Five Star Medical Care with One Star Customer Service....

Recently I had back surgery at a world-renowned teaching hospital. Before the anesthesia kicked in I counted 12 professionals in the OR, including a Neuro-Surgical Tech team electronically tracking my body's every impulse. The surgery successfully removed a benign tumor in the spinal sac, with no nerve damage. I am grateful - for having health insurance, for the availability of diagnostic tests to determine so precisely what the problem was, and of course for awesome scientific advancements that make this micro-neurosurgery possible.

Then comes the low-tech hospital part of the experience. I was moved to a double in the spinal surgery unit which consisted of about 25 rooms off a long central area. Nurses dutifully come around and dispense meds, but beyond that, you are no longer the center of attention. The second night I was in the hospital, when my mind was working but my body couldn't do much, I found myself composing a blogpost about all the ways hospitals miss the mark for good customer service - the customers being the patients, of course. It was a nice way to channel my energy. Here are a few of my observations. If I Ran the Zoo, hospital designers and managers would have to lie in a bed for a day before proceeding with their jobs.

• Clocks. Patients generally are told not to bring any valuables, and all your personal belongings are hung in a closet which a back surgery patient has no access to. So no watch. Time matters a lot to a hospital patient - for general orientation purposes, to know when your pain meds are wearing off, etc. My room had one large wall clock. When the curtain was pulled to separate the two patient areas, I could no longer see the clock. Apparently only 926A needs access to the clock; screw 926B.
• TV Access. I hardly ever watch TV, but the last night, restless and not able to hold a book up, I experimented with the overhead TV. There were a couple of junky cable stations, plus a station featuring the head of the hospital telling patients how valued we are. But if you wanted any conventional stations (I was hoping for NPR), you have to pay an upgrade! I just saw a bill for my treatment: $68,000+ - but no decent TV unless you pony up! It is not easy to pay if you don't have a credit card at the ready, having listened to the advice of the hospital and not brought your wallet. Man, that pissed me off. My husband tells me there was a number on the TV screen to call for activation, but I figured there was no point if I didn't have a credit card.
  
• Food. I probably wouldn't have eaten any food, but the offerings were astonishingly unappealing. The meal that comes to mind - the vegetarian offering - was a plate of white rice. You don't get condiments unless you order them, apparently. Like there's no connection between nutrition and healing? To go with it was a piece of pumpkin pie. I was reminded that in the developing world, hospitals do not provide meals. Patients' families encamp and provide food. Not very efficient, but I bet it has lots of psychic benefits for the patient, as well as straightforward physical benefit.
  
• Call Buttons. Despite the existence of technology that could communicate a patient call instantly, the system employed is a light board. The patient presses a button and a light goes on; when staff happen to notice it, they come. My roommate waited 90 minutes to be taken to the toilet. Unreal.

This hospital did offer a concierge upgrade package, but it was a secret, apparently. Seems like it would have been worth it. I could have used someone holding my hand (once my dutiful husband had checked out for the night), serving me some food that didn't offend, and generally listening to what I was concerned about....

Fortunately I am healing well.

Organic College Cuisine vs. Bed Bath and Beyond

The first day of college is a wonderful ritual. Unlike my day when my folks shipped my trunk and put me on a plane, now parents join their kids.
A friend who is writing a piece on environmentalism pointed out how local food is now the sexy area of activism, while paying attention to material objects' origins and fates is less so. This was readily apparent at my daughter's very socially-conscious school Kumbaya U. The dining hall options are eco-awesome! Each table posts their many sourcing options which include vegetarian, vegan, "Farm to Fork" local food, organic, Monterey Aquarium approved sea food, in addition to normal college fare. (But with plastic plates, silverware, and glasses. Go figure. Maybe that was just because of the extra number of visitors there yesterday?)
Contrast that with the scene in the dorms: next to the recycling receptacles were mounting piles of packaging (not readily recyclable on-site), all the boxes and plastics from the essentials provided by Bed Bath and Beyond. We did not fail to stop at BB&B ourselves, since they sell every imaginable item under the Chinese sun. They cleverly provide shipping to your college's closest store, from any location in the country. For a few weeks dorm stuff is this big box store's special feature. As my daughter astutely pointed out, they play on new college students' anxieties about what they will need to be happy away from home. The thing that caught my eye yesterday was a CEO-sized swivel cushioned office chair. Apparently for some the standard issue desk chair is now insufficient for academic success.
Of course come May, a huge percentage of this stuff winds up in the dumpster, since there's no simple way to bring it home, nowhere to store it, and lots of it is not really necessary anyway. What is being marketed is not quite disposable, but not long-term use either. Very clever of BB&B.
Check out Dump and Run and individual colleges' adaptations of this program, groups which promote salvaging and reusing all the discards at the end of the academic year.

The Confisgated ATM Card Theory of Feelin' Poor

The underlying point of this series of posts is that past the point of "enough", feeling rich or poor is primarily subjective. My last two posts were about feeling rich, so I decided to write about times I have felt poor. 

I preface this first story by saying I am not poor. I was raised in a middle class household, and have never lacked for any basics, so the feeling was subjective and temporary.
About 10 years ago we took our two children on a long-planned trip to Europe. My husband was on sabbatical and working at home, not at another location, so we took the opportunity to literally think: where in the world would we like to go as a family? We zeroed in on Germany where my husband's parents were raised before they escaped prior to WWII. Some Jews avoid going to Germany, but since the family had so much history there, we decided we wanted to show our children the places their grandparents talked about fondly, from their happy pre-Nazi childhoods.

We arrived after a night flight. I hadn't slept a wink, never do, so I was pretty groggy when we got to Munich. I knew that we could use our ATM to get Deutsch marks (this was before Euros) so while trying to ignore the sound of German blaring over the PA system and reminding myself it was 50 years later and not WWII anymore, I gingerly marched up to the ATM. I punched in my PIN #, but the transaction didn't go through. I repeated the procedure, but the second time it didn't work either. Then I remembered we had brought two different ATM cards and that I was punching in the PIN from the other account. I corrected myself on the third try and wham! The ATM confisgated my ATM card! I just stood and stared in disbelief. How dare they!!

There we were with our kids in tow, and not ten minutes after arriving in Germany our money had already been taken from us! I reacted somewhat hysterically, partly I realized later, for precisely that reason. We made a hasty visit to the local bank, and their snotty indifference to our undeserved plight was even more maddening.

Hmmmmm. A five-week family vacation ahead looming, and no ATM access to our cash.
In truth I don't recall how we solved this, since the replacement ATM card never arrived as promised. But until we devised other methods -which we did once I got a grip - I felt very poor. All the money sitting at home in our checking account did nothing for me, without the ATM card.

We take for granted how our assets cushion us. It was not the same as actually being poor, but it was a good lesson in humility.

Political Contributions: Not Philanthropy, but What Exactly?

I had never donated to a specific political campaign candidate until a few years ago. Since I am a committed voter, have volunteered on campaigns, and follow politics closely, why not? For the simple reason that no one ever asked me personally. We sent an occasional very modest contribution to the Democratic party [yes, big surprise that I am a Democrat, right?!], but that was it.
In 2004 a friend solicited us to donate to the State Senatorial campaign of a young unknown underdog, Josh Shapiro. I trust the friend's judgment, the donation was insignificant in our budget, and it made me feel good to say yes to my friend (who has said yes to things I have asked him to contribute to), even though it wasn't in my district. Not only did Josh WIN, he has already been re-elected and is a rising star in the State Legislature. That feels great! For $25, when I ran into him at a fundraiser for a different candidate, I got to tell him I was one of his backers - he even sent us a complementary 2007 calendar. Note that I actually do feel very invested in him; I am very proud of his success and I'm sure I will contribute to further war chests as he rises up the ranks. It's rather like buying a flyer stock; you feel really smart for being an early investor. So I can only imagine how the Big Donors feel when they help elect a candidate.

We did get on a list of invitees to other campaign fundraisers and decided to contribute to a bigger donor event for this past fall's congressional campaign. The reception held a room full of people who had made significant gifts to attend the event and meet and hear from the congressional candidates; I felt like I was being inducted into a secret society. I recognized a few folks from around the neighborhood, some from other donor benefit events whom I think of them as my Fundraiser Friends, since that is where we intersect. I realized I was quite the naif: obviously this is how political campaigns have always been run, but before then I had never paid enough to have access to this scene. [Once again our guy, Patrick Murphy, won. I'd say we were on a roll, but the other candidate we supported lost, as did the mayoral candidate whom we backed.]

There are campaign contribution limits which change the game some, though I don't believe there are limits on HOW MANY campaigns to which one can contribute. Volunteering is another way to contribute, of course, but donating, or donating and volunteering gains you more visibility. A willingness to lead a candidate to one's wealthy contributer friends obviously makes a person very attractive.

These are not selfless gifts. They help the candidate a donor has determined is his or her choice. Donations finance the campaign of a candidate the donor hopes will win, and then support the causes the donor cares about, some of which may benefit the donor directly. On the other hand, donor motives are not all selfish; many of those who will benefit from the candidate's decisions are people whom have no money to influence campaigns. Donors focus on every issue imaginable. It is a form of lobbying.
We have concluded that while not tax-deductible, our political campaign contributions are at least tithe-deductible. I feel a certain sense of noblesse oblige. Backing candidates, even to a modest degree, seems like good citizenship, a kind of self-tax on privilege.

But it doesn't feel like this is how democracy is supposed to work! It was heartening when a local wealthy businessman spent $10,000,000 of his spare cash to run for mayor and lost; however that was the good news. The bad news is that successful candidates have to be excellent fundraisers, period.

PS Josh Shapiro was elected Governor of Pennsylvania in 2022. :-)

The $300 Prom Challenge!

I've decided to repost this, since it's prom season again, and I wrote this when I had many fewer readers. Enjoy!

It's prom season, and plenty of parents have their credit cards at the ready, financing this perfect teen Night To Remember. Some high schoolers take on extra jobs to help foot these gigundu bills. Our daughter attended a private, affluent suburban high school (which I generally loved), so I braced myself. While her friends were generally more distinguished for their idealism than their materialism, when the occasions arose, the money was there. For Junior Prom, I looked the other way and encouraged her to spend what seemed appropriate in such a context. I didn't want ruin the fun or embarrass her with my soapbox preaching about waste and excess. She found a great dress on-line, in the low 3-figures, needing alteration ($50). There were the shoes, the requisite Up-Do , also $50, the boutonnière, the ticket ($75, chivalrously picked up by her date), and the one that really got to me, and mortified my daughter, too: the Hummer Limo. She skipped the manicure and day-at-the-spa, but quite a few of her friends added that to the day's prep. They all looked great and had a lot of fun. About a million pictures were taken by adoring baby boomer parents.
Senior year the story was different. She had decided to take a gap year and was focused on earning money to cover her living expenses, so we made her a deal. We figured out a prom budget of $300 based on Liz Pulliam's article citing the American average of $296. We told her if she came in lower than $300, she could pocket the difference. I figured I'd rather spend it on her than on all the trimmings, and she quite agreed.
Here's how it all worked. She went to a conventional department store to see what the dresses were like. Awhile later she called from Daffy's, a designer discount fashion store, to ask if she should buy a terrific black long dress that looked great on her and cost $35. The answer from her mom was "Yes! What are you, crazy?" Score. She wore junior year shoes, bought a brooch on Ebay, tried (unsuccessfully...) to lobby against limos and do a trolley bus, which would have been cheaper, and covered her ticket. I read up on boutinniere-making, which is simple as could be. The yellow roses were in bloom, and I made her date's boutonnière. I will never see yellow roses in early summer without happily thinking of her senior prom.
The biggest challenge was the hair. Having performed in scads of musicals, Nomi knew how to use a curling iron and copious hair spray to do fancy hairstyles. I volunteered for the job, though I hadn't done hair since her pigtail days. It takes a very long time, and I unfortunately wielded the curling iron against skin a few times, but eventually I got the hang of it. She was very patient. It did cross my mind that I might have been better off springing for a professional to do it, but slowly beautiful ringlets, and a radiant daughter, emerged. It was actually quite a creative thrill, and something very special to share. That night when the cameras snapped and friends complimented her on her hair, she winked at me, and said "My mom did it!" Priceless.
The bottom line? She socked $115 away for her gap year, aced the financial challenge, and looked like a million bucks!

The Revenge of the Baby Boomer Parents

Baby boomers do not like getting old, it cramps our styles. Prosperous baby boomers seek challenges, take good care of themselves, and like adventures. Some are finding their children are offering new opportunities to visit cool places. Your kid goes to study in South Africa, so you go too. Ditto many other places on the planet.
My visit to Israel has evoked many memories of my being a student abroad here in 1972. I was part of a program of 47 students and unless my memory fails me, I don't remember parents coming around to visit. My parents did, but as part of a tour. On my daughter's program, virtually every kid had a parent visit, some more than once!
Visiting your young adult student/child is actually a nice balance of parenting and following. The fact that the child knows his/her way around a place where the parents are completely unfamiliar and out of control shifts the power, even though the parents are still the ATM. And parents love seeing the kids confident and capable in a foreign environment. The kids love a little pampering - it is exhausting living and studying abroad.
Another thing that baby boomer parents are doing is going on adventures and sharing experiences with their kids. On the bikeride my husband just finished - hooray, it went well! - there were at least half a dozen baby boomer parents participating with teenaged or young adult kids. This is not a bikeride for the faint of heart - they went 300 miles on desert terrain. How cool that they can share the physical challenge, as well as using their privilege (it is expensive to gear up, train, and travel for this ride) for philanthropy. I can truly not imagine, in my wildest dreams, any of the moms and dads in knew in the 1960's doing anything this edgy. They didn't have the time, the money, or the exposure to any of these possibilities. My mother would have considered a 300 mile bikeride in the desert in the same category as a trip to Mars.
The word is generally that baby boomers and their kids are much closer than the youthful baby boomers were to their Greatest Generation parents. Sounds right to me.

Schedule T: Tithing

A few years ago my husband and I made a commitment to tithe, donating 10% of our income to charitable causes. This reflected a growing confidence in our financial situation, a desire to become more systematic about our charitable giving, and the availability of software to make tracking easier. Of course many people in the world tithe on very modest incomes, but it was not yet part of our consciousness. It was also spurred by the fact that as income grows, the percent that one spends on necessities decreases. (Of course as income increases, it's often accompanied by an escalation in one's definition of necessities, but that's a post for another day.)
The ten percent is fairly random. We were inspired by the biblical tithe, but while we consider charitable giving to be commanded in some sense, our formulation is idiosyncratic. We take our gross earnings, both earned and investment generated, subtract all the various taxes we pay, and add some of our pretax benefits. The net of that equation yields our number for the next year. I think of it as Schedule T because we don't have the numbers in hand until we've prepared our income taxes. Our list of "tithe-deductible" donations is not identical to our itemized charitable donations, because for tithing purposes we include political donations and some gifts to lobbying causes which are not tax exempt.
Tithing is widely observed in some church communities, but in secular life it seems to have more or less disappeared. We like it because it is a structured approach and takes some of the randomness out of charitable decision making. We know what our annual pledges and commitments are and how much "discretionary" contributing we can do. We can track where we are in the year, as with any budget information. We simply set up a GoogleDoc, and list each donation on it, with a running tally. And at year's end, if the funds are gone, we have a graceful way to decline solicitations. "We overspent our charitable budget" feels less icky than saying "no!". One common pitch is "don't give until it hurts - give until it feels good." This feels great.
And it's nice to know we've inspired at least one young person do to this, too.
When I went looking for a visual, the tithing images were very pious. To me this is not about piety. Giving is one of the great privileges of being privileged. But to my surprise I did find a tithing Money Clip.