Russian Medical Fund 24 November 2008

Twelve years coming to a close today. We have saved the lives of more than 3,000 newborns and changed their families forever. We brought hope to a dark place when they thought there was no hope. We kept the entire children's hospital open in 1998 during the ruble crash.

With the hospital gaining political support from the government, I can move on to other projects. But this was a special baby for me, a lifelong dream to help children in other countries who were dying from lack of medicine. It seemed so wrong, and I vowed as a child I would do something when I grew up.

With great affection for my colleagues and supporters, I declare the Russian Medical Fund closed. I think I need to go have a good cry now.

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Urgent Care

This amusing brain shaped building is the neurosurgery center in Hannover Germany.

Have great memories of working at the neurosurgery and neurology departments at Mass General Hospital during the B.C. era, Before Children.

The chief of the former became the head of the Boston Symphony board, and the latter became Dean of the Harvard Medical School. I tried to train them properly.

In fact I took eldest egrdaughter with me to work for a few months until she wanted to start crawling around, then it was time to resign. There wasn't day care back then and I wouldn't have turned her over to strangers even if there was.

Have done a little hospital work since then as you know, and may yet again at Stanford.

Today's urgent task was to keep calm during the ups and downs of getting an individual health insurance plan in a different state. The insurance company seemed nervous about the line where I said I was being treated for depression. Guess we still are in the dark ages. Once again, teamEgregious to the rescue. You know who you are, and thank you.

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photo by tragesessel4350

To save the nation. But which one.

My most recent trip, #30 to St. Petersburg, was for the purpose of seeing the installation of $1,000,000 of monitors and newborn respirators in the ICU. Equipment which could have saved the life of my brother who died at age 3 hours.

We were supposed to have a ceremony with the governor, but I guess this didn't rise to the level of importance. We have decreased the level of infant mortality by half a percent by this program, but maybe that's not important to the powers that be. Altho I do read in the newspapers that they are concerned about their demography, where people are dying much faster than can be replaced. Probably saving the lives of infants doesn't figure in. Ah well.

The larger victory is we have encouraged the city government to begin to become interested in the survival of its own newborns. Those of us who are mothers instinctively get why this is urgent, for bureaucrats it takes a bit longer.

This victory is at some cost to the management. Mental health is most likely overrated. Hope it's worth it. [Good thing everything is calm and fine in my native country, that for example democracy and indeed the entire Constitutional government thingie is not at stake.] I've been doing this now for 11 years and estimate that my work has saved 3,000 lives.

I simply cannot grok this number and care to consider the children one at a time. We had an unusual case where the father was a cabinet minister in an Asian -stan where the nation was in civil unrest, we advanced the surgery in order to help their country. The first example I am aware of where we promoted a child above others for non-medical reasons [obviously excluding emergencies].

Life and death in Russia

You would think I am talking about the death today of former President Yeltsin. That would be wrong.

I am interested in the tens of thousands of newborns who will die this year because of lack of investment in neonatal congenital surgeons and the requisite ICU's.

Once I read someone trying to calm people down by saying If a baby dies in Russia does it matter? Well, actually, yes it does, very much. If this child dies from a congenital defect which is treatable by surgery, it matters very much indeed.

I have worked for the past eleven years to provide millions of dollars of supplies and equipment for the purpose of saving newborns who are born with a heart defect. Very often a simple surgery can save their little lives. It breaks my heart that those who have money do not choose to invest in their own newborns. They are beginning to, perhaps that must be enough.

We have new equipment from the city worth $1,000,000 for the ICU which is a miracle. And it would take another miracle for the city to acknowledge that human beings must take care of these newborns during and after surgery.

Russians are very big on new buildings and new equipment, with perhaps not such great followup with regard to staff and ongoing expenses. New buildings and equipment are very glamorous and if I may add an opportunity for some people to earn a percentage of the contract. Ongoing expenses for ICU nurses and surgeons are not glamorous but are yet essential.

It should be embarrassing to them that people from another country are buying suture thread for the hearts of their newborns. It should be embarrassing that we provide groceries for nurses and doctors who are paid starvation wages. I can hardly believe that professionals are willing to work under these conditions.

My reward, to see a month old girl recover from near death, day by day, and finally be discharged from the ICU. Thank you God! If I have had any small part in this I am grateful and humble.

Another curious story is our patient whose father is a cabinet minister in a country which I may not reveal, where there is civil unrest. He urged us to go ahead with the surgery for his child, so that he could return to his country and help with the political situation. We almost never interrupt the surgical schedule for anything non-medical, but this was quite compelling.

Nearly every time I go over there I am tempted to quit as the obstacles are just ridiculous. Then I look into the eyes of a tiny patient, or the hysterical mother or father, and feel that I do not have the luxury to quit. What if it would be my child? They need me and the help that our organization can provide. I must go on, what choice do I have?

Gagarin and Vonnegut

Am working at the children's hospital in Russia. Two events of notice: the anniversary of Gagarin's flight into space and the death of Kurt Vonnegut, fellow Cornellian.

April 12, 1961: Yuri Gagarin is the first human in space. Headlines around the world.

Such is the power of propaganda that I was an adult before I realized John Glenn wasn’t the first to orbit the earth.

Man rises, man falls. Kurt Vonnegut finds a new existence somewhere in the universe. I hope he's having a cool time joking around with Mark Twain.

Consider this: the same university produced Vonnegut, Olbermann, and egregious.

I won’t believe Vonnegut’s dead until he comes and tells me personally.

Speaking of life and death, today we saved the life of a premie who is 2 days old and weighs 4 pounds. Tiny changes create enormous life and death consequences. Political analogy = blog issue du jour. Personally I'm in for the USA's scandal x93.

We were just talking about him yesterday wrt a Vonnegutian moment: once I signed for my own international Fedex package. Sent the package from the U.S., left for Russia a couple days later, went to the hospital, and opened the office door to see the Fedex guy with: my package.

My Russian colleagues had been permitted to read Vonnegut under Soviet times. Why? I asked, he is so subversive. Yes they explained, but he was viewed as anti-American. Somebody slipped that one by the censors.

And so it goes.

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Best friend moving: no April Fools

Stunned to learn that my best friend for many years will be moving to Chicago within the year. Excuse me, but no. It might very well be what is best for her and her family, but it is breaking my heart.

This friend has worked with me from the beginning 11 years ago to support our Russian children's hospital work. When I was considering who I wanted on my new board of directors, she was the first one. She has helped in myriad ways and has come over weekly to help support our work.

Support takes a variety of forms. In theory it is envelope stuffing, however the deeper work is listening to the president rant about the ridiculous, unfair, and evil obstacles to our work in Russia. She has endured a great many of these rants over the course of my thirty trips to St. Petersburg. How shall I prepare for future trips without this feedback?

We met thru our daughters' music and bonded over their teenage difficulties. We found out rather late in the game that both of us are amateur genealogists, active in her case and rather lapsed in my case after writing up 150 pages when the girls were little.

They moved to Hawai'i just at the time when things were becoming chaotic and intense with our work, when we were building a new ICU and planning a new operating room suite. I didn't realize how much I had depended on her for home baked goods and other symbolic forms of pre-trip support until she was away for two years. Hope the military appreciates what I gave up in the interim.

Now it seems I must prepare to lose her to the wider world again. There had better be planes between Washington and Chicago, that's all I can say. Email is good, phone calls are good, but there is nothing quite like the raised eyebrow in support of one's latest rant to feel that things will be all right, because my friend understands.

Senator Webb on war and peace

Senator Webb [man, I just cannot stop smiling at that phrase] was great today on ABC This Week.

Let’s see if this link to the video will work. Ok looks good.

Democrats have pushed the administration into having serious diplomatic talks with the nations around Iraq.

Wounded are being severely undercounted in the official tally.

Backlog of 400,000 for transition to the VA system is part of the Walter Reed mess.

For Rayne—he says Levin is particularly effective on these issues.

He has a poker face when asked about being the VP nominee. I know his expressions pretty well, this is a question he’s obviously heard many times. He says he is enjoying being in the Senate and there is much to do.

Committees: Foreign Relations, Armed Services, Veterans Affairs

Both Armed Services and VA committees have had separate hearings and now there will be a joint hearing.

His take on the Libby trial: part of the overall politics of character assassination by Rove and others against anyone who criticizes the rush to war as he and Wilson both did.

It's so refreshing to see REAL LEADERSHIP in Washington. We have waited so long.

PS---Here's a link for all of Senator Webb's videos at his website.

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Money for hospitals: never enough

I am reflecting on the scandal at Walter Reed Hospital while finishing up the annual report for our charity supporting Children's Hospital in St. Petersburg Russia.

There is never enough money for hospitals. I worked at Mass. General for 4 years before taking time off to raise my lovely children. Who knew it would be a 15 year maternity leave? I couldn't leave them to the care of anyone else. But while I was there I was first a financial analyst, then business manager. In Boston, at MGH---medical mecca---there wasn't enough money.

In Russia our hospital scrapes along as well as it can. Several years ago I saw the health budget for the whole city. Reaction: no way! Where's the rest of it? And that's not even counting the sums that never quite *cough* reach the hospitals. Twenty million in that offshore account would buy a lot of supplies. Just sayin'.

At Walter Reed, I imagine there are similar dynamics in play. The VA hospital system has been shrinking over the last several years, as the bulk of wounded World War Two veterans pass away. The system was totally unprepared for the influx of 30,000 seriously crippled young people from what was supposed to be a quicky war.

Shock and awe. Well, we are shocked at the results, and they are awful: the army's top hospital in a scandal for not caring for its most grievously wounded patients.

When there isn't enough money, it's necessary to be attentive to the necessary choices, as every family on a budget knows.

I think what happened with Walter Reed is that there was chronically not enough money as with every hospital in my experience, from rich to poor. Then thousands of severely injured people came pouring in. Then their plans for expansion and improvement were several years behind the urgent need.

In addition, there may be callous administrators and any number of nearly burned-out people who have been desperately carrying small buckets of water to put out this fire.

So where DID all that money go, the regular Congressional appropriations, the 'emergency' appropriations? Well, clearly not enough to this hospital.

But beyond that, in an era of scarcity and urgent need---which I know a little bit about from Russia---it is necessary to prioritize; to watch your funds like a hawk; and to manage your institution with diligence. It is entirely possible that Walter Reed Hospital failed on all three accounts.

It's easy to be a manger when there are plenty of resources. But in scarcity, you need top people to run things. This didn't happen, and our young men and women who have lost arms, legs, eyes, and sanity are the poorer for it. FOR SHAME.
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Knowledge is delicious

This morning I was having fun researching the proposed skyscraper for St. Petersburg, Russia, the first building over a few stories in the entire city. For Gazprom, it would be in the shape of a natural gas flame, and blue, and astonishingly tall compared with the rest of the city. Architectural and aesthetic battles are ongoing.

While looking up the proposed location, I discovered the Google map showing where it was. This program is not new but I've not been able to find very much in St. Petersburg before. It was all fuzzy, no resolution possible, so they said. I have to believe we have long had the capacity to see quite clearly from sky to ground there.

So hey! Let's look up the children's hospital, there it is! I felt like waving hi or something. Then looked up the city center and my colleagues' apartment buildings.

That was great, what about on the home front. I switched it from Map to Satellite and headed on over to North America. Now we see what the astronauts and cosmonauts see: land with no stripes and words on it. I was astonished how much I think of our country with the state lines and labeled cities on it. Even around Washington it took me a while to find familiar territory.

Zooming in and out gave a very different sense of perspective of how close things were to each other. I kept wanting to switch to Map, to get boundaries and names, but resisted as an experiment. Finally I found chez egregious, and traced the path of my forest sanity walks. It was different that I had supposed.

And so does our perspective vary on other matters, life, politics, creativity. I am experimenting with different levels of perspective in these areas, somewhat uncharted terrority.

I feel that I am looking in Satellite view, and would like to find familiar places with Map. But this time I must draw my own maps.

A man dies in my presence

Speaking to you from the airport in Frankfurt, more than 24 hours after my trip home from Russia began. We took off from St. Petersburg only to turn around for a man with a heart attack. I fear his outcome was not good, since they stopped the CPR. It was a strange experience to sit quite close to where they were working on him with CPR, thank goodness there was a doctor on the flight. I always think about volunteering in case there isn't a doctor available. Memo to everyone: refresh your CPR skills. This could be you.

I have seen many people die in my presence, which is not so common outside a war zone. Except for my grandmother they have all been children. It is an opportunity for prayer, urgent energy, and reflection on the meaning of life and death. What is it which animates this human flesh?

And I think there is something more, beyond what we know here. As a Christian I have certain beliefs about the afterlife, but here is an idea for everyone: There is conservation of matter, conservation of energy, why wouldn't there be conservation of the life force?

Realizing how precious life is, keeps me from quitting time after time. [See below post for me deciding I've had enough, yet again.] NZexpat has such a good quote about pushing back against the forces of darkness:

"I hope the miracles of what you are doing can filter through the curtain of obtuseness, obstruction, and ignorant power."
---------NZexpat of firedoglake

This is deeply healing for me. What are we fighting? Stupidity, selfishness, refusal to see beyond one's own world...yet I am also sympathetic to those things. Every day it is a struggle to think beyond my own mental illness.

To reach out and help other people in an unusual way makes as much sense as hiding at home under a blanket---very appealing many days, especially during my seasonal winter depression. So if it's hard to get thru a normal day, and only a little bit harder to work at a children's hospital in Russia, why not go for it?