Baskets? Yes, Baskets!

virgin_islands_national_park__virgin_islands_usSomething happened recently that I’d like to share with you. I’ve decided to change tacks and follow my heart and my gut. Together, Erin Coyle and I have been trying to help others understand the broken health-care system and how to work their way around and through the intricacies of it.  We’ve enjoyed doing it and have even gotten some favorable responses. From time-to-time some of the ideas have shown up as blog posts or as topics on my website: www.imperfecthealthcaremarket.com.

Early in November, I got a call from the St. John Historical Society. They were planning a meeting in December honoring St. John baskets, and they asked me to come down to talk about them. The Virgin Islands, volcanic in origin, rose out of the ocean like mountaintops cropping out of the sea. The two larger ones are St. Thomas and St. Croix. The smallest — St. John — is where I lived for eighteen years. When I first moved there in 1987, I studied St. John basketry. Through basketry, I met Mr. Herman Prince, St. John’s premier basketmaker and basketry teacher. When I told Mr. Prince that I wanted to write an article on St. John baskets, he said, “Before you write an article about baskets and basketry, you

Mr. Herman Prince. St John's premier basketmaker and teacher.
Mr. Herman Prince. St John’s premier basketmaker and teacher. (Picture courtesy of the St. John Historical Society.)

should learn how to make one.” So I took his course at Hawksnest. Not only did I learn how to make a basket, I also learned much about the culture. In 1990, I published a basketry article, entitled, “Basketmaking on the Island of St. John,” in The Clarion, the magazine of The Museum of American Folk Art. My interest in basketry didn’t end there; during my 18 years on St. John, I collected more than 25 baskets, many made by preeminent St. John basketmakers.

The phone call from the St. John Historical Society got me thinking. Sometime in late November, I pulled the collection of baskets out of the attic, looked them over, and realized how special and beautiful they are. Five of Mr. Prince’s baskets arein my collection, as well as others from St. John basketmakers such as Louise Sewer; her daughter, Lorrel; Victor Sewer; Felicia Martin; and Ina George. I also own a basket made by renowned basketmaker Jackie Abrams, who visited St. John in 1993-94.

Looking over my baskets, I thought, “Wow – some of these baskets really are fine art.”

Unbeknownst to me at the time, the Renwick Gallery of the Smithsonian American Art Museum had just launched a basketry exhibit: “A Measure of the Earth: The Cole-Ware Collection of American Baskets” on display from October 4, 2013 to December 8, 2013. Looking over the catalog, I realized that one of the 63 baskets in the exhibit was made by my old friend and teacher, Herman Prince! His “St. John Market Basket” was in the exhibit and is now part of the Smithsonian’s permanent collection; you can see it on the exhibit’s website and on page 144 of the show catalog. One of Jackie Abrams’ baskets was also in the exhibit as part of the Cole-Ware Collection.

I began to really think about my time on St. John, especially the time I spent with the basketmakers. Many basketmakers that I knew, including Mr. Prince, have already died. I quickly realized that if I don’t tell the stories about them, valuable information about the basketmakers and the baskets will be lost, forever.

Preserving the collection – and the stories that go with it – is important not only so people can learn about St. Johnian basketry and its relationship to the culture; it can even preserve and pass on the art of basketry itself. One of the baskets in

Mr. Herman Prince's, St. John Market Basket.
Mr. Herman Prince’s, St. John Market Basket.

the collection is a miniature St. John basket with a cover, made by Ms. Lorrel Sewer. She learned basketmaking – the form called wist work – from her mother, a premier basketmaker in her own right. Ms. Lorrel gave me the basket for the collection in 2000. A number of years later, I got a call from her asking if I would be willing to send it back to her. She wanted to make another one, but she had forgotten how to make the cover.

Ms. Lorrel had lost that skill, and there were no other basketmakers alive to teach her. Because I had preserved the basket by keeping it as part of the collection, she was able to re-learn how to make a basket cover by studying her own work!

So what I’ve decided to do is to make a video that documents my collection of baskets. It will bring the baskets and their history to light and to life. It will honor the basketmakers who came from the small, isolated island community of St. John. I want to help tell the story of how they raised the level of the baskets they produced to museum-quality fine art. I want to make sure that the stories, memories, and culture of these beautiful people will not be lost! I plan to donate the video and  all of the baskets in the collection to the St. John Historical Society. I want to honor the makers and help preserve their stories and culture for future generations of historians, visitors and viewers.

In short, I have decided to follow my true passion. For now, the other important things we have to offer will just have to wait.

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Should I Enter a Clinical Trial–Part Four

What to Consider Before Deciding

choiceIntervention is frequently based on the medical and public perception and assumption that doing something is better than doing nothing. That is not always the case. There are times when the net benefits of all interventions are negative — that is, anything you do will make you worse off.  Rather than starting with the underlying philosophy, “You/We should be able to do something that will fix it” begin by asking what are the likely benefits and costs of each of the alternatives. Then chose the one where the net benefits — the benefits minus the costs — are likely to be the greatest. Take no action when that provides the best results.

When the patient/consumer is not paying for the service, he/she is placed in the position of not having to consider what they are giving up when having the procedure. When that happens they are more likely to elect to have more services than they would if they had to pay for them. Historically, that goes under the name “Moral hazard”. Moreover, the prescribing practitioner and the PhysicianFirm almost always benefit from the additional revenue they receive from providing those services. Often it is someone else, like an insurance company or the government, who ends up paying the bill. Continue reading “Should I Enter a Clinical Trial–Part Four”

Should I Enter a Clinical Trial–Part Three

An Example of What Happened

We would like to provide a concrete example about the consequences of participating in a clinical trial. It is based on Amanda Bennett’s The Cost of Hope. She is a fine journalist and currently Executive Editor of Projects and Investigations at Bloomberg News. The book documents her husband, Terence Foley’s, seven year bout with kidney cancer. Initially, Foley was diagnosed with an atypical and aggressive form — collecting duct kidney cancer. It was spotted in December 2000 during the operation to remove his intestines to treat his ulcerative colitis. There were only 50 known cases of it worldwide at the time. This alone makes questionable whether his participation in the clinical trial contributes to our understanding of the potential benefits for future patients. In January 2001 when it was diagnosed, the prognosis was that he had a few months to live. [Bennett, p. 66] He died of it seven years later in December 2007. Continue reading “Should I Enter a Clinical Trial–Part Three”

Should I Enter a Clinical Trial–Part Two–The Beneficiaries

The Beneficiaries

It is at best uncertain whether you or anyone else currently in your condition will benefit from your participation in a clinical trial. If the trial is successful — and as we have mentioned earlier not all of them are — and the drug or appliance is cleared for marketing, some of those who get a similar condition in the future may benefit from it. Your participation is your legacy to them. But the important question is, “Who benefits now?” That is particularly relevant since large amounts of time, effort and money go into clinical trials. Someone must believe the investment is worthwhile. Let’s take a look at each of the stakeholders.

The stakeholders

Those conducting trials are stakeholders in it. They benefit from it. They include:

  • The doctors and other practitioners involved.
  • The organizations and institutions they are a part of and represent– the Medical Centers, Hospitals, Universities and PhysicianFirms.
  • The pharmaceutical and medical equipment companies whose products are being tested and who sponsor the trial whose self-interest is definitely connected to the success of the project.

The principal investigators — a.k.a., the lead doctors — have their reputation on the line. The study is based on their hypothesis. If the clinical trial turns out favorably, they can say, “See I was right!“ Not only is that a boost to their ego, it enhances their reputation and all that goes along with it. If successful, they get to publish the results and present the findings at national meetings. Moreover, it enables them to test out their ideas, to get funds for their projects and it increases their income as well. Those personal benefits contribute to their wanting you to participate and, perhaps, inadvertently encourage you to do so. That is particularly true when the number of possible candidates for the clinical trial is limited, and the lack of participants threatens the validity of the results or even makes it impossible to conduct the trial. In fact, the possibility of being pressured to enroll has led to the requirement that in order to participate in a clinical trial you must sign a form indicating that you are giving your informed consent. Continue reading “Should I Enter a Clinical Trial–Part Two–The Beneficiaries”

Should I Enter a Clinical Trial?

pillsWe have all seen the ads on TV, heard them on the radio or read about them in a magazine. There are many clinical trials being conducted all the time devoted to the study of numerous conditions and potential treatments for them. It is likely that whatever condition you or a loved one may be dealing with, somewhere there is a clinical trial being conducted.  Maybe you or someone you know has been asked to enter a clinical trial. Perhaps your doctor suggested it, and since nothing else seems to be working, you think, perhaps, it would be a good idea. You may be asking yourself “should I?” or “shouldn’t I?”  In order to answer that question it is important to understand the nature of clinical trials and how participating in one will affect your life.

In this four part series we will address:

  • What clinical trials are all about and how they work.
  • Who are the beneficiaries.
  • An example of what happened in one case.
  • What to consider before deciding to enter one.

If you allow yourself or a loved one to “enter” a clinical trial it is important that you understand what you are doing, what is involved and what you can expect. Moreover, it is also important to recognize that the stakeholders have a significant vested interest in your participation. In this series of posts, it is our objective is to help you understand the likely consequences — the benefits and the costs — beforehand. Hopefully, we can help you make the decision that will be best for you. Please post your stories, insights and experiences. We always enjoy hearing from our readers.

 

 

The Internal Adjustment System: A closer look

The Internal Adjustment System: A closer look

Let’s look at the body as a self-regulating machine to see how it functions to maintain body temperature. Its ability to do that is dependent upon the energy and other inputs required. They must be available. When the system is working the body is able to perform the tasks and produce the outputs required of it. As with all other mammals, a primary function – one necessary for survival – is maintaining its body temperature. For humans typically that is 98.6°F. Humans have developed a bodily system that enables it to maintain that temperature. They are able to do that in spite of considerable variation in the temperature in the external environment. Let us define what we will call the ideal external temperature. It is one that requires the body to expend the least amount of effort and energy to maintain its internal temperature. Let’s assume that it is 68°F. Any lower outside temperature requires more energy. As does any higher one to cool the body off. Continue reading “The Internal Adjustment System: A closer look”