurance. It is sad but not surprising that becoming a doctor is no longer seen as the highly desirable career path it once was, given the associated financial and legal burdens. If things don’t change, we run the risk of a doctor shortage in the coming decades. We all need a system that allows doctors to continue to grow and learn in their practice of medicine.

 Bravo! Hats off to Brigham and Women’s Hospital for taking this first step!

 

Coming Next

HUBweek Day 1, Part 2: Fenway Forum: A Master Class with Professor Michael Sandel

HUBweek is currently accepting idea submissions for this year’s HUBweek, through May 20, 2016.


 
References

Benson, Herbert, M.D., with Miriam Z. Klipper. 1975. The Relaxation Response. New York: Avon Books, a Division of The Hearst Corporation.

Burton, Thomas. 2015. FDA Panel Seeks Tougher Antibiotic Labels. The Wall Street Journal, 6 November 2015, p. A6.


Carr, Teresa. 2016. Fluoroquinolones are Too Risky for Common Infections. Consumer Reports, March 2016.


Fiumara, Karen. 2016. Why one hospital is going public with its mistakes. STATnews. May 3, 2016.


Fleming-Dutra KE, Hersh AL, Shapiro DJ, et al. 2016. Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011. JAMA. 2016;315(17):1864-1873. doi:10.1001/jama.2016.4151.


Laday, Jason. 2016. Common medication errors to avoid. Healio.com 2016 (Published 5 May 2016).


Levenson, Michael, 2014. Institutions formally announce HUBweek festival. The Boston Globe. December 12, 2014.


Makary, Martin A., and Michael Daniel, 2016. Medical error – the third leading cause of death in the US. BMJ 2016; 353:i2139  doi: http://dx.doi.org/10.1136/bmj.i2139 (Published 03 May 2016)


Oz, Mehmet. 2016. If you get an Rx for a strong antibiotic like Cipro, should you push back? The Good Life. April 2016.

Swetlitz, Ike, 2016. Medical errors are third-leading cause of death in the US. STATnews. May 3, 2016.


Weintraub, Karen, 2015. Stress may make you more likely to cheat. The Boston Globe. August 15, 2015.


 

© 2016 Rosemary A. Schmidt
Rose Schmidt is the author of “Go Forward, Support! The Rugby of Life” (Gainline Press 2004). Use of individual quotes with proper citation and attribution, within the limits of fair use, is permitted. If you would like to request permission to use or reprint any of the content on the site, please contact me. Twitter: Rosebud@GainlineRS

 

Monday, April 25, 2016

HUBweek 2015 Day 1: De-Stress Boston


Now that plans are underway for HUBweek 2016 (slated to run from Sep. 25 – Oct. 1, 2016), it’s about time I wrote up my posts on HUBweek 2015. I will update this preface each time I add a post. I had been planning to attend HUBweek since it was first announced by its sponsoring partners (Massachusetts General Hospital, MIT, Harvard, and The Boston Globe) back in December 2014.
 
As HUBweek approached and the agenda crystallized, I started mapping out the events and locations, just as I would for a conference, weighing both how interesting the topics sounded and the logistics of getting around to the various locations scattered across Boston and Cambridge. Here was my planned itinerary:

Sun.     Oct. 4: De-Stress Boston (MGH) and Fenway Forum
Mon.    Oct. 5: STEM Speed Networking (MGH)
Tues.   Oct. 6: Paul Revere Meets 3-D Printing and Driving Ourselves Happy (MGH)
Wed.    Oct. 7: Coping with Climate Change (Harvard) and Your Brain on Art (Harvard)
Thurs.  Oct. 8: Mindfulness (MIT) and Healing Arts of Music and Medicine (MGH)
Sat.      Oct. 10: Luminous art & music festival at Fenway
Some of the events were taped and are still available for viewing online:
http://hubweekboston.com/video/


De-Stress Boston



 
Our attendance at De-Stress Boston began with a little driving/parking stress, as we left the house just slightly later than planned, and then hit traffic on Storrow, so if we didn’t park at the hospital, we’d miss the talk entirely, and so I sort of had to lie to the security guy at the entrance to the hospital parking garage, saying that we were indeed a patient and/or visitor. In our defense, Susan’s foot was still in a walking boot, and we really had a legitimate medical need to park nearby, but lying is stressful, as many studies have shown. It’s how lie detectors work, picking up the tiny physiological changes our bodies make when suppressing the truth. Lucky for me, they don’t have those rigged up at the entrance to parking garages. Recent studies also show that stress can increase the likelihood of cheating/lying (Weintraub, 2015).
 

This brings up the entire debate about how much of our behavior is a reflection of one’s individual personality/character, and how much is merely situational, a function of one’s current life circumstances. We hadn’t even arrived at our first HUBweek event, and look at how much debate and introspection it had already generated for us! Yes, yes, of course, I am fully aware of the horrible irony that we were getting stressed out on our way to a talk about stress reduction. 

After an introduction by John Henry, Dr. Herbert Benson spoke of how the relaxation response had moved from a hippy alternative concept in the 70’s to being accepted by mainstream science and medicine as a real, practical, and effective way to improve health by decreasing stress, resulting in tangible physiological changes and effects at the cellular level. By invoking the relaxation response, we can attain a quieter mind and improved perspective. What may have seemed like the worst thing imaginable now seems manageable. This reminded me of a bit of advice that Colin Powell shared during his talk at last year’s Sage Summit. When first presented with bad news, he would say to himself: “It’s not as bad as you think,” fully acknowledging that this was “not a plan, but a hope,” but one that allowed him to maintain some calm during crises.  

It’s noteworthy that meditation is now being proposed as an effective tool in managing things like Post-Traumatic Stress (PTS). Back in the day, meditation was something that only hippies did. When an old friend of mine was at Basic Training in the Army, back in the late 1980’s, the instructor was quizzing the class on various acronyms, and he asked my friend, “What does TM stand for?” She was pretty earthy-crunchy, and so the only thing she could think of was “Transcendental Meditation,” which just made him get agitated. “Tran-sen-what?!” Of course, the correct answer is Technical Manual.

Dr. Benson led us through a little practice meditation, and the next speaker had us do some chair yoga. There’s an awful lot of work that goes into doing and thinking nothing, quieting and stilling the mind. The speaker suggested using a word or phrase, as “words do focus us.” The problem with words is that there are simply so many to choose from. I had trouble deciding on a good word or a fitting phrase, and so that was a little stressful. I put it on my list of things to do, to come up with a good word or phrase.

The next speaker, Zach Valenti, showed off his Project Uplift that “game-ifies stress reduction.” Using a headset and a giant globe, the deeper you relax, the higher you lift the globe, providing immediate gratification and visible, tangible evidence of your relaxation progress. Part of me wanted to try it during the break, but a long line had formed very quickly, and lines stress me out. Plus, I tend to be just a little bit competitive, so I would have wanted to lift the globe higher than everyone else, and I would have been bummed out if I couldn’t even get it off the pad.

We moved from our back row seat in the balcony, to a table on the veranda with a better view overlooking the stage. As the next series of speakers were getting ready to talk, we found ourselves getting drawn in by the smell of soup from a nearby table. Was that clam chowder? Or, would that be calm chowder? Ha ha. We soon found ourselves making our way downstairs to the Eat Street Café, getting a nice cup of hot chicken noodle soup, which I highly recommend: savory, hearty, comforting. 

I’d feel bad about our little detour to the MGH cafeteria, but it turned out to be quite handy, when we returned to MGH just a few weeks later, quite unexpectedly, after a friend had a heart attack.

In the process of making our way to the cafeteria, it was hard not to notice the faces of the various caregivers, nurses, doctors, and aids we saw along the way: They all looked so stressed. They probably needed the De-Stress Boston talk every bit as much as we did, and maybe even more. But, if you think about it, maybe it’s understandable. Their jobs deal with life-and-death decisions and consequences. In many lines of work, you can remind everyone to maintain perspective, and that every decision is not a life-and-death matter. Except that at a hospital, it is life-and-death. Or, at least, it might be. It could be. How do you deal with that? There are a number of jobs that carry similar gravity: police, fire, pilots, soldiers, engineers. While some of these fields rely on a certain level of heroism/bravery/honor, how do you make the constant stress of life-and-death decisions manageable? The answer in many cases: policies, protocols, values, and standards. Take it out of the individuals’ hands. Institute checklists. It works for airlines, why not the medical field? Use feedback loops to ensure continued learning. Give people the tools to know they did the best they could under the given circumstances.

There is an old episode of “Scrubs,” where the old curmudgeon doctor and the resident, played by Zach Braff, get into a competition in treating two patients with the exact same symptoms. They both come up with the same diagnosis and treatment plan, but Zach Braff’s patient dies, while the older doctor’s patient lived. The young resident asks why. The older doctor says, “You forgot something…” Before he can finish, the young resident rushes off to do more research, tormenting himself, thinking that if he had only done something different, his patient would have lived. At the end of the show, the older doctor comes to him and finally explains: The resident had done everything right, but he had forgotten one thing: Sometimes people just die, even when we do everything right. It’s not all in our control. 

And, sometimes we patients probably forget that doctors are just human, not superheroes, as much as we and others and maybe even themselves would like to make them out to be otherwise. They’ve not been imbued with special powers; they just know what they know, but they don’t know everything. The inner workings of how the human body sustains life is a universe yet to be fully explored and understood.

Bellies full, and feeling just slightly less stressed, we embarked for home. Irony of ironies, the drive home was equally stressful, though, as I got in the wrong lane at what used to be Leveritt Circle. “Are we going home to Watertown via the Zakim Bridge?” “No, of course not.” No, instead, we took 93 South to the Pike, through the bowels of the new and improved Big Dig depressed Central Artery. Traveling on 93 South, a giant Peter Pan bus the size of a townhouse goes hurtling past in the lane next to me, and then my exit lane splits off into oblivion, re-surfacing into a microscopic merge zone. It all works – on paper – but I can’t help but think: wouldn’t it have been nice if they could have had the benefit of a 3-D model or virtual reality tour prior to construction? Of course, 3-D printing is a topic for another day.

After taking Susan home, my next stop that afternoon would be Fenway Forum, a Master Class with Professor Michael Sandel.
 

Post Script
I always see getting lost as an opportunity for picking up clues that might come in handy in some way in the future. It’s part of my incorrigible belief that everything happens for a reason, and some studies in the field of psychology show that we might just be wired to think that way. Little did I know, but my visit to MGH turned out to be just the start of my tour of the major hospitals and healthcare systems (and their cafeterias) in the metropolitan Boston area. But, that’s a topic for another blog, another day. 

I was recently going through our book cases at home and found Dr. Benson’s original book, and added it on to my ambitious 2016 reading list:



Art & Fear, by David Bayles and Ted Orland. This one came as a recommendation via Stu Rook of Lux Lisbon, congrats on the sold-out show at Scala London on 21 April! One of the most interesting concepts I found in this book was the fundamental difference between art and science; the expectation that scientific results be reproducible and objective, while art is expected to be original and offer a unique perspective, and so in this way they are almost diametrically opposed.

Presence, by Amy Cuddy

The Varieties of Religious Experience, by William James (father of American Psychology, but just as much a philosopher); thank you to Dr. Nancy Etcoff for the recommendation.

Super Genes, by Deepak Chopra, M.D, and Rudolph E. Tanzi, Ph.D.

Give and Take, by Adam Grant

Originals, by Adam Grant
 

Coming Next
HUBweek Day 1, Part 2: Fenway Forum: A Master Class with Professor Michael Sandel

 
References
Benson, Herbert, M.D., with Miriam Z. Klipper. 1975. The Relaxation Response. New York: Avon Books, a Division of The Hearst Corporation.

Levenson, Michael, 2014. Institutions formally announce HUBweek festival. The Boston Globe. December 12, 2014.
 

Weintraub, Karen, 2015. Stress may make you more likely to cheat. The Boston Globe. August 15, 2015.

 
© 2016 Rosemary A. Schmidt
Rose Schmidt is the author of “Go Forward, Support! The Rugby of Life” (Gainline Press 2004). Use of individual quotes with proper citation and attribution, within the limits of fair use, is permitted. If you would like to request permission to use or reprint any of the content on the site, please contact me. Twitter handle: Rosebud@GainlineRS