review | A Mild Voice of Reason

Grand Staycation V is entering its final days. I return to the office on Jan. 4.

I’ll admit to looking forward to 2016 with a sense of expectation. Caffeinated Press has taken off by leaps and bounds. I’m soon to join the board of directors of the National Association for Healthcare Quality and am excited to help tackle the organization’s aggressive strategic plan. I’m in a good place right now.

Over 2015, some significant things happened —

We wrapped up work in January on the Health Data Analytics competency framework within NAHQ. Even managed to be profiled as a national expert on the subject.
Caffeinated Press launched several products — including Brewed Awakenings, A Broken Race and A Crowd of Sorrows as well as The 3288 Review literary journal — and leased commercial office space in July. Hard to believe we’re already listed in P&W and Duotrope and are kicking the 100-submission mark for the third quarterly issue of the journal.
Managed to attend a musical, an opera and a symphony performance over the course of the year, as well as to add a couple of new entries to my diving log.
Went to the National Quality Summit in Philadelphia in April and presented at the RL Solutions conference in New Orleans in May.
I bought a 2013 Chevy Cruze over the summer.
I managed to get my department at Priority Health fully staffed and firing on all cylinders.
The 2015 annual educational conference of the Michigan Association for Healthcare Quality — which I chaired — enjoyed more than 60 attendees over the two-day event at the Amway Grand Plaza Hotel.
The VLO podcast crossed the 250-episode mark in November. And Tony has been editing for several months now, to great effect!
For the third consecutive year, I “won” National Novel Writing Month. A day early, to boot.
In September, for all practical purposes, Demand Media froze most of its editorial operations. I’m still on “the list” and I do occasionally get small-project pitches, but the days of DMS being a consistent source of supplementary revenue have evaporated — a situation with both upside and downside potential for me in the long run.
I ended the year at the same weight at which I started it. Which, while not great, is at least consistent with the fact that I ended 2014 at the same weight as I began it.
Baby Emma was born in September to my second-eldest cousin and her fiancé.

So it was a good year. I’m happy with the outcome. I didn’t get all my goals accomplished, but other goals I knocked out of the park, and some of my biggest wins I could not have envisioned on 1/1/15.

I’ve had one real major life lesson, though, that will guide how I approach 2016.

Let’s begin with some context. The first half of last year was busy; a consistent low-grade buzz of stuff to do kept me hopping. Over the summer, the pace intensified. We had a ton of CafPress work, plus extra time at the day job, plus conference planning for MAHQ, plus, plus, plus. It got to the point where I fell more than 1,500 emails behind and was running two to four weeks, on average, just to respond to non-urgent messages. And then people yell: Authors who want their books published, MAHQ colleagues with questions about conference planning, folks at the office who want their projects prioritized, people who cannot grasp that just because they have free time doesn’t mean that I do as well, etc.

I spent a lot of time apologizing and a lot of time stressing; that anxiety took a bigger toll physically and emotionally than I care to detail. Then, in November, as a counterpoint to some of the “processing” I wrote about in October, I had an epiphany: I am not beholden to other people’s proprietary expectations about what I should do, when I should do it or how it ought to be done. I am a capable, competent adult who knows how to set priorities and get things accomplished. With the exception of work-related subjects relative to my day-job boss, I don’t need to explain or defend my choices or my problem-solving approaches to anyone. Of course, this epiphany isn’t exactly rocket science; most of you beautiful readers will nod your heads and say, “Well, duh.” The thing is, for me in November, that knowledge moved from being an abstract concept to an internalized reality — it migrated from the head to the heart.

My thinking now is that I do the best that I can with the time and talents allotted to me, and if people don’t like it, such disappointment is solely their own to bear. I have better things to occupy my mental focus!

I refuse to be bullied into getting things done in half-assed fashion just because someone acts like the squeaky wheel and needs it now-now-now. I refuse to be bullied into responding to falsely urgent fire drills at the expense of stuff that’s genuinely important. I refuse to be bullied into responding to something before I’m ready on account of snarky comments about how difficult it can be to reach me at the commenter’s own convenience. I refuse to be bullied by people who throw temper tantrums just to get attention or to coerce some due date that meets their needs but doesn’t make sense in light of my entire workload. I refuse to be bullied into apologizing to people because I’m not Burger King and they didn’t get it their way.

I refuse to be bullied.

I fucking refuse.

And in such refusal, as if by magic, I feel better about the world. When your mental focus pivots to doing the right thing and doing it well, instead of making people happy, you’ll end up achieving more and incurring the respect of others. (Well, maybe not the jackwagons, but no one cares about their opinion anyway.)

I sometimes wonder why so many people believe they’re entitled to set expectations about how others should live their lives. Much of the angst that I’ve experienced over the years flowed from the self-inflicted injury of trying to meet other people’s expectations, without seriously evaluating whether those expectations were even legitimate.

But not anymore.

Like I said: I’m looking forward to 2016 — and to a lower-stress year.

January is already a memory. Wow. Let’s recap some highlights.
Auto-Mania
Around Thanksgiving, I started my GMC Jimmy one morning and heard a bit of a squeal and smelled an odd aroma reminiscent of a mix of oil, burning rubber and ozone. It came, it went, life went on. But Jimmy started to act a little funny — eventually, I’d experience intermittent periods where the charging system would fail. Then it would come back to life, as if by magic.
Over my Christmas vacation, I vowed to fix the problem myself, if I could. I popped the hood and voila! — it was immediately obvious that the pulley on the belt tensioner was broken. As in, chewed to pieces. The entire serpentine belt was chafing and parts, like the alternator, weren’t being properly driven.
“I can fix that!” I said to the cats. So I did. I bought a replacement pulley from AutoZone (1.04 miles from my house by foot) and replaced the damaged part. In single-digit temperatures. Outdoors. Without gloves. Woohoo. So I got that part replaced and what happened? You guessed it — sitting for a few days, in the cold, after having had intermittent charging, left the already worn battery too weak to soldier on. So on one of the snowiest days of early January, I trudged to AutoZone on foot, bought a replacement battery, carried it home through drifts as high as two feet — and, after I installed it, thought, “Geez, why didn’t I just call a cab?”
Battery worked. But still no charge. Damn it.
So back to AutoZone for a replacement alternator. When the weather got a little nicer — as in, the upper 20s — I swapped alternators. Only hard part about that process was getting the bolts aligned on the new unit. So I fired up the ol’ girl and watched the voltmeter go from 11 volts to about 14 over the course of a minute. Then I flipped on the defroster and the system immediately dialed to 11, never to recover.
By that point, any other fixes would be guesses, because I lacked the tools and expertise to diagnose what might have been an odd fault somewhere. I took Jimmy to Community Automotive, whereupon I was informed that the problem was that the alternator wasn’t putting out a charge. Translation: They said AutoZone sold me a defective replacement part.
They also told me that the tensioner was screwed up and the serpentine belt was super worn. So I said, “Fine. Replace the entire tensioner assembly and the belt. I’ll deal with AutoZone on my own.”
I picked up Jimmy from the shop — and lo and behold, the charging system works. I’ve been driving it for a week and my voltmeter is fine and I’m clearly not driving on the battery alone.
My guess? Community Automotive determined a bad charge on the alternator with a misaligned belt. After the belt was replaced and the tensioner re-aligned, the alternator was good to go. But I’m still keeping my eyes peeled for a while for signs of charging-system faults.
Food Deserts, Public Transportation and Good Health
While Jimmy was undergoing repairs, I opted to play it safe and keep it parked until I knew the problems were fixed. That left me to find alternative transportation to work. Daily cab fare runs $50 between my house downtown and the office on the far northeast side of the city. But, I live near a bus stop, and there’s a stop about an eighth of a mile from the office. So, problem solved — for $3/day, I can just Ride the Rapid.
I don’t mind the bus. The Rapid buses are clean and run mostly on time. My biggest gripe with the system is that the metro area consists of an urban core surrounded by inner-ring suburbs that aren’t well connected to each other. The transit system uses a hub-and-spoke model that routes most buses through the downtown Central Station; there are just a handful of crosstown routes that don’t connect through Central. In a practical sense, then, getting most places takes longer than it needs to. My drive from home to office is about 15 minutes; my bus commute, door to door, takes a full hour. We really need more ring routes and crosstown routes to connect disparate parts of the metro area without having to head downtown so frequently.
(I think a shuttle service between Standale Meijer and the Grandville Library is essential, as is a park-and-ride lot at Plainfield and the Beltline where Route 11 extends all the way to the Beltline, then a crosstown route connects that lot with Knapps Corner, Meijer Gardens and then Woodland Mall. If the Rapid folks were super clever, they’d run a two-way square ring route starting at Leonard and Alpine, proceeding on Leonard to Plymouth, south to Franklin, west to Godfrey/Market, then follow Wealthy to Straight, Seward and back to Alpine — thus crossing a whopping 19 routes without actually putting in at Central Station, a potential time-saver for folks who just want to get from one part of the periphery to another. But I digress.)
My location, in the South Hill neighborhood, puts me within reasonable walking distance of a small Family Dollar and the small Wealthy Market. Neither establishment stocks an assortment of healthful foods. Family Dollar, for example, offers no fresh fruits or vegetables and the freezer section consists of pizzas, burritos, ice cream and such. Were I to aim for healthy eating, my only real option is to trudge a few blocks to a bus stop, head to the Kalamazoo Ave. Meijer, buy groceries, then trudge back. That’s a lot of time and effort — moreso than most would undertake.
I’m not a huge activist for Michelle Obama’s “food desert” propaganda, but I do note in passing that if I were permanently confined to public transportation, I’d either need to radically re-think my daily routines or acquiesce to less healthful foods. Puts the “chronic co-morbidities” question into a different lens, methinks.
Caffeinated Press
I’ve mentioned it before, but perhaps not in adequate detail. So here goes.
In mid 2014, a group of colleagues and I established Caffeinated Press, Inc., a for-profit S corporation organized in Michigan. Our mission as a small independent publisher is to connect authors and readers in the West Michigan market. I serve as chairman of the board and chief executive officer; in that capacity, I also oversee the acquisitions and editorial processes. The company includes five board members and several outstanding associates who are working hard to build the company.
I’m putting the final touches on Brewed Awakenings, the first of what we intend to be an annual house anthology. Production has been labor-intensive. I’ve had to proofread roughly 85k words, manage layout, design the cover, develop the front matter, etc. Takes a lot of time — indeed, the bulk of my month has been spent on anthology production. Eight local authors contributed novelettes to the anthology; I’m in it too, with “Providence,” a story set on Lake Michigan. Our very loose theme was “all goes dark,” but the work we’re publishing includes some humor, some gore, some romance, some speculative fiction. Good stuff. We’re producing the anthology in both paper and e-book formats; the paper version will appear in the Ingram catalog and the e-book versions on Amazon, Barnes & Noble, Overdrive, etc.
The board recently authorized the production of a quarterly literary journal, called The 3288 Review. More details on that, later.
Health Data Analytics; State Leaders Team
I’ve wrapped up most of my work on the Health Data Analytics project for the National Association for Healthcare Quality. With my colleague Tricia, executive director of outcomes for an Illinois hospital, we led a team of health quality practitioners from across the country on an exercise to define the emerging competencies necessary for the next generation of practitioners. Our charge focused on health data analytics — i.e., Quality pros who specialize in analytics. Interesting work. Our report goes next to the NAHQ board of directors.
And on the subject of NAHQ, this year’s president asked me to move my cheese a bit. Instead of rotating into the second-year lead role for the Special Interest Group team, she asked me to begin a new two-year cycle as co-lead of the State Leaders team. That puts me and my new colleague, Andrew, in front of the presidents and presidents-elect of the various state-level health care quality associations across the country. Andrew is a top-notch fellow and our assigned staffer at NAHQ and our board liaison are very easy to work with. Looking forward to this new opportunity.
Surgical Site Infections
With one of our physician medical directors, I recently authored an internal white paper about the costs associated with surgical site infections for patients who are fully embraced within a particular accountable-care organization. The numbers were low — but we recognized that part of the problem was identifying SSIs correctly amid a paucity of accurate physician documentation that works its way into an administrative claim record. Looks like this early report will fuel a broader review of how healthcare acquired infections are managed within our ACO. Potentially publishable research!
Texas, Ho!
Still on track, in a few weeks, for a brief excursion to Texas. My plan is to drive from Grand Rapids to Shreveport, LA, and spend the night at a casino there. Then, drop of my friend Duane’s stuff in East Texas, then push through to the Dallas Metroplex to catch some of the Thinline Film Festival shenanigans. I’ll head back to The Mitten by means of Oklahoma City, so I can catch some prominent casinos along the way. Basically, killing three birds with one minivan.
Miscellaneous Updates
Some other tidbits of interest —

Enjoyed a lovely podcasting marathon yesterday with Tony. We had sushi at Maru, enjoyed some Japanese whiskey and cigars at Grand River Cigar, and then retreated to my dining room to push out four episodes. The cigars came to us courtesy of Famous Smoke Shop, an online retailer, that’s partnering with our podcast.
I get to hire a new intern and a new senior analyst this fiscal year. Yay!
One of my contract clients had a change of leadership in my area; the upshot is that I’m being invited to do more management stuff, as a contractor, that had formerly been the sole domain of company personnel.
We’ve got a severe winter warning right now. As I write this, I see heavy, blowing snow creating white-out conditions at a quarter mile. Beautiful. If only I had thought to buy firewood so I could have a fire tonight.
Looking forward to the county convention next week, in anticipation of the 2015 Michigan Republican state convention.
My next writing project might be a textbook about health care quality.
Fleshing out my author page on Goodreads reminds me of how little time I have to actually read. That said, I’m about 60 percent done with Francis Fukuyama’s Political Order and Political Decay, the second of two volumes dedicated to revisiting and extending the groundbreaking research of Samuel Huntington into the origin and evolution of political institutions.
I cut the cord. After paying Comcast $220 per month for years for TV I rarely watched, a phone I never used and Internet that sometimes crawled to a halt, I gave them the boot and now rely on AT&T DSL for $40 per month. I still have Netflix and Hulu Plus, and Skype and my cell phone, so … yeah.

Hoist Upon Chait’s Petard
Some concluding thoughts about this week’s pundit nerdfight over Jonathan Chait’s essay, “Not a Very P.C. Thing to Say.”
The back-and-forth over whether Chait makes a good point or whether he is some sort of hypocrite or whether he is locked in his own view of privilege — well, it’s all already been said. The most fitting coda, I think, is merely to observe that the dour puritanism of today’s Left will, perhaps inevitably, engender a systemic backlash from within the Left itself.
The human mind enjoys a finite capability to accept cognitive dissonance, let alone the doublethink that lets people hold mutually inconsistent assertions to be true without it even triggering that dissonance. Indeed, the New Soviet Man was a creature of this doublethink. But even with relentless propaganda, nuclear missiles and Kalashnikovs, the spark of truth couldn’t ever really be repressed. The events of 1989 bore that out. Yet the Left today is increasingly reliant on authoritarian systems of psychosocial control that require doublethink to avoid cognitive dissonance. At some point, the average Man of the Left will ask: Is this really what I believe? And when that happens, the bottom will fall out.
There’s something odd, for example, in holding that the concept of a gender construct is sufficient to change reality. Were I to announce that I identify as female and henceforth want to be known as Jane, most on the Left will applaud my bravery, call me Jane and use “she” as a pronoun. All that, despite inconvenient reality of my XX chromosomes (and sexual organs). One would think the “science is settled” about biological sex at least as strongly as it’s allegedly settled about climate change, but ….
So, again — the mind’s ability to square the cognitively dissonant circle isn’t without limit. Regardless what you think of Chait, or his arguments, the Thermidor he points to may dawn more swiftly than some expect.

Onward, 2016, to the Year of Refusal!

What a Month!