
I
My paternal grandfather, James Harold Cantwell, in his last years, between about 1969 and 1972, his mind and body in sharp decline with chronic illness, wanted to write a book. In the one, single instance he writes about his health it is with panic—“I haven’t any time to spare.” And he did run out of time, dying at age sixty-seven with the book unfinished. It was not for lack of effort. He worked on it for years, writing almost every day, isolated in his own bedroom/study, scribbling away for hours in dozens of spiral notebooks that piled up around him. As a child of nine or ten, I remember seeing him hard at it, bent over his desk in a kind of trance. Though I knew not to disturb him, I peeked in a couple times anyway, my curiosity aroused by a sense that my family didn’t approve. I wondered why.
Continue reading




In 1999 Annie Dillard published
My physician neighbor works in several urban emergency departments where mental illness and substance abuse cases run rampant. When I ask him about the impact on readmissions, he lights up: “Are you kidding? It’s off the charts!”
You’ve probably noticed it’s been a bumpy regulatory ride for bundled payments of late. On November 30, 2017, CMS cancelled two “mandatory” bundled payment programs that targeted cardiac and joint replacement care episodes. Then, on January 9, 2018, they announced a new “voluntary” bundled-payment model for 32 clinical-care episodes. What are we to make of this? Will a voluntary approach work? And what does this have to do with teamwork?
Late one night in April 2018, my good friend and work associate finds it so difficult to breathe she wakes her husband to drive her to Emergency. One day she’s on her feet at work, the next she’s in the ICU, diagnosed with Streptococcus Pneumonia, on oxygen, intravenous antibiotics and pain medication.
My oldest son is on the autism spectrum which brings him both challenges and unique skills, such as perfect pitch and encyclopedic memory. One of his gifts is an ability to see patterns that most of us miss. At least I do.