Ian Bull's Blog, page 3

How to Meet Someone in Los Angeles

Calling all gals! Calling all fellas! Are you looking for love? Do you work in entertainment, TV, music, or the movies, but you’re finding it difficult to find the man or the woman of your dreams? Is toiling in the dream factory destroying your mojo?            My advice is to leave Hollywood and enter Los Angeles. True, one is a subset of the other, but it’s also a mind-set. I have concrete advice that will get you on point immediately.            Working in the entertainment industry is exciting and wonderful, but when you’re in Hollywood and everyone is chasing the brass ring, a few attitudes can sneak into your life without you realizing it. Years ago I read a line in an article in LA Weekly that stuck with me -- “If you’re at a Hollywood party, half the people there are worried that there’s a better party somewhere else that they’re missing.” I remember witnessing this first hand, when I was at the MTV Movie Awards, which was by far the biggest Hollywood party of that particular week, yet dozens of people were on their cell phones checking out what else was going on in town and planning their next move. It’s a fun roller coaster, but ten years can disappear in an instant. When my wife Robin left entertainment and joined the regular world again, she felt relief, and said -- “I’m looking forward to finding out who my real friends are.”            On the flip side is Los Angeles. I remember being at an art opening at the old Wacko Soap Factory and Luz de Jesus art gallery on Melrose, and a movie star showed up with a camera crew in tow.  The publicity was going to be mutually beneficial to the movie star, the artist and the gallery, but people resented the feeling that the camera’s presence somehow legitimized the event and only then made it real. I heard mutterings from the crowd -- “I hate it when Hollywood invades Los Angeles.”            Now take that tension between the dream industry and the city, and lay it like a blanket over the single dating world. The over-judging, self-doubting and ceaseless worry can drive you crazy. I see so many talented and attractive young people with whom I work, torturing themselves with their Hollywood blinders on, just like I did fifteen years ago. But here’s my advice for you:            If you want to find someone -- leave Hollywood and go to Los Angeles.Forget the screenings, mixers, clubs and bars. Los Angeles is vast and confusing, but she’s getting better at providing a way into her mysteries. Here’s one coming up:                        Dance Downtown, at the Music Center



            Starting Friday evening, May 16th, and continuing every second Friday night through the middle of September, you can come to the open plaza between the Dorothy Chandler Pavilion and the Mark Taper Forum and dance with complete strangers.            Imagine this --            After a long week at work, you knock off early on Friday, let’s say 5:30. You have nice set of evening clothes with you, so you can change outfits at work. Guys trim their beards and don their small fedoras while girls slip on colored skirts with long sleeved lace tops and a statement necklace.            You head downtown early. The earlier you go, the cheaper the parking is, but you can arrive as late as 6:30 and pay 8 to 12 dollars to park at the Music Center itself.            The weather is perfect in a way that only happens in Southern California. It’s warm with a light breeze, and there are no bugs. The sky is golden as the sun starts to set, lighting up the Grand Park and City Hall in the distance below you.             You know those temporary moveable dance floors you see at weddings? They put one of those down, but big enough for two hundred people, right in front of the Lipschitz stature to World Peace, and a night of open air dancing ensues. Every second Friday is dedicated to a different dance style. This year the schedule features 60‘s dancing, Colombian Cumbia, Tango, Two-Step, Bollywood,  K-Pop, Samba, Disco, Salsa, and more.


            From 6:30 to 7:30 an instructor will come on the microphone and teach you the basics of that night’s dance style. As the sun begins to set and the sky darkens, they turn on strings of Chinese paper lanterns that they’ve strung across the dance floor, so it really does feel like a wedding for two hundred people. There’s beer and wine for sale, some people bring picnics, some people bring cakes and dessert to share, just to strike up conversation. Wander around and chat and have fun. You’re now in Los Angeles.




            And then, you notice the women. Or, if you are woman, you notice the men. You’ll spot the dance fiends in the crowd right away. They’re wearing beautiful tailored clothes in colorful silk and linen, usually sharp retro fashion from a better-dressed decade, but loose and comfortable enough for dancing. Yeah, they’re showing off, but they’re pulling it off too. Almost everyone else is in their version of their Sunday best, and men and women circle the perimeter of the dance floor, checking each other out and making eye contact. It feels like a cross between a Sunday promenade in Mexico or Italy, and a dance from the 1940s. You spot someone you like on the dance floor, and you and your wing woman (or wing man) move in.            You’re supposed to line up and pay attention to the instructor, but you spend as much time glancing around and smiling awkwardly at the people around you. Relax, it’s okay, because everyone else is doing it too.            The instructor makes you rotate partners, even if you came with a significant other, so you‘re forced to meet a lot of people. And you’re forced to touch them. You’re supposed to touch, folks, it’s dancing. Hands hold hands and you twirl. A man puts his hand on a woman’s back and they both say “hello.” You’re allowed to stand close and move in rhythm. It’s not just allowed, it’s required. A foot steps on a foot, you laugh and apologize, and you try to pay attention to the instructor while you look into your partner’s eyes and trade small talk. It’s a safe and easy way to meet someone disguised as a dance lesson. Plus, I think you can size up someone pretty fast on a dance floor.




            From 7:30 to 10:00, it becomes a public open-air dance, with men and women just having fun. Some people are slick show-offs, and others hang on the edge of the dance floor, afraid to reveal that they have two left feet. The men look rakish and sharp, and the women are chic and well-coiffed. It feels grounded and natural, and it gives people an excuse to meet, talk, and to stay together longer, or to move on. There are people from every decade of life, from every background and race, and you will spot someone alluring who is within five years of your age and you will feel a magnetic tug. Let celestial gravity draw you close enough together to fall into each other’s orbit. Trust me, you won’t regret it.            People dance, people eat, people drink, people talk------people hook up. I’ve seen it every time my wife and I have gone. And there’s no pressure. There’s another one in two weeks, so if people want to see each other again, but don’t want to trade numbers, they’ll be another one soon enough. As the sun sets you can stay and dance, or go out to dinner -- and there’s plenty hip eateries downtown.            When I’m there I always feel like I’m part of Los Angeles. It’s quaint compared to the high-powered Hollywood party going on somewhere in the hills above Sunset, but it’s fun. Both are good and both have value, they’re just different.


            Robin and I had our first date down at the Music Center. It wasn’t this event, but the fact that our first date was in Los Angeles and not in Hollywood made a difference, I think. I was out of the dream factory and in the real world long enough to be awake and see what was around me. It was also when I started to fall in love with Los Angeles.            And it’s FREE!! You just pay for parking, or for the subway if you ride Metro.            Guys, girls, pick your outfits, pack your picnics, bring your desserts and be ready to dance and meet someone awesome. It’s funded by the James Irvine Foundation, it’s all to benefit the Music Center, the arts, and downtown Los Angeles:            http://www.musiccenter.org/events/activearts/Dance-Downtown/

Pandamonium!

As I helped my daughter research her 3rd grade project on Giant Pandas, I was struck by a couple of things:

1. How cute they look at first glance.
2. How utterly creepy, moronic and disgusting they are once you really get to         know them. 

Let’s start with their appearance.  Those sweet, fuzzy faces with the adorable black patches around their eyes?  Look again, and you’ll see that a panda is nothing more than a giant furry black and white bear costume with a smaller demonic person inside.  No, seriously.  Look at the little human eyes inside the black patches.  Eww.  Creepy. That might work for a plushie or a furry (sexual deviations you can look up elsewhere), but it doesn’t work for me.
When they are first born, panda cubs are pink, blind, toothless, and completely helpless. They weigh between 3 and 6 ounces, and are about as long as a stick of butter. A stick of rancid pink butter. They look like hairless pink rats and are repulsive to look at (though maybe my particular disgust stems from an encounter with a pink hairless dog in Bali, but that’s another story). They are 900 times smaller than their mothers -- there is no other mammal mother who has babies that are so small compared to her size, which is weird in and of itself.









Two is a good number in Chinese culture. There is a Chinese saying, "good things come in pairs". That’s why you see double symbols in Chinese product brand names, e.g. double happiness, double coin, double elephants. But that doesn’t translate when it comes to twin panda cubs. If a panda Mother has twins, she lets one die so she can take care of the stronger one. Be strong, little panda cub!

Giant Pandas are notoriously sex averse. Panda Girl can only conceive 2-3 days a year and that is the only time she sees any action.  Well, she doesn’t actually “see” the action, because Panda Boy takes her from behind, Panda Doggy Style. The rapturous lovemaking goes on for a laborious 30 seconds. That’s it.  No after sex cigarette, no pint of Haagen Dazs in bed and definitely no morning afters. It’s not a one night stand, it’s a 30-second stand.  
Who’s your Daddy? That 375 pound, 6 foot tall lug disappears after the 30 second love fest, never to be seen again.




Because Giant Pandas are endangered, Chinese scientists have spent millions of dollars and gone to extraordinary (some might say absurd) lengths to perfect a captive breeding program for the notoriously shy, sex-resistant animals. Using methods ranging from Panda porn movies (watching other pandas copulate—it’s unknown if lacy red lingerie and stiletto heels are worn, but that image amuses me) to electric rectal probes and Viagra (yes, Viagra; and no, it didn't work), they were able to cough up some new panda cubs.
Their taxonomic classification is carnivoran, meaning that Pandas are carnivores (meat eaters), but, get this: the panda's diet is over 99% bamboo! And they can’t digest plants! I guess nobody told them about their species, so they just keep eating food they can’t digest… as much as 45 pounds of bamboo a day! Pandas eat fast, and they spend up to 16 hours a day eating. They also poop about 60 times a day. They are sluggish because they need to conserve their energy, since they get none from what they eat. They should be eating burgers instead of bamboo! And that is an illustration in Panda Stupidity.







Speaking of food, who wants feces and urine for lunch?  Panda mom raises her paw and says, “I DO!” After she nurses her cubs, she licks them all over “down there” to stimulate them to go Number One and Number Two.  And while she’s down there she hangs around for the best part…eating their poop and pee.  Yum!It’s said she does that to eliminate smells, though I think a spritz of Glade air freshener beats that hands down. Note to Panda moms: You’re taking “odor eaters” a bit too literally. 
Not enough potty talk?  Giant Pandas mark their territory by spraying urine as scent markers. Nice.
And back to the cute factor.  Giant Pandas are not aggressive, but they will attack if annoyed. So don’t annoy them.





I think the whole panda phenomenon can be summed up with this quote found on Yahoo Answers from Eggman: “They are really cute, so people tend to think of them as harmless, but they will kill you and eat you if you aren't careful around them.”

my daughter doesn't sleep

My daughter Lily doesn’t sleep well. She never has. From her birth to age six, she only slept through the night twice. I earned my grey hair during those six years, because I never slept a full night either, except when I was out of town. This was by choice; my wife Robin has trouble sleeping as well, but I always fall asleep easily, so we play to our strengths.            We tried every method and cure on Lily, but nothing worked. We were firm, we were indulgent, we had a schedule, we had a routine, we gave up on the routine, we stopped all electronics, we changed her diet, fed her more fish, we went to doctors, we did a sleep study, we even studied restless leg syndrome and iron deficiency. She needed to sleep and so did we, so we never gave up. Then, gradually, over about a year, she started to sleep through the night. She simply grew out of it -- mostly. She still has some trouble, and about once a month she wakes up in the middle of the night and can’t get back to sleep...like last night.            Lack of sleep fucks with your mind. Worrying about sleep fucks it up even more. I’m messed up today, and so is she, and the only solace is that once we get through the day we’ll probably sleep like logs tonight. Like I tell her, there has NEVER been a night where she didn’t eventually fall asleep.            I also had trouble sleeping when I was a kid. My problem was falling asleep. I think I mostly did it to myself. For whatever reason, I wasn’t tired when I went to bed and I’d lie there awake and start to worry about what my body was doing.            Am I sleeping now? Is this sleep? Am I falling asleep...now?            And I’d wake myself up. I worried myself into a state of on-and-off insomnia that lasted over a year, and it made me afraid and anxious. I remember enjoying a beautiful day with my family and then suddenly thinking that it would end and night would come, and I’d be filled with dread. I was afraid of the night in the middle of the day. I hated that feeling, yet it dominated my thoughts. However, I consider the experience a lucky gift now because when I see Lily experience the same dread, I can reassure her: I was like you. I know the feeling. It will pass. Don’t be afraid. I will help you.             Lily’s problem isn’t falling asleep. Her problem is staying asleep. It has many names, and it has many causes, but a lot of people have it, and it’s part of who she is. My grandmother had it her whole life. Our good friend Julie Murphy has it too, and when she babysits Lily she laughs and reassures her that she is not alone, because they share the same trait as well: I’ve never been a good sleeper either! I always wake up!            When Lily was two years old we visited San Francisco, and when we asked her what she liked most about the trip she said “watching TV together in the hotel bed.” I laughed, since that had nothing to do with the actual trip itself, but then she stopped me and said with a tear in her eye:            No, daddy. Sleep is hard for me. When I wake up, I’m alone.            She said that out loud at the age of two.From that moment on, I promised her that she wouldn’t have to worry alone about it again, which comforts her.             After eight years of light sleep, I am finely tuned to her night patterns. I can be dead asleep and hear a bump in her room and the floor creak, and I am instantly awake, no matter how little sleep I’ve gotten. I lie there and listen to her. She’ll get out of bed, creep down the hall, go to the bathroom, get a drink and go back to bed. If I hear a sigh within five minutes I know that she’ll go back down. This is how it works almost every night now. But once or twice a month, she doesn’t go back down. The sighs continue. I know that the mental spinning has begun:            I can’t sleep. I am alone. No one is with me. When will I sleep? I have a math test today. I can’t sleep. I can’t get comfortable. I’m too hot. I’m too cold. My blanket isn’t perfect. I can’t sleep. My life isn’t perfect. Lila will corner me at recess today, and won’t let me play with Carmen. I’m thirsty. I can’t sleep. Why am I alone?            After ten minutes, she may get out of bed and wander the house. That’s when I remember how my own dread worked at age ten, and I get up. There’s a blanket ready at the foot on my bed and I take that, steer her back into her room and we get back into bed together and I reassure her, an adult man and a girl, lying together in a small double bed:            You are just like me. Don’t worry. You’re not alone. This too will pass. I turned out fine and so will you. This is normal too. You ALWAYS fall back asleep. It will happen.            We have about a thirty-minute window. If I can get her eyes closed and her mind calm within thirty minutes of that first sigh of dread, we can both go back down and only lose 30 minutes of shut-eye.            If it goes longer, things get tough. Damn it, she’s just awake. Who knows why? And suddenly I’m awake too. I don’t give up, however. I massage her back and feet, I touch her face, we snuggle, she puts her head on my chest and feels my heartbeat as I slowly breathe. We both do ten breaths. We count slowly to one hundred. I tell her a boring story in the dullest whisper I can muster. Everything I do is slow and repetitive so she can focus on something else besides her elusive sleep.            When she was younger and still small enough to carry, we had other rituals. I’d pace the house with her in my arms, and she’d eventually fall asleep on my shoulder. When that didn’t work she’d ask to go outside. The cool air would calm her and regulate her senses. I would always sleep in sweats with flip-flops by the bed in case we had to go outside, so I could wrap her in a blanket around me. I have vivid memories of walking up and down our street in the middle of the night in all kinds of weather, with the moon shining through the clouds, or with a cold breeze blowing. The world was quiet except for the rustling leaves from the wind, and the 101 Freeway rumbling a mile distant. Sometimes I’d hear a train whistle, which was at least five miles further away.  A police car drove by once and the officer lowered his window, but when he spotted Lily they just nodded, waved, and rolled on. A sleepless father and child walking in the middle of the night is not an unusual sight for them, I guess. We’d then go back inside and collapse, and sleep would overtake us. This is the second best scenario because we only lose an hour or two of sleep, which is what happened last night.            Once every few months, however, sleep doesn’t return. If after two hours of trying, she’s still awake, we give up. I understand her frustration at that point -- the whole world is dark and she is alone and wide awake, which is irritating and lonely, and it’s better to just do something else.            We lie and whisper in her bed, and I tell her about my childhood, and we talk about her fears and hopes and dreams. There’s a tall redwood tree in our neighbor’s yard and in the past two years an owl has moved in, and late at night if we lie still we can hear the owl calling. One night there was a lightening storm and we went on the back porch and watched the crackling bolts streak across the sky. We sing songs and I tell her about falling in love with her mother, or how I would walk to school with my brother when I was her age, and that we even took the bus downtown for karate class, which she thinks is amazing.  We pull back her curtains and stare at the redwood tree next door and look for the owl, and stare at the stars. She usually falls asleep before dawn, and I lie awake, listening to the silence. For me, I no longer hear true silence. When there is absence of noise I hear a slight ringing in my ears, which is like a background hum while I watch her sleep until I finally pass out too.            I don’t wish her challenge on anyone, but it’s made her resilient and given us time together we wouldn’t have had otherwise. I want to commission a painting of Lily staring out the window in the middle of the night, her braids on her pillow and her mind full of thoughts as she searches for the owl in the tree.  We all have issues, and our challenges teach us and have their benefits, and Lily is mature beyond her years because of it.            A few years back every night was rough and the days were sometimes rougher. I was producing a show for Ted Skillman of Snackaholic, and he could see that I was exhausted, so I explained my whole story. To his credit, he found my plight intriguing and didn’t make me feel bad about my performance -- he knew my work would get done.             He also confirmed how typical Lily’s condition is, and may actually be normal. He explained how sleeping eight hours straight is actually new in human history. Before electricity, before the constant 24-hour clock, our waking and sleeping rhythms ebbed and flowed with the seasons and the work that needed to be done. Sometimes we slept ten hours, sometimes more, sometimes less. There was usually an “awake time” in the middle of the night, when people would wake up after four hours of sleep, and they’d enjoy the night for two or three hours, and then sleep another four.  They’d eat a meal, make love, look at the stars, study astronomy, write a letter, philosophize -- all in the quiet darkness, slow and unhurried. It was a night rhythm, like cats padding slowly through the alleys at night. Thoughts could come, drifting on a river of life moving deep and slow in the darkness. Discoveries, decisions, observations and appreciations were made, all in slow time.            Maybe there’s nothing wrong with Lily at all. Maybe she has it right, and the rest of the world is wrong. When I told her what Ted told me, we both smiled. We own the night. We’re in no rush.

Here’s some information on divided, or segmented sleep: http://en.wikipedia.org/wiki/Segmented_sleep
Segmented sleep, also known as divided sleep, bimodal sleep pattern, bifurcated sleep, or interrupted sleep, is a polyphasicor biphasic sleep pattern where two or more periods of sleep are punctuated by periods of wakefulness. Along with a nap ( siesta ) in the day, it has been argued that this is the natural pattern of human sleep. A case has been made that maintaining such a sleep pattern may be important in regulating stress.Historian A. Roger Ekirch has argued that before the Industrial Revolution, segmented sleep was the dominant form of human slumber in Western civilization. He draws evidence from documents from the ancient, medieval, and modern world. Other historians, such as Craig Koslofsky, have endorsed Ekirch's analysis.
This is a news report on divided sleep:
http://www.bbc.com/news/magazine-16964783
This is on sleep and the teenage brain.
http://www.brainpickings.org/index.php/2013/07/17/sleep-and-the-teenage-brain/
Most of all everyone...take naps and sleep!

Uncle Jim

My Uncle Jim passed away last week at the age of 83. He grew up the middle son of three, sandwiched between my Uncle Bob the eldest, and my own father Andrew, the youngest. There had been a fourth brother, Donald, after whom I am named who died before the age of ten.            Jim Bull was the fun-loving middle child of the three boys, which is actually a serious and important role in any family. Being a middle child myself, I understand how a well-timed silly comment can diffuse the family tension around the dinner table, while other family members dig in their heels, hold grudges, or mentally check out. We become the bridge-builders between parents, parents and children, and between brothers and sisters. Uncle Jim was willing to listen, willing to teach, and willing to play the jokester to keep people talking.


            It comes not from a desire as much as a need -- the oldest and youngest are secure in their roles, but when you’re in the middle you feel most secure when all others are secure. When I saw my Uncle Jim in action, talking with my grandparents and brothers, I recognized myself in him.            He was an accomplished and award-winning teacher, both at the high school and university levels, a calling I now hear as well and which I hope to make one of my next vocations.            He was my father’s best friend growing up. When my mother first dated my father, she knew him as “Jim Bull’s younger brother,” since all the young women throughout the small town of Fort William, Canada knew Jim. My mother has a vivid memory of him showing up to a high school football game with his then girlfriend, dressed in straw hats, raccoon coats and waving pennants as if it were the 1920’s.            He made chores fun -- when we visited his family at their cabin on Lake Shebandowan, he’d gather the boys from both families and we’d go out on a hike. The miles were filled with jokes and laughter and we ended up carrying back wood for the stove and fireplace, not even realizing we were doing chores. I try to use his technique now as I raise my daughter Lily.



            I felt special because as an uncle he wanted to be in our lives and wanted us to know him as our father’s brother. He anointed himself “Uncle Adonis,” and insisted we call him that, which was both absurd and hilarious, but also a name only we nieces and nephews could use, and each year we’d get a new Uncle Adonis photograph for the refrigerator.



            He was also my father’s best friend growing up, and he could soften my father’s more serious personality. My father was happiest and had the most fun when some other man around him gave him permission to relax and have fun -- and that was often Uncle Jim. One long summer James Bull and his family left Canada and came to San Francisco to spend three months with us, and that summer was a highlight of my childhood, with two big families under one roof. All summer long it was day trips, Giants games, camp outs, and Disneyland.


            No one gets out of life unscathed, and the Bull boys had their share of problems. Youngest Donald passed away in childhood. My own father died twenty years ago from pancreatic cancer, meaning my Uncle Jim outlived two younger siblings. Jim was in a car accident in 1989, which almost killed him, and the resulting brain bleed took away some cognitive function and robbed him of much of his vitality for the last 25 years of his life.



            My cousin Jeff helped take care of his Dad in the final years of his life, while he was also raising his three own boys...just as I remember my Dad and my Uncle Jim taking care of my grandparents as they aged.            Now the life cycle is repeating again with me. I am raising a daughter and supporting a family while also working with my brother and sister as we help our own mother decline with dignity and grace. While we do her taxes, plan her long-term care, and argue with her about her health, Lily looks forward to time with her cousins, just like I did with my Uncle’s family. And like I once was, she is vaguely aware of her grandmother’s decline and the work her children are doing, a job she will inherit when she takes care of me one day.



            The business of life invades our busy schedules while we make all our other plans, but it is the business of growing, living and dying that makes us human. When I wake up in the morning I have so much I must accomplish for three generations, yet now is the age that I feel truly alive and aware of life’s continuum. I see the beginning, middle, and end, all at once. I also feel alive because I know that it’s passing. Years pass, roles pass, torches pass, mantles pass, and people step into their new roles and life goes on. 

From the Mouth of Babes

Since my daughter Lily could speak, she’s made some hilarious statements. All kids do; what makes Lily’s statements different is that I wrote them down. As I read what she’s said over the years, I feel how she’s changing from adorable to adult, from precocious to profound, but losing her innocence on the way.
Age 2:After coming home with a haircut: “Daddy your head got smaller!”During a rainstorm: “The rain is a massage on my ears.”While playing hide and seek: “Look at me! I’m hiding from you!”In a large restaurant bathroom with an echo: “Listen! My voice is dancing.”
Age 3:After hide and seek: “I was hiding and I found myself.”“I can burp and fart at the same time.”Staring at cereal on her spoon: “Is he a creature? I don’t want to eat a creature.”“We’re American? I thought we were Jewish!”When Lily’s head gets stuck in her shirt before popping through: “Don’t worry, I’m not scared of the dark inside my shirt.”
Age 4:After building a house for the fairies out a shoebox: “These fairies are making it very hard for me to believe in them.”After watering the plants in Lily’s fairy garden, Lily said the water on the blades of grass “looked like beads of glass shining in the sun.”While rolling her eyeballs like marbles: “Look, I can make my eyes go in circles!”Throwing her hand up at the dinner table: “Raise your hand if you like Lily!”
Age 5:Looking at a tree in winter, with no leaves: “That tree looks like it’s full of Chinese writing. The twigs are the brush strokes.”
After a nightmare, in which a giant squid visited her in her bedroom: “He knocked on my door and whispered ‘wake up Lily, I’m going to take you away,’ and then smashed the door and stuck in a long tentacle -- and then he slapped me with his tentacle and said ‘NOT!’ and left. Then I woke up!”
She had a dream in which we were all genies in a castle: “Daddy could float up high, Mama could float where she wanted, but I was still learning and was hanging onto the castle doors.”
Talking about a mean girl in the playground: “I took her bad words and I threw them in the garbage, and I took the nice words and held them in my heart.”
After finishing her chicken dinner; “Chicken Accomplished!”
“This new gum tastes like a convention of fruit.”
“The irises of Mama’s eyes look like the part of the artichoke just before you get to the heart.”
After I inflated a blue doctor’s exam glove: “Finally, I have an udder! I always wanted an udder! Now milk me!” (She then insisted we milk her.)
After learning she could have French fries: “Holy cannoli, hit myself with a meatball!”
Age 6: Lily asked me to throw her over my shoulders and carry her around upside down. Hanging by her heel she says: “Ahh...this never gets old.”
Waking up on New Years Eve: “I just had a dream that I had a play date with the entire world.”
“If there is a God, he must be inside us. It’s not like he’s in the sky and looking down like he’s watching TV or something.”
Robin and I were whispering while Lily was in bed, and Lily asked why. We told her we thought she was asleep and we didn’t want to wake her.  She said: “If I’m breathing slow, I’m still awake. If I’m snoring and drooling on myself, THEN I’m asleep.”
I asked her if she wanted her bedroom light on in the morning: “No, my eyes are still committed to darkness.”
Her aunt Andrea complimented her on being so well-behaved: “Not at home...trust me.”
“I can feel myself growing. It’s like a tingling.”
Lily is watching a TV show in which the dad is present but the mom is rarely around. Robin asks where the mom is: “She’s always out buying groceries, like you.”
We were playing balancing games on the front lawn and I had to stop because I had a muscle spasm: “I know the feeling. We all have pain in our lives, daddy.”
Lily started a spy club, and initiated Robin and I in as members by touching our ears, noses and shoulders: “We spy on people, and if there are no people, we spy on stuffed animals.”  These are the rules of her spy club: “Be respectful, help others, be nice, and never punch or hit.”
Age 7:As we walk down to an isolated cove overlooking the bay: “Let’s search for something mysterious!”
“Daddy, I want to go to the patent office and get a patent for the words I invent. That way people have to pay me to use my invented words.”
After creating a fort in her room out of purple sheets and blankets: “I have created a purple world.”
“I dreamed I could fly, and my braids were spinning like a helicopter.”
Age 8:“I am going back to sleep to find a better dream.”
“I’m just goofing around. It’s my duty.”
“I don’t want a birthday cake this year. I want sausage. I want a birthday sausage.”
Lily’s nightmare (with tears): “I was visiting friends who had fairies in their home. The grandmother hated the fairies and tried to kill them with a hammer, but the kids objected. The grandmother then said she would punish the kids and me if we refused to help her, and she made me wear an orange vest to do her dirty work. I said no and took off the vest.  The grandmother said she didn’t care and lit the house on fire, and as the house burned I watched a fairy burn in the flames.”
When I confront her about the amount of clutter in her room: “But Mama and I love our stuff. This is the way we live. Don’t try to change us.”
“Daddy, promise me that when you die you’ll be buried, and not cremated. I don’t like the idea of you being cremated.”
Consider these statements protected by copyright. They will end up in some book or script someday.  What about you? What’s the wildest thing your kid has said?

Hidden Costs, Hidden Payments -- THE BLOOD CHURN

This is the third blog post that examines the cost of health care in California -- and how money is being spent and maybe wasted.
This week, I need your feedback.
I’m afraid that someone is churning my blood.
Let me explain:
            There’s an excellent rheumatologist with a medical office in the Cedar Sinai Office Tower.  I will call her Dr. Stephanie, although that’s not her name. When you call Dr. Stephanie’s office to book an appointment, the office requires you to have a blood test, before you can see Dr. Stephanie. You may only need to talk. You may want her to look at a report done by another doctor. You may have had a blood test done earlier in the week, for another doctor in the same office tower. It doesn’t matter. You must have a blood test.            Dr. Stephanie’s office then charges my insurance $900.            My insurance pays 90%, so I end up paying $90, until I reach my deductible limit.            When I book an appointment to see my regular internist, they also want a blood test. Sometimes I may be going back for a follow-up appointment, or to get a referral to another specialist. Again, they draw blood. He charges $400, which my insurance company pays 90%, and I pay $40.00.            I am familiar with blood tests, and I’ve had them many times, for everything from prepping for surgery to a medical exam for a life insurance policy.             A blood draw is a hassle, especially if you’re getting a lot of them. For proper results, I’m not supposed to eat 12 hours prior to a blood test. So what if I have an appointment with Dr. Stephanie at 3:00 in the afternoon?  Do I wake up at 3 in the morning to have breakfast? Usually it means I must go hungry all day, and I’m starving by the time I get to the doctor’s office. Or, I can go first thing in the morning, get the blood draw, then eat normally, and then return at 3:00 for the appointment. That’s two trips in the car and more time off work, but at least I can function and I won’t be chewing on my knuckles all day.            Yet, it’s often me who must clarify what I need to do before a blood test. This is a typical conversation I have with most medical offices:            THEM: You’ll need your blood drawn before you see the doctor.            ME: Okay. Can I come in the morning for that, and then come back?            THEM: You want to come here twice? Why would you want to do that?            ME: Because I don’t want to go all day without eating. Don’t you want me to fast?            THEM: Oh, right. I guess you should fast before a blood draw. Please hold.            ME (TO MYSELF ON HOLD): Is this a joke? Is this test even real?            THEM: Yes, it’s okay if you come in the morning and then come back, but make             sure you explain why you’re here.            It makes me suspect that the “required” blood test is just the doctor’s office churning my account, to get easy money from the insurance company to help pay for their expensive overhead.            I get doubly suspicious when I don’t get the results of the required blood test. I ask them to call me or e-mail me with the results. I don’t need much. Just tell me that everything’s fine, or e-mail a photocopy of the results with some scribbles in the side, I can then save it for my records, and compare it to the results of my next blood test. I am also paying between $40 and $90 out of pocket for the test, and my insurance is paying even more. I expect that communicating the results is part of the cost.            Or maybe it’s all a sham.            What do you think? Are they churning my blood?            I spend too much time writing stories in my head, and naturally I made one up for the excellent Dr. Stephanie:            She is in private practice by herself, so she doesn’t split the cost of the office with another doctor, which is a lot of overheard to pay each month.  She also deals with a variety of insurance companies, which don’t pay in a timely manner. She may perform a procedure in January, but not get paid by the insurance company for 60 to 90 days. They may also dispute her bill for a variety of reasons, from a new medicine she prescribed, to using an unapproved device in a surgery.            Dr. Stephanie still has tens of thousands of dollars in student loans she’s paying off, even though she’s in her late 30s. After all, when she finished her final fellowship at age 33, she was $250,000 in debt before her career even started.            So how can Dr. Stephanie keep her business moving with a good cash flow? How can she afford to hire an extra person to man the front desks, or ask the insurance company for more timely payment, or afford the newest diagnostic machine?            Simple: she charges $900 for a blood test.            It’s a fast and easy way to get money coming in.            The longer I wait, the more suspicious I become. It also makes me question the larger cost we are ALL paying for health care. Are all the doctors “churning” the blood tests? Is it all one big blood churn? If every visit requires a new blood draw, how much extra cost is it adding to our health care system?            I then write a different story in my head, where the blood test is justified. Some specialties rely on a lot of blood tests. A pregnant woman gets her blood drawn on every visit to the doctor. A pregnant woman’s blood reveals a lot about an unborn baby, whom the doctor cannot examine firsthand. Dr. Stephanie is a rheumatologist, so she deals with the diseases of inflammation and pain, like arthritis, lupus, auto-immune disorders, and fibromyalgia. The blood is where she may glimpse your problem. She’s not setting broken bones or dealing with rashes, where the problem is obvious. The blood test may be the best tool she has.            Then I think that maybe the blood test protects the doctor. Let’s say I’m seeing two doctors in one week. Is my blood on Monday going to be that different than your blood on Wednesday? Can’t the second doctor just get the same blood results from the first doctor? Sometimes they’re using the same lab! But if that first test misses something, that second doctor may end up answering for it later. I can imagine the lawyer asking the questions:            You mean this medical problem could have been identified with a simple blood test, yet you didn’t order one? Instead, you relied on the blood test done by another doctor’s office, earlier that same week? Why so negligent, Dr. Stephanie?            Maybe doctors are afraid of being sued, so to cover themselves they get a blood test every time to reduce their risk.            However, I have another question as I sit in the doctor’s office, twiddling my thumbs: Why don’t they call me with the results? Am I an oddball?            I guess most people assume that no news is good news, and if there was something wrong with the blood test they’d call...or worse, ask you to come in to talk to the doctor face to face. Maybe I should go with the flow (or blood flow).            I look around and count six people waiting. Let’s say the doctor sees twenty to forty people a day. Maybe they don’t call because it’s too much of a hassle for them. If a doctor or nurse practitioner called every patient who got a blood test, that’s a lot of time on the phone, mostly to reassure people that everything is normal.            But I’m still hungry and waiting, and the longer I wait, the more I suspect a churn after all.            My father was a doctor -- an ob/gyn, and he drew a lot of blood out of women over the years. He got together with four other doctors in the same medical office building, and they invested in a blood lab. That meant that his personal practice got paid a certain amount for drawing the blood and ordering the test, and then the lab made money actually running the tests on the blood. It was a good financial hedge bet. While the insurance company sometimes delayed payment because it objected to how a surgery was done on a particular patient, the payments for the blood tests, and from the lab were pretty steady.            As I sit, desperate for caffeine and an Egg McMuffin, my mind turns dark and I wonder if Dr. Stephanie and my internist both own a piece of the lab downstairs.            No, I’m being too resentful. I should give them the benefit of the doubt. They’re being squeezed by the new economy, just like the rest of us.            I have one more flip flop in me, however.            I come home and my wife shows me a letter from her doctor announcing he will be charging $500 a year to all regular patients, for maintaining their medical records. The $500 will cover the cost of photo-copying and sending her any records she requests (including blood test result), and also calling her and talking to about her medical condition (including the results of your blood tests). She can opt “out” of the $500 charge, but she’ll need to book a separate appointment to come in and discuss her case. No more free follow-up calls.            And before she can see the doctor, she’ll need to have another blood test.            What do you think? Is it all one big blood churn?             How much extra cost is it adding to our health care system? It seems inefficient and wasteful, but it may be the fat that greases the system so the doctors can keep moving.            But I’m tired of losing blood and being hungry.            I am one patient, one consumer -- am I wrong? Is there something I’m missing?             I’d love to hear from you!

Be Your Own Medical Advocate: The Reference Number and the Diagnostic Code

The best movie of the year is Dallas Buyers Club. The Oscars are this Sunday and I hope it wins Best Picture and a wheelbarrow of golden men.            Ron Woodroof, the main character, discovers that to survive he must become his own medical advocate, and the best way to do that is by being a medical advocate for other people at the same time. Ron is willing to break the law, skirt the law, and offend people in the process (which I don’t recommend) but in his mind he must do it survive.            Growing up in San Francisco in the 1970s and 1980s, I saw how AIDS destroyed lives. As a budding wannabe journalist, I also met several Ron Woodroof-type medical advocates, and they impressed me with their patient persistence.            I remember one man with HIV, Steven, who was working hard to get insurance companies to pay not just for Pentamidine to help combat the onset of pneumocystis pneumonia, but to get them to approve aerosolized Pentamidine, so AIDS patients could breathe it right into their lungs and fight the pneumonia that often killed them. Insurance companies had not yet approved this new method of treatment.            Steven was a medical advocate for three men with AIDS who were too sick to fight for better care for themselves, and he took a living stipend so that he could work full time for them, and also for himself. He worked the phones all day, five days a week, on their behalf, and his own, and fought for service he could get for them. As he grew sicker, he knew he may need to then pay for his own medical advocate who would then fight on his behalf. I had a lot of respect for him working those phones.              You may need to become a medical advocate yourself some day, and work to get great care for yourself, a parent, spouse, loved one, or a child. You may want to behave more like Steven than Ron Woodroof, but you’ll need to be patient and persistent.            The American Health Care System works, if you have a challenge they know how to address. You may be having a baby, need to set a broken bone, or need surgery. The care, the cost, and the payments and the insurance are pretty straightforward. Problems start when you have a health challenge that doesn’t go away, doesn’t get better, and they don’t know what to do. Or, your doctor wants to try something new and different. Expenses rise for everyone, and a complicated game begins.              That’s when you’ll need, or need to become, a medical advocate.             Here are some tips on how to become patient and persistent.
1)  Keep a phone log, and make sure they keep one too. Keep a log book. Whenever you call a doctor’s office, a billing department, or an insurance company, write down the name of the person to whom you are talking, get their extension (if they can give it), and write down all the details you can about your conversation. Ask them if they are logging the conversation as well.  Before you hang up, go over your information to make sure it’s accurate, and ask the person if you should ask for them personally the next time you call. Finally, ask if there is a reference number for the call, so that you can refer to it the next time you call them.
2)  If you are talking to an Insurance Company, each call has a Reference NumberThis is important. Insurance companies are run by people. The rules are so complicated and changing so quickly, the assurances that one person gives you may not backed up by the next person you call. This is a bad conversation to have:            “I just got my doctor’s bill, and my new asthma breath test wasn’t covered by my insurance, but when I called last month, Debbie said it was.”            “There’s no Debbie here.”            “I called on the 21st, and 9:30 a.m. and talked to Debbie, and she said that my policy would cover that visit and that test at 90%.”            “Sorry, whoever told you that was mistaken, or you heard it wrong.”When you call and get information and assurances, make sure you get the reference number of the call, and write it in your log. This way, your conversation will go more like this:            “I just got my doctor’s bill, and my new asthma breath test wasn’t covered by my insurance, but when I called last month before my visit, Debbie at extension 712 assured me that it was. May I give you the reference number of that call?”            “Sure, give me the number and I’ll look it up for you.”            You must track your costs, and who pays -- otherwise you will pay more. At the same time, listen to what the voices say while you are on hold. When you call Blue Shield, the recording does say that (I am paraphrasing) the conversation you are about to have is not a guarantee of services, coverage, or payment.              That’s an even better reason to get the reference number, since it allows you to keep the conversation going, even when they get their information wrong.
3) Doctors offices don’t really know what insurance covers. If you call a doctor’s office and book an appointment, you may wonder if the visit, the procedure, the drug, or the diagnostic test you will have done is covered by your insurance. The hard-working staff may assure you that it is covered. They may even sound like experts, since they work with insurance companies every day.            But your doctor’s office is NOT the insurance company!  Offices are run by busy people who write, enter, print, bill and mail information. What one person says on the phone isn’t always right. Someone in a doctor’s office can speak from experience, but they cannot guarantee anything about what an insurance company will do.            A doctor’s office is sometimes guilty of saying what they think you want to hear, to get you to come in the door. A patient is a customer, after all.            Therefore, if you are going to a doctor or a clinic for a new test or new procedure, or you’re being referred, you can call up and ask for the Diagnostic Code that the office will use for what is being done. Keep a log of the call.            Then call the insurance company, and give them a description of what you are going to have done, and then give them the diagnostic code (numbers and letters) of that procedure/test/exam and see what they say.  Only they can tell you whether it is truly covered.             And get a reference number for that call. Otherwise, you may get a surprise bill from your doctor’s office, for something you thought was covered, but isn’t.
4) The Surprise Bill -- Use the information you gathered to lower your costs.            I had bad asthma that was keeping me awake at night.  I’ve had asthma intermittently since I was a child. It gets worse in spring and at the start of winter.            I went to an allergist and asthma specialist who wanted me to exhale into a machine, which would test the inflammation damage in my lungs.            My insurance pays for the test, if it is coded for “asthma.”            My insurance does NOT pay for the test if it is coded for “seasonal asthma.”  My insurance company considers using that machine and that test for “seasonal asthma” as “experimental,” and is therefore not covered.            I had my reference number of my call to the insurance company. I had the code for the test for asthma. I had my call logs to both the insurance company and the doctor’s office.            I called my doctor’s office and my insurance company and asked that the bill be resubmitted, with the code for “asthma” instead of “seasonal asthma,” and the bill was resubmitted and I saved myself $285. My co-pay was $15.            I did not have to debate anyone whether my asthma was seasonal or a life-long issue that came and went. Because I had phone records and reference numbers and diagnostic codes, they simply did it.            But I did make sure I recorded that conversation in a log, with a reference number, and I got everyone’s name and extension as well.
5) Once you are dealing with the Billing Department, the medical office can’t help you, but they still want you to pay.             Big hospitals and larger medical practices have billing departments that are separate from the doctor’s office, and you cannot visit them. If you object to a charge on one line of a bill, you cannot walk into the doctor’s office and ask to speak to the person who sent you the bill, because they are not there.            The person behind the desk will take your information and help get you the service. They will take your credit card and receive payment from you, but once you object to the cost, they can’t help you. Here’s a typical conversation:            “I’m here for my follow up with the doctor. I had my first procedure last month.”            “You have an outstanding bill for that procedure that you haven’t paid.”            “I know, there was a mistake. Can I talk to someone in billing? The insurance company told me something different.”            “The billing department isn’t located here. All I know is that you have an outstanding bill, and we’d like to receive payment before you see the doctor. Is there some amount you can pay today?”            “Can I visit the billing department? Can you give me their address?”            “No I can’t. You can’t visit them.”            “They don’t get back to me. Can I still see the doctor?”Instead, you want the conversation to go this way:            “I’m here for my follow up with the doctor. I had my first procedure last month.”            “You have an outstanding bill for that procedure that you haven’t paid.”            “I know, there was a mistake. I printed out this document for your files. I am disputing the bill because the first procedure was coded incorrectly, even after I called this office and the insurance company. Here is a record of my calls, their reference numbers, and their names. In fact, I’ve been in touch with Joan in your billing department. In the meantime, I have to keep my appointment, because the doctor said it was necessary for my medical care.”            “I’ll put these in your file.”            “Sorry to bother you with all this, but I wanted you to see that I’m organized and I’m on top of it, and I’m sure this will all be figured out soon.”
6) Do you research before you go to a new doctor or clinic.             Name your Chronic Condition -- Arthritis, Asthma, Fibromyalgia, Irritable Bowel Syndrome, Diabetes, Pain, Back Problems, Insomnia, Chronic Fatigue --             There’s a clinic that deals with nothing but your problem!            However, check their reviews on yelp.com and on vitals.com and RateMDs.com before you got to any appointment. If you read that their billing is wacky, or they overcharge, or they ding you with hidden costs, cancel the appointment. Go somewhere else, even if it’s more expensive.
7) If you keep a good log -- don’t be afraid of the Billing Department.             Once you dispute a bill, scary things can start to happen. If you have a good log with names, dates and reference numbers, you don’t need to be afraid.            Just be prepared to spend a long time on the phone, a lot of time on hold, and be ready to leave a lot of voice mail messages as you get the runaround.            The bigger the medical provider, the scarier it can be. My family has had the biggest billing disputes with Cedars Sinai and UCLA.  Because they are huge they have huge billing departments, and the bigger the department the less compelled they are to deliver great customer service.            My family had a medical bill that was coded incorrectly from the very beginning. It was truly an error, and we had reference numbers of calls and the correct diagnostic code. But for two years we kept receiving a bill for over $5,000.            We called twice a week for over a year. We left messages. We asked to speak to supervisors. We go reference numbers and supervisors assured they would call us back. The bills kept coming, and eventually the even sent it to a collections agency. We then communicated with the collections agency with the same patient persistence that we treated the doctor’s office, the billing department, and the insurance company. Eventually, they backed down, and we had our bill coded correctly.            It can be scary and exhausting.  Your time is valuable and you may want to just pay the bill and be free of it. However, if you know you are right, and if you keep good logs, don’t stop fighting. Stay diligent with the collection agency, and explain your situation. Tell them your story, and that you have an entire file that you can send them.  Eventually, the supervisor will call you and work with you. People fight audits from the IRS, and people fight collection agencies over incorrect bills and they win. If you are right and you keep great records, you will win too.
8) Be Patient, Polite, Kind, Funny, and Insistent             It is easy to dismiss someone who is just a voice on the phone. Its even easier to dismiss someone who has a rude voice.  When you make your first call and you start your log, be patient, kind, polite, and funny...but insistent.            If you start having billing problems, there is a good chance you will call that same person again. They are doing their job. Part of their job may be to dodge you. Be friendly. Find out if they have kids. There’s a good chance you’ll end up trading stories. After many calls, that person will become an acquaintance, and even an ally.            Then, the phone calls don’t seem so bad either. After all, the person on the other end of the call has issues of his or her own, just like you.  It can even be pleasant, if you remember that we are all in this together.
            Good luck!

            

Valentine Notes

Friends and Family are telling me to lighten up.  Today’s blog post shouldn’t be about climate change, or California politics, education, or the health care system.  They want a blog post about love, for Valentine’s Day.  And they’re right. St. Valentine, imprisoned in Rome, would pass notes -- Valentine notes -- to other prisoners, to  give them hope.  These are my notes of hope, because where there is life, there is hope.Candace Escobar helps me with this blog every week. She is my sounding board and my editor, and she keeps me honest. Candace helps Robin and me with our little company and she is kind and patient with our daughter Lily. Thank you Candace, this is for you.Julie Murphy -- five years ago Robin and I went out on Valentine’s Night for a date, and you came to babysit. You and Lily made Valentine Hearts with love notes and stuck them all over our kitchen. We loved them so much that we left them there, and five years later they are still stuck to our cabinets, faded and curling, but such a part of the house that we don’t even see them. Now you’re having your baby, and Lily will babysit for you, and make you Valentine hearts.


David Trulli -- you have another art gallery opening tomorrow at Bergamot Station, which I can’t attend, but I want this blog post to promote it.  What I like about your artwork is that there is always a sliver of hope in it.  A woman on a swing, a man wanting more, a vine on a fence, a blade of grass pushing through the sidewalk. Break a leg tomorrow night.


To everyone, this is my Valentine note of hope that I pass to you. Be thankful for the problems in your life that never go away.  If you can say, “My life would be perfect, except for...” that means your life may already be perfect. The “except for” problem -- money, health, parents, children, wife, husband, home - contain the seed of awareness of how lucky we all are. It’s the dark that reveals the light, the yin to the yang, and we all share in it. Until it ends.Thank you life, for the rock I push. I look over and see everyone else pushing their rocks, and our pain, toil, and joy unite us.Here are lyrics to two great Valentine songs that capture everything I could ever want to say about the beautiful ache of life and love, and Jobim says it all in fewer words than I’ve already written here. 

Whenever I hear these songs, I think of Robin. My love. With you in my life, I am never alone. You are my blade of green grass that I keep in my pocket wherever I go. Together we can push up any sidewalk. Most of all, this post is for you.  Happy Valentine’s Day!
The Waters of MarchA stick, a stone, it's the end of the roadIt's the rest of a stump, it's a little aloneIt's a sliver of glass, it is life, it's the sunIt is night, it is death, it's a trap, it's a gunThe oak when it blooms, a fox in the brushThe knot in the wood, the song of a thrushThe will of the wind, a cliff, a fallA scratch, a lump, it is nothing at allIt's the wind blowing free, it's the end of the slopeIt's a beam, it's a void, it's a hunch, it's a hopeAnd the river bank talks of the waters of MarchIt's the end of the strain, it's the joy in your heartThe foot, the ground, the flesh and the boneThe beat of the road, a slingshot's stoneA fish, a flash, a silvery glowA fight, a bet, the range of a bowThe bed of the well, the end of the lineThe dismay in the face, it's a loss, it's a findA spear, a spike, a point, a nailA drip, a drop, the end of the taleA truckload of bricks in the soft morning lightThe sound of a shot in the dead of the nightA mile, a must, a thrust, a bump,It's a girl, it's a rhyme, it's a cold, it's the mumpsThe plan of the house, the body in bedAnd the car that got stuck, it's the mud, it's the mudA float, a drift, a flight, a wingA hawk, a quail, the promise of springAnd the river bank talks of the waters of MarchIt's the promise of life, it's the joy in your heartA snake, a stick, it is John, it is JoeIt's a thorn on your hand and a cut in your toeA point, a grain, a bee, a biteA blink, a buzzard, a sudden stroke of nightA pass in the mountains, a horse and a muleIn the distance the shelves rode three shadows of blueAnd the river bank talks of the waters of MarchIt's the promise of life in your heart, in your heartA stick, a stone, the end of the roadThe rest of a stump, a lonesome roadA sliver of glass, a life, the sunA knife, a death, the end of the runAnd the river bank talks of the waters of MarchIt's the end of all strain, it's the joy in your heart
"Waters of March" is track #9 on the album Encanto. It was written by Antonio Carlos Jobim.





"Corcovado"
Quiet nights of quiet stars Quiet chords from my guitar Floating on the silence that surrounds us
Quiet thoughts and dreams Quiet walks by quiet streams And a window on the Mountains and the sea, how lovely
This is where I want to be Here with you so close to me Until the final flicker of life's ember
I, who was lost and lonely Believing life was only a bitter, tragic joke Have found with you The meaning of existence, oh, my love
"Corcovado" is track #6 on the album Elis & Tom. It was written by Antonio Carlos Jobim.



Waters of March - video




David Trulli - Event Horizon - Robert Berman Gallery
Exhibition: February 15 - March 22, 2014Reception: Saturday, February 15, 5-8pm
Robert Berman GalleryBergamot Station Arts Center2525 Michigan Avenue, B7Santa Monica, CA 90404310.315.1937

I just got a fax----I'm paying too much for Health Care.

            The Health Care Industry  is ripping off my family.            Over the last ten years, we have been misled, misinformed, and overcharged by doctors, hospitals, medical offices and insurance companies. All have been guilty, and it’s been going on long before the Affordable Care Act was passed.            Like many American families with chronic health challenges, one quarter of my family’s time and money go to health care and health insurance. But after we pay good money for top-notch care, we spend time battling the rip-offs. They dodge our questions, and don’t return our calls.             What pisses me off the most? The FAX MACHINE.            You’ll have to fax that.            We didn’t get the fax.            Can I get your fax number? I’ll try to fax that to you later today.            Are you near a fax machine?            Our copier is down, so I can’t make a copy to send you that fax.            Fax machines are 20th Century Technology. I have a cell phone, and I can take a high quality photo of any document and send it to you while waiting for coffee. I can keep my entire medical history, organized, in my pocket, and it’s backed up on my hard drive at home, on my computer, and in “the Cloud.” It’s even encrypted.            For business, I am now expected to be digitally organized. I haven’t used a fax for business in ten years. If I told my boss or a client that he has to wait because I’m not near a fax machine, I wouldn’t keep my job for long.             However, when I walk into a doctor’s office and see four rows of open horizontal filing cabinets jammed with thousands of manila folders, I feel like I just entered 1988 -- but they’re charging me like it’s 2018.            Since the economic downturn of 2008, any business that has survived has been asked to do more work for less money. When I create a budget for a potential client, that client will always ask for a better deal, because someone wants a better deal from him. There has been a relentless drive for efficiency.             I believe, however, that our health care system has been able to dodge that squeeze for six years now. As the Affordable Care Act kicks in, only now is the pinch beginning to happen in a major way. Doctors, hospitals and health care providers are all worried that they can’t deliver the same quality care for the same price, and still break even, much less make a profit.            But when someone in a hospital, a billing center, or a doctor’s office asks me if I’m near a fax machine, I lose all sympathy. I’m happy to pay more in 2016, but I don’t think I should pay to help someone catch up to the second decade of the 21st Century. I feel like I’m paying for their tuition.            Everyone in the American Health Care System should get used to a question we’ve all been hearing and asking for six years:            What am I paying for? I want a better deal.            Actually -- I would settle for a fair deal.            Here’s an example, in which all facts are true. Someone in my family needs an MRI once a year, to track whether a chronic condition is stable, improving, or worsening. Getting the MRI is preventative and therefore cost-effective. If he waits and his condition worsens without him knowing, it can lead to an expensive emergency.            His insurance pays for an MRI prescribed by a doctor.             He called the Mark Taper Imaging Center, which is part of Cedars Sinai, to book his prescribed yearly MRI, and they told him there were no openings in the next month, even though it’s the facility his doctor recommended.             They told him, however, that there were openings at another MRI facility associated with Cedars Sinai, the Mark Goodson Imaging Center, where they could take him right away. He asked if it was the same procedure. He was told yes, it’s the same procedure...an MRI scan.            He got the MRI procedure, and his co-pay was $1500, but he already had spent $500 out-of-pocket last year, so he only had to pay $1000, which made him feel like he’d saved money.            Then his doctor told him that he should have waited and gone to the other facility, because that MRI machine has more current technology. The facility he went to had an older MRI machine, and the readings aren’t as thorough, which was not volunteered. It was also the same price.             I don’t know what happened, but I will now speculate: the older MRI machine has been paid for several times over, and it’s now profitable. However, everyone wants the newer machine, so the older machines tend not to get used as much. I speculate that he was encouraged to use the facility with the older machine to maximize its use, get some profit, and reduce crowding at the other facility.            He also has a friend with the same condition who also needs an MRI once a year. He feels nervous about the headaches he’s been getting, and he wants to be pro-active and get a second MRI, just to be sure.            On a whim, his friend called an outside facility -- Tower Imaging, a private facility not associated with a hospital, and he asked how much it would cost if he paid cash. They told him $1000, and they could take him right away. He negotiated them down to $900.            My family member feels misled and ripped off. He spent $1000 for the wrong test, and he’ll have to spend $1500 again to get the right one.            No laws were broken. However, my family member is now a gadfly activist for his own health care, and he costs billing departments and office staff a lot of time and money with all his phone calls, as he checks every prescription, every procedure, and every line on every bill, as he calculates how to get the best deal.            And guess what? He bought a fax machine and got a second phone line, just to deal with antiquated medical offices and billing departments who dodge him.             Here’s his typical telephone banter, while standing up in the kitchen:            So, can I get that price in writing?             Yes, I have a fax machine. I’m standing next to it now.            Can you fax that to me now?            I was on hold for 30 minutes to reach you, do you mind staying on the line            until I get the fax? I’m standing next to it, I will see it come through.            I signed the document and sent it back. My fax machine said it went through. I don’t mind waiting, can you go see if you got it? Yes, I’ll hold.            It sounds like he’s talking to the lady who books rooms for the Sochi Olympics, but he’s talking with the best medical service providers in Los Angeles, at Cedars Sinai and UCLA.            Most patients just accept the status quo, however. They are so worried about their health care, they’re afraid to question its speed, price or quality.            But you should ask questions. You’ll get better care, and you will help an industry join the 21st Century.             Over the next few blog posts, I will share more medical stories. Consider them rants, consider them advice, consider them guidance. They may help you.            I am the son of a doctor, the grandson of a doctor, the brother of two doctors, and the nephew of a doctor. Although I am not a doctor, I run a business that provides health care coverage to employees who work for more than six months, and my family has typical chronic health care problems that require me to know insurance policies and the health care system. I have some good stories to share.            Here’s my first piece of advice about ALL health care providers. Embrace this, and it will give you strength as you ask your questions:            Most doctors are merely adequate, and not great.             Remember that, no matter what they charge, or how they treat you.             That is not disrespectful to doctors. The truth is, most people are adequate. Most people fall into the middle of the bell curve on everything in life -- which is the definition of average. A few people are exceptional, and a few people are terrible. This same statistical truth applies to doctors of all kinds, even in the top specialties. If there are 2,000 brain surgeons in the country, only 200 can call themselves great. The mere fact that you are a brain surgeon doesn’t mean you’re a great one. The Peter Principle may be in play here, as well; a doctor may have been a terrific general surgeon, in the top 10%. However, by choosing the more challenging speciality, that doctor may actually have ended up being merely an adequate brain surgeon.            This is true of lawyers, architects, teachers, and movie directors. It is a fact of all professions. Most people are average at what they do, and only a few are fantastic.            There is nothing wrong with being adequate. I love paying an average price for adequate service. I also don’t mind paying for an adequate procedure on an older machine, if it does the job I need. I never want to pay top price for the best when adequate will do just fine, thank you.             However, I don’t want to be misled, or overcharged, or to endure disorganization and inefficiency. The same applies for the office staff. A bad office staff can sully the health care experience that a fantastic doctor delivers.            Therefore, be your own advocate. They are people, mostly average, just like you.Ask questions about your service and your bill. And please...tell them to get rid of the fax machine.            Next week:            The Cost of Your Medical Records!            And...            The Medical Reference Number!            Stay tuned!

I Want to Kill Augustina Part 2

Two weeks ago you read my first installment of my noir tale of how I’m plotting to murder my lawn -- that yellowing bitch with the bald spots that I call Augustina.  I still wake up in the middle of the night and toss and turn thinking about how much she’s costing me.            I am in the pre-meditation stage, which is more like ceaseless agitation.  As I proceed I still want to slay her, but flaws in my various plans are popping up -- plans that will either cost me money, or risk me terrible neighborhood embarrassment.            However, I no longer feel ashamed for wanting to kill my lawn. In the last two weeks, the story of the looming California “mega-drought” has become almost a daily story.  The town of Willits, California, in Mendocino County, has less than a 100-day supply of water available, and this is the “rainy season.” Lake Cachuma, an artificial lake in Central Santa Barbara, is drying up. Los Angeles County currently has no problem, but that’s because we’ve been stealing water from Mono County near the Sierra Nevada range for decades.             We’ll be fine for a few months here in L.A., so we can keep watering our lawns. The Central Valley farmers may not have enough water to grow crops to feed us or their livestock, which means our economy will crash and there will be food shortages, but at least we’ll have nice green lawns when the riots start.            The powers-that-be are preparing us, however, with these stories. By summer, I predict that we will have a repeat of the California Drought of the mid-1970’s, when there was severe mandated rationing.  I remember that drought, and how we had to carefully plan our water usage for the week. It wasn’t that bad. We washed clothes less often, we only ran a full load of dishes, and we had timed showers. In Southern California they emptied their swimming pools, which skateboarders loved. In the movie Dogtown and Z-Boys, pro-skater turned filmmaker Stacy Peralta identified the two sparks that started the worldwide skateboarding craze in the mid 1970s -- good polyurethane wheels, and empty swimming pools in Southern California. I remember loving the cool photos in Skateboarder magazine of thrashers getting their board over the underwater light in the deep end of the empty pool. My parents’ high water bill did not register.            What was hard was the building resentment within neighborhoods. Mandatory rationing came with heavy fines -- but there were people who had enough money to water their lawns and gardens and endure the fine, which angered their neighbors. We were being asked to work together, across class, and mandatory means everybody, or so we thought. Different counties set up “snitch lines” where you could make an anonymous call and turn in a scoff-law you saw watering his driveway. People would surreptitiously water their lawns at 3 a.m. to avoid detection, and neighbors would hear the hiss of the sprinkler system next door and place snitch calls to the County Water “Stasi” at 3:15.             There was also a drought in the Western United States in the mid-80s, and I remember going to a decaying outdoor public pool in Los Angeles, a cement tank which had a large leak in the bottom, and to keep the pool filled they ran cold water from a 5’’ diameter pipe 12 hours a day. There was also news reports of old prisons and jails which had toilets so broken they never stopped flushing. Anyone who’d been fined for a high home water bill was outraged by the double standard, and tempers were short.            All this is coming, and we should be ready for it.            Which brings me back to Augustina.            My murder-for-profit (or at least savings) has hit some stumbling blocks. Take notes, fellow homeowners:            First, I am currently wasting water trying to revive a near-dead lawn that went without sprinklers for 4 to 6 weeks in autumn. I need to keep it alive so that it looks good enough in photos to qualify for a rebate, and then I can kill it.              I fill out the form, take four pictures, include my water bill, and describe how much square footage of turf I am willing to remove.  I need 1) a high enough water bill, 2) a lawn with enough square footage to impress them 3) photos of a lush green lawn that is wasting water. If I get all three, I may get as much as $2400 back!            However, my lawn is brown and yellow, so I may spend $300 in water to then find out that I don’t quite qualify for the rebate. They won’t pay you for a lawn that’s already dead.            Lucky for me (I think), a solution appeared. A film location scout liked our fence and our front yard, and they offered us $1600 to shoot an Alka Seltzer commercial that features a postman with indigestion who gets bitten by a dog -- all featuring Augustina.            “We love your fence, we love your yard,” the art director said, “but your lawn doesn’t look so good.”            Yeah, we noticed.            “Do you mind of we paint it?”            We agreed, of course, and the art director sent crew guys to sprayed our 1500 square foot front lawn and walkway with green food coloring.



            I now take four more NEW photos, and my lawn looks lush and thirsty again -- and maybe alive enough to qualify for a rebate!            Do I proceed? The truth is, however, that I am now engaging in deception. Potential fraud. I’m an Eagle Scout with Canadian roots, which means I’m as transparent as a pane of glass. I get caught cutting the dessert line. I get reprimanded for having 13 items in the 12-item line at Trader Joe’s. I will send in the rebate application with my new fake photos, and knowing my luck, I’ll get the one inspector come and takes blade samples, and I’ll be arrested for trying to defraud the City of Los Angeles.            However, I do get a rush having a green lawn again, even if it’s green from paint. My neighbors all nod at me, and I feel their admiration and envy. I’m living a lie, but it sure feels good. This is one of the key character flawsin any good noir story, so I must proceed forward with hubris toward my own demise. I believe I can get away with it.            And there is yet one more vainglorious plot that may backfire in my face. If it’s going to be a dry summer with mandatory rationing, why not replace Augustina with some artificial turf? That seems like it might be a good option. Then I can feel this green rush all summer long. Sure, it’ll be fake, but I’ll have the only green lawn on the street!            The DWP doesn’t agree, it turns out. After examining their website, I couldn’t find a definitive answer as to whether they would give me the $2400 rebate if I put in the fake lawn. I called several days in a row, and got the “due to high call volume, your wait to talk to a customer service representative will be 45 minutes,” recording.  I finally got a very nice woman who kept me on hold for ten minutes, and returned to finally say that NO -- the DWP will NOT give a rebate to a homeowner who removes turf who then puts in an artificial lawn.              It’s not green enough. I would be putting down 1200 to 1500 square feet of petroleum-based rubber and plastic, which is a giant carbon footprint. It’s like setting fire to a stack of tires on your front lawn. Then, once it’s installed, in impermeable. Water doesn’t flow in to the beautiful sandy alkaline soil, increasing the water table of our dry San Fernando Valley, which defeats the purpose. We’re trying to keep the water that manages to fall from the sky, not divert it away. My fake lawn would send all the rainwater down the street and into the storm drains, just like every other paved surface in the city already does. I may as well lay down asphalt.            My daughter wants a lawn though. Therefore, I am going to proceed with this plan as far as I can take it. I know I should be green, but I’d also like save some green, especially if I never need to water again. It may be more hubris on my part, but I want to know what kind of deal I can get.            I found out a fake lawn could run me as high as $8000. The guys who spray-painted my lawn, however, are trying to hook me up. They know a guy, who knows a guy, who knows a guy...know what I mean? You have to spend top dollar for a fake lawn that looks real, but not if I go through Hank’s buddy, who runs a fake lawn place way out in Panorama City.  Hank warned me about how hot the fake lawns get in the summer -- hot enough to burn your feet. Unless, of course, you get the special T60 grass. Hank insists that I buy the T60 from his buddy, but then hire his other buddy to install it.            I spent two hours on Saturday reading websites for fake lawn companies and I was ready to call for an estimate on Monday morning. This is the response I got:            “The T60? You do NOT want the T60, not anymore. Trust me. But what I can do, for you, s to send one of our sales reps out next week with some samples, and he’ll give you a free estimate. We have a special, this week only. How does that sound?”
            I feel there may be trouble.             After all, we’re in the second act of this Valley thriller.            I’ll keep you posted.           
HERE”S THE LINK TO THE REBATE SITE. RECENTLY IT’S BEEN MYSTERIOUSLY UNAVAILABLE:
ladwp.com