Like Two 747’s Crashing Every Day: the worst airline accident in history


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What are the three leading causes of death in the United States? Most people quickly identify heart disease and cancer, which in fact respectively account for about 750,000 and 550,000 deaths annually. The third leading cause of death is usually a guess: Alzheimer’s? Diabetes? Obesity? Traffic accidents? Airline crashes? With at least 440,000 deaths a year almost no one guesses the correct answer: medical errors. The practice of medicine, including diagnosis, treatment and surgeries, is the cause of deaths that approximate the number of fatalities of two full capacity 747’s crashing every day. If on one day there was such a loss of life due to airline crashes there would be massive investigations and media comparable to the March 1977 crash in Tenerife considered the worst airline accident in history: the search for black boxes, analysis of the weather, integrity of the equipment, the qualifications and behaviors of the pilots, and the airline’s quality assurance procedures. If two 747’s crashed on two consecutive days, there would be implications of terrorism, accusations of conspiracy. If two 747’s crashed on three consecutive days, the impact and reaction are unfathomable, but one could only guess that mass panic would set in nationally and internationally. Yet 1,200 Americans, twice the number of the casualties at Tenerife, die day after day, 365 days a year with the resulting death toll being that of the annual wiping out of the populations of major US cities: Atlanta one year, Sacramento the next, Miami the next, year after year. These tragic losses are not just numbers. They are our grandparents, mothers, fathers, siblings, our children and our friends. They are the victims of wrong site surgeries, the aorta sliced instead of the renal artery, over-medication due to a misplaced decimal point, a misdiagnosis of a hypokalemia leading to cardiac failure, a hospital acquired infection from inadequate cleanliness of supplies, equipment and hands, or a sponge left inside the surgical site.

How this is happening without public knowledge, panic and outrage is a simple question of multiple determinants. There are explanations when required, which is seldom. Hospitals are complex environments. To Err is Human, as the 1999 Institute of Medicine report citing the underestimate of 98,000 deaths a year was titled. In 2013, John T. James, PhD, a NASA toxicologist who’s own son was the patient who died from misdiagnosed hypokalemia, published his robust study based on findings using four different research tools, in the Journal of Patient Safety. His study results more than quadrupled the IOM number to 440,000 deaths a year. To err may be human, but in truth, all too often decisions for care are dictated by financial initiatives to benefit the hospital rather than the best care of a patient; hospital error reporting that is voluntary ; hospital quality assurance that is actually cover up ”risk management”; the autonomy of doctors who are never evaluated, tested or required to upgrade training and cannot admit that they have made a mistake. Atul Gawande, MD, in his book Complications stated, “There is a saying about surgeons, meant as a reproof: sometimes wrong; never in doubt.” Government, regulatory agencies and patient advocacy organizations have pressed for changes in reporting, hospital policies and procedures, and checklists ironically based on those used in the airline industry, but the number of deaths has not decreased, the needle on the scale of improvement hasn’t budged.

The Veterans Administration hospital scandal in June 2014, exposed the deaths of at least 40 veterans who died due to medical errors including delays in their diagnosis and treatment. But months and even years before the exposure, when lives could have been saved, employees in the hospitals had been raising concerns and reporting dangerous practices, inadequate care, and fraud. These whistleblowers were intimidated, threatened, harassed, transferred, put on administrative leave without pay and fired. Not unusual treatment for whistleblowers as recent high profile cases have been broadcast in the news.   The VA is now hustling to correct care deficiencies and provide remedies to the whistleblowers, but not enough to restore lives and repair permanent damage.

The Veterans hospital deaths as tragic as they are, are the tip of the iceberg of the 1,200 a day medical error deaths. Patients are dying in private hospitals, public hospitals, community hospitals and super-sized academic medical centers. Within these facilities whistleblowers have attempted to report and correct wrongdoing and system flaws that lead to the daily death count as well as almost 4 million errors a year that leave patients disabled, damaged and compromised. Like the whistleblowers in the VA hospitals these health care employees, nurses, lab staff, managers, and some doctors themselves, have lost their jobs, their health insurance, their retirement benefits, their professions, and ability to find other employment. Dr. Marty Makary states in his book, Unaccountable, which documents his experiences of patients suffering from medical errors, “if I was labeled as a whistleblower, my career would be shot.” Telling the truth in health care is risky business.

There is a long history of retaliation against those who have spoken out against the medical status quo that puts patients at risk. In 2008, Dr. James was presented with the Semmelweis Award, named for Dr. Ignatz Semmelweis, considered now the father of patient safety.   The observational case control study conducted by Semmelweis in the mid 1800’s indicated that women and babies in hospital maternity wards were dying because doctors were not washing their hands after examining cadavers and then delivering babies. With a maternal and infant mortality rate of over 18% in hospitals where doctors delivered babies in comparison to a 2% mortality rate for deliveries at home with midwives or even poor women whose babies were delivered in tenements, Semmelweis wrote a treatise, The Etiology, Concept and Prophylaxis of Childbed Fever, on the imperative for doctors to wash their hands between patients. The medical community was outraged that he would state that doctors’ lack of clean hands was killing women and babies. Semmelweis was declared mentally unfit, and confined to an institution where 14 days after his admission he was mysteriously found dead, presumably beaten to death by guards. His work was not recognized as valid until two decades later after Pasteur and Lister presented evidence of germ theory. In 1965, to mark the 100th anniversary of his death, Semmelweis was honored with his image on an Austrian postage stamp. Doctors in the United States today are still less than 50% compliant in hand washing.

Despite current legislation in healthcare law, shooting the messenger is still the general practice in medicine. Retaliation is often couched in legal defense of protecting patient confidentiality, and hospitals misuse HIPAA as a way to attack whistleblowers. But more effective to deter whistleblowing, hospitals maintain cultures of don’t talk or else.   Special Counsel Carolyn Lerner of the Office of Special Counsel, a whistleblower protection agency, has stated that 125 VA hospital employees have filed retaliation cases. Three of the whistleblowers she has represented are Dr. Katherine Mitchell, Paula Pedene and Damian Reese. Mitchell reported understaffing and inadequate training of staff in the emergency department at the Phoenix hospital and was removed from her position as the co-director of the emergency care. Pedene, formerly the hospital chief spokesperson, was re-assigned to a job in a windowless basement office after she reported financial mismanagement in Phoenix. Reese complained about the data manipulation that covered up delays in care; he was given a negative performance review. Lerner stated in a PBS report, (September 29, 2014,) “Dr. Mitchell, Ms. Pedene and Mr. Reese followed their consciences and reported wrongdoing, and their efforts have improved care and accountability at the VA,”

The recent British National Health Service report on whistleblowing, Freedom to Speak Up? (February 2015,) by Sir Robert Francis QC, documented the retaliation that was mounted against staff in hospitals for reporting systemic problems, incompetence and medical errors that impacted patient safety. The report includes recommendations for a shift in culture to not only protect but value whistleblowers, and zero tolerance for retaliation.

Like whistleblowers in other fields, most healthcare whistleblowers say they would do it again even knowing what the consequences would be. Why would they engage in such high-risk behavior? A 2011 National Business Ethics report states that most whistleblowers are very committed to their workplace and they have been successful performers. An article by Vicki D. Lachman, Whistleblowers: Trouble Makers or Virtuous Nurses? (MEDSURG Nursing, April 2008,) bases whistleblowing in healthcare as driven by the ethics of the duty to tell the truth, the standards of professionalism (nursing Code of Ethics,) virtue, and that inexplicable courage that causes an individual to jump into harm’s way to safe the life of another. She also states that, “They (whistleblowers) are above average performers committed to the organization with a strong belief in moral principles.” Lachman however notes the potential retaliation:  “The list of negative consequences to whistleblowers seems endless: broken promises to fix the problem, disillusionment, isolation, humiliation, formation of an “anti-you” group, loss of job, questioning of the whistleblower’s mental health, vindictive tactics to make the individual’s work more difficult and/or insignificant, assassination of character, formal reprimand, and difficult court proceedings.”

The victimization of patients and the victimization of people on the inside of healthcare trying to save lives cannot be ignored. These tragedies are deserving of a hard look at where the bodies are buried, who is causing these deaths, and what needs to be done to protect whistleblowers so that when we access medical care we are not inadvertently boarding a plane destined to crash and burn.

 

 

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The Write Stuff

The patient presented with multiple diagnoses:  Morbidly alcoholic with fits of anger, depression, anxiety, and insomnia.  His appearance was one of self-neglect with a disassociated affect.  But the doctor did not prescribe antidepressants, counseling or electroconvulsive shock therapy.  He placed a blank journal in front of the patient and positioned the pen on the page toward him.  “Write it down,” he said.  “A memory, a thought, a place.”  The patient was Nick Carraway.

Write something.  I do not mean for this to be an intimidating suggestion.  It makes no difference whether you write five paragraphs for a blog, a paper for a professional journal, or a poem for a reading group.  Just write.  What you write need not achieve perfection.  It need only add some small observation to your world.  Atul Gawande, MD. in his book Better: A Surgeon’s Notes on Performance  is writing about changing the world.  The doctor at the Perkins Sanitarium, in Baz Luhrmann’s The Great Gatsby, is telling Nick Carraway to write to change himself.  He tells Nick that it doesn’t matter if anyone else reads what he writes or if he burns it.  Just write.

Far be it from me to suggest that anyone who has a mental illness not receive necessary treatment, but there is something about the prescription of writing that is healing, that is life enhancing, that is empowering, that is both personally and publicly changing.

We all know the power of writing from the glyphs on the walls of the caves of Lascaux, to the Guttenberg printing press, to the emails and texts we now zap off and retrieve in nano seconds. John Snow’s essay On the Mode of Communication of Cholera in i849; Ignatz Semmelweis’s Etiology, Concept and Prophylaxis of Childbed Fever both had powerful, although delayed, effects on public health.  But what does writing do that changes the writer whether it is a blog, a poem, an essay, a professional paper, or The Great Gatsby?

First, there is the actual physical act of writing.  Nick starts out writing in the journal in cursive which Luhrmann conjures up as the words scrawling and draping across the screen.  In 3D, the curlicued letters actually float out to embrace the audience.

….scientists are discovering that learning cursive is an important tool for cognitive development, particularly in training the brain to learn “functional specialization,”[  that is capacity for optimal efficiency. In the case of learning cursive writing, the brain develops functional specialization that integrates both sensation, movement control, and thinking. Brain imaging studies reveal that multiple areas of brain become co-activated during learning of cursive writing of pseudo-letters, as opposed to typing or just visual practice. Other research highlights the hand’s unique relationship with the brain when it comes to composing thoughts and ideas. Virginia Berninger, a professor at the University of Washington, reported her study of children in grades two, four and six that revealed they wrote more words, faster, and expressed more ideas when writing essays by hand versus with a keyboard.

There is a whole field of research known as “haptics,” which includes the interactions of touch, hand movements, and brain function.  Cursive writing helps train the brain to integrate visual, and tactile information, and fine motor dexterity.   MEMORY MEDIC by William Klemm, D.V.M., Ph.D.       What Learning Cursive Does for Your Brain | Psychology Today.html

Then there is the whole right brain/left brain relationship in writing that connects the creative emotional side of ourselves with the sequential verbal side.  So here is what is going on in each side of our sophisticated bicameral brains that developed around 1,000 BC when a purely reactive brain was not capable of figuring out complicated stuff, and a meta consciousness was required:  thinking about thinking, desiring about desire, worrying about worries, wondering about wonder.  Julian Jaynes thought about these thoughts documented in his 1976 book The Origin of Consciousness in the Breakdown of the Bicameral Mind.

Here’s what each side of the brain does.

LEFT BRAIN FUNCTIONS

uses logic
detail oriented
facts rule
words and language
present and past
math and science
can comprehend
knowing
acknowledges
order/pattern perception
knows object name
reality based
forms strategies
practical
safe

RIGHT BRAIN FUNCTIONSuses feeling
“big picture” oriented
imagination rules
symbols and images
present and future
philosophy & religion
can “get it” (i.e. meaning)
believes
appreciates
spatial perception
knows object function
fantasy based
presents possibilities
impetuous
risk taking

Writing gets the major highway system between the two sides of the brain, the corpus callosum, activated in fact, bringing a wholeness to our thoughts, our expression, our selves.  Fantasies, dreams, ideas, fears, beliefs, travel into verbal language, knowing, acknowledgement, comprehension.

So this is what happens when we write, and I can tell you it is happening to me right now.  There is a total engagement, there is a sense of being “together,”  there is what Mihaly Csikszentmihalyi calls FLOW in the book by that name, subtitled Steps Toward Enhancing the Quality of Life.  Enhancing the quality of life; isn’t that what we strive for in our personal health and public health?  (Don’t right brain panic over how to pronounce Mihaly Csikszentmihalyi .  It is actually quite simple if you don’t let all of those consonants throw you and your left brain just goes with the sequence.  First name: Me High.  Last name: Cheek Sent Me High.)  Flow is what happens when your left brain and right brain are working in complete participation with each other, when we are “lost” in experience, in creation, in process. Experiencing flow is a positive experience; in fact, some people refer to it as “optimal experience.” Flow doesn’t just happen for writers—athletes call it being “in the zone.” Artists, surgeons, dancers, and others also experience flow when they’re completely passionately focused on something they love.

So this is the fun part of being healthy, enhancing the quality of our lives, of choosing to go with the flow, of optimal experience.  There isn’t one single prescription.  It isn’t one size fits all.  There is no standard operating procedure.  Natalie Goldberg in her book on writing, Writing Down the Bones notes that journals should be big enough to write big, but William Carlos Williams, the poet who was also a pediatrician, often wrote his poems on his prescription pad.  How perfect, the prescription of a poem.

It’s all about you and doing what engages your self fully, right brain, left brain, body, soul, spirit.  Garden, bird watch, play music write music listen to music, paint, dance (actually no matter what else you do always dance,) practice yoga, solve mathematical equations, build something (I can actually get a little too engaged walking around Lowes,) heal someone, heal yourself.  And do write.  You can do it anyplace on anything at any time.  I have actually written various stories, essays, articles on the back of grocery store receipts and pay stubs.  If you feel the least bit inhibited about writing something, I recommend a book called Wreck This Journal.  If you write in this book you will never feel inhibited about writing again, in fact you might never feel inhibited about much of anything again.

“Write something,” prescribes Dr. Gawande, ”it need not achieve perfection.”

So back to Nick Carraway, (fresh faced and glowing after a nap on the couch and the accumulation of his typed pages,) and the final line of The Great Gatsby with my own edits, (and no apologies whatsoever to Mr. Fitzgerald, who would probably have loved to have been able to approve,) on this fine morning, May 27, 2013:

but that’s no matter–tomorrow we will run faster, stretch out our arms farther…and one fine morning–so we write on, boats against the current, born ceaselessly into the moment.”

 boats against the current

Blogadenda

Some of you know that in addition to writing this blog, I write essays, professional articles, and short stories.  I wrote the following for my granddaughter and so it is titled For Sonoma at Bedtime, but it is also known as

The Mermaid and the Cowboy

Once upon a time, under the great blue green curls of the waves in the deepest most beautiful ocean, lived a mermaid with golden curls and eyes the color of the blue green waves.  With her beautiful blue iridescent tail she swam with the whales and played with the dolphins and raced with the seahorses.  She and her mermaid friends dreamed of love and adventures and flirted with the sailors on the passing ships.

Over time all of her friends fell in love with sailors and traded their beautiful iridescent tails for feet.   Ah the better to walk with on the piers and dance and love their sailors.  But the mermaid with the blue green eyes was determined to find love and keep her iridescent beauty and the power of her swimming.  So as her friends left one by one she was lonelier and lonelier but also bolder and bolder as she explored the ocean from the crests of the waves to the deepest darkest crannies of caves and she became acquainted with every living creature in the sea.

And so it happened that one night as she swam over the castle spires of a reef, a great storm blew in from some dark and violent place and the mermaid, caught in the winds of change and the rains of despair, was carried far from her home in the sea, to craggy coastlines, up muddy rivers to a sandy creek’s edge.  Covered with mud, scraped and bruised she lay on the sandy bank sleeping off the nightmare of the storm.

A cowboy, dusty and weary, walked his pony along the creek looking for an easy place to settle in for a quiet rest and to let the pony drink.   As they wandered down the bank, the cowboy was dazzled by a glimpse of iridescent blue at the edge of the water.  When he scooped into the sand he found beneath a layer of mud, golden curls and glistening scales and peachy, though scraped and bruised, arms and hands and shoulders and a face that slowly revealed, as her eyelids flickered open, the blue green of a sea he had only imagined.  And the mermaid, her vision a little blurred from the night of tears and fears, looked at the cowboy and was dazzled by the gold dust glistening in the sun that shone upon his face.

Though he was awkward, at the water’s edge the cowboy washed the mud off of the mermaid, and then bandaged her cuts and scrapes.  He made a pot of coffee on a little fire he built at the edge of the creek and took some biscuits and wild strawberry jam out of his saddlebag. The mermaid sipped the coffee and ate the biscuits with him and was warm and cozy, feelings she had never experienced in the deepness of the ocean.

For a month the mermaid and the cowboy lived on the sandy bank of the creek while her bruises and scrapes healed and his exhaustion faded.  She told him about the ocean and the creatures of the sea, the waves and the deep dark places in the underwater caves.  And he told her of the prairies and the forests, of snow and butterflies and falling leaves.  He took his guitar from his saddle and sang to her of moonlit nights and lost loves and little lambs found.  And the mermaid sang to him in the lulling voices of whales and the cadences of the dolphins and the soothing tones of the tides.  Some days the cowboy would ride off for a while on his pony and the mermaid would dip and swim and splash her tail in the creek as she grew stronger.  And once, just once, the cowboy joined her in the water and clumsily tried to swim by her side.  But he floundered, frightened by what seemed to him dark and scary beneath the surface of the water.  He sank and had to spit out the water that poured into his mouth.  And once, just once, the mermaid tried to sit on his pony and go for a ride, but her tail slipped and she fell into the grass.   She tried to maintain her dignity, but she was embarrassed and tearful.

So the days and nights passed and one morning after a night with a full moon, the cowboy and the mermaid simply said, “good-bye,” and she swam away down the creek, along the stream and into the river and out to the sea without once looking back.  And the cowboy climbed up onto his pony and rode away from the creek, across a field, through a forest and over some mountains and out onto the prairie, and he tried not to look back.

There were no calendars in the sea or on the prairie and so no one could guess how many days or months or years passed, but after many many full moons and snowfalls and campfires, the cowboy realized that he had left his heart on the sandy bank of that creek and it had been carried deep into the sea.  And after many many tides and migrations of whales and births of seahorses too many to count, the mermaid also realized that she had left her heart at the edge of that creek and it was far away somewhere on a dusty prairie.

And so the cowboy and his pony boarded a ferry, and then a boat and then a ship and they sailed around and around the world looking into the sea for a glimpse of iridescence and the blue green eyes of the mermaid he loved.  And the mermaid swam up rivers and into streams and creeks, and painfully wriggled into ponds and the shallowest of puddles on the prairie looking for a cowboy who was dusty and dazzling and who she loved more than anything.

It was a kind storm of graceful rains and fortunate strong winds that tipped the ship and beached the cowboy and his pony and that washed the mermaid out of the puddles and down the creeks and into the rivers, back to the sea where the whales and the dolphins and the seahorses conspired to carry her to a brilliant beach where she awoke in the cowboy’s arms.  In the moonlit nights of days that were on no calendar, on that beach at the edge of all oceans they sang together and danced.  And each fine morning a cowboy, holding the hand of his mermaid, swam in the blue green curls of the waves and each evening, a mermaid safe in the arms of her cowboy, sat proudly on the back of his pony as together they rode off into the sunset.

A Beautiful Day in the Neighborhood

“When I say it’s you I like, I’m talking about that part of you that knows that life is far more than anything you can ever see or hear or touch. That deep part of you that allows you to stand for those things without which humankind cannot survive. Love that conquers hate, peace that rises triumphant over war, and justice that proves more powerful than greed.”

It was not a beautiful day in the neighborhood.  The river swelled with rain, the high tide and the pull of the full moon which was obscured by the storm clouds. The wind blew houses apart, ripped out electrical wires, knocked down trees and set violent waves into motion.  On the streets of my little village, the storm left hundreds of people along the river and creek with water and mud in their basements, their living rooms, bedrooms and kitchens.  Some homes were missing entire walls. Docks were washed away.  Boats were in the streets and crushed into houses.  Without electricity the village was dark and people we had always welcomed as tourists became voyeurs to the devastation and some sadly came back under the cover of the darkness to take advantage of exposed boats and homes that still contained valuables.  We had a curfew in our little village.

As the days went on and communication was slowly restored we all became more and more aware of the assault on our larger neighborhood, other towns and villages where our family and friends live. Jersey City where two of my daughters live, Hoboken, the Jersey Shore with shocking pictures of homes washed out to sea and the roller coaster mangled and submerged.  Staten Island devastated; a woman walking around rubble where her house once was.  Battery Park under water and much of Manhattan at a standstill: a New York Moment became a long continuum of slow dark nights and days of daunting challenges of finding food, drinking water, housing and comfort.  There were deaths from falling trees, isolation, flooding.

Here in our little village we gathered last Thursday morning at the Village Hall for instructions, information and opportunities to help each other.  Our Mayor Chris Sanders said, “We didn’t lose anything of value; we lost stuff.  No one died.  We can replace the stuff but we can’t replace a life.”  “Life is far more than anything you can see or hear or touch.”  He didn’t say that, but it was the message in his message.

And the villagers joined together to help with the stuff.  Crews bulldozing the streets, neighbors helping neighbors pump water and clean sludge out of their homes, the Fire House serving as a temporary shelter.  I was fortunate.  I got to help just by doing something I love, cooking big pots of soup for people staying at the Fire House and the volunteers.  I also had the opportunity to just listen to some people who just needed to talk.   It was hard to listen knowing that I couldn’t fix anything that these women needed help with. I didn’t have answers, but I think there were people like Judy and Jackie and Helen and Sue who just needed someone to listen to their questions.  Like, “Can I ever go back to my house on the river?”  I thought of Atul Gawande’s book Better citing one of the five ways to change the world as listening.   I just tried to quiet myself down and truly listen.

There were all the public health issues of contaminated water and requirements of boiling drinking water, of wearing protective clothing in water that contained sewage and chemicals.  Concerns about food spoilage and gastrointestinal infections.   And the importance of safeguarding against stepping into water that had electrical wires concealed beneath the surface.  Although not too many homes in our village have garages I reminded people to not sit in a closed garage running their car to charge their cell phones.

In the midst of this I received an email from my daughter Kierra who had gotten information from my grandchildren’s Montessori School about what to tell kids about all the damage and devastation.  So often in the crisis and busyness of trying to cope and clean up and take care of and rebuild we forget that kids can’t understand what happened not just to them, but to others in the big neighborhood.  The email referenced a quote for parents, really any grown ups,to help children during a crisis in their own home, in the village, in the big neighborhood.

“When I was a boy and I would see scary things in the news, my mother would say to me, “Look for the helpers. You will always find people who are helping.”  Fred Rogers

Those of us who are of a certain age and our children remember watching Mr. Rogers’ Neighborhood which was on PBS for more than 30 years from 1968 to 2001.  It was in fact always a beautiful day in the neighborhood as Mr. Rogers slipped into his zip-up sweater and sneakers.  Although Mr. Rogers’ Neighborhood was a little cardboard town, he gave kids and all of us who watched the understanding of the big neighborhood and our responsibilities for each other.  He helped us all understand, “That deep part of you that allows you to stand for those things without which humankind cannot survive. Love that conquers hate, peace that rises triumphant over war, and justice that proves more powerful than greed.”   And helpers that put the neighborhood back together after a superstorm that devastated homes and businesses and people’s lives.

As I look at the newspapers and the TV reports, at the online pictures of the damage left by the violent winds and surging water, I keep looking for the helpers and I keep reminding everyone I know, big and little that there are always helpers.  I don’t mean this in any way to be flippant.  The damage is real in real neighborhoods, not the little 1960’s cardboard TV set.  Precious irreplaceable lives have been lost and it will take a long time and immeasurable resources to fix and repair and replace the stuff.   But the messages that Mr. Rogers left for us are real, too, and I believe that these messages help us as helpers and as those who need so very much to be helped.

The Marathoners ran to Staten Island with rakes and shovels and bottled water. My friend Linda Burnside in Winnipeg ran her own fund raising  “Run Anyway.”  On the news last night there was the report of a man from Texas who drove to Long Island with supplies and food.  There was a fund raising concert last Friday night with Sting and Springsteen and Christina Aguilera supporting the Red Cross.   Senator Kirsten Gillibrand and Congresswoman Nita Lowey came to our village.  The Salvation Army was here in Piermont, so were our DPW, Fire Fighters, Women’s Auxiliary, Police Force and our inspiring Mayor Chris Sanders.   The helpers are everywhere on this beautiful day in the neighborhood.  They are us.

(And by the way, “I have always wanted to have a neighbor just like you, I have always wanted to live in a neighborhood with you.”)

http://video.pbs.org/video/1415187976/

► 1:28

http://www.youtube.com/watch?v=OFzXaFbxDcM

Fred Rogers > Quotes

“Anyone who does anything to help a child in his life is a hero to me. ”

“Love isn’t a state of perfect caring. It is an active noun like struggle. To love someone is to strive to accept that person exactly the way he or she is, right here and now.”

“If you could only sense how important you are to the lives of those you meet; how important you can be to the people you may never even dream of. There is something of yourself that you leave at every meeting with another person.”

“Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone.”

“Forgiveness is a strange thing. It can sometimes be easier to forgive our enemies than our friends. It can be hardest of all to forgive people we love. Like all of life’s important coping skills, the ability to forgive and the capacity to let go of resentments most likely take root very early in our lives.”

“When I was a boy and I would see scary things in the news, my mother would say to me, “Look for the helpers. You will always find people who are helping.”

“We live in a world in which we need to share responsibility. It’s easy to say “It’s not my child, not my community, not my world, not my problem.” Then there are those who see the need and respond. I consider those people my heroes.”

“You rarely have time for everything you want in this life, so you need to make choices. And hopefully your choices can come from a deep sense of who you are. ”

“Often when you think you’re at the end of something, you’re at the beginning of something else.”

“Mutual caring relationships require kindness and patience, tolerance, optimism, joy in the other’s achievements, confidence in oneself, and the ability to give without undue thought of gain.”

“Love and trust, in the space between what’s said and what’s heard in our life, can make all the difference in the world. ”

“The greatest gift you ever give is your honest self.”

“In times of stress, the best thing we can do for each other is to listen with our ears and our hearts and to be assured that our questions are just as important as our answers.”

“Whether we’re a preschooler or a young teen, a graduating college senior or a retired person, we human beings all want to know that we’re acceptable, that our being alive somehow makes a difference in the lives of others.”

“Who we are in the present includes who we were in the past.”

“I hope you’re proud of yourself for the times you’ve said “yes,” when all it meant was extra work for you and was seemingly helpful only to someone else.”

“The thing I remember best about successful people I’ve met all through the years is their obvious delight in what they’re doing and it seems to have very little to do with worldly success. They just love what they’re doing, and they love it in front of others.”

“We need to help people to discover the true meaning of love. Love is generally confused with dependence. Those of us who have grown in true love know that we can love only in proportion to our capacity for independence.”

“The child is in me still and sometimes not so still.”

“Discovering the truth about ourselves is a lifetime’s work, but it’s worth the effort.”

“It’s very dramatic when two people come together to work something out. It’s easy to take a gun and annihilate your opposition, but what is really exciting to me is to see people with differing views come together and finally respect each other.”

“The connections we make in the course of a life–maybe that’s what heaven is.”

“Little by little we human beings are confronted with situations that give us more and more clues that we are not perfect. ”

“It’s not the honors and the prizes and the fancy outsides of life which ultimately nourish our souls. It’s the knowing that we can be trusted, that we never have to fear the truth, that the bedrock of our very being is good stuff.”

“I’m proud of you for the times you came in second, or third, or fourth, but what you did was the best you have ever done”

“When we treat children’s play as seriously as it deserves, we are helping them feel the joy that’s to be found in the creative spirit. It’s the things we play with and the people who help us play that make a great difference in our lives.”

“In the external scheme of things, shining moments are as brief as the twinkling of an eye, yet such twinklings are what eternity is made of — moments when we human beings can say “I love you,” “I’m proud of you,” “I forgive you,” “I’m grateful for you.” That’s what eternity is made of: invisible imperishable good stuff.”

“At the center of the Universe is a loving heart that continues to beat and that wants the best for every person. Anything that we can do to help foster the intellect and spirit and emotional growth of our fellow human beings, that is our job. Those of us who have this particular vision us to continue against all odds. Life is for service.”

“Whatever we choose to imagine can be as private as we want it to be. Nobody knows what you’re thinking or feeling unless you share it.”

“The world needs a sense of worth, and it will achieve it only by its people feeling that they are worthwhile.”

“What’s been important in my understanding of myself and others is the fact that each one of us is so much more than any one thing. A sick child is much more than his or her sickness.
A person with a disability is much, much more than a handicap. A pediatrician is more than a medical doctor. You’re MUCH more than your job description or your age or your income or your output.”

“Peace means far more than the opposite of war.”

“Knowing that we can be loved exactly as we are gives us all the best opportunity for growing into the healthiest of people.”

“There is no normal life that is free of pain. It’s the very wrestling with our problems that can be the impetus for our growth.”

“There are three ways to ultimate success:
The first way is to be kind.
The second way is to be kind.
The third way is to be kind.”

“I don’t think anyone can grow unless he’s loved exactly as he is now, appreciated for what he is rather than what he will be.” “Try your best to make goodness attractive. That’s one of the toughest assignments you’ll ever be given.”

“How great it is when we come to know that times of disappointment can be followed by joy; that guilt over falling short of our ideals can be replaced by pride in doing all that we can; and that anger can be channeled into creative achievements… and into dreams that we can make come true.”

“A young apprentice applied to a master carpenter for a job. The older man asked him, “Do you know your trade?” “Yes, sir!” the young man replied proudly. “Have you ever made a mistake?” the older man inquired. “No, sir!” the young man answered, feeling certain he would get the job. “Then there’s no way I’m going to hire you,” said the master carpenter, “because when you make one, you won’t know how to fix it.”

“I believe that appreciation is a holy thing–that when we look for what’s best in a person we happen to be with at the moment, we’re doing what God does all the time. So in loving and appreciating our neighbor, we’re participating in something sacred.”

“There was a story going around about the Special Olympics. For the hundred-yard dash, there were nine contestants, all of them so-called physically or mentally disabled. All nine of them assembled at the starting line and, at the sound of the gun, they took off. But one little boy didn’t get very far. He stumbled and fell and hurt his knee and began to cry. The other eight children heard the boy crying. They slowed down, turned around, and ran back to him–every one of them ran back to him. The little boy got up, and he and the rest of the runners linked their arms together and joyfully walked to the finish line.
They all finished the race at the same time. and when they did, everyone in the stadium stood up and clapped and whistled and cheered for a long, long time. And you know why? Because deep down we know that what matters in this life is more than winning for ourselves. What really matters is helping others win, too, even if it means slowing down and changing our course now and then.”

“It’s really easy to fall into the trap of believing that what we do is more important than what we are. Of course, it’s the opposite that’s true: What we are ultimately determines what we do!”

“It’s a beautiful day in this neighborhood,
A beautiful day for a neighbor.
Would you be mine?
Could you be mine?…

It’s a neighborly day in this beauty wood,
A neighborly day for a beauty.
Would you be mine?
Could you be mine?…

I’ve always wanted to have a neighbor just like you.
I’ve always wanted to live in a neighborhood with you.

So, let’s make the most of this beautiful day.
Since we’re together we might as well say:
Would you be mine?
Could you be mine?
Won’t you be my neighbor?

Won’t you please,
Won’t you please?
Please won’t you be my neighbor?”