August 2019

August 2019 has been an interesting month for several reasons.  Now that I have two hands and arms to use, let me highlight the meaningful aspects of this month.  Early in the month Carol and I flew to Spokane, Washington, rented a car and spent the week in the great state of Idaho.  Visiting Idaho has been on my list for several years given that it was the last of the 50 states for me to visit.  Now that it has been accomplished, I can move on although my list is getting shorter and shorter and physical limitations seem to pop up with every-so-often frequency.  Something I have always wanted to do was to hang glide off a mountain or cliff but does not look as if this will happen.  From teen years forward, I have always wanted to drive in a stock car race, but that’s not going to happen either.  Life goes on and the list simply includes seeing another day.  A phrase attributed to the late Senator Jerimiah Denton has become my mantra—"If the doorknob is on my side of the door, it is a good day”.  Thus far, I still see the doorknob!

Back to Idaho.  The first day and evening we stayed in a small village, Coeur d Alene.  A neat area with a large lake.  Would not mind returning and spending some time.  There was a street fair going on and we could not find any parking so went back to an area away from the activity.  The next day we drove on to Lewiston driving through Hell’s Canyon on the way.  The Snake River is at the bottom of the Canyon and the gorges are some of the deepest in the country.  Much of Idaho was created by volcanic activity so there is evidence of this throughout the state.  While in Lewiston we crossed the Snake River into Clarkston, Washington.  The two cities are named for Lewis and Clark who conducted expeditions in this part of the country.  Additional evidence of the impact of volcanoes are the miles and miles of lava fields which have been in place for thousands of years.  We visited a national park, Craters of the Moon, which is nothing but black fields of lava.  An impressive, but somewhat eerie sight.  We had the experience of being lost in the mountains as we tried to get to Sun Valley—thankfully, the young lady at the Chevron station at a crossroads to nowhere was very helpful in turning us around.  While in Twin Falls, we were encouraged to go to the Shoshone Water Falls which are purported to be higher than Niagara Falls and were very impressive.  Well worth the side trip.  Flew back home from Boise.  The time in Idaho was most enjoyable and I am glad that we brought the list to closure with the visit.

Upon returning to Alabama, Carol and I celebrated our 57th Wedding Anniversary.  Through the years she has been asked, how she put up with me for all the years.  She smiles and I cannot recall that she gives an answer.  I am very fortunate to have her in my life and I truly love her for all she has been to and for me.  Through these years she has been with me through some challenging situations.  Most recently, being there when I entered the DCH Hilton (Hospital) to have a Pacemaker inserted.  As a  result of this procedure, I could not drive for a couple of weeks and she was most Tolerant and supportive as she transported me about Tuscaloosa,  As of late last week I can drive, but have to wear a sling which I also have to wear when I sleep so my left arm does not flail about in a fit of nightmarish dreaming.  This hospital venture was not expected, but we were convinced it needed to be done.  Hope it does what it’s supposed to do!

The final event of August 2019 was that I reached the ripe old age of 80.  If anyone would have suggested that I’d still be here at this age, I would have laughed and said, “no way”.  I continued to take out double indemnity insurance policies because I was convinced, I would come to the end as the result of a car accident.  Ain’t happened yet, but there is still time.  The policies are still in force!  Carol had a party for me on the actual date of my birth and I was grateful for those who gave of their time to participate.  Both girls, Vicki and Julie, and their husbands were an important part of the celebration as were several good friends.  It was a very, very good and special time and I am, indeed, fortunate, to have people in my life who seem to care.  Makes for a good feeling!

Well, these are some of the highlights from my life this past August.  What I have shared pales in comparison to all that is going on in this country and the world.  In my 80 years, especially the adult years, I have never seen such chaos, uncertainly, confusion, repeated falsehoods and hatred as seems to characterize the daily news.  There has got to be a better way.

The Eagle has landed

It was fifty years ago that people around the world gathered around a television to witness a marvelous feat of human perseverance and accomplishment.  It was July 20, 1969 that Neil Armstrong stepped down from the lunar module on to the moon’s surface and uttered the phrase, “That’s one small step for man.  One giant leap for mankind.”  It was a shinning day for the space program and brought to fruition President Kennedy’s challenge for America to be the first to land on the moon.  It was an event that brought together Americans from all walks of life and from all political ideologies.  For a moment, all of America was on the same page, regardless of race, ethnic background, religious ideology, occupation, or economic status.  Landing on the moon served as a coalescing event which led to, temporarily, setting aside the bitterness and hatred that had been rampant during the 60’s.   There was a “oneness” that was pervasive throughout the country. 

 Keep in mind that the 1960’s was a turbulent decade of painful confrontation.   The assassinations of President John Kennedy, Dr. Martin Luther King, Jr., and Senator Robert Kennedy were grim reminders of how “differences” could reach such a traumatic level.  The Civil Rights Movement provided a daily reminder of the extent to which the human spirit will go to achieve a measure of respect and dignity.  The bus boycott in Montgomery, the march from Selma to Montgomery, the Children’s March in Birmingham, sit-ins at lunch counters throughout the south were reminders of a divided nation.  The burning of the Freedom Riders bus in Anniston, Alabama, the police dogs and fire hoses in Birmingham and the untold number of lynching’s reinforced the reality of “two worlds”  The bombing of the 16th Street Baptist Church in Birmingham, which left four young girls dead, was a painful reminder of how far the Ku Klux Klan would go to instill fear and intimidation in the black communities.  The number of blacks who were arrested, jailed and convicted of trumped-up charges was quite common occurrence throughout the south.

 Other traumatic aspects of the 60’s included the war in Vietnam which was pulling individuals and families in varied directions.  Leaders were being challenged as to the reason young men and women were dying or being maimed for life defending such an obscure area of the world.  Thousands returned home in a “pine box” and thousands of others returned with injuries that would be with them for the rest of their lives.    Demonstrations against the war and the pain it was inflicting on the nation were common.  Riots left cities throughout the country in charred ruins.  Businesses were looted and many small business owners were left with nothing.  The Democratic Convention was held in Chicago and this led to the streets of the city being turned into battlegrounds as demonstrators clashed with police. 

 The approval of the oral contraceptive led to young people being swept into the era of “free love”.  The “peace and love” movement culminated in the Woodstock Music Festival which drew thousands to a remote area of New York.  The passage of civil rights legislation and the voting rights bill were positive happenings during the 60’s.  Medicare and Medicaid were added as amendments to the Social Security Act and provided a medical safety net for a multitude of Americans.  Ford Motor Company produced the Mustang automobile and other car manufacturers followed with the production of their “muscle cars”.  The Beatles landed on American shores and were a rousing success for several years.  All was not problematic during the 60’s.

 Indeed, the decade of 1960 was a period characterized by a great deal of conflict, division and hatred.  As we pause and reflect on what was occurring during this time, do we see some of the same conflict, division and hatred today.  The root cause is not the same as we have seen in the past, but some of the outcomes are quite similar.  Division and difference characterize the current times.  The extent of behavior influenced by hatred toward difference is ever so like what we experienced during the 60’s.  In the absence of a landing on the moon, we need leadership that encourages coming together and working together to deal with issues and concerns.  We need a leader who appreciates the diversity that is the hallmark of this country.  We need a leader who can effectively modify and handle opinions that may not be familiar with his own.   We need a leader who respects the dignity of all humankind and kindles an environment of acceptance.  We need a leader who puts the country above self.  We do not need a leader who fans the flames of hatred.  We do not need a leader who relishes in the expressions of bitterness.  We do not need a leader who demeans those who are a bit different. There needs to be a commitment to work toward the reconciliation of difference and seek to achieve that oneness that we experience on July 20, 1968.   

It is my body!

Recently, the Governor of Alabama signed legislation into law that allows for the chemical castration of convicted sex offenders who molested a child, 13 or younger.  The sponsor of the bill has spent a decade trying to get legislation of this nature passed by the Alabama Legislature.  It is interesting to note that his success came during a period when the state legislature passed the most restrictive abortion bill in the country.  The Governor signed this bill as well.  Additionally, during this same time frame, the state is being mandated by the federal government to address egregious issues in the state’s prison system that have characterized this system for decades.  The recent publication of the Annie E. Casey Foundation’s, Kids Count, has Alabama listed as the 44st state in child well-being.  This ranking is two spots lower than last year, and further illustrates the state’s lack of attention to issues that affect the children of the state.  It seems that the only time any action is taken is around issues that undermine the fabric of an enlightened society.

Having spent some time in and around child welfare systems throughout the country, I would be the first to agree that nothing is more heinous and heartbreaking than the sexual violation of a young child.  This is especially so when an infant is the victim.  Indeed, such violations must and have to be addressed, yet to do so by artificially attempting to control the perpetrator’s sexual impulses is not the answer.  Study after study has shown that such behavior is not attributed to any sexual motivation, but to the desire and need to have control of another person.  Chemically modifying a person’s testosterone level does not address the control and power issue.  To view this law as a deterrent focuses on an erroneous expectation.  It might play well for the uninformed, but it will not lead to the deterrence of the offender’s behavior.  There needs to be more attention placed on providing treatment for sex offenders. There are treatment programs that have had a measure of success.  Treating sex offenders is exceedingly challenging, but the emphasis should be placed on addressing this challenge.

The decision that the Alabama legislature and the governor reached can, certainly, be viewed as a “slippery slope.”  When the “state” dictates what happens to a person’s body, where are the lines to be drawn?  Back in 1973, the State of Alabama violated the bodies of the Relf sisters by having them sterilized to prevent them from becoming pregnant.  At the time of their involuntary sterilization, Mary Allice was 14 and Minnie Lee was 12 and were mentally challenged.  Both Mr. and Mrs. Relf were illiterate African-Americans subsisting on $150 per month.  They were receiving services from the Montgomery Alabama Community Action Program and it was under the auspices of this agency that the sterilization took place.  The sterilization of African-American women was common throughout the country.  The family planning clinic of the Montgomery Community Action program sterilized a total of 11 females, 10 of whom were African-American.  In the 1970’s 65% of sterilizations in North Carolina were done on African-American women, even though only 25% of the state’s population were African-American women.  As ordered by the district court in North Carolina, a 14-year-old woman was subjected to a total abdominal hysterectomy because she was judged to be severely mentally retarded.  The practice of eugenic sterilization was an attempt to eliminate the reproduction of genetically inferior women, such as the mentally disabled.  It was believed that allowing the procreation of these individuals would undermine the genetically superior members of society.  This can lead to a very scary proposition of governmental control.

During the reign of Hitler, there were programs that experimented with the genetic alteration of humans.  Hitler believed that there were those who were “life unworthy of life” and included prisoners, degenerates, people with congenital and physical disabilities (feeble-minded, epileptic, schizophrenic, manic-depressive, cerebral palsy, muscular dystrophy, deaf, blind), homosexuals, the idle, the insane, and the weak.  He concluded that all of these, along with Jews and gypsies, should be “eliminated from the chain of heredity”.  Over 400,000 of those in these categories were involuntary sterilized and 300,000 were killed.  Hitler was convinced that he could create the perfect Aryan race by maintaining its purity through the culling of the undesirables.  It was because of governmental control that such outcomes occurred.

There is a reason that in the United States we live by the principal of checks and balances, yet the scales can and do get tilted.  When any government entity begins to engage in the alteration of one’s body, the potential for taking the control away from the individual and giving it to the state is possible.  What might be the next “cause” that a politician feels embolden to pursue?  Most recently it has been chemical castration and unheard of restrictions on abortions, earlier in the 20th century up until the 1970’s it was the practice of eugenic sterilization in the United States, and during the 1930’s and 1940’s it was the effort to purify the Aryan race.  The current climate seems to be ripe for additional governmental intrusions.

Will Alabama ever learn?

The year was 1972 when the prisoners being confined by the Alabama Department of Corrections filed a class action lawsuit against the State of Alabama alleging violations of the Eighth and Fourteen Amendments.  The Eighth Amendment protects against the infliction of cruel and unusual punishment and the Fourteenth Amendment includes the requirements for due process to be followed in legal actions taken against citizens of the United States.  There were three significant cases filed in the Federal Middle District; Newman v. Alabama, Pugh v. Locke: and James v. Wallace.  Each of these suits focused on conditions in the prisons that violated the U.S. Constitution.  Included in the cases were issues such as overcrowding, classification and placement, assault and abuse of inmate on inmate, sanitation problems, staffing (number, training, qualifications, pay), suicide prevention, medical and mental care. Each of these cases was granted class action status and included all inmates, female and male, incarcerated in the state’s prison system.  It is interesting to note that in open court the attorneys for the state agreed that they were in violation of the Constitution by inflicting cruel and unusual punishment within the prisons.  Each of these cases was closed in the 1980’s with the Pugh v. Locke case having a closing date of 1988.  The Chief Judge of the Middle District of Alabama was Frank M. Johnson, Jr., and his rulings in these cases were upheld by the Fifth and Eleventh Court of Appeals as well as by the Supreme Court of the United States.  Let me point out that one of the hallmarks of the rulings made by Judge Johnson were the thoroughness in providing specific remedies to be followed by the defendants.  His decisions in the prison cases followed this pattern and the state was specifically mandated to address each of the issues identified in the suits.

The above background is provided as a backdrop for fast-forwarding to the present time.  There has been a great deal of attention given to the inadequacies of the prison system in Alabama in recent years.  Once again, the Federal Court is making specific rulings about what must be done to comply with the court’s directives.  Judge Myron Thompson is the current Chief Judge of the Middle District of Alabama and he is following the trail laid down by Judge Johnson.  The state, as was true back in the 1970’s and 1980’s, is being forced to make changes or the Federal Government will, once again, take the necessary steps to effect change.  The most significant action could be the Federal Government taking control of the state’s prisons.   

There is a myriad of issues that mirror the earlier cases.  One of the most telling statistic is the number of suicides that have occurred within the prisons.  As of this writing there have been 15 since December 2017, and 13 in the last 14 months.  The spike in suicides in Alabama is four times the national average.  Judge Thompson has mandated that the Department of Corrections make improvements and called the prisons’ mental health systems “horrendously inadequate”.   The abuse of the use of solitary confinement has been a major contributing factor in the number of suicides.  The absence of significant mental health professionals providing treatment has been an additional factor.  

A report of the U. S. Department of Justice alleged that the men’s prisons were in violation of the Constitution because of the level of violence, rape, weapons, extortion, and other problems.  An article in the Alabama Political Reporter, written by one of their reporters, Josh Moon, described a man he met, a white, middle-aged businessman, who was to serve a two-year sentence for some illegal business deals.  In his first year he lost 80 pounds, was held for ransom, had his back broken, was stabbed and would have been murdered if not for the aid of another inmate.  He was also repeatedly denied prescribed necessary medication by guards and prison officials.  No mystery as to why prisoners are killing themselves.  The incidents of abuse by inmates and guards are legion and story after story could be told. 

The issues, included in the Department of Justice’s report, fall into five main categories: hiring more correctional staff (guards); pardons and paroles reforms; internal problems such as sexual abuse, suicides, and violence; prison construction; and, sentencing reform.  Indeed, much needs to be done.  A danger is that those in control of the decisions will look to building more prisons as the answer.  The previous Governor, Robert Bentley, laid out a very ambitious plan for the construction of new prisons.  He proclaimed this as the primary answer to the problems with the prison system.  However, building newer, more humane, prisons as replacements for the existing “hell-holes” housing both male and female inmates is much-needed.  

There is a need for more, better trained and qualified staff in all the prisons in the state.  Coupled with the need for more is the need to adjust wages to a level that attracts those who are committed to making a difference.  Keeping wages at a paltry level will lead to “getting what you paid for”. The sentencing practices in the state are abysmal.  The habitual offender law needs to be modified to deal with the most serious of offenders and not the addicted person who got caught three times, thereby being sentenced for life.  Yes, there are approaches to sentencing that have and do work such as treating addiction as a disease, not a crime, and allowing individuals to enter rehabilitation programs, rather than being sent to prisons.  Alternative sentencing does work.  Home detention, electronic monitoring, and community-based corrections are examples of alternatives that have been successful. 

The housing of inmates also requires significant modification.  Inappropriate classification and placement can be a detriment to an individual’s motivation to improve and work on issues that led to his/her incarceration.  More humane and credible supervision of inmates always must be a priority.  Such supervision pertains to monitoring inmates in the yard, in work assignments, movement from one place to another, and making sure that a limited number of inmates are showering at one time.  Many of the rapes occur in the shower.  The managerial and supervisory staff must be held accountable and questionable practices must stop.  An example of a questionable practice is the shackling of inmates to buckets in the Limestone Correctional Facility.  Those who are shackled must defecate six times in the bucket to have their restraints removed.  This is an unbelievable, inhumane, and unacceptable practice and the warden of that facility should be removed.  A practice of this nature cannot be tolerated.    

During his visit to American, in the 1830’s, Alexis de Tocqueville, and a colleague, conducted a study of the American penal system and Tocqueville is reported to have stated that American prisons were schools of crime.  He also stated that the level of a society’s morality can be determined by how they treat their prisoners.  In Alabama, we have not come very far from those days when the animals in the field were treated better than those put into the state’s prisons.

What has been put forth should not be construed as an attempt to suggest we coddle those who have been convicted of violating a law of society.  What I have attempted to do was to provide a brief historical context for what the state is currently experiencing.  Action must and will be taken, one way or the other.  If the state continues to delay in responding to the court, then they will come under the control of the Federal Government.  Literally, the clock is ticking and those in positions of leadership and power in the state will be required to do more than talk.  There is a reason the Founding Fathers included the Eighth Amendment in the Bill of Rights.  We cannot engage in or support ongoing cruel and unusual punishment of those in the state’s custody.

Privacy in a hospital setting--does it exist?

Every day of the year, individuals are admitted to a medical care facility whether it be a hospital, infirmary, or some variation of an entity designed to provide medical help.  Within the confines of these facilities, the patients are placed in situations where their privacy is compromised.  The Google Dictionary defines privacy as: “the state or condition of being free from being observed or disturbed by other people.”  The legal definition included in the Merriam-Webster Dictionary is: “Freedom from unauthorized intrusion: state of being let alone and able to keep certain especially personal matters to oneself.”  These definitions are included to provide a backdrop to what goes on day-in and day-out in medical facilities throughout the country.  Recently, my wife was admitted to the hospital and was placed, against her requests, in a semi-private room.  The patient’s privacy is violated throughout the patients’ stay in a semi-private room.  To argue that a flimsy curtain separating the two beds assures privacy is farcical.  During times that I was visiting my wife, I became aware of the various ailments of the patient in the other bed.  I know that she was diabetic, had gout, was incontinent, and unable to walk without assistance.  My wife described the bathroom, which they had to share, as a disaster, including dirty diapers lying on the floor.  While we were cognizant of the women’s condition, she and her husband were, no doubt, aware of my wife’s condition.  A curtain does little to muffle conversation and provide any modicum of privacy.  We continued to request a private room but did not get one until the third day of her hospitalization.    

Indeed, privacy has become an important concept in the age of the Internet.  How do you protect the privacy of another person?  In 1974 the Federal Government passed the Privacy Act and in 1996 the Health Insurance Portability and Accountability Act (HIPAA) became law and included a Privacy Rule section.  In a Department of Health and Human Services (HHS) document, the Privacy Rule is discussed.  It is noted that the ‘Privacy Rule standards address the use and disclosure of individuals’ health information—called ‘protected health information’ by organizations subject to the Privacy Rule –called ‘covered entities,’ as well as standards for individuals’ privacy rights to understand and control how their health information is used.”  Although these laws deal with privacy from a broader perspective, it can be argued that the protection of an individual’s health-specific information fits with the spirit of the laws, if not the letter of the laws.  While there is this emphasis on protecting the patients’ health information, it should be noted that there is a concept known as “Incidental Disclosure” which tends to undermine the intent of the protections included in the HIPPA Privacy Rule.  It allows for the sharing of medical information in a manner that creates a risk of such information not being protected, i.e., a physician talking to a patient in a semi-private room.  Regardless, the patient’s right to privacy should not be compromised for the sake of convenience.  This protection must be adhered to in all communications where health-specific information is being discussed.  

Protecting a patient’s privacy is impossible in a semi-private room.  In Dr. William G. Wilkoff’s article, No Space for HIPAA in My Semi-Private Room, he concluded by stating: “As it stands now, HIPAA in a semi-private room is a bad joke.”  For a medical facility to have all private rooms, does create a bit of a financial issue, yet privacy should not be reduced to a matter of dollars.  The hospital industry includes some of the primary defenders for having the option of semi-private rooms, yet in the American Hospital Association’s, A Patient’s Bill of Rights, the fifth Right is: “The patient has the right to every consideration of privacy. Case discussion, consultation, examination, and treatment should be conducted so as to protect each patient’s privacy.”  The Patients’ Bill of Rights in New York State includes the right to: “Privacy while in the hospital and confidentiality of all information and records regarding your care.”  There is a recognition that the privacy of each patient is a right that must be protected.

As noted, there is an inherent principle of privacy that permeates the health care industry and protections must be in place to protect the privacy of the patient.  When a person is hospitalized, they are at the mercy of the health care providers.  Patients do not loose their right to privacy once they are admitted to a medical facility.  It is incumbent on hospital administrators, physicians, nurses and anyone who encounters the patient to recognize their rights and adhere to them, particularly, the right to privacy.  Further, regardless of the financial implications, semi-private rooms must become a vestige of the past.  Each person has the right to their space and their privacy.