Cell Phone Free Christmas

Like most adults under the age of 60, Romeo Sierra and I tend to be tethered to our cell phones.   Regardless of the day of the week, where we're physically located, or how we're feeling, the cell phone is always along for the ride.  And while that instant connectivity in the palm of the hand can be great, there's also a downside to it in that we lose sight of what's in front of us in the here and now.  So while the world celebrates Christmas, Romeo Sierra and I have decided to make it a "Cell Phone" Holiday, which means no looking at, touching, or using the phone until 5 P.M.   Computers, TV, Xbox and other technology is OK for the day, so while she catches a few extra winks of sleep, I'm  hopping on the blog.

Regardless of the what you celebrate, the holidays are a good time to slow down, take inventory of what is going on, and look forward to what's on the horizon.  And although I'll keep some of my reflection to myself, I figured I'd throw together a "Year in Review" to take a look at what 2012 was all about.

When I began writing on the blog, I shared some thoughts around a framework I used to define health.  I essentially "chunked" life into major components (my physical health, my career, my finances, my hobbies, and my relationships) and set some goals about what it would look like to be "healthy" in each component of life.  My thinking was that if I could objectively define what "success" or "happy" looks like in each of these areas, I could focus my time, resources, and efforts on those activities that I believe will translate to a 'better' state.  For example, if financial health meant saving $X in a certain time period, I could set up a savings plan to save that dollar amount.  If physical health meant working out a certain number of times each month, then I'd track how many times I went to the gym, and so on and so forth.  I even took it so far as to set goals and track the number of books I read, concerts I attended, and rounds of golf I played.

Over time, I've gotten a little less objective about how I'd define happiness but I still find value in shining a spotlight at each area of life as I think about where I'm at and how things are going.  The last few months have been very intense and at times dramatic on the "physical health" side of things, so we'll start there and see where this "year in review" takes us.

Its no secret to regular readers of ADW (Adventures of Delta Whiskey) that I've had a long history with health challenges.  Around age 12, I was diagnosed with Crohn's Disease, which is a not so fun gastrointestinal ailment.  Throughout my teens, into my 20's, and eventually my 30's, Crohn's cast a shadow over life; and at times that shadow got pretty dark.  Back in 2006, after years of fighting with my gut, I had the bulk of my plumbing removed, with a small portion left behind in case I decided to 'reconnect' things at some point down the road.  After that initial surgery, I went through adjustments both physically and mentally, and got more comfortable with having a body that was different than other 30-somethings.  Although I wasn't crazy about my "little buddy" (my ostomy), it allowed me to be active and live a life that did not revolve around a toilet, doctor's office, or pharmacy.

In the years since my initial surgery, my doctors in both Seattle and Chicago advised against "reconnecting" my parts, and after consulting with Romeo, my doctors, my family, my friends, and my conscience, I decided to have the remaining parts of my colon removed.   The risks of keeping those parts around (Cancer, Infection, etc.) were far greater than the benefits of attempting a very risky reconnection and the longer I kept those parts around, the greater the risk became.  So on October 22, I had the remaining parts taken out for good.  

I wish I could tie a nice bow around this story, and say it all ended perfectly, but that is not the case.  I was hospitalized for five days following my surgery and went home later in the week feeling "OK" despite the incisions in my belly and other parts of the body.  I probably underestimated the impact the surgery was going to have on my day-to-day life, and the first week or so out of the hospital was rough.  Getting in and out of showers, bed, cars, and even chairs had its challenges, and although I was able to walk I was pretty 'home bound' during that first week of recovery. 

About a week after coming home from the hospital, I was enjoying a Fontano's Sub Sandwich with Juliet Mike (a prior ADW guest) when I began to feel "not so good."  After spending about 24 hours praying to the Kohler Gods, Romeo and I ventured back to the hospital's Emergency Department to see what was wrong.  After running me through a few tests, they determined I had a blockage (obstruction) keeping me from digesting foods and they'd need to set me up to an NG tube to help 'move things through or move things out.'  This tube would run out of my stomach and through a tube in my nose to the wall, so that suction and pressure could relieve whatever was stuck. 

 

For three days, I laid in a bed, attached to the wall while my body's pipes were emptied--no food, no drink, no moving, and no fun.  Those were among the three most miserable days I had in 2012, and as you can imagine those days were mentally grueling as I relied on others to take care of me while I counted down the minutes until the tube was removed.  Eventually, that tube (and others) was yanked, and I went home to continue my recovery.  I joked afterwards, but if they're looking for new terrorist interrogation tactics, NG tubes would be a good alternative to waterboarding.  

Since the second hospitalization, I've been on a steady, incremental trend upwards.  My strength and muscle is returning, the areas where I've had surgery aren't as sore, and I'm gradually getting back into the activities I did prior to October 22.  Most importantly, I'm thankful to be without Crohn's for the first time in 20+ years.  This past few months has given me a humbling reminder about how delicate our health can be, and how important it is to everything we do--from our relationships at home to our success at work.   

You might expect, with all that time in the bed, alone with my thoughts that I'd have some deep, profound epiphany on life, health, and how all of these setbacks or challenges with my health are tied to some 'greater purpose.'  But the only insight I can think of came from my aunt who said, "sometimes shitty stuff just happens."  Plenty of shitty stuff happened to me, and as much as I want to try to piece together the underlying cause and reason for it all; I find myself a heck of a lot happier  taking the "acceptance" road and enjoying what I've got rather than complaining or griping about what I don't. 

So in conclusion, my holiday message would be this:  we're all lucky to some degree to be alive, healthy, and surrounded by people who bring joy into our lives.  I hope the coming year allows you to spend your time and effort enjoying those things, rather than dwelling on some of the "shit that happens."

Happy Holidays!

My Idea to Fix Chicago's Worst Problem

I'm on a Medical Leave from work, and with time on my hands, I am back to the blog.  As some readers know, the past few months have had personal health challenges, but I am on the mend and closer to returning to a life I enjoy.  But today's post will not be some deep reflection on my experience (although that may come at a later date)--today's post is an open letter to whomever is willing to listen to an idea that could improve safety in the city of Chicago. My hope is you'll read this, add a comment or two below, or pass along to folks who may be able to do a bit more about this problem than I can.

Dear Chicago, Cook County and Illinois Residents,

For starters, let me begin by saying that I am not an expert on criminology, sociology, or why murder happens.  In fact, I have very little understanding for why people take to violence to solve problems.  I do not look down upon those who do, in fact, my guess is those acts of violence are a "means to an end" for folks living in a pretty crappy situation. 

But what I can say with confidence is that I love the city of Chicago and am troubled by the rate of violence in my hometown.  As of today's post, there have been 476 homicides in the city of Chicago.  More than once per day, a person is being killed in our town.  (And by the way, if you are curious about the data, the Chicago Redeye provides an updated spreadsheet to the public) Each one of these homicides is tragic for the individuals involved, their families, and the communities.  Young lives are permanently changed (or ended) and nothing good comes out of these killings for anyone.

In addition, I can say with confidence that each of these incidents are EXTREMELY expensive for all parties involved.  Beginning with healthcare, victims of violent crime often require very expensive surgeries, treatments, doctor visits, physical rehabilitation, etc, ...and sometimes even the best of modern medicine cannot save a life. Paying for these services is often the obligation of the state, as victims are frequently enrolled in Medicaid, a state-run health insurance program for low-income individuals that is intended to pay healthcare-related expenses for those without insurance. 

The healthcare cost of each gunshot is estimated at approximately $50,000, and for those who know about our state's Medicaid program, we are broke.  So you can start doing the math in your head, but let me cut to the chase:  these incidents are contributing to our state, county and city financial crisis.  If we only looked at homicides, the state has incurred approximately $23 Million in expenses...and this is only 2012, and only healthcare expenses for victims who have died.  This dollar amount does not take into account the cost of the courts, the cost of the rehabilitation system (prison/jail), and other downstream costs that are incurred when someone decides to resort to violence. 

And if you have picked up a newspaper in the last two years, you know our city, county, and state are BROKE.  So those bills that are sent to the state are being paid, but often with long delays and at a very small percentage of what it actually costs for those patients to receive care.

On top of it, the organizations that care for victims (hospitals, instituations) are running on shoe-string budgets and swimming in operational messes.  Ever visit an Emergency Department on a Saturday night in the city of Chicago?  Well I have, and its not pleasant when you're there for a legitimate health concern, feeling miserable, and the nurses/doctors and others are not available.  And what happens when a victim shows up an ED?  Nurses, doctors and others swarm to the victim, taking services from others in need.  This creates delays, chaos in our emergency departments, and awful care for patients. 

So to recap:

• People are dying every day from violence in Chicago; more frequently than any other major city in the United States
• Each of these deaths are expensive to the state and the organizations who serve victims of crime
• The costs of these incidents are staggering and bills are not being paid or are being paid late.
• Considering ONLY healthcare related costs, we in Illinois have spent somewhere in the neighborhood of $23,000,000 on care for people who eventually died.

None of this is newsworthy, I'm merely summarizing the current state of the problem.  But what I'd like to propose is an idea that I think could work with the right support from everyone involved.  I have shared this idea with a handful of people and have yet to hear it is a bad idea, so I'm taking to the blogosphere in hopes that someone on the world wide web will see this and pass along to someone who can make decisions that would move the idea forward.

So here goes:

About a year ago, I had a chance to see The Interrupters--a fantastic Documentary that tells the story about Cure Violence's (formerly Cease Fire) work in our community to minimize the frequency of violence.  The film (which I highly, highly recommend) shows the powerful story of how “interrupters” work alongside members of their community to prevent the gunshot, the stabbing, the assault, etc., before it happens. If you saw Hoop Dreams, this film was done by the same producers and is outstanding--whether you live in Chicago or elsehwere.

In addition to the work of the Interrupters themselves, the film includes their Physician Champion highlighting the data/metrics that validate the impact their work has had in some of the city’s most violent neighborhoods (their website has info about the film and data if you are curious). While controversial; Cure Violence hires former gang members, criminals, etc., to work alongside current gang members and kids to minimize violence before it happens.  This idea, involving those who have "been there before" has been known to work on many public health problems--just think about the success of 12-step programs and the millions they have helped if you're looking for an example.


After watching the film I couldn’t help but think about where many of the victims end up after the incident: our hospitals and trauma centers in the Chicago area. And as I thought about the tremendous costs of these hospitalizations, the chronic overcrowding of EDs, and the missions of our local healthcare entities (to keep the public healthy), an idea came to me.

My idea is to create a “Shared Savings” program between geographic areas where Cure Violence is involved and Chicago's local hospitals/trauma centers. In a nutshell: if Cure Violence is successful in reducing the frequency of violence in specific areas, we should see fewer admissions to these facilities. With fewer admissions, there should be some type of cost savings for these facilities, given who the payer is (Medicaid) and the high cost to care for victims.

With the money the hospital saves, a portion could be returned as a “payment” from local hospitals back to the Community (or Cure Violence) based on improved performance in a designated geographic area. We’d need some good information about the true costs of each violent act, and good data on location/site of each incident, but I'd imagine we could dig this up or figure that out that amount based on some historical data.

So with my idea, let’s say Neighborhood A has 200 victims brought to a Trauma Center Z in 2012 at a cost of $10M (based on $50K/per estimate). If this number is reduced to 150 in 2013, Trauma Center Z would save $2.5M, and provide a payment back to the Neighborhood (or Cure Violence) based on what the hospital saved by having 50 fewer victims brought to their facility. Even if Trauma centers paid just 5% of the savings to the community, this would be $125,000; enough to pay a salary or two for the Cease Fire team, another social worker in the community, etc. All in all, it could be a "win win" all around: fewer kids dying, fewer victims taking up beds, money saved by the hospital, money gained by the community/group solving the problem, and an ongoing revenue stream to support those working to solve the problem. 
And if you think this idea is crazy or unique, it is not.  A similar type of “shared savings” initiative with the community is going on in Camden, New Jersey with the work mentioned in a fantastic New Yorker article from several months back by Atul Gawande. Although the work in Camden is focused on different conditions (Asthma, Diabetes, etc.) my concept is very similar—using geographic data to identify frequency of admissions and providing financial rewards to community-based efforts that reduce the admissions. As time has gone on, the folks in Camden have found, there is something very powerful about returning savings back to the organization, community, and people most effective in solving the problem and I believe in the people of Chicago when it comes to tackling the problem.

I could even envision posting "real time" performance metrics so that communities and the city is aware how geographic regions are performing relative to their goal...I mean, if we can post deaths due to traffic accidents on highways, the speed I'm travelling, and all sorts of nonsense on billboards, why can't we display death rates so others can track something meaningful to them and their areas?

My thinking is the money returned to the Community could be spent on anything the community (or Cure Violence) feels will prevent even more violence….whether its training or treatment programs, lighting on streets, more parks, special events, Gun “Buyback Programs”, more Cure Violence staff, etc. but I suppose that is getting ahead of ourselves and something I know very little about.

But this idea of spending the money on what the community feels is needed can be very powerful—when those involved in the problem have a vested interest in its solution, we tend to see traction/engagement (this is one of Lean’s core tenets…those closest to it are the best ones to fix it). In Camden, there are buildings in the worst neighborhoods where citizens (not trained Administrators or Physicians) are making decisions about how they want to spend the money they’ve received from hospitals that came due to avoidable ER admissions!

The way I see it, we are getting precisely the type of results (Homicides) that our Government, Healthcare, Judicial, and Law Enforcement system is set up to create.  If we'd like to see a different outcome, we need to think radically different about how we tackle the problem before it becomes a problem and reward what we want to see, rather than resorting to methods that have shown to be ineffective, expensive, and far from proactive.

If what you read about here interests you, I'd welcome feedback, ideas and suggestions to build on the idea and bring it to the right folks.  Before you suggest Cure Violence and a major health system...yes, I have reached out and no I have not heard anything.  This probably needs to get to the Mayor, Alderman, County, State, or other entity so if you have friends in high places, feel free to pass along.

Morning Radio, Moms, Work, and Life

I joke with Romeo Sierra and my friends about my completely irrational, dramatic, and over-the-top reactions after tough sports losses.  I revert back to the 8 year old Delta Whiskey, the one who wants his way and blows a gasket when it doesn't work out.  And this past week stung.  So one of my tactics is to shut down all media consumption related to Sports.  It keeps the painful reminders out of sight, out of mind, and I can move on mentally.  It doesn't mean I forget about it, just means I'm not going to keep revisiting the pain.  Another of my tactics is the Web, which allows me to vent in short form (twitter, facebook) as well as long form (Adventures of Delta Whiskey).

A challenge with throttling down my sports consumption is that I need to surf the FM side of the dial or my iphone for entertainment as I travel back and forth to work.  Normally, my ride consists of toggling back and forth between Mike and Mike (National Sports Talk Radio) and Mully and Handley (Local Chicago Sports).  The Local show is where I spend most of my time, and I get a kick out of the 'experts' who like to solve all sorts of problems on the field in the radio booth.  The hosts do a nice job of giving callers space to blab about all sorts of problems with the current state, ideas about a target state, and proposals to close the gaps.  Most of the proposals involve firing someone, spending lots of money, or getting rid of players.  Just interesting how much blaming of people go on, without looking at the results/data to validate those observations.  And of course, this is Chicaaaaaago, home of da most biased, one-sided fan base on the planet.  Those bits on Saturday Night Live are not too far off from what you'll hear on the airwaves.

So back to my radio dilemma, I spent Friday morning bouncing around the FM dial and landed on the old reliable, Lin Brehmer and 93 WXRT.  This is what my alarm clock at home is set to, its the #1 preset on my radio, and its the most complete station on the radio.  In addition to the best variety in music (Past, Present, Future?), their On-Air personalities are insightful, funny, and seem to love what they do.  I remember riding the bus to junior high with Mr Bruss behind the wheel, hearing Lin Brehmer and all sorts of interesting music blaring out of that tiny speaker next to his seat--and I continue to enjoy what Lin and his gang pull together in the morning.  Lin himself is also a golfer, a die hard sports fan (Cubs/Bears/Bulls/Hawks profile), and a guy who seems to "get" the important things in life.

One of my favorite features is "Lin's Bin", which occurs on Friday mornings, when Lin tackles a listener question.  Lin's responses are always very well written, with accompanying music in the background that highlights key points and messages.  So yesterday, I jumped in mid-stream to hear Lin talking about Mothers, and figured I'd add my $.02 about Moms, and my mom in particular.  If you'd like to hear Lin's entire entry (and hear old ones), you can click here.

As you'll hear Lin describe, moms do so much that we forget as we age.  Every thing they do, starting at pregnancy, is intended to help us grow into living, breathing, human beings.  That's a big job!  And in my case, my mom had that job times 4 kids, aged three years apart.  So I wanted to give a brief shout out to moms, as they are one of the primary reasons we are who we are.

Throughout my life, my mom (aka "Ma") has been the beacon of support and helped me learn (sometimes painfully...for both of us) at every stage of my development.  I've interviewed her on the blog, which you can access that interview in my archive (over there to your right), or just click here.  Reading that interview was entertaining for me; and good gosh are those photos of me (and siblings) awful!  I don't need to rehash everything from that interview, but much of what she taught me is reflected in her responses.

What I thought about as I re-read that interview was how she was able to cram so much into every day, with four kids running around the house, involved in activities, and at different stages of life.  She spent time with all of us, taught us much about what is important in life, how to treat others, and how to work hard.  And for those lessons, I am and will forever be eternally grateful for her. We still talk a few times a week, mostly about things like upcoming family events, work, pets, and the like, and anyone who knows my mom knows there's always a "movie I've gotta see." And I know its not just me she spends time with, she continues to be a source of inspiration, support, and guidance for all of her kids.

There is MUCH happening in my world, so I will segue into a brief update on other topics and news/notes in the world of Delta Whiskey.

The World of Work

Work has been unbelievably busy over the past eight weeks or so, and the gas pedal will be coming off the floor in the coming weeks.  I've been working on all sorts of interesting things and am psyched about work these days.  It has not been easy, and I am challenged daily (sometimes every hour), but I am enjoying the people I work with, the work I do, and the impact it has on the world.

This week, I spent time with a team of doctors, nurses, administrators, and IT people to define how we need to improve the use of a patient "portal", which allows as a patient to access their records, send requests to their doctor/staff for things like prescription refills, and see upcoming appointments.  As you can probably imagine, technology offers an opportunity for us to streamline processes, reduce the time for patients to get what they need, and access any information they may want to see from their chart.

But the technology alone is not the answer.  There are workflows to service those requests and needs that aren't running as smoothly as patients would like.  The team looked at everything that happens from the time a patient hears about the portal (aka Marketing) until requests are fulfilled, and identified a bunch of ways this can run better.  My job (along with those who work on my team) is to help the team see this reality through facts, data, pictures, and group exercises.  The team pulled together some ideas on how to 'fix' these things, which will involve both technical 'rollouts' as well as improvements to how work is done in a clinical setting.   While these things won't be fixed overnight, it was a good week to set a course of action for how we intend to make things better.

The neat thing for me this week was bringing in a patient to help the team understand and incorporate a patient's feedback into the process.  So often, healthcare gives an "ironclad" impression to its customer, and I really enjoyed bringing someone with no agenda into the room to help the team see and hear what he's experiencing.  The patient who joined us was perfect--very blunt about what he observed, but also insightful about ideas/solutions that could make the process and our technology more useful for him.

But work like this is VERY resource intensive on me, and I've had several events like the one I describe above over the past few months.  I've been working with teams on everything from pre-operative workflows to planning space needs, so needless to say there is much on the plate.  Over the next few weeks, things will slow down and I can spend more of my energy on things like writing, reading, travel (New Orleans, San Diego, Minneapolis, Traverse City ALL in the next 5 weeks), and some exercise/golf.

On the health front

Most of my health concerns these days are between the ears.  Keeping my stress level down, finding time to exercise, and taking it easy are important things I need to do.  With less time to be spent on work in the weeks to come, I should be able to find more time to work out.  For those who visit our home, you know Romeo and I are visually tracking our monthly on the kitchen chalkboard and I  had only ONE workout in the month of April!  Yes, I have been busy, but that is no excuse--so I will be heading down the gym immediately after this entry is complete.  But relatively speaking, health is pretty stable these days...

On the fun front

All of the upcoming travel is going to be fun, and included are a few bachelor parties--one in New Orleans (never been) that will be next weekend.  The trip coincides with the NATO summit in Chicago and I am glad to be skipping town during that nonsense.  In addition to the bachelor parties, I'll be headed back out to San Diego to see the greatest endodontist in the world, so I can finally get my missing tooth replaced.

This weekend I am not doing ANY work (that has become a pattern) and tomorrow will be a blast, as we celebrate Mothers day with our moms (Our being Romeo Sierra and myself) and prematurely celebrate my nephews 5th birthday.  He doesn't know this yet, but he's getting his own basketball hoop, which I am PUMPED to break it in with him on the driveway.  One of the best things my folks did for us was hanging a basket above our garage, which provided hours of endless individual and group entertainment.  In the evening, we'll be spending time at Second City with Romeo's mother which will be a great capper to the weekend.

Down the road, there are a few great concerts on our calendar (The Wall at Wrigley Field, Wilco, Lollapalooza?), a number of weddings, and some summer travel for the two of us at a location yet to be determined.

On the sports front

It wouldn't be a blog entry without a final commentary on the 2012 Bulls, so I will get this off my chest and be done with it.

Everyone gave up on the Bulls' hopes after Rose, then Noah went down with injuries.  My father, who has had season tickets for 30+ years sold his game 5 tickets on the internet--a first in his time as a season ticket holder.  There were a handful of believers (myself included) that thought they could make a good run through the playoffs with what they had, but as the series went on it was tough to see them competing with the Heat or other serious contenders.

In my case, I just wanted to see how far they could take it, and it stung to see a good group of guys have such a disappointing outcome from their work.  It was obvious how hard they battled to get back into the series and I watched game 6 proud to be a Bulls fan.  Guys like Taj Gibson, Omer Asik (I know he missed those last few free throws, but his defense in games 5/6 erased probably 18-30 points), Luol Deng (can't dribble with his left hand due to injury), and others laid it out there over the past few months.  Played hurt, played tired, and played a LOT and I commend them for the effort.   I acknowledge there's room for roster improvements (would not be shocked to see a guy like Kirk Hinrich return), and I believe there are learning lessons they will incorporate into future seasons.

In a nutshell, I'm disappointed and down about it, but also hopeful about the franchise, the team's nucleus, and their leadership.  Titles are hard to win, but I'm confident these guys will get one with their approach and discipline.  Hang tough, bulls fans....

Twice in a Day?!?

Today marks the first time I've blogged twice in a day, but given the outcome and end to the Bulls game I felt the need to hop back on and give my $.02 on what we saw and what's to come.  I write from my minimal experience as a junior high basketball coach, a two-year high school player, and a guy who has watched upwards of 60% of Bulls games in my life.  That number may not seem like much, but you have to remember I've lived in Florida, Washington State, and a "cable free" house as a youngster.

I thought the Bulls played a great game for about 40 of the 48 minutes.  There were a few lapses where Philly got in the bulls' grill, one which occurred in the middle of the third and towards the end of the fourth quarter.  The offense got stagnant, the D started to look slow, and Philly got a couple of easy buckets to shrink the lead.  I wasn't in full on "paranoid" mode, but felt the end of the game was getting sloppy.

The Rose injury was tough to watch.  I'm not an orthopedic surgeon, nor do I have an understanding of human anatomy--but that knee buckle was not a pretty sight.  He has been such a mensch throughout his career as a Bull, and seeing him go down was heartbreaking.   I immediately felt bad for Rose, and for Thibs, because I knew there'd be questions about whether he should be in the game.

In terms of Rose, it has been well documented that he is going to play no matter what.  So if his coach wants him in the game, he's playing.  And the guy knows how to play at one speed, so I can't fault him for playing hard down the stretch and going hard to the basket.  He's been snake bit with the injury bug (combining metaphors there), and it stinks.  No ifs ands or buts.

The other guy I feel for is Coach Thibs.  A good buddy of mine, and fellow die hard Bravo Kilo (also present for one of the greatest nights of my life..and his too) sent me a great article about Thibs in the New York Times.  I read this almost immediately after the injury and my heart goes out to a guy who works his ass off to be the best coach he can, and has sacrificed so much for his life's passion.  His story is really inspiring, and although many question the man's priorities (its pretty much just basketball), I respect his dedication to his craft, his respect for the game, and his desire to continuously improve himself and the teams he leads--just check out this graph for quantitative validation of his value to teams.  I actually sent him a thank you note last year for the work he did with the bulls--as a customer of his product he needs to know I appreciate what he does for me and fellow bulls fans.  Let's not forget, this team sucked sh*t for many years in the 2000's, and he has led them to back to back #1 seeds in the Eastern Conference.  Its clear this guy will only be satisfied with a championship ring, and Rose's injury could be a devastating blow to him as well.

So where does this leave us, bulls fans?  I suppose this is where we get into philosophical perspectives on sports, life, and what we do when the chips are down.  I've chronicled some of my ups and downs, and all of us have had them from time to time.  But I somehow have had it ingrained in me to look on the bright side despite having a few bumps along the way as both a human being and a Chicago sports fan.  And although this is certainly not the ideal, I'm not ready to give up on this team just yet.  Until they lose four games in a series, this season will continue, and I do think they can rally around the injury (provided it is extended) and make some noise in the playoffs.  Let's not forget, there are 11 other guys on that team who are "Chicago tough" and will not back down from this.

Another thing to keep in mind, strange things can happen when teams lose a star player.  Bill Simmons, a writer whose style I've ripped off in many ways, wrote an outstanding column that summarizes the "Ewing Theory" and other examples of teams who still found ways to win without a star, or after a "star" has left.  Interestingly enough, the most popular example occurred in 1999 when the Knicks lost Patrick Ewing to a torn achilles in the playoffs.  Those knicks went on to the NBA finals as an 8 seed, also in a strike shortened season.  The assistant coach for those knicks???  Tom Thibodeau.  If you want some inspiration, read this article which summarizes it all.

Finally, I guess this strikes at the core of all of us as sports fans, but it is so easy to be negative about sports--whether we're talking about the Bulls, the Hawks, the Cubs, or whoever.  Our radios are filled with guys (and gals) who spend their entire day, mostly griping about the state of sports in this town.  As a frequent listener of these programs, I too have my thoughts and ideas as to why things aren't always as good as we hope, but I really see no point in the blowhards who want to second guess a coach or a player after a situation like this.  Sh*t happens sometimes, and you're either on board with a team, or you're not.  And for me and the Bulls, well, that's a train I don't plan to hop off anytime soon.  So I'm with them through this, and hope you are as well if you've gotten this far through the entry.

I leave you with a little inspiration from a range of inspiring coaches and athletes below...feel free to post your own if it helps ya move on....its never over 'til we say it is and NO EXCUSES!!

What time is it???? IT'S GAME TIME...HUH!

Everyone has their favorite time of year--for me it runs from mid March (birthday, NCAA tourney, weather getting better) until mid-June (the NBA finals, end of school, golf season in full swing).  You'll notice a few of the things I like about this time of the year are basketball related, and with the playoffs starting today I figured I'd take to the airwaves for the Delta Whiskey NBA Playoff Preview.

Back in the day, sneakers were a big deal to me, as they probably were for most kids in the late 80's and early 90's.  I remember sitting with my dad in these unbelievable seats, fixated more on what was on their feet than the scoreboard.  I loved to see what guys were wearing, partially for fashion/pop culture reasons, but also because I played the game and felt some kind of "kinship" with the player who wore the same shoes as me.  And in the 80's, the Bulls began a tradition for the playoffs that I thought was the coolest thing ever--the black shoes/black socks combo.  I don't know the entire history behind whose idea it was, but I loved that the team "flipped the switch" into playoff mode and used their uniform to show their collective state of mind.  

The NBA was strict about uniforms back in the day, so teams had to wear the same colored shoes and everyone wearing black was a sign of solidarity as they went into playoff battle.  It was also pretty amusing to see guys like Dave Corzine, Ed Nealy, Will Perdue, and other guys I'll deem "stiff" wearing shoes that made them look even slower.  But regardless of how they looked, it was clear when the Bulls stepped on the floor in the playoffs that things were going to be different.  And as a die-hard fan, I liked that the team that meant everything to me was showing such unity as they headed into battle. Nowadays, black shoes aren't such a unique thing, and you'll see Bulls (and NBA players) wearing black shoes during regular season games, along with red ones, white ones, and even green ones when its St Patty's Day--with just about everyone wearing a different color most nights and very little consistency from player to player.  Maybe its because the game/team dynamic has changed, maybe its because there's a lot of cash in sneakers and the players are walking billboards. 

The other great Bulls playoff tradition, which probably was just a regular season tradition we saw/heard more about in the spring was the pregame huddle.  No need for me to describe it,  just watch: 

So those are a few random memories/thoughts about da bulls as we kick of the 2012 Playoffs in just a few hours.  And since I spend so much of my life listening to others yap about opinions on Sports Talk Radio and in local media/twitter, I figured I'd take to the airwaves to give you my thoughts as we head into the Post-Season.

I'll break it down in terms of the the Bulls, then the competition, but there won't be predictions...just stuff I'll be paying attention to in the weeks to come.

The Bulls

It's been a choppy year for the Bulls, yet somehow they've ended up with the best record in the NBA and home court advantage throughout the playoffs--which means they have earned the right to play more games in front of their fans than any other team in the league.  Crowd noise never scored a basket, but it does cause turnovers and create momentum, and I'm glad the title has to come through Chicago.  And if you think this doesn't matter to the team, check out this speech from Brian Scalabrine prior to their last game of the season:

They'd be the first to say this, but the regular season means nothing at this point.  They've scrapped, clawed, and fought their way to the best record, but once the tournament begins, everyone has the same record (0-0), and they will need to overcome a ton to win the title this year.  This is not to say they can't do it, but it'l be tough and they'll need some good fortune to raise a trophy in June.  I'm not going to break down position by position analysis of the roster, but will point out a few questions I'm wondering as the playoffs unfold.

Continuity:  Can they stay healthy?

Like every other team in the NBA, the Bulls have had to cobble together lineups for the bulk of the season.  The opening-day starters have played 14 games together, and while they've been 12-2 in those games, they haven't had a ton of time together as a unit.  With injuries and substitution patterns creating havoc from game to game, this means guys may not have tons of comfort with each other.  One of the things you can notice when continuity isn't there are missed assignments on D, turnovers and bad shots on offense, and indecision--this isn't to say those will be common, but it may be an issue as the Bulls come together in the playoffs.  They should get more comfortable with each other as the playoffs unfold, but this will ONLY be possible if they stay healthy.  Much has been documented about D-Rose and his injuries so no need to belabor the point--but if he goes down in the playoffs it'll be trouble.  

The Bench Mob:  Can They Go Both Ways???

Much has been written about the Bulls depth as well, so I won't belabor that point--I'll just say that going 10 deep is a nice luxury most NBA teams don't have.  The Bulls bench includes guys that are very strong on one end of the floor (Defense - Asik, Brewer, Gibson; Offense: Korver, Watson) but the problem with these guys is that they struggle to play both ends.  In recent months, guys like Taj Gibson have shown improvement on both ends, and the Bulls will need these guys to contribute on both ends of the floor.  Here's hoping we see a few throw downs like this in the coming weeks:

RIP:  Can he dial it up???

Scoring is the topic most bulls fans gripe about, particularly after their struggles to score against teams that can D up on D-Rose.  The Bulls tried to fix this problem by going out and grabbing Rip Hamilton from the Pistons, who has had a a great career as a sniper, scorer, and great defender.  He's been fragile this year, but if he can dial up his game to the 2003 Rip Hamilton they will be in better shape than last year.  He's looked much better in the last 2 weeks, and if he's able to stay healthy he could be a huge contributor on both ends of the floor--something they'll need to get past teams like Boston, Miami, or even Indy (side note:  could not be happier Bulls will not see the Pacers until Eastern Finals at the earliest...this is a team that will cause problems for someone).

D-Rose:  Can he stay out of the Doctor's Office?

The other topic everyone knows about is the injuries that D Rose has struggled with all year.  I know he's been back for a few games in the past month, but he hasn't looked like the same guy we saw last year.  He's been beaten up all season, and some of the injuries he's had would hold someone like ME out of work, not to mention an NBA player.  There's no telling how healthy he really is,  but it will be hard for them to win a title with him limping around on half a leg.  The schedule in the playoffs gets a bit more spaced out meaning he'll get more rest between games, but there's no telling how hurt he really is.  A few of these (see video below) in the weeks to come would go a long way towards helping ME feel better about his health:

Is there another gear?

Playoff basketball is a different animal than the regular season.  For most teams, this is when REAL defense is played, and you notice much less open court, easy basketball.  The Bulls have defended and played all 66 games like playoff games.  Their intensity throughout the regular season is part of the reason for their league-best record, but this gap will close quickly once the ball is thrown in the air later today.  There was an old phrase the Bulls used to describe turning up the intensity, which was "unleashing the dobermans."  In the 80's and 90's, you knew when those dobermans were unleashed, as teams struggled to get off shots, much less get into their offense.  I'm certain these bulls have that "doberman" gear they can kick it to, the question in my mind is whether they can turn it on when it matters most and whether it'll be enough to overcome some of the teams they'll face on the way....which brings me to the competition.  Some doberman footage in case you've forgotten, from those great bulls teams (along with a catchy song that will stay in your head for hours):

The Competition

 I'm not going to waste more than a few words on the competition, but they've all improved since last year's playoffs (and throughout the year)--it will not be easy winning a title with some of these teams standing in the way.  I have not checked odds in Las Vegas, but I'd be willing to guess there is no clear cut "favorite" that stands out in the eyes of the gambling public.  More than any year in recent memory, the Title is up for grabs this year and the playoffs are shaping up to have some great battles pitting old NBA vs. new NBA, teams vs. individuals, and all of those other cliche story lines you're certain to see/hear about during broadcasts.  A few words on some of those teams:

Miami - everyone's favorite team to hate is still Public Enemy #1 here in Chicago (and probably throughout the country).  The addition of Shane Battier was big for them (one of the more intelligent/crafty vets in the game), and with talent like Lebron, Wade, and Bosh they will be tough to beat 4 times in a series.  It has been done (Dallas last year), and can be done, provided the Heat are forced to play a half court game and defend for 20 seconds of the shot clock.  A task much easier said than done, but a few teams like the Bulls, Indy, and even the Knicks will make their road to a title a rocky one.  

Boston - the Celtics are a team I have tremendous respect for--partially because of their history, and also because of their contribution to the Bulls (Thibodeau).  They are an aging bunch, but in recent months they have been playing much better and seem to be peaking at the right time.  They will not be an easy out for anyone, and this team will NOT go down easy.  Between Rondo, Pierce, Garnett, and Allen there is plenty of firepower, and their role players are better than you'd think.  If there's a Bulls-Celtics series in round two, it will be a war.

Indy - the Pacers are a team that has flown under the radar on a national scene, but fans in Chicago are very familiar with this group from last year's playoffs.  They are deep, have tons of length, and defend the crap out of teams.  They're also not a very likable team, although with Jeff Foster no longer around to swing elbows they're not as hate-able as they have been in prior years.  Either way, these guys will not go down easily and as I mentioned earlier, I'm glad the Bulls won't see them until the Eastern Conference Finals if it gets to that point.

My time in Champaign Urbana

I don't write too much about work on here, partially because I invest so much brainpower in it while I'm there (making thinking about it at home a hassle) and partially because in this day and age of digital connectedness there is a footprint I leave behind on this thing called the internet. Ideally, that footprint leaves something interesting for folks to read, and gives me an outlet for some of my thoughts, ideas, and ramblings on just about anything. But after spending a few days in Champaign, I felt the need to reflect a bit on what I saw and experienced.

For starters, the road trip began in Aurora, IL on Wednesday afternoon with the CEO and her right hand women (and yours truly) down the back roads of I47. For a guy who spends most of his life racing down The Eisenhower (290) and i88, it was nice to see something other than obnoxious billboards lining the drive. We got to Champaign at around 730, grabbed a bite to eat at a local college bar (Murphy's for those of you Illini fans), which I think made all of us feel slightly old, but young at heart. Our conversations ranged from my terrible App ideas (vocal "games" with siri so drivers can play something but not text...think sporcle.com on your phone with audio), the end of my professional swimming career (I hung it up after finishing 12th in the 50 Butterfly at Junior Olympics in Champaign, circa 1987...just like MJ, I went out on Top of my game!), and all sorts of other interesting topics about our lives both at work and elsewhere. We checked in and crashed around 9 to rest up before our visit to a healthcare system based in the Champaign community.

Oddly enough, this health system is almost identical in size, scope of services, number of physicians, and the community they serve. This visit is something that allows leaders of systems like mine to "go and see" how others are continuously improving the care they provide through the eyes of patients. My job is to help my current organization create a similar "culture", which means bringing people together to solve problems that patients, physicians, and even staff are dealing with. The approach we and this clinic (and many other great places) use is based on something called Lean, and there are lengthy texts, courses, blogs, and other such venues about Lean if what I describe sounds interesting. The methodology is what helps make sure your plane doesn't crash, your coffee experience at Starbucks is fantastic, and applications across just about every industry. Lean is based on several ideals and includes a number of fancy (sometimes scary looking) tools, but at its core it is about how we make things better by involving the people who do the work.

For those who know me personally, you know some of the challenges, drama, and upheaval I've been through as a patient over the last, oh 20 years of life. Thankfully, life is stable these days, but I've lived in enough hospitals, doctor's offices, pharmacies, etc., to understand a bit about when things aren't so nice for patients.

On another tangent, this week (April 18) will mark six years since the colectomy, and as my mother constantly reminds me, I wasn't so upbeat back then about my life. I was feeling like crap both mentally and physically and there were some grueling nights, some hard decisions that I wish I didn't have to make, and my outlook was shitty. I DIDN'T think life would get better at that time, and I'd be willing to guess many of you have (or will) face one of those moments when life doesn't seem fair. I have written plenty about all of that so no need to rehash it all...but after all of my drama, the one thing that mattered to me was that I was part of making it better for the next guy, the next family, the next kid, etc. On top of all that mushy gushy stuff, I saw my father end his career with a somewhat negative experience as a physician. And I'd like to see the people who make such important decisions on our behalf are respected for the work they do. Same goes for nurses who deal with patients like me, and the other folks who care for patients who are usually in a pretty tough spot when they come to see them. Before I go too far down this path, it probably helps to give you a definition of respect. Respect to me means instilling a feeling as if my skills, talents are supported in making the business better. Most people feel squashed by "the man" telling them what to do and how to do it, which couldn't be further from respectful in my mind and folks in healthcare are not much different.

So part of the purpose for this trip was for a few of our leaders to check out what was going on at this Clinic in downstate Illinois and how they're working to continuously improve in the eyes of their patients, docs, and staff. I had heard a few of their leaders speak last year at a conference out in Seattle, and from memory I knew they had the right blend of quirkiness, humor, and discipline around Lean...and on a personal level, it is always great to be around others with a similar perspective on making things better.

Without walking through every step of the visit, I'll describe what I saw as briefly as possible:

Our morning and afternoon involved 30 minute rotations to a number of departments to observe a process that happens every day, in every department across the clinic. This process involves a huddle (yes, similar to what you see on the football people), where folks are coming together at the start of their day to say, "How'd we do yesterday?" and "What do we need to do today to make it a great day for our patients?" In each department, those questions have slightly different variations, but these huddles are part of how everyone starts their day. And yes, there is some "homeroom announcement" kinds of things as part of the huddle, but they are looking both retrospectively and proactively at how they're doing. A big part of these huddles is discussion of team ideas, and each person at this clinic is expected to implement 2 ideas a year. Ideas can range from where to locate supplies to minimize searching, to improve how they do a certain task (i.e., labeling specimens), and even a few other ideas related to making the workplace more fun, healthy, or community focused.

Each huddle had its own "theme", which were pretty amusing--everything from sports to entertainment were used to help teams have some 'fun' with it, and they had free reign to do really whatever worked for them. We had a chance to ask questions to folks after their huddles, and it was so neat for me to hear from folks how inspiring it is for THEM to have a say in how things are run, how things can improve, and a sense of purpose to their work. This theme came out throughout the time we spent in Champaign, and what got me really jazzed was hearing a few doctors who were probably just as downtrodden as my father talk with excitement, passion, and enthusiasm about the work they do.

The cynic or doubter would probably read much of what I've written about and say "that can't possibly work" or "it must be a mess working at a place like that", but there is an incredible amount of discipline beneath the surface of the visual displays the teams use as part of their huddles. And of course, there are things that can be improved that they are aware of, but it was so nice to see a true "system" of people all working together to make it better and genuinely pumped about the place they work.

Our drive home was filled with some great discussion about how we can take what we learned and expand how we apply what we saw to our work, which is a task that is extremely inspiring with a high potential for great impact to patients, the docs that care for them, and the people I work with. As all of us went our separate ways, I took some time to reflect on where I'm at and how life continues to evolve for me, which is probably why I find myself on the blog this morning.

So much of what I've experienced over the past 5 years has centered around that concept of helping to make things better for me, the place I work, the planet I live in, and life in general, and I'm genuinely humbled and grateful for life's turns. I haven't always been comfortable or happy at each of those turns along the way, but each of them have allowed my outlook and focus to become clearer in terms of "what I want" out of life (including work). And our trip to Champaign was physical evidence of my enthusiasm to work in an environment others who share a similar passion for making things better in a systematic fashion. In simple terms, its great to have a team standing alongside me as we work to tackle the healthcare animal...

It's Been a While!

As life has evolved over the past few months, I've often thought about the blog and had fleeting moments of wanting to hop on for a chance to reflect and share what's been going on. I don't really know where to start, but I figured I'd think back to other methods/tools I've used to reflect on where things stand across the board. For me, "across the board" involves five major components: my heath, my relationships, my career, my finances, and my hobbies. Some of those components make for interesting blog fodder, others don't. I've used this blog over time to reflect on something in those categories, so I'll stick to that for today.

My health - things are pretty stable on the health front, which is a blessing I forget all too often. It was around this time of the year back in 2006 when I thought life as I knew it was going to be permanently miserable as doctors advised me to have my colon removed. I fought that idea tooth and nail for years and thought life was going to be awful if that happened. One thing led to another and on April of this year it'll be six years since the procedure. It wasn't an easy road to stability, but I've gotten comfortable enough both physically and mentally to be OK with it. My little buddy isn't going anywhere in the near future, and there's still an option out there that would involve some significant time away from work and enjoying life. I have set monthly goals with robin around workouts (8 rigorous sessions per month), which may sound easy to some of you...but when I describe my work situation you will understand why. Let's not let perfect be the enemy of good people!

My relationships - first and foremost, I've moved in with miss romeo sierra. We've been cohabitating for the past few months and the transition has been great...even the dogs are getting along just swimmingly! More important than the logistics has been knowing we can peacefully coexist and have fun doing it. Romeo turns 32 on Monday and we've got lots of fun plans to get her year off to a good start!

Still see plenty of my parents, siblings and their kiddos and am extremely pumped to be taking my nephew to his first Blackhawks game in a few weeks. I wish I saw buddies and friends more often, but all of us have busy and complex lives so that isn't so easy....but I will say that Super Bowl sunday this year was one of the best I've had (and I've seen my fair share of Las Vegas sportsbooks on the big day).

My career has been a wild ride, to say the least. All of the activity has challenged me, but in a really good way. After leaving the lab, I joined a medical clinic in a role that had some parameters but would be a new position for them. As things within the organization evolved (people moving to different jobs) I've been taking on a pretty significant amount of responsibility for the organization's process improvement/lean efforts. This work is mentally, physically, and even emotionally challenging but I'm pushing myself in new ways that are exciting and fun. I would say the work/life balance has not been great--I drive a total of 84 miles a day which means there are less hours for those other things I'd like to do. Like spending time with romeo sierra, exercising, seeing friends, reading, you get the idea.

My hobbies - As the demands for time increase, its not as easy to find the time for the fun stuff, but when possible I'm getting to shows (Megdaeth/Motorhead last week!), plays (American Idiot), and sporting events. I wish I had more time to blog about the bulls and my thoughts on this year's squad. In a nutshell; I'm very grateful to Tom Thibodeoau for his commitment to making the Bulls the most prepared, disciplined team in basketball. Rose is great, and he's a huge part of their success, but this is a team full of B players with the best record in basketball. I've only been to one game this year (the fighting Kardashians), but the bulls haven't been home much and I'm not the only guy who likes a bulls game. Travel-wise, Romeo and I were out in California in January and it was great to get away from it all for a few days. There's a trip to new orleans on my horizon for my cousin's bachelor party (he's getting married to one of romeo's best friends) and I'm certain Romeo and I will find some time to get away for a weekend down the road. On the arts and sciences front, I will give a quick movie plug to a film we watched last night called The Interrupters. If you can find it via netflix or your local movie theater you should check it out. The community engagement around a shared problem (murder of youth in chicago's worst neighborhoods) really had me thinking about our reward system for those who are discharged from facilities/jails following bad crimes. I ended the film and turned to Robin and asked: What if we paid these guys based on their ability to prevent gun-related deaths in a geographic area/zip code? We could calculate the cost for all of the healthcare that is provided to those kids who have been shot and put this in a shared account. If they perform well in their area, they're eligible to receive a payment out of this shared account. Yes, we'd have to think through parameters and ways to gather good data, but if these guys can't get jobs working IN the system they can work to help the system. I'll get off my soapbox, but think about it people.....would we rather pay to keep folks in jail and kids killed???

Finances - some of the above requires money, as do other things. I wish I had more cash, but who doesn't. I can live comfortably and that is a blessing in this economy. Watching that film last night gave me a smack in the face that I live very comfortably. I can help with my time and/or cash more than I have been.

So that brings me full circle to the blog, which is one of those activities I lump under "hobbies." I like to write and I like to reflect about what is working well and what could be better. Writing for some kind of public consumption helps me step back and see the big picture. I would LOVE to write as a profession at some point, and the blog is an outlet for me to see how I like it. It's hard for me to find the time to do it, so when there are small windows of time (like this morning), I'll try to hop on Romeo's computer with an opinion, an update, or a thought or two!