Saturday, February 21, 2009

The Yellow Scar

I believe that certain people are put in your life for a purpose. There is a certain man in my life who is of great importance to me. It was once said that "If you are cut deep enough several times, you are left with a scar--an everlasting reminder of every single wound." Over and over. Beaten with that verbal whip. Preceding each lash on your psyche with a cringe of pain before the whip has even been raised in preparation to crack.

I know I am not alone in my pain; those around me have to endure the "task master." Try as I might, to hold in my sorrow, I lash out in defense--helpless and alone. I hide in my closet; that is the only place to go. It's dark and I am safe...for now... The next attack could be soon or afar off, but no matter, everything belongs to him. He can come and go as he pleases; he can say what he wishes without a single regret or force to stop the words flowing from his slithering tongue.

I want to feel close to him despite all of the hate I feel towards him. I want to feel free express myself in front of him without worry of criticism or sarcastic remarks. I want to feel secure in his love for me.

Friday, May 2, 2008

The Magic Flute

Wikipedia tells us that “The Magic Flute (German Die Zauberflöte, K. 620) is an opera in two acts composed in 1791 by Wolfgang Amadeus Mozart to a libretto by Emanuel Schikaneder. The work is in the form of a Singspiel, a popular form that included both singing and spoken dialogue.” Also, Wikipedia summarizes The Magic Flute quite simply when it says “Sarastro, the wise priest of Isis and Osiris, has taken Pamina to the temple for the purpose of releasing her from the influence of her mother, the Queen of the Night. The queen induces the young Prince Tamino to go in search of her daughter and free her from the power of Sarastro; Tamino accomplishes his end, but becomes the disciple of Sarastro, whose mildness and wisdom he has learned to admire. The prince and the princess are united."

My expectations were proven true as soon as I was seated. This is was going to be an excellent performance. My friend, Maggie, was in it and that alone was one of the main reasons for me to attend, however, I knew that there were many musicians in the pit orchestra I knew that played well, and of course the lovely gowns and wigs they would wear—it was all so exciting! The stage was just waiting for those prepared and anxious singers to fill in order that the show could begin. Many people around me looked anxious also; there was a lot of murmuring and sort of an excitement in the air. And as the lights dimmed and the curtain opened, I knew that I was in for a real treat—not only was the singing lovely, but the entire seemed to light up with the combination of an attentive audience and a communicative group of musicians.

Propaganda Analysis

It’s spring. A mother shows her child how she cares for her world. Her brunette hair, pale complexion, and clean, cut outfit are symbols of the typical American woman. This woman has a stately air about her stance; she seems completely comfortable and stable—physically and emotionally. The clothes that hang on her slender and curvy body are simple. The focus of her body is on her countenance and the action she is engaged in. She gently pours water from a garden pitcher on a lawn where flowers are blooming. Her son watches intently; he sits cross-legged on the ground with a clumsy smile wiped across his face. His caring mother is showing him that she cares for the Earth and she desires for him to learn the same. CVS/Pharmacy emphasizes that they care as much as you do about the Earth and it’s dwellers through their advertisement. This mother is intended to represent a pharmacist at CVS/Pharmacy whose love and care for the Earth is reflected in her work ethic. Through an appealing display, CVS/Pharmacy
Commercials take use of visual, emotional, and verbal cues. Word choice can affect the way in which a person perceives you, the product you are selling, and/or the company you are promoting. One technique that can affect the amount information you, as the consumer, retain is repetition. A company repeats their slogan or motto many times. CVS/Pharmacy’s slogan, for example, is “For all the ways you care.”

is repeated verbally in the commercial and is most likely visually displayed, as well. Another persuasive technique is words that are too general—nice, nature, care—that are much too relative to the background of the reader/listener/viewer. During a 2007 CVS/Pharmacy commercial, CVS uses a famous artist (Sarah McLachlan) to perform a song (Ordinary Miracle) that sends the message that they want throughout, and in closing, they leave you with a question. “It’s in your nature to care for others, to listen, to advise, to always be there. Isn’t it nice that there’s a pharmacy that cares as much as you do?” The couple minute monologue is to persuade viewers that CVS/Pharmacy is positive and encouraging, yet they expect you to view their pharmacists as loving and caring. Throughout the entirety of the commercial, “Ordinary Miracle” is heard; its lyrics are specifically designed to challenge you to act upon the message. “Life is like a gift they say, wrapped up for you everyday; open up and find a way, to give some of your own. Isn’t it remarkable? Like every time a raindrop falls. It’s just another ordinary miracle today.“ CVS/Pharmacy desires that all their potential costumers have the mindset that their pharmacy will be something that is ordinary and accessible, but the care and treatment you will receive is unordinary and rare.
It’s summer. A quiet evening with a full moon shining brightly in the cloudless sky allows for a romantic night. The couple sits silently gazing on the thousands of stars and the glowing moon; comparatively, they are so entranced with the sky and each other, that their surroundings are viewed as miniscule. Their white house has a lovely porch swing on which they are both comfortably resting. The man’s arm is placed lovingly on the woman’s shoulder. CVS/Pharmacy facilitates the appearance of the compassionate

and respectable couple through the decent apparel they are wearing and their sweet, innocent quality time. And the artist strategically placed a few flowers toward the front of the picture. The flowers are not only a reoccurring theme in the summer visual advertisement, but they represent peace and beauty; this implies labor on the yard and therefore a beautiful outcome.
An animated commercial like CVS/Pharmacy’s makes use of the propaganda tools in their box. Words like “ordinary” imply that the company desires to be in your community and promotes the philosophy that the employees and location should be local. Plain Folks is the propaganda reference I would place on this “community” emphasis. Throughout each sketch, the company has been careful to represent their idea of a “typical” American. Phrases such as “in your nature to care for others, listen to others and to advise,” allow for viewers to believe that CVS/Pharmacy hires only the most caring and thoughtful pharmacists—an example of glittering generality.
It’s fall. Two girlfriends are taking a brisk walk, breathing in the crisp autumn air. Appropriate clothing and plain colors allow for the viewer to admire their clothing, but concentrate primarily on the expressions on their faces. The one on the left is endearingly placing her hand on the friend that so eagerly seeks her guidance and/support. The women have mocha skin and brown wavy hair. And as the sun shines brightly behind them, they look hopeful for the future. These friends know that they will be there for each other throughout every season of the year and of life. CVS/Pharmacy claims to care for you the same way that you care for others, but can they live up to their standards?

Interview with Jacque De Fouw 5

9. What do you feel is the most important lesson that you teach you medical students? What do you want to them to accomplish as a result of this knowledge?

One of my favorite quotes and I don’t know who said it, but “nobody cares how much you know until they know how much you care.” I think that is very important. I think it’s something that the hospitals need to remember.

10. How do you think the education you received and taught would be affected if the United States had a globally run health care system?

The hospitals would be a lot different. I think that the hospitals and private clinics might have an easier road because they wouldn’t have to deal with so many insurance companies. They would have one entity. Perhaps, just like TennCare here in Tennessee, they would sell it through different companies. There are for profit companies that sell government health care plans. I think this clinic would probably be run the same as it is now; however, the funding might be different in that they might allocate money to college health care centers. All of the money that we receive is through student fees, that’s why we treat students and not faculty and staff. We do treat faculty, however, they have to pay.

Interview with Jacque De Fouw 4

7. How would you compare your experiences of studying and teaching health care at different universities on a national level? Do you feel that the government needs to find a new health care system for its university students?

It is hard for me to compare because I worked at a community college campus in Michigan and we didn’t have a health care center. I have worked in hospitals in Michigan.

8. What would you say are the pros and cons to having a privately run health care system in the United States?

I think we have been having a crisis for probably the last twenty years; prior to that, there weren’t as many people, it seemed better then—we didn’t have as much litigation or fear of litigation, people were very trusting with hospitals and I’m sure that probably led to the litigations and things. But I think that HMO’s are run on the same type of thing that we do here, that you pay ahead and then you can go in and be seen for whatever you need to be seen. We have two major parts in our health center here and one is to educate, to teach people ways to stay well, which is my job, and then if they get sick or hurt, to take care of them and get them back into wellness. And of course, our big theme is “Wellness must be pre-requisite to all else. Students cannot be intellectually proficient if they’re physically and psychologically unwell.” That was written by Earnest Boyer. I know a lot of health educators use this statement, but the bottom line is if you’re sick, you can’t do well in school, and we want to keep you well—mentally, physically, socially, in all realms. So that is a big calling. To use a clichĂ©, “you lead a horse to water, but you can’t make it drink.” And we do as much education as I can handle. Myself, I have two graduate assistants and we try to do the education. Now with an HMO, they will triage a person when they come in; they will decide if that person needs education, if they need maintenance or if it’s an acute episode and they need intensive care. So, they kind triage them into those ways and decide what they need. And a lot of the people that come in here, only need to learn how to do something or how to take care of themselves; they may be fine, but they might need to change their diet or something like that. We kind of do the same kind of thing. So, if someone has a bad illness, we send him or her off to a hospital or that type of facility. I think that we are much like the HMO’s.

I like being able to choose my own provider. I like to be able to go to the provider that I have chosen and not one that is chosen for me. I think it’s important to be able to make informed decisions.

I lived in a city right on the Canadian border and “the grass is always greener on the other side of the fence.” And it sounds great; countries like Great Britain and Canada have the social medicine system where you are entitled to medical care. It sounds wonderful, but in actuality, our hospitals in the states are filled with Canadians. Two-thirds of the nurses in the hospital in which I worked were Canadian nurses. I taught in a nursing school, and they would hire the Canadian nurses over our students, because they maybe had more experience and they tended to work for a lower wage. These Canadian nurses would take the ferry across or come across the bridge to work in our hospitals and the patients would come to us because they couldn’t get the care they needed when the needed it. We had patients come for orthopedic surgery that had broken their leg and they needed surgery on it, but they were scheduled for six months down the road, or they had breast cancer and they couldn’t have their breasts removed right away and they had to wait for three months. Well, you don’t wait with those things. There was a terrible back log and plus they are under staffed like we are in the hospitals and the nurses tend to be coming to the states to get paid more. It was not a panacea that we see it as. When I break my leg, I want to take care if it right away; I don’t want to have to live with it for at least six months and have it re-broken and set. If I had gallbladder disease and needed to have my gallbladder removed, I need to do it now, not in two months when they have an opening. That has been a problem. It sounds great for everybody to be covered.

Interview with Jacque De Fouw 3

4. Dr. Edmund Pellegrino, author, physician, and educator, argued that it is “ethics, not economics, [that] should drive the nation’s health system.” Do you believe that the United States government is more focused on the economics of health care, rather than the ethical aspect? Why?

Well, the health care industry is the largest economic thing in The United States. If the health care industry would fail, we would probably go into a really deep depression or something. It seems that economics rule over ethics at the present time. I would have to say in larger areas, such as the university health care center here, we are very in tune to ethics and what is going on. We are concerned that people get the most care for the smallest amount of money; we’re very fortunate that we can do that. And we do not deal with insurance companies. We don’t take any insurance here, so it’s not something we have to deal with. The politics of it all is very discouraging, and I’m glad I’m not in that system anymore. It’s so discouraging when you have a new mother that really needs to how to take care of a new baby and yet her insurance will only let you pay for that twenty-four hours in the hospital. Or you have someone that have complications from their surgery or they may not have a competent care-giver at home. I mean there are just a hundred different things. And you know that they need care in the hospital for a longer period of time, but they’re prohibited from staying because their insurance will not pay for it, and the hospitals don’t like to have to cover the costs of people staying longer.

5. Does the average University of Memphis student have health insurance? Do you believe that providing University health insurance is the answer for more effective on campus health care? Why?

We do keep statistics on students that do come in here, so that we know how many do have outside health insurance. If a student comes in and needs something further than we can do or they need to see a specialist, we tried to refer them to someone that will be able to handle whatever insurance that they do or don’t have.

6. How would you compare the health center at other universities you have worked versus Memphis’? Would you say that overall, students at The University of Memphis need a better health care system?

I think that having the health care on campus certainly provides access for care for students and I think they wouldn’t seek care as often if they didn’t have some place here to go. And the fact that it is pre-paid through their student access fee, it is very convenient for them to be able to come in and be seen by a doctor or a nurse practitioner and not have a cost involved. We also have the lab and x-ray that frequently there are no charges for, because it’s things that we can do here on campus, whereas, if we do have to send them out, we have to charge. Then we let the student know how much it would cost them. But the fact that we don’t take any insurance is good for students, whether insured or not. I hope that because we have this facility that students don’t think they shouldn’t get insurance, because there are a lot of things that we cannot cover here; I mean if a student were to get hit by a car or have a disease or develop diabetes, we can help them in the crisis, but we can’t manage that occurrence since we don’t have hospitalization or anything like that. Students really should carry their own health insurance, so that if something unplanned happens, they would have some sort of bridge.

Interview with Jacque De Fouw 2

2. One organization that is working to transform and regenerate the health care system of the mid-south is the Memphis Quality Initiative (MQI). Their goal is to be [a] catalyst, a resource, and a capacity-builder for health care quality improvement in the Mid-South. By working together, member hospitals strive to provide the right care to every patient, every time. [This includes]: pursuing perfection by providing care that is safe, timely, effective, efficient, equitable, and patient-centered, encouraging patient-centered customized care while discouraging unwarranted variation, improving care by sharing quality initiatives among medical and administrative professionals. Would you say that these goals are being met?

I’m not really involved in much of what the city is doing. I know of health initiatives that they have, but I’m not sure if they are through the program which you’re speaking. I know that one of the big initiatives is to eradicate syphilis from the city. They have a coalition that goes around and does free HIV and syphilis testing in different areas. They offer this free testing at different times, especially on awareness days. They used to come to the college campus and provide it for us for free every other month. I know that the city is active in doing things. I’m more concerned with health college campuses.