ABILITY Magazine Scott Caan Issue by ABILITY Magazine

MAGAZINE

VOLUME 2009

SCOTT CAAN

OCT/NOV

THE VOICE OF OVER 50 MILLION AMERICANS

$4.99 Volume 2009 SCOTT CAAN OCT/NOV

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M ANAGING E DITOR Gillian Friedman, MD

M ANAGING H EALTH E DITOR E. Thomas Chappell, MD

C ONTRIBUTING S ENATOR U.S. Sen. Tom Harkin (D-IA)

H UMOR W RITERS

Jeff Charlebois George Covington, JD Gene Feldman, JD

E DITORS

ASHLEY’S COLUMN — Breaking News

ABILITY HOUSE — Laura’s Story

SEN. TOM HARKIN — SSA Backlog

BONNER PADDOCK — King of the Mountain

ADAM LEE — Inspiration Through Inflation

CONCUSSION JUNCTION — Head Injury for Dummies

BAD BOYS — EEOC Tackles Job Discrimination

STRAIGHT FROM THE HEART — Vascular Disease and You

PLUCK O’ THE IRISH — Exploring the Emerald Isle

TAKING THE SKY — Paraplegic Adventurer Flies Again

USBLN — Business Leadership Celebrates Disability

SCOTT CAAN — Entertainer Makes Waves for Autism

BLUE CROSS — Insurance Expert Dishes on Health Care

THE SKINNY ON OBESITY— Breaking Down the BMI

TAP INTO YOUR POTENTIAL — An Excerpt from Wise Mind

CROSSWORD PUZZLE

H EALTH E DITORS

Larry Goldstein, MD Natalia Ryndin, MD Travels Through Ireland p. 24

Paralympic Games Beijing

Extremity Games

HUMOR — I Do?

C ONTRIBUTING W RITERS

Gale Kamen, PhD Laurance Johnston, PhD Andrea Kardonsky Deborah Max Myles Mellor - Crossword Puzzle Dana Nelson Paula Pearlman, JD Richard Pimentel Allen Rucker Kristen McCarthy Thomas Betsy Valnes Leslie Margolin p. 42

W EB E DITOR Joy Cortes

G RAPHIC A RT / I LLUSTRATION

Scott Johnson Guy Uesugi Liz Angeles - Paintings Music Within

P HOTOGRAPHY Mastering Your Mind p. 52

Nancy Villere— CrushPhotoStudios.com Annie Moses - Ireland

T RANSCRIPTIONIST Sandy Grabowski ABILITY’s Crossword Puzzle

Surfing with Scott Caan p. 32

Liz Angeles Diane Chappell Dahvi Fischer Renne Gardner Sonnie Gutierrez Josh Pate David Radcliff Denise Riccobon, RN Jane Wollman Rusoff Maya Sabatello, PhD, JD Romney Snyder

DIRECTOR OF BUSINESS AFFAIRS John Noble, JD

MARKETING/PROMOTIONS Liz Angeles Andrew Spielberg Tonight Show Concussion p. 18

PUBLIC RELATIONS JSPR

NEWSSTAND CIRCULATION John Cappello

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NON-PROFITS Ashley Fiolek p. 8

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PUBLISHER

Chet Cooper ABILITY Magazine is published bimonthly by C.R. Cooper, 8941 Atlanta Ave. HB, CA 92646 (ISSN 1062-5321) All Rights Reserved. Subscriptions: $29.70 per 1 year (6 issues). Periodicals postage rates at Irvine, CA and at additional mailing offices. POSTMASTER: Send address changes to ABILITY Magazine, Attention Subscriptions Manager, PO Box 10878, Costa Mesa, CA 92627; Volume 2009 Scott Caan Oct/Nov Printed in U.S.A.

ABILITY5 5 ABILITY

Should I Do “I Do?”

ith the divorce rate over fifty percent, should people get married? I say, why not? What the hell else is there to do?

Really...What else is there to do? You can’t play football your whole life (I don’t care how big a girl you are). You can’t hit the bars every night. (Man, your liver needs a holiday, too). People are lonely creatures. More than that, we all need someone to fight with, yell at and humiliate. It’s just part of who we are. You can’t even pretend to be married. Without that piece of paper and those vows there’s no way anybody would continue to put up with a partner in that type of setting. When you’re dating or living together there’s always an escape route. (Running out for a pack of smokes and never returning is an all time favorite. Even if you don’t smoke, it works. You just can’t top the classics.) Living together simply gives you no reason to stay and fight…and that’s what marriage is all about— dishing it out and taking it from your spouse. When I got married I started sleeping around. I’d sleep on the couch, in the garage, the dog house—it just depended how mad she was. 6

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A lot of women need a sign before they get married… it’s called a dollar sign. That’s right, women like a man who has money. I never see the hot babe flirting with the panhandler. “Will marry for food” is never a good sign…even if the words are spelled correctly. Women like the little things in a man—a job, a bank account an expensive car. Men, on the other hand, are simple beasts. They like a semi-hot meal and that special someone to bring the roof down in the bedroom. They can’t go wrong with a nymphomaniac chef. However, after that wears off they’re left singing “Is That All There Is?” A man had better be prepared to work when he gets married…and I don’t mean a real job, although he’d better have that. All the things he’d once become used to putting off (like taking out the trash, cutting the lawn, putting his dish in the dishwasher)…well, that party’s over. That dirty sock in the corner no longer becomes a

decoration. Football games must now wait until the chores are done…and incidentally, men, the chores are never done. Men are happy when their wives are happy. That usually means their households will be calm and they’re not going to be ripped apart for not doing something they were supposed to do. Women, on the other hand, do not want their men happy unless they are happy. If a woman feels miserable, her man had better feel the same way, and if he doesn’t, she’ll do every thing in her power to make sure he does. Women view marriage as a partnership. They’re not going to feel lousy by themselves— they’re taking their men with them. After a year or two of marriage, wives have learned to answer all questions pertaining to the relationship. They’re always ready to chime in. It’s unclear whether this is because females love to talk, or if they just can’t trust their hubbies to give out information. A woman often believes she is going to change her man, never realizing that a man is lucky if he changes his underwear. People rarely change. If the guy’s a pig when you married him, he’ll be a pig when you divorce him…but with less money. A marriage is a constant battle to change that spouse you once loved everything about. Just when you think you’ve fixed the little thing that’s been irking you for the last year, BOOM! You’re blindsided by another annoying habit. If your marriage is going to have a chance, it’s important to realize you are always going to be disappointed. A wife has some very powerful weapons at her disposal. They’re called her voice and her knack for nagging. That’s a good knack to have—all too often, men need to be knocked upside the head. Boom boom side-a-head, boom, boom side-a-da-head! Nagging prevents the home from turning into disarray and looking like a crack house. A wife knows she must always keep her husband busy, or else the sneaky louse will be hiding in the office looking up porno on the internet. Every marriage is going to have its slew of fights. That’s the way humans show love for one another. Someone really should find a way to reveal this to young lovers to warn them of the pending battles. Perhaps instead of, “I now pronounce you husband and wife,” the priest could say something like, “Let’s get ready to r-r-r-rumble!” Fights are okay to clear the air. There’s nothing like a good ol’ fashioned spat to open the waves of communication. The back-and-forth banter: “You repulse me!” “I despise you.” “I hate you.” “Rat face.” “Lizard lips.” Before you know it you’re in the bedroom making out and making up…or in the kitchen throwing culinary ware. Too much fighting and then sadly it’s time to send in the clowns. Unfortunately, marriage can make a person lazy. You become a creature of habit. You come home from

work, sit in the same chair, watch the same TV show. The only time you shake things up is when you snack on a different-flavored bag of chips. You figure, why work out? I already landed a partner. Yes, marriage can breed lethargy. I remember one time my wife said to me, “Let’s go into the other room and have sex.” And I was like, “Well, just pick one—either go into the other room or…” People grow together in a marital relationship. They learn each other’s intimate secrets. She watches where you scratch yourself. He sees when you pluck your facial hair. More importantly, you can trust your spouse to keep these clandestine activities under his or her hat. Your wife will certainly not to tell anybody you still sleep with a teddy bear and listen to The Carpenters. And your husband will never reveal that you dye your hair and wax your butt. One of the great things about marriage is you always have someone to talk to about other people. There’s nothing that brings couples closer than talking smack. It usually starts out with, “Nobody’s supposed to know this, BUT…” or “Don’t tell any of your friends this, BUT…” The key to a long-lasting marriage is keeping the focus off your own faults and deflecting them on to colleagues, friends, neighbors and other unsuspecting dupes. Married couples should hang out only with other married couples. Trouble arises when singles are brought into the mix. Single life is exciting. Married life is boring. Singles tell stories about crazy dating excursions or getting locked up in jail for the night. It’s always good stuff. Married couples talk about…their kids. If they don’t have kids the conversation is usually about the DVD they rented a few nights ago…and they both explain the movie to you while correcting each other. Ultimately the single lifestyle wears thin and you tire of sneaking out of a stranger’s house at six in the morning, racking your pounding head to come up with the name of that bed companion. At least when you’re married, you remember your partner’s name…most of the time. So should people get married? Yes! Marriage elevates us. It gives us responsibility to help us become fully developed. It teaches us to care for someone other than ourselves. It also offers companionship—the opportunity to have someone to grow with. We understand how to love unconditionally. We learn how to tolerate smells, unspeakable behavior and loony family members. But, most of all, we learn forgiveness for imperfect actions. Like everything worthwhile, marriage takes a lot of work to make it work…otherwise, they say, marriage is the quickest way to divorce. One thing’s for sure, it is a beast that constantly needs nurturing. Everyone should do it… hopefully just once. It is a journey with many rewards. “Ham on a Roll”

by Jeff Charlebois ABILITY 7

ell, my motocross season has come to an end and now I am on a long break. The women’s race series consisted of eight races and we just wrapped up the final round at a track in Pennsylvania called Steel City. My last round of racing didn’t end quietly—it went out with a bang! I came into the last round 48 points ahead. We figured that I would need top 11 or better in the first moto (there are two) to cinch the title so that I could just go out in the second moto with no worries. My first moto started off okay, but was not the best. I was about fifth at the start but I didn’t really want to take any risks. I moved my way up and made it into second place. I saw one of my fellow racers take a bad crash as I was working my way up through the pack, closing right behind her. The next two laps went by and I was flying to catch up to first. I am not exactly sure what happened next—I must have hit a rut or something—but suddenly my bike went one way and I went another! I flew over my front handlebars and as my chest slammed onto the bars I had the wind knocked out of me. I crashed to the ground with my right shoulder taking most of the crash. Adrenaline kicked in and I knew if I wanted that championship, I had better get back on my bike! I ran over to it and twisted the throttle. Luckily, the engine was still running! I quickly got back on but as soon as I hit the first jump I knew that my collarbone had been broken! I had gotten back up so quickly that no one had thought anything was wrong. I kept passing my mechanic and pointing to my neck but he didn’t see the crash so he didn’t know what I was doing. My mom and dad were watching from the stands and they didn’t know what I was doing, either. At first they thought something was wrong. But then, every once in a while, I would jump, so they just thought I was playing around. I didn’t know what place I was in, but I knew I didn’t want the girl behind me to pass me. I would do some of the jumps anyway, even though it was horribly painful.

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The race finally ended and, even though I was in seventh place, I won the championship because of how I had performed throughout the season. I made my way, slowly, to the podium. My team and family ran up to me and knew I was in a lot of pain. My adrenaline was gone after the race—and that’s when the pain started to kick in. But I was still pretty stoked that I had won! I made my way to the podium with a smile on my face and held the number one plaque high with my Honda/Red Bull team behind me. After the celebrations, I made my way over to the medical semi and they confirmed that I had broken my collarbone and would probably need surgery. A few days later, after I had flown back home, I went to my sports doctor here in Florida, and learned the bone was completely broken and had dropped down. I needed surgery. I now have a metal plate and six screws in my collarbone. No one could believe I had continued on for five laps with a broken collarbone! But hey, it was for the championship, after all! Only a week after my surgery, I flew out to California to do a few events that had been set up for me, so there was no down time for much recovery. Last week I came out to L.A. with my family and some friends. My first stop was the Washington School, which is a school for deaf kids and children of deaf adults (CODAs). This school was so amazing. Everyone there can sign or is learning to sign, so no one feels left out! My family and I walked into the school and saw a banner the students had made that said “Welcome Ashley.” Inside the auditorium was another banner that said “Thank you, Honda.” Some of the mechanics from the Honda team came to the school and set up my bikes so all of the kids could see what I do. I gave a short presentation and Red Bull made a video for me to use, and then the kids asked me all kinds of questions. It was a lot of fun and it felt so good to be giving back to the deaf community.

After leaving the deaf school, we headed over to the Honda building in Torrance. I thought I was just going there to sign autographs for the employees, but as it turned out, it was a huge deal to celebrate my championship with cake and everything. I was shocked! Two of the Honda representatives I have worked with since 2004 interviewed me and then the employees asked me questions. It was a lot of fun. After that, I signed some autographs. The line went on forever! The president of North American Honda happened to be there for a meeting and he even came down and got my autograph and took a picture with me. How cool was that? Afterwards, we had cake (yum), then a Honda rep took my parents and me upstairs for a tour. It was really interesting and we all loved meeting and talking with everyone. After our visit to Honda, it was off to Red Bull. We met a couple of new people there and my mom had never seen the building so she wanted to stop on by. We talked about my website and also picked up some Alpinestar, T-mobile and Red Bull shirts for an event on Saturday. The Red Bull building is so cool. There is a huge ramp inside and Ryan Sheckler has skated in there and other Red Bull athletes have ridden their BMX bikes inside the facility. One of the Red Bull race cars was inside and there was even a theater inside the building—so sick! On Friday I went to city hall. In the marble foyer, Red Bull had set up my championship video and Honda had brought my bikes and put them on display. I received a resolution from Councilman Cardenas and the City of L.A. mayor’s office! It is this big proclamation and it was in a frame and my number “67” was on it in hand shapes.

Deaf Fest

Last Call with Carson Daly

This was all part of the “kick-off” of Deaf Awareness Week in California. I had been invited to be honored for my efforts in the deaf community and for all that I have achieved this year. Way cool! I had to give a speech (yikes!) and the councilman gave a speech about me for the media. Then we went into the council meeting and I was presented with the resolution. It was an amazing morning! After that, I got to go hang with the Honda guys and have lunch at the train station. From there we went over to NBC Studios and pre-filmed Last Call with Carson Daly. We went to an old warehouse that Green Day used when they were on the show. My bikes were set up and my dad and I sat on directors chairs as the show’s producer asked us questions and I was told that later they “add in Carson Daly.” How crazy is that? I guess. I can’t wait to see it! Saturday was the Deaf Fest. Councilman Cardenas was there and we had the awards presentation again for the deaf community. Afterwards, Honda brought my bikes and the sprinter van. I signed autographs and posed for pictures next to my bikes and a Honda 70. I am so lucky I got to participate in this year’s Deaf Fest for Deaf Awareness Week in L.A. If you ever have the chance, check it out.

ashleyfiolek.com

t’s a hot, humid summer day in Ocala, Florida, and Durren Omans is helping build a house for a woman he just met. Darting from one window to the next of what is at this point only a wooden skeleton of a home, Omans nails supports to each window, stopping only to grab another nail from the fabric apron tied around his waist. A few feet away, other volunteers are stooped over in the sun, swinging their hammers while beads of sweat trickle down their foreheads. My teammates, Dana Nelson and John Siciliano, have joined in to help as well, with Nelson and other volunteers leveling the ground in the front of the property to prepare it for sod, while Siciliano transports four-by-fours from a pile outside to the inner workspace. I take up a hammer and a nail apron, crouch alongside another volunteer named Simone Roach, and help build a wall. We are building a house for Cynthia King, a resident of Ocala, who has never before owned a home. King will soon join the other 1.5 million people who have been provided with decent, affordable shelter through Habitat for Humanity, the world-renowned non-profit organization that has changed the lives of volunteers and new homeowners across the world. With numerous, dedicated volunteers working underneath the mid-day sun, it seems that this particular build is not significantly different from other Habitat builds. Those who have never held a hammer are taught on site how to build a wall or lay a foundation. Seasoned carpenters provide assistance to rookie construction workers, coming by to fix a mistake or compliment a job well done. Everyone laughs together, learns from each other, and grows. Most of the volunteers at this particular build site have a disability. John Siciliano has a prosthetic leg. Durren Omans and Simone Roach, along with over half of the other volunteers, have some sort of developmental disability. At the beginning of the workday, the standard Habitat for Humanity speech was complemented by a brief training session wherein Siciliano spoke about issues that may arise when working with people with disabilities. While listening to Siciliano’s speech early that morning, it was hard not to be struck by the simplicity and clarity of what he was saying. He pointed out, for example, that if someone has a developmental disability or uses a wheelchair, other workers should not assume the need to speak loudly in order to communicate. If someone on a worksite is blind, his fellow builders should be careful

not to leave nails and loose wires scattered around. “And most importantly of all,” Siciliano said, “it should never be assumed that anyone knows a person’s capabilities better than that person himself.” While Siciliano’s speech may have seemed like the stuff of common sense, the fact remains that the nearly 50 million people living with disabilities in the United States continue to be held back by unfounded and damaging axioms. In industrialized countries, the unemployment rate of people with disabilities is estimated at 50% to 70%. Despite being employable, people with disabilities continue to suffer not from their disabilities but from common misconceptions about those disabilities. How can one account for the abundance of misinformation about people with disabilities? In many instances, it is possible to denounce verbally any stereotypical assumptions one minute, only to unwittingly reinforce them through actions and body language the next. Based on my own experience at the ABIITY Build in Ocala, a lack of communication and interaction between people with and without disabilities plays a large role in perpetuating social stigma. What was most striking to me at the ABILITY Build, however, was a slight but perceptible shift in the general mood of those on site during the course of the day. In the morning, when all of the volunteers with developmental disabilities arrived, there was a slightly tense feeling in the air. Volunteers without disabilities stood apart from the group, not fully interacting with the volunteers from the Independent Living Center. As the day wore on, however, that strange, uncomfortable ambience dissipated completely. Everyone talked to each other, helped each other, and worked together as a team. This transformation took place largely because everyone was given the chance to interact and to work together on one important project. Though change in the on-site mood that day may have been slight, its profundity was incalculable. Opportunities like ABILITY Builds, which allow people of all disabilities and limitations to communicate and interact, could very well make the difference between a world where every human being is treated first and foremost as a person, and the world as it too often is today. As I hammered away next to Simone that afternoon, it struck me that perhaps by building walls, we can break other walls down. by Laura Evans abilityawareness.org

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SSA: PROGRESS IN THE BACKLOG Dear ABILITY readers, The Social Security Administration (SSA) recently announced that it had reduced the backlog in disability claims for the first time since 1999 and will end the year with fewer disability hearings pending than in the previous year. For those living with disabilities, waiting for benefits is a long, difficult process, so this is good news and I commend the agency for reducing this number. As Chairman of the Senate’s Labor, Health and Human Services Appropriations Subcommittee, I have provided substantial increases in funding to help SSA reduce the backlog in disability claims and improve SSA’s other core services. The 2008 appropriations bill provided $9.7 billion for SSA’s administrative budget, $150 million more than requested by the President and $447 million more than the 2007 level. In 2009, I included $10.5 billion for SSA’s administrative budget, $126.5 million more than requested by the President and $708.9 million more than the 2008 level. In addition, given the dramatic increase in workloads caused by the economic recession, the American Recovery and Reinvestment Act included an additional $500 million for SSA for fiscal years 2009 and 2010 to help process rising disability claims and other workloads. Eliminating the backlog won’t be easy, and requires more than simply providing SSA with additional staff to process the increasing workloads the agency is experiencing. It also requires the SSA to use its resources well. That’s why I asked the Government Accountability Office (GAO) to assess SSA’s plan for reducing the backlog and preventing its recurrence. I’m pleased to note that on September 9, 2009 the GAO released its report which found that the SSA’s plan should help the agency reduce its hearings-level backlog. This news, coupled with the funding headed its way, means that the SSA should continue to aggressively tackle this problem in order to eliminate this backlog completely. I will continue my work to ensure that the agency has the resources in order to do so. Sincerely, Senator Tom Harkin (D-IA) harkin.senate.gov ABILITY 11

limbing Mount Kilimanjaro is a tremendous achievement for anyone. With challenges ranging from severe altitude sickness to sub-zero temperatures, it’s a mammoth (19,340 ft.) undertaking that had never before been conquered by anyone with cerebral palsy (CP). Then came Bonner Paddock. With corporate sponsorship, a small film crew, and a remarkable amount of willpower, Paddock trekked up the mountain to raise money for development of his foundation, “One Man, One Mission,” which will create early learning and health centers in Africa and the United States for people with disabilities. His documentary, Beyond Limits, is entering the film festival circuit. ABILITY Magazine’s David Radcliff recently sat down with Bonner Paddock to talk about his foundation, his life, and climbing with CP.

Radcliff: Yeah, judging by the film, it seems you’re mostly on a continual upward slope, walking. Paddock: Yep. Up at that height, you don’t even need that much incline. You lose your breath just bending over to get into your tent. Radcliff: According to the film, there was someone on your team on day two, who-Paddock: Yeah, on the morning of day two, one of our team members bowed out. We didn’t anticipate her to leave that early, but we also didn’t anticipate it to be that cold. We started at 10,000 feet. Radcliff: There’s some talk in the documentary about your circulation and damage to your ankles, and the doctors saying, ‘Maybe you shouldn’t do this.’

Radcliff: Why this? Why choose to climb this mountain? Paddock: Kilimanjaro came about through an email from a good friend I had traveled with to China. He’s a world traveler, a total free spirit, who loves to just pick up on a whim and travel. He wrote, “I climbed an even bigger Great Wall. I just did Kilimanjaro.” The way he described the climb was just captivating. I thought, “We’re kind of comparable in terms of ability, so I might have a shot at this thing.” Radcliff: This guy has a disability too? Paddock: No, he doesn’t. But he showed up with no training, so I thought if I trained hard, I could do it. I just started researching. It didn’t seem like anybody with CP had climbed it. There had been attempts, but no one that I could find had made it. With the name, the mystique, and being the tallest mountain in Africa, I think Kilimanjaro has a lot of cachet and a certain perception about it. It was also a climb that wouldn’t need a lot of mountaineering skills, barring any weather craziness. 12

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Paddock: Oh, but I’m never good at listening to that. My mom will tell you I was the most stubborn kid. I played soccer, so my ankle problems were the first to show. I sprained my ankle a lot growing up. Radcliff: But did you have any health issues from the climb? Isn’t it possible you could have done damage to yourself? Paddock: My recovery time was something the doctors were really worried about. The muscles and the joints in my legs seem to hurt more. I don’t know how to describe what that mountain does to people, but it’s like it slowly breaks you down over days. Eventually things that never hurt... After the seventh day of doing it again, you don’t think you can do it anymore. Radcliff: Maybe your stamina is better than some because you’re accustomed to having to push through challenges due to your disability. Paddock: Yeah, I think so. In sales with the Anaheim

Ducks hockey organization, for example, I work just as hard as I would if I were trying to run or walk or hike or climb. So my disability’s a huge benefit in terms of endurance. It’s made me more successful with work, because my work ethic is perceived to be stronger than most. It’s great to really be ahead at something. Radcliff: Tell me about what kind of a stubborn kid you were growing up. Paddock: I was very interested in sports. I had two older brothers and both of them were really great athletes. So I was just doing the little brother thing: whatever they did, I wanted to do because they were cool. My oldest brother was an All-American swimmer and water polo player, but I wasn’t very good at that because I couldn’t do the eggbeater kick. I couldn’t tread water without my arms like the water polo players do. Radcliff: I know you were diagnosed at age 11. What was your physical capability as a kid, prior to that diagnosis? Paddock: I ran a little differently and started riding a bike a lot later than most kids. I didn’t have the leg strength to keep the bike going if the road went anywhere but downhill. It was a total fluke that we went to see Dr. Arnold Starr at UCLA after my brother had an accident. That’s where the lightbulb went on, and it was CP. Radcliff: And seeing how you navigate and walk, I wouldn’t have guessed CP. You must have really worked hard to get to the level you’re at today. Paddock: Tons of physical therapy. That’s what I’m grateful for, as much as I hated it growing up. It was every day after school, and they didn’t have those cool interactive centers like the ones I’m trying to build now. It was boring and it was repetitive. But I think the leg strength I have now is from years and years of that. As kids, we don’t think that far in the future. Radcliff: How did the other kids treat you as you were growing up? Paddock: I got teased. Luckily, everyone seemed to think I was funny, so humor helped to sort of eliminate my insecurities, and looking back, that’s what they were. Back then I just thought, “go with whatever they’ll accept you with.” So we never really talked about my disability at all. I had size 11 shoes in fifth grade and I was slower than you-know-what in sprint meets. The P.E. coach at school helped me by telling me to just run the long distance stuff, because then it wasn’t about physical speed, it was more mental. Radcliff: And what is your workout regimen like now? Paddock: I’m actually doing these boot camps that are an hour-and-a-half long. Saturday morning, 8:00 am, and they’re just brutal. But it’s cool because it’s outside:

you run, do push-ups, sit-ups, and then you’ve got to run some more. It’s a really, really good workout. Radcliff: What’s your objective with the learning centers that you’re creating? Paddock: I don’t think the United States, and definitely not Africa, does a good job of servicing kids with disabilities. And if you don’t get to them early, I think you’re hurting their chances of becoming something that you hope or wish they can be. It’s one thing to just sit there and go through the motions of, ‘Oh, I hope and I pray.’ You can hope and pray, sure, but get them the proper care and you’ll notice more advanced development in these kids. In Africa, from ages zero to 16, they have nothing. 99 percent of homes in Tanzania have dirt floors. So the kids usually die from insect bites or snake bites because they’re on the floor. So I thought, “How do I give back to the mountain guides who basically saved my life and took care of us? Let’s give their villages something they really need. It’s the best way I can say ‘thank you’ and help them out.” So I’m partnering with one of the charities there, Kids of Kilimanjaro, as well as with the United Cerebral Palsy (UCP) of Orange County, to build a center there to work with and help local families of kids with disabilities. Radcliff: I would imagine the level of acceptance for people with disabilities in the Kilimanjaro region is— Paddock: Zero. They still kill albino kids and eat their organs there. The Kids of Kilimanjaro organization just rescued three kids because the villagers blamed the albino kids for the lack of rain. They think these kids are the devil. Radcliff: Wow. In 2009. Doesn’t that make you feel even more fortunate? If you and I had been born anywhere else, as people with disabilities— Paddock: We’d be dead. In 95 percent of the world, we’d probably be dead. It took me 30 years to realize I don’t have a disability, I have a gift. That’s been part of my maturing process. I understand now that trying so hard to fit in and keep up and blend in with everyone doesn’t help anyone. Radcliff: When did that happen? At what point did you start to embrace the thing that made you different? Paddock: It was actually during the lockout in hockey. My bosses would tell us, “Instead of feeling sorry for yourselves, go give back. Join a charity you’re passionate about.” I was really disconnected from the disability community. I had never dropped a dime with them. When UCP of Orange County brought me on, I found that no one else on the board had CP, so I came and told my story. Radcliff: And you hadn’t really addressed your disability before, growing up? ABILITY 13

Bonner Paddock, who has cerebral palsy, climbs Mount Kilimanjaro with his team.

Paddock: It wasn’t talked about, so it never got in my head. Parents sometimes coddle their kids with disabilities too much. By doing that, you’re not pushing them in the right way. Just because they have a disability doesn’t mean their brains don’t work. Over time, they can do it. Maybe not right away, but they can do it, and coddling only hurts that child in the long run. My family taught me that you don’t quit. I don’t care what you have, you never quit on anything. Radcliff: You’ve certainly lived that philosophy. Aside from Africa and China, have you done much international travel?

kicking power with fins and scuba gear. Radcliff: And now you’re taking on a whole new challenge. What stage is your foundation at now? Paddock: It’s fully-formed. We have 30 people on the board, and each has a key strategic job. We’ll go in and partner with other organizations, like UCP of Orange County, to build these early learning centers. We don’t run it, we provide the funds and get the thing built, and then we move on to the next city. We’re more like a sister spaceship that parks into the mothership. Radcliff: And you’re finding a lot of support?

Paddock: Yes. Mexico, Belize, Bahamas and Canada. I backpacked through Europe alone for a month when I was 19, and I’ve been over twice since then. I’m planning a trip to Dubai in September. Radcliff: Wow. Is there anything you avoid because of your disability? Paddock: I am the worst hockey player on Earth. It’s very hard for me to turn. I can’t stop, I fall down a lot and I have no balance. I don’t enjoy not being good at something, so hockey is something I continue to try. I just need to wait for my body to heal again, and I’ll give it another run. Radcliff: You work for a hockey organization and hockey is your Achilles heel. That says something about you. Paddock: In my opinion, hockey players are the toughest athletes out there. They also have the most complete skill set. I can play basketball, I can play soccer and I can play tennis, but I sure can’t play hockey. I really love scuba diving, though. You don’t need much

Paddock: Tons. In this economy, to raise over $300,000 is really something. We’re aligning with other organizations like Home Aid, who take on these projects after we provide minimal capital. They have multiple chapters all across the country, so if it’s successful here in Orange County, we can utilize Home Aid in other cities and analyze which charities out there best help kids with disabilities. Radcliff: Do you think you’ve grown more comfortable with who you are in recent years? Paddock: Yeah, I think I matured late, and I don’t think I was always a positive person. I was more, ‘put your head down and work.’ I guess I was thinking I deserved better than what I was getting, and that good things should just happen because I believed I was a good person. That’s not the right mindset. Go out and get it if you want it. It’s not going to come to you. Paddock’s documentary, Beyond Limits beyond-limits.com United Cerebral Palsy of Orange County ucp-oc.org

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L to R: Adam Lee with Trinity Broadcast Network; The Simpsons creator Matt Groening; Paralympics; Martha Stewart

dam Lee has an uncommon hobby. Describing himself as a “balloon twister,” the 22-year-old from Olympia, WA, has successfully parlayed the skill of making balloon characters into something of a one-man franchise. Where others might struggle to fashion a dog or a giraffe out of a balloon, Lee tackles more complex subjects, ranging from actor Samuel L Jackson to fire engines to television host Martha Stewart. “I have this ability to really study someone’s face,” Lee said. “I consider if they have facial hair, where their bangs are, how they smile…and then I mimic that with balloons. Sometimes I’ll work for four hours just on someone’s hair, because it has to be perfect. I’m a little bit of a perfectionist.” Lee’s knack for perfectionism is a welcome counterbalance to the difficulties he faces in his day-to-day life. Diagnosed at age six with specific learning disability (SLD), Lee recalls that doctors and teachers were not optimistic about his chances for a rewarding future. “They said I wouldn’t be able to do math, read the paper, speak or reason very well. They said I was pretty much a dud.” Since that diagnosis, Lee has gone on to become an educator and motivational speaker, sometimes addressing crowds of thousands. At 12 years old, he was a guest at the White House (where he played piano for President Clinton), and this fall he’s helming a play for Olympia’s Evergreen Christian Community Church, guiding a cast made up of children with and without disabilities. One of the performers in the play is even having her wheelchair suited up to appear as a wagon, thanks to Lee’s artistic ingenuity. “Whenever I work with kids with disabilities,” Lee said, “the parents really love it. What I do is I open up about myself. I’m 22 years old and I can barely read at all, but I tell these kids that you and I are going to be in this play together and we’re really going to make these opportunities for ourselves.” Even with his considerable accomplishments and

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optimistic spirit, Lee doesn’t deny that many of the tasks most people perform with ease, remain challenging for him. It frequently takes him 20 minutes to fill out a bank check, and can take him just as long to write down a person’s name, even when each letter is spelled out for him. “I was in special education classes throughout all of my education,” Lee said. “Kids would just think I was dumb because I wouldn’t be able to respond to questions. But I actually really enjoy learning and schools and being a well-rounded individual. It can be difficult, though, because disability affects every aspect of your life.” Lee credits his tight-knit family with helping him to overcome the challenges inherent in his disability, and with encouraging him to pursue his talents for music and art. He describes his mother as his “better half,”and says his invitation to perform at the White House came on the heels of a letter that his grandfather had written to President Clinton. “I don’t know what my grandpa said or how it happened,” Lee said, “but it happened.” That experience of being a guest of the President, and of perfecting a special skill that set him apart from other children, had a lasting impact on Lee’s perception of himself. “It really opened me up,” Lee said, “recognizing the fact of being disabled, but having an extraordinary talent. And instead of kids calling me dumb at that point in school, I was hearing things like ‘Wow! This kid went to the White House? But he can’t even do all the classwork!’” It wasn’t until age 16 that Lee discovered his uncommon artistic gifts stretched beyond the realm of music and into the lesser-known arena of balloon twisting. A 15minute balloon class in June of 2003 sparked a curiosity and passion in Lee that, six years later, show no signs of slowing. “I soon realized I didn’t need balloon-twisting instructions like most people,” reads the biography on Lee’s website. “I simply could mentally see how to pattern the balloons.”

Only a year after having taken that basic balloon-twisting course, Lee created a balloon replica of Austin Powers, and followed it with one of Senator John Kerry. “I saw Kerry’s face on the news,” Lee said, “and I thought, ‘That guy is balloonable.’” Lee received an opportunity to meet Kerry on a presidential campaign stop, and has since met a wide range of celebrities thanks to his unique balloon-twisting skills. What began as a hobby has now become a business, with clients including the Portland Trailblazers, Fox Broadcasting, and a slew of weddings, Bar Mitzvahs and holiday parties. In May, Lee appeared on the Trinity Broadcasting Network (TBN) and fashioned what he describes as the most difficult balloon creation of his life: the TBN logo. With its ornate crest and shield, the network symbol took Lee two days to replicate. Though he is pleased that balloon-twisting and music have continued to offer him countless opportunities to surmount his disability, Lee maintains that his greatest joy is working with and educating children. Every Wednesday night, Lee teaches balloon twisting and stage performance to students ranging from five to 12 years of age. He notes that he’s particularly interested in helping children who, just as he was, are in need of a little encouragement, inclusion and inspiration. “It’s almost like a proud father complex,” Lee said. “Disability can make you kind of timid, and I love seeing

these students grow, and when they open up and come out of their shells, sometimes these kids become even more popular than the popular kids. It’s complete bliss for me to see these kids start to feel empowered.” Today Lee, who failed kindergarten before his SLD diagnosis and who faced disheartening odds for personal success, is perhaps more empowered than ever. His work has earned him audiences with ambassadors and Secretaries of State, has landed him praise in Ripley’s Believe it or Not!, has secured him entry at the Black Enterprise Pre-Oscar Party, and has played a significant role in educational and fire safety programs in his hometown of Olympia. Now, with the help of his brother, Lee is hard at work producing a monthly community-based television program called “Today’s Twists,” for which the pair uses their own camera equipment. Lee describes the production as an “inspirational variety show” which unites his loves of balloon-twisting, music and education. “My whole life I’ve been blessed with these talents and opportunities,” Lee said. “So I really want to use them to open up possibilities in children’s minds. I want kids to think, ‘Maybe I can do that, too. Maybe if I work hard enough, some odd talent or gift I have might take me all around the world.’” by David Radcliff adamlee.net ABILITY 17

What year is it? What’ya’ mean “what year is it?”

f you happen to strike your head so hard that you feel you need medical attention, as Conan O’Brien did recently, the doctor will ask you a series of seemingly silly questions—that is, if you’re cognizant enough for them to seem silly. Failure to answer one or more of these questions correctly may raise concerns. An injury like Conan’s is commonly referred to as a concussion. The questions from the doctor are used to determine the severity of the injury and the level of necessity for concern. Questions might include, “do you know what year it is?”, “do you know who the President is?”, or “can you count backwards by tens from 100?” Failure to answer some of these questions after a significant bump on the noggin is not the end of the world, and is usually temporary, as the brain’s cells are theoretically “stunned.” The strictest definition of a concussion includes a period, however brief, of lost consciousness. This period, which some may call “blacking out” or being “knocked out,” typically involves an inability to process or respond in a meaningful way to stimuli such as sound or touch. Such a loss of consciousness is almost always associated with loss of memory for the events that occurred just before, during, and for some period after the impact. Many of these memories will return, though most people never remember what happened immediately prior to, or after their blow to the head. Conan probably does not remember much of what happened to him, but he has at least seen the video or the event, an opportunity most of us don’t get. The period of memory lost as a result of a concussion is roughly proportional to the amount of time one is “knocked out,” which is roughly proportional to how

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hard one strikes his head, which is roughly proportional to how much damage was done to some of the brain cells. The great majority of concussions do not cause detectable permanent damage to the brain, although seemingly minor cranial injuries sometimes result in long-term symptoms. It is also possible to experience a significant blow to the head which does not result in a period of lost consciousness. Some may say they were “stunned” or believe they were “just out of it for a few seconds.” This sort of event may still be referred to as a “concussion.” Blows to the head that render one completely or partially unconscious until an ambulance arrives are much more serious injuries and are a topic for another time. It is exceedingly rare for one to go his entire life without experiencing at least a “minor concussion” or without being “stunned” by being struck on the head. Those who have seen the video of Conan’s accident may find his experience a familiar one. Particularly active people or those thinking back to their childhood may recall slipping and falling backward just as Conan did on his stage, briskly striking the back of the head. This may bring back memories of “seeing stars.” Conan probably did, too. This experience of “seeing stars” happens because our brains basically “float” in fluid called “spinal fluid,” which is found predominantly in our spinal column, but which is produced in the brain. When our head strikes or is struck by an object, our brain actually bangs up against the inside of our skull. Think of shaking a jar full of water with a golf ball in it—except imagine that the golf ball is soft. The impact of the brain striking the skull can result in the temporary dysfunction or even permanent damage of some of the cells on the surface of the brain where the impact with the skull has occurred. The brain, which shares the consistency of Jell-O, may

be briefly distorted by such impact. Though the brain itself immediately returns to its normal shape, cells throughout the brain might be temporarily or permanently affected, causing a loss of consciousness. The cells responsible for our consciousness lie deep in the brain, far from where the organ might strike the inside of the skull. We may “see stars,” particularly with a hard blow to the back of the head like the one Conan sustained, because the back part of the brain is where our vision is processed. A blow to the back of the head causes the brain to suddenly float backwards, striking the “vision area” against the inside of the back of the skull. While we can tolerate the loss of a small number of cells in certain areas of the brain without any noticeable effects, loss of a few cells in just the right area of the brain can have considerable permanent effects. Additionally, even minor injuries can cause breakage of small blood vessels on the surface of or deep inside the brain. If a CAT scan is performed after a concussion, areas of bleeding similar to a bruise may be visible inside the brain. Despite how serious this phenomenon may sound, it is seldom of consequence in a person who has fully regained his faculties shortly after a concussion. Most of us don’t seek or require medical attention for a concussion. If even a small percentage of all concussions were serious, they would represent a major health problem in society, which is not the case. Then again, a relatively minor blow to the head can sometimes fracture the skull, which may result in a torn artery inside of the head. This can cause rapid development of a large blood clot that presses on the brain, often causing coma and even death unless it is removed quickly by a brain surgeon. A period of time during which the person seems perfectly fine may occur between this sort of blow to the head and the development of coma. The blood clot resulting from this scenario is called an “epidural hematoma,” and the time between the blow and the coma is called a “lucid interval.” This is what happened in the sad case of Natasha Richardson, who was reportedly chatting it up with ambulance personnel just before she died. Alternatively, older persons may sustain a minor bump to the head that they hardly even notice, yet these bumps may be sufficient to tear a vein over the surface of the brain. Such sort of brain damage may go unnoticed for weeks, during which time an initial blood clot may slowly develop. The reason why this sort of damage may go unnoticed for a longer period of time in older people than in younger is because our brains shrink as we age, meaning that the elderly typically have a bit more room inside of their heads than do younger people. This natural brain shrinkage has nothing to do with loss of mental capacity, but does allow for a sizable blood clot to exist without an effect. Over time, however, the body’s natural processes result in more fluid–not more blood, but more fluid—to enter the clot potentially caused by a head injury. Slowly, the clot gets larger until it begins to affect the brain’s function. This process is referred to as “chronic subdural hematoma,” and was suffered by Ronald Reagan in 1989 after a minor fall from his horse. As was the case with President Reagan, chronic subdural hematomas are treated with brain surgery, as doctors attempt to remove the build-up of fluid. Reagan’s injury, which occurred after his time in office, came before he had begun to suffer the effects of Alzheimer’s disease, though the injury had nothing to do with his developing the disease. Fortunately, epidural hematomas and chronic subdural hematomas are relatively rare. Concussions like the one Conan O’Brien experienced, however, are a part of life and are frequently forgotten shortly after they happen—except, of course, in cases involving popular television hosts. by Thomas Chappell, MD thomaschappellmd.com ABILITY 19

he Equal Employment Opportunity Commission (EEOC) enforces federal laws prohibiting discrimination in employment. The following are recent cases brought about from the EEOC.

tive relief to end the discriminatory practices, plus back pay and compensatory and punitive damages to compensate Cahill for his monetary losses and emotional pain and suffering.

99 RESTAURANT AND PUB FRANCHISE SUED FOR DISABILITY DISCRIMINATION AND RETALIATION

“It is not just cruel when a manager repeatedly mocks an employee because of a disability, whether actual or perceived—it is also a blatant violation of the ADA,” said Acting Regional Attorney, Debra Lawrence of the EEOC’s Philadelphia District Office, which oversees Pennsylvania, Delaware, West Virginia, Maryland, and parts of New Jersey and Ohio.

Restaurant Fired Server Who Complained About Harassment, Federal Agency Charges. A Trevose, PA restaurant franchise violated the Americans with Disabilities Act (ADA) when it fired an employee, TJ Cahill, because he had complained about harassment, the EEOC charged in a lawsuit. A restaurant manager repeatedly harassed Cahill based on his perceived disability, the EEOC charges in its lawsuit against 99 West Inc., doing business as 99 Restaurant and Pub, filed in US District Court for the Eastern District of Pennsylvania. Cahill, who has a speech impediment and underbite that affect his ability to articulate certain sounds and words, received exemplary performance evaluations when he worked as a server at the chain’s Philadelphia facility. After he transferred to the franchise’s Trevose facility, however, the restaurant manager regularly referred to Cahill with demeaning language, including “slow” and “Re-J,” which meant “Retarded TJ.” She also used derogatory sign language gestures to refer to Cahill as a “retard.” Cahill made repeated complaints to the general manager about the harassment, but management failed to stop it. Instead, the restaurant issued Cahill unjustified reprimands and then terminated him in retaliation for his complaints, the EEOC charged. The ADA prohibits discrimination based on an individual’s actual or perceived disability and forbids employers from retaliating against people who complain about disability discrimination. The EEOC filed its lawsuit only after its Philadelphia office completed an investigation into the discrimination charge and attempted to reach a voluntary settlement. The EEOC seeks injunc20

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SEARS, ROEBUCK TO PAY $6.2 MILLION FOR DISABILITY BIAS Federal Court Approves Largest Monetary Amount Ever in Single EEOC ADA Suit; Employees Allegedly Terminated Based on Inflexible Workers’ Compensation Leave Exhaustion Policy. The EEOC today announced the entry of a record-setting consent decree resolving a class lawsuit against Sears, Roebuck and Co. (Sears) under the ADA for $6.2 million and significant remedial relief. The consent decree, approved by Federal District Judge Wayne Andersen, represents the largest ADA settlement in a single lawsuit in EEOC history. The EEOC’s suit alleged that Sears maintained an inflexible workers’ compensation leave exhaustion policy and terminated employees instead of providing them with reasonable accommodations for their disabilities, in violation of the ADA. “The facts of this case showed that, nearly 20 years after the enactment of the ADA, the rights of individuals with disabilities are still in jeopardy,” said Commission Acting Chairman Stuart J. Ishimaru. “At the same time, this record settlement sends the strongest possible message that the EEOC will use its enforcement authority boldly to protect those rights and advance equal employment opportunities for individuals with disabilities.” EEOC

Chicago District Director, John Rowe, who supervised the agency’s administrative investigation preceding the lawsuit, said that the case arose from a charge of discrimination filed with the EEOC by former Sears service technician, John Bava. According to Rowe, Bava was injured on the job, took workers’ compensation leave, and, although remaining disabled by the injuries, repeatedly attempted to return to work. Sears, Rowe said, “Could never see its way clear to provide Bava with a reasonable accommodation which would have put him back to work and, instead, fired him when his leave expired.” Regional Attorney, John Hendrickson, of the EEOC Chicago District Office, said pre-trial discovery in the lawsuit revealed that hundreds of other employees who had taken workers’ compensation leave were also terminated by Sears without the company having considered reasonable accommodations to return them to work while they were on leave, and without the company having considered whether a brief extension of the employees’ leave would make their return possible. “The era of employers being able to inflexibly and universally apply a leave limits policy without seriously considering the reasonable accommodation requirements of the ADA are over,” Hendrickson said. “Just as it is a truism that never having to come to work is manifestly not a reasonable accommodation, it is also true that inflexible leave policies which ignore reasonable accommodations making it possible to get employees back on the job cannot survive under federal law. This consent decree is a bright line marker of that reality.” In addition to providing monetary relief, the three-year consent decree includes an injunction against violation of the ADA and retaliation. It requires, in addition, that Sears amend its workers’ compensation leave policy, provide written reports to the EEOC detailing its workers’ compensation practices’ compliance with the ADA, train its employees regarding the ADA, and post a notice of the decree at all Sears locations. “This is not merely a garden variety, so-called ‘cost of litigation’ settlement,” said Greg Gochanour, EEOC supervisory trial attorney in Chicago. “We discovered well over 100 former employees who wanted to return to work with an accommodation, but were terminated by Sears—and some of them found it out when their discount cards were rejected while shopping at Sears. We believe Sears’ decision to accept this decree makes good sense.” The lawsuit, filed in November 2004, was assigned to Federal District Court Judge, Wayne Andersen of the Northern District of Illinois and Magistrate Judge Susan Cox, and is captioned EEOC v Sears Roebuck & Co., ND Ill. No. 04 C 7282. The decree is dated September 29, 2009. The court will hold a final hearing, currently slated for February 2010, at which time the

court will make a final determination as to the fairness of the individual distributions from the $6.2 million settlement fund. In addition to Hendrickson and Gochanour, the EEOC litigation team has included Chicago trial attorneys Aaron DeCamp, Ethan Cohen, Deborah Hamilton and Laurie Elkin.

EEOC SUES GREATER BALTIMORE MEDICAL CENTER FOR DISABILITY DISCRIMINATION Agency Charges That Community Hospital Denied Accommodations and Fired Clerk for Genetic Disorder and Stroke-Related Impairments. A Towson, MD regional community hospital violated federal law when it fired a clerk because he had neurofibromatosis, a genetic disorder, and stroke-related impairments, the EEOC charged in a lawsuit announced today. In its suit, the EEOC said that since at least May 2006 and continuing to the present, the Greater Baltimore Medical Center (GBMC) denied Michael E Turner any reasonable accommodation, such as a possible reassignment, then fired him and refused to rehire him in any capacity because of his disabilities. Turner had been successfully employed as a part-time unit secretary since October 17, 1984, and became full-time on December 23, 1990. Although he was physically capable and willing to perform his duties, the EEOC said, GBMC declared him incapable of working, with or without an accommodation, and fired him. The ADA makes it unlawful to discriminate against a qualified individual because of a disability. The EEOC filed suit in US District Court for the District of Maryland, Northern District, after first attempting to reach a voluntary settlement. The complaint seeks monetary and injunctive relief, including back wages, the reinstatement of Turner, compensatory and punitive damages, and changes in employment policies to provide equal employment opportunities for qualified individuals with disabilities. “Employers must make employment decisions based on the individual’s ability to perform the job,” said EEOC Acting Regional Attorney, Debra M Lawrence. “Society’s myths and fears about disabilities are often more limiting than any physical limitations that may or may not flow from a physical impairment.” EEOC Senior Trial Attorney, Maria Salacuse, added, “The ADA is about breaking down barriers to employment for people with disabilities and allowing them to compete in the workplace on a fair and level playing field.” eeoc.gov

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eripheral Vascular Disease, also known as PVD, is a common condition affecting the arteries. Development of PVD can double the risks of heart and brain disease, heart attack and stroke. Treatment of the disease is a frequent undertaking of vascular surgeons across the globe. To become a vascular surgeon, one typically must complete five years of training in general surgery before training an additional year or two on diseases of the blood vessels. An understanding of PVD requires considerable background about the circulatory system and the components of the heart. To survive, the human body depends upon blood circulation by way of arteries (which carry blood, replenished with oxygen and nutrients, from the heart

A bright dye called“contrast” is allowed to flow through these catheters, ultimately allowing blood vessels to show up on an xray like roads on a map. into the tissues of the body) and veins (which carry blood from the body back to the heart). In an adult human, this getting-and-giving supply cycle repeats around 70 times per minute. All organs and tissues in our body, including the heart itself, depend on arteries for the transference of oxygen and nutrients. When cholesterol builds in coronary arteries, the blockage that results induces a heart attack (also called a myocardial infarction), which is the leading cause of death in the US. The heart’s arteries can be aggravated by such common conditions as high blood pressure and diabetes, all of which are linked to lifestyle choices such as high-fat and high-sugar diets and a failure to regularly exercise. The coronary arteries are not the only victims of our indulgent behaviors, however: all of the body’s arteries are subject to the dangers of an unhealthy or frequently inactive lifestyle. Though coronary arteries are the most susceptible to health concerns, other commonly-affected arteries include those in the legs, as well as the main

large artery extending from the heart to the rest of the body, which is called the aorta. For many years, advancing surgical techniques have allowed surgeons to successfully treat blockage of these arteries by borrowing segments of “less important” veins and by using them to bypass blockages. These are major surgical procedures, performed while a patient is under general anesthesia for several hours, and require that surgeons make large incisions in the body to get to the arteries in question. In the case of coronary artery bypass, the patient’s chest is opened, the heart is exposed, and the body’s blood circulation is briefly regulated by a machine while the arteries of the heart are bypassed. More recent medical techniques allow arterial blockages to be treated without need for invasive surgery. Often these procedures are done with local anesthesia, and are known as “interventional radiological techniques.” During such techniques, doctors insert a needle into the patient’s skin, puncturing into an artery in the upper part of the thigh. Long narrow tubes called catheters can then be inserted without general anesthesia or large incisions. A bright dye called “contrast” is then allowed to flow through these catheters, ultimately allowing blood vessels to show up on an x-ray like roads on a map. The same catheters used for the flow of contrast can also be inserted in the arteries to carry small tubular devices. These devices begin in collapsed form on the end of a long tube (called a “cannula”), allowing a stent to be positioned across the inside of arterial blockages. When the stent is released or deployed, it springs open, pushing the blockage aside and restoring passage for the flow of blood. As interventional technologies improve, so does the expertise of the professionals who use them, resulting in the ability to treat increasingly complex types of blood vessel blockages. Many skilled vascular surgeons today find that they seldom need to make conventional deep incisions into the bodies of their patients. Because of continually evolving medical capabilities, the chances of surgical complication are diminished, medical risks are considerably reduced, and patients are often quickly sent back to their homes to recuperate in a place where they feel most comfortable. by Lawrence Goldstein, MD ABILITY 23

hanks to an invitation from the Tourist Board of Ireland, ABILITY Magazine recently explored the warm hospitality, lush landscape (and flavorful beverages) of the emerald isle, all on the eve of Lance Armstrong’s cancer summit in Dublin. What the Tourist Board didn’t know, however, is that one of our new contributing writers, Liza Flatley Callahan, is 100% Irish. What follows are the recollections and observations of ABILITY’s very own leprechaun as she reconnects with her native country.

can still be visited today at Newgrange and Knowth in County Meath. These impressive tombs are older than both Stonehenge in England and the Pyramids of Giza in Egypt.

The magic begins upon your first view from the airplane window: dozens of different green fields neatly divided. Rugged coastlines make the cliffs look like they were torn away from some other piece of land as the white foamy waves of the ocean crash against them. A large section of the Irish soil originates from drift, the icescoured waste formerly frozen to the base of ice glaciers.

Dublin, an ancient city that to this day has a medieval feel, is shockingly contemporary in many ways, with ultra-modern hotels, restaurants and hip clubs providing plenty of reasons for everyone to hit the pavement and get moving in this upbeat city.

Ireland was thought to be first inhabited in 6000 BC and later began the Neolithic culture, leaving behind megalithic passage tombs built around 3200 BC that 24

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In about 441 AD, St. Patrick arrived from England to teach the Irish about Christianity. The Vikings raided Ireland in 795 before the great famine fell upon the potato crops in 1845 and lasted four years, killing over a million people while two million more emigrated.

If visiting, be sure to stroll down Grafton Street, Stephen’s Green, and O’Connell Street. Also check out the Liffey River as you take in the city. Give yourself a chance to soak up the European flavor of the outdoor cafes, street musicians and vendors selling fresh bou-

quets of flowers. Check out the National Gallery of Ireland, a famous art museum that is definitely worthy of your time. Don’t miss the amazing tour at the Guinness Brewery and don’t forget the Book of Kells at Trinity College. As reputation might suggest, there are plenty of famous pubs where you will be met by traditional Irish music and roars of laughter—just remember to bring cab fare, as you will be in no condition for walking! If you’re not sure about throwing back some Guinness, look around you and you’ll find loads of lads with a nearly empty pint of Guinness in front of each of them. Pull up a seat next to one, as it is always smart to consult a professional. He’ll probably recommend you chug the first pint in one big gulp and then the second one will go down more smoothly. He will prove to be precisely right! Now you will love Guinness so much that it will become all you will drink for the entire trip, outside of the tea, of course. Look forward to the people of Ireland being friendly and full of tremendous humor. You might never laugh

harder in your life. The Irish are filled with infectious energy and joy. Truly, you will feel funnier just being around them. Be sure to see the region of Galway, even if you’ve been sampling the local brew in Dublin. Contrary to popular opinion, where beer is concerned, two heads are not better than one. Fortunately, however, the Irish people are very understanding with that sort of thing and will probably ask you if you have chosen whether to “bury it or suffer it.” When you hear this, they are asking if you would like a little hair of the dog, “a wee little suppean” as they refer to it, or you can “suffer it.” The Irish people have such a delightful way with their words. While in Ireland, you are sure to be offered the full Irish breakfast, which consists of Irish sausages, rashers (bacon), eggs, fried tomatoes, baked beans and sometimes potatoes along with toast and home-baked brown bread and Irish soda bread and tea or coffee. As if that weren’t enough, they may also offer you cereal, fruit and yogurt. You couldn’t be treated better if you were royalty. ABILITY 25

On one of my visits to Ireland, I was seated near a man who was in the best of moods. When restaurant staff came to take his breakfast order, he joked that he wanted a pint of Guinness. The young waitress said to him, “Are you serious?” And he said, “Sure. I can’t eat on an empty stomach.” The whole room roared with laughter and he told her he actually doesn’t drink at all—he just loves that joke! A person could fall hopelessly in love with Ireland. The scenery changes as you travel throughout the counties, as do the dialects, and much of the cuisine is not to be missed. For dinner, don’t miss out on McDonagh’s Seafood Restaurant for the best fish and chips ever! You can smell the food and hear the laughter coming from inside as you park the car. You’ll know immediately that you are in for a great night of good food and “craic,” the Irish word for “fun.” A day in Connemara is like spending a day on Mars. The rugged beauty of the bogs and mountains is wild and barren, and the vistas feel so remote, it seems impossible to imagine that anyone has ever walked through them before you. Magical streams and little waterfalls complete a landscape where tiny fairies might seem likely to dwell. It would be an ideal place to grow up for a small child with a giant imagination. Be sure to drive up by the twelve pins (also called the twelve bens), a set of peaks in the hills with scenery sure to take your breath away. The locale feels so ancient, that if spirits do roam the earth, there is a very good chance that you would find them there. While in Galway, be sure to visit Clifton, an absolute gem of a town by the sea. This proverbial dream town is truly unforgettable. You can smell the ocean air and hear live Irish music coming from what seems like every pub in the area.

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While in Clifton, pop into EJ Kings in the square and have a “jar” (the word the Irish use for a “pint”). The live music is phenomenal in some of these pubs and you will not believe how fast these young locals can play their fiddles alongside older experienced musicians who wear their caps tilted sideways. These guys and gals must practice together for years, as they all seem to know the same old songs. There is enough talent there, on any given night, to keep Simon Cowell in business for ages. When you ride your bike in Ireland, it’s not uncommon to hear a man advise you to, “Get in out of that rain before you get yourselves drownded!” If you work up a healthy Irish appetite, duck into a little “chippy,” a takeaway shop, to get in out of the pouring rain and devour some burgers and chips (called “fries”), which are piping hot and drenched with malted vinegar and salt. Before you end your trip to Dublin, head out to the Temple Bar, in a small section of town lined with cobbled streets and live music everywhere. You might find yourself amongst a group of young ladies there for a ‘hen’ party, the Irish equivalent to our bachelorette party, or bump into the husband-to-be and his ‘stag’ party. You might even encounter a charming older couple, like Paddy and Anne Marie, who might tell you about all of her medical problems, starting with her high blood pressure and then moving on to her open heart surgery, her knee replacement surgery and her diabetes. Just as Anne Marie might start in on her migraines, suddenly Paddy might clap his hands together and say, “Right, but other than that she’s in grand form.” When you say your goodbyes, you might feel like you are are saying farewell to relatives, even though you’ve only just met a couple of hours before. The Irish people are angels. They cannot seem to feel like they do enough for you and they never stop smiling.

Lance Armstrong (middle of pack) races up a hill during the Tour of Ireland

They are the happiest race of people and you will certainly see why. Imagine living in a place that looks like heaven and smells like the ocean, where pillowy clouds make shadows on the beautiful fields of soft green grass. It’s a place where walls of stones stretch from mountaintop down to the seashore, where meadows are dotted with cottonballs of sheep and beautiful mares and foals. A place where sleepy villages are spotted with smokey chimneys and dogs sleep on the doorsteps. To top it all off, of course, Ireland has the best beer on the planet, and for dinner they serve salmon fresh from the ocean! But what will always be the country’s biggest draw? The natives, of course.

LIVE STRONG In his continuing fight for a cure to the disease that nearly took his life, cancer survivor and seven-time Tour de France champion Lance Armstrong visited Ireland this August to open his three-day LiveStrong Global Cancer Summit at Dublin Castle. The summit, whose goal was to increase political focus on finding a cure for cancer, was the first cancer conference held outside of the United States by the Lance Armstrong Foundation (LAF). Though he formally retired from professional cycling in 2005, Armstrong returned to the sport this year and finished third in the Tour de France. He preceded August’s Global Cancer Summit by competing in the Tour de Ireland and is scheduled to continue his comeback season with races at MilanSanremo and the Vuelta a Castilla y Leon.

As mentioned in this piece, the vibrant people of Ireland are often welcoming and accessible. The nation’s landscape and buildings, however, might present challenges for some with disabilities. ABILITY Magazine recommends that all prospective pondjumpers research necessary accommodations and plan their trip wisely before setting off for the great green yonder. Visiting accommodation websites while developing your travel plans can often make your excursions smoother and more manageable. Airlines such as Aer Lingus are equipped with accessible restrooms for in-flight ease. accessireland.info tourofireland.ie Air travel provided by Aer Lingus

In an interview with The Sunday Business Post, LAF president Doug Ulman noted that Armstrong’s decision to come out of retirement was driven largely by the cyclist’s desire to bring the crusade against cancer to broader public discussion. “He said he was feeling really good and was considering riding again, especially if it was going to bring attention to the cancer campaign,” Ulman said. “He was on a mission.” Since its inception in 1997, the Lance Armstrong Foundation has raised more than $315 million for various cancer-related causes and has solidified Armstrong as a living symbol of hope for all who are afflicted with the disease. livestrong.org

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fter a paragliding accident over the mountains of Brazil left him with T-11 and T-12 vertebrae fractures, Lois Neubauer found himself confronted with the sobering thought he may not be able to walk again. But for Neubauer, it was even more important that he regain a way to fly. “I know that a lot of people have difficulties accepting their condition after an injury,” Neubauer said, “but believing I could fly again kept my dream alive and gave me the motivation to overcome all of the difficulties that followed.” In a steadfast effort to achieve his dream, Neubauer dedicated himself to six months of intensive physical therapy and four months in a rehabilitation clinic. Today, at 37 years old, he is able to use assistive technologies and adapted flight techniques to capture the rush of paragliding once more. Though the challenge of adapting to and overcoming his paralysis was initially frightening, Neubauer says that the experience has given him a greater appreciation for those things in life which are too often taken for granted. “I had to learn almost everything anew, day after day,” Neubauer said. “Keeping around me the people I loved most and finding new ways to accomplish things that once were simple made me discover the enormous importance of social bonds.” It has now been 13 years since Neubauer was crumpled in the mountains of Minas Gerais, fearing that his freedom and independence might be gone forever. Through perseverance, patience and strength, he has transformed that fear into a thirst for new adventure. Now a business owner and communications consultant whose company develops adaptive web tools, Neubauer describes himself as “militant in defense of the rights with persons with disabilities” and continues to dive, raft, sail, climb and, of course, to fly.

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“What companies need to do,” Romano asserted, “is understand that integrating people with disabilities into more productive roles in society is directly related to hiring, retention and promotion. Packaging, marketing and advertising for people with disabilites need also be considered,” Romano said, “in ways that integrate, engage and involve all American business.”

eld at the Gaylord Convention Center in National Harbor, MD, and set against the backdrop of the Potomac River, the United States Business Leadership Network’s (USBLN) 2009 conference convened with the theme “Connect the Dots.” Sponsors of this year’s conference included McDonald’s, Walgreens, Merck and Starbucks—the last of which added a $5 gift card and a packet of instant Starbucks coffee to each attendee’s gift bag. A host of new faces were invited to speak at this year’s event, including Kathy Martinez, President Obama’s Assistant Secretary for Disability Employment Policy (ODEP), and Kareem Dale, a key White House advisor on disability policy. Dale holds the distinction of having the highest-ranking position a president has ever carved out for advancement of disability issues. It would seem Dale and Martinez have their work cut out for them: a November 2008 report from ODEP found that only 19% of businesses surveyed reported hiring people with disabilities. A national organization with 55 affiliates in more than 30 states, the USBLN uses a “business to business” approach by which its 40-plus corporate members work to promote employment opportunities for people with disabilities. Despite the nation’s weakened economy, most USBLN speakers agreed 2009 was a ripe time to bring more people with disabilities into the workforce. Neil Romano, former assistant secretary of the Labor Department and current CEO of Creating Opportunities by Recognizing Abilities (CORA), explained that difficult times provide opportunities to redefine employment policies, particularly with respect to people with disabilities. “Businesses care about profits, so you have to show them how you’re going to make a difference to their bottom line,” Romano said, emphasizing that many companies today base their views of employees with disabilities on old hiring models of charity and do-goodness. “It’s not about hiring a few guys for the mailroom anymore,” Romano said.

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The current political discourse also worked its way into the forum, with Dale speaking on the topic of health care reform. Dale noted that the poverty level is still too high for people with disabilities, many of whom “cannot earn a true wage based on the parameters that are set up.” Dale went on to explain that federal programs such as the Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) could and should do more to help people with disabilities find employment. “People with disabilities want to work,” Dale said, “but the lack of health care has contributed in a great way to the high unemployment rate. In an effort to combat this,” Dale added, “the White House’s current health care reform proposal would allow people with disabilities and others to get access to affordable health care.” Other speakers used the conference to illustrate various successes their companies have had with employees who have disabilities. Randy Lewis, Walgreens’ Senior Vice President of Distribution and Logistics, noted that 40% of the workforce at the retailer’s highest-producing distribution center has some sort of disability. The center, which Lewis oversees in Anderson, SC, also boasts low employee turn-over and low accident rates. “There’s a sense of purpose and teamwork there that that don’t exist at any other of Walgreens’ many plants,” Lewis said, noting that the company also has centers in Connecticut and Texas which are currently specifically seeking people with disabilities. “Many of these employees,” Lewis said, “are recruited through vocational rehab agencies.” The retailer’s goal, according to Lewis, is to hire 1,000 people with disabilities by 2010 and 2,000 by 2018. At present, the Anderson facility has 670 employees with disabilities. Roy Flora, group president of Microtel Inns & Suites, took the floor to explain how his company has been wooing—and wowing—its guests with disabilities for many years. The budget hotel chain offers three ADAroom designs: a single queen, double queen and a suite. Microtel rooms also include removable showerheads, roll-under sinks, and low-positioned peepholes in doors. For Little People—those who are 4’10”and under— Microtel provides Short Stature Accessibility Kits at every hotel. The kit includes items such as a stepstool with a handle, an ergonomic reach-grabber, door latch and closet rod adapters. Travelers with disabilities have $250 billion in discretionary income, according to the Society for Accessible

Travel and Hospitality, for which Microtel serves as a sponsor. “This is a huge, burgeoning market,” Flora said. “We want to be the preferred hotel chain for people with disabilities.” The USBLN’s event also included vendors and non-profits throughout much of the expo hall, many of which are dedicated to providing resources through which companies can find qualified employees with disabilities. AbiliCorp promoted its student career summits, while Hire Vets First provided pamphlets promoting the hiring of war veterans. ABILITYJobs.com, the oldest and largest stand-alone resume bank for people with disabilities, was also present to share information about its database. Two assistive technology consultancies, AbleData and Job Accommodation Network, were on-hand to discuss their technology database and consulting services—while ABILITY Magazine provided complimentary copies of its publication to all conference attendees. The primary draw, however, was the line-up of speakers, who collectively held more than a dozen breakout sessions. These sessions included a forum on reaching people with disabilities through social media (led by Debra Ruh, CEO of TecAccess, a disability consultancy); an overview of the Social Security Administration’s Ticket to Work Program; a discussion of ways in which companies can integrate disability into their brands; and methods for inclusion of disability-owned businesses in supply chains. The USBLN event also featured the announcement of a new program that will certify disability-owned business enterprises. The program, called DOBE, is the only national program with the goal of bringing more diverse small businesses into corporate supply chains. “In order to qualify for inclusion in DOBE, a disability-owned business must be at least 51% owned and operated by a person with a disability,” said John Kemp, the USBLN’s executive director. The conference, which ran from September 15-18, had a few surprise entertainers as well. Josh Sundquist, a Paralympics skier turned inspirational speaker, tickled the crowd with his stories of life on one leg. Sundquist, who lost his leg to cancer as a teenager, addressed the advantages to finding humor in the face of adversity. The high-energy speaker amused the crowd with a story of how he successfully donned a pair of sweatpants and snuck a liter of soda in the “empty” pants leg in order to avoid paying for a cup of soda at the movie theater. Not to be outdone, actor Robert David Hall topped off Thursday evening’s events, relaying his tale of a car accident and how it gave him newfound purpose. Hall, who plays coroner Albert Robbins on the hit show CSI, unveiled the Campaign for Disability Employment, which was launched on September 17 by a consortium of organizations, including the USBLN and the American Association of People with Disabilities. The ambitious campaign includes a public service announcement which stars seven people with disabilities who implore businesses to hire them for their talents. Though high unemployment rates for people with disabilities are no doubt a harsh reality, nothing could dampen the applause from the crowd at this year’s USBLN gathering, nor quell the realization that hiring people with disabilities is an idea whose time has come. by Suzanne Robitaille usbln.org

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Photos by: Nancy Villere - CrushPhotoStudios.com

hough he shares the rugged good looks of his father James, actor Scott Caan has steadily made his own way in Hollywood, with roles in films like Ocean’s Eleven, Gone in Sixty Seconds, and in HBO’s hit series Entourage. He’s also proven himself as a writer-director, with credits including Dallas 362, The Dog Problem, and the soon-to-be-released Mercy. But few of Caan’s fans are aware of his volunteer work with Surfers Healing, an organization which introduces autistic children to the joy of catching a wave. Joined by Caan’s surfer buddy, Keith Kendall, ABILITY Magazine met with the artist at his Hollywood Hills home to discuss his work outside the limelight, and how helping others learn to surf has had a lasting impact on Caan’s life.

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Chet Cooper: When did you guys start volunteering with Surfers Healing? Scott Caan: About four years ago. Surfers Healing was doing an event in Malibu, inviting a bunch of families with autistic children to come and surf. These are kids who aren’t really big enough to surf by themselves, but instructors put them on the front of the boards and paddle out and stand them up in the waves. When Keith and I had discovered Surfers Healing, they had 120 kids and maybe six, seven instructors. Since the waves weren’t really that big that day, the instructors asked a couple of the local surfers at Malibu to take some of these kids out. So Keith and I volunteered, and we’ve been doing it every year since then. And now our friend, Jimmy Gamboa, has started another organization called TheraSURF where we’re taking kids with disabilities out surfing. The whole thing is getting bigger. I have a couple of kids I take out.

very capable in the waves. When Jesse surfs, of course we have people stacked up along the beach to rescue him in case he falls off or rolls over, but with autistic kids, we’re sort of just giving them the sensation of riding. A lot of autistic kids don’t like to be touched. A lot of autistic kids are initially timid about getting into the ocean, so we kind of have to grab ‘em, yank ‘em, hold ‘em down on the board, paddle ‘em out, and force ‘em to do it. But I would say six times out of 10 times, kids who were kicking and screaming not to get into the water are pleading to surf once we take them back to shore. They’re like, “One more. One more. One more.” Cooper: And then you start kicking and screaming, “I want to go home!” Caan: (laughs) I’m like, “I’m tired. I can’t paddle any more!” Cooper: They have to grab you and throw you on the board?

Cooper: When you say “take out,” you mean... kill? Caan: (laughs) yeah, kill them. Liz Angeles: I know that Life Rolls On has a similar arrangement, taking out people with disabilities. How is that different from what you’re doing with Surfers Healing and TheraSURF? Caan: Well, I’ve only been involved with Life Rolls On for about a year. I met [Life Rolls On founder] Jesse Billauer a couple of years ago. With the autistic kids, we actually pick them up and stand them up on the boards. We don’t push them into waves and let them go like we would with someone like Jesse, who is paralyzed, but 34

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Caan: (laughs) Yeah. But it’s really amazing. I mean, I have this girl that I take all the time, named Olivia. She’s nine years old and she’s deaf and she’s autistic, and she does not want to get out of the water when we’re done. When I say it’s time to stop surfing and we paddle in, she throws a tantrum and gets mad at me and pouts and gives me dirty looks for an hour. (laughter) But most of my experience with Life Rolls On, and it’s been limited, is that most of the people there have surfed before, and are wanting to surf again. Keith Kendall: And it’s a different experience, because that’s specific to people who are paralyzed or paraplegic.

Surf Photos by: Sean Swentek

Scott Caan surfing with Oliva via the Surfers Healing program

Caan: I did an event with Jesse at Zuma, and some of the guys there were like, “Do not hold on to me. Let me go,” just wanting to charge into big overhead waves by themselves. I remember being so amazed at the courage. I was out with this one guy, waves were crashing, and there wasn’t a lot of space in between set waves, and we were getting hammered. I looked at him like, “Should we go in [to shore]?” And he was like, “No, let’s keep going.”

Keith Kandell: Jesse goes big. Caan: Jesse goes big. At the event they did at Huntington, I got there and I was like, “First of all, I don’t want to surf in these waves.” (laughter) “And I certainly don’t want to take these guys out in these waves.” I was nervous, and I was hoping that they had called it off. And I was surfing with a lady named Alyson, who— Cooper: Was she Miss Wheelchair?

Angeles: This is a former surfer? Caan: I actually don’t know if he had surfed before, but he was charging and he wanted to surf. Angeles: This is with Life Rolls On? Caan: Yeah. I couldn’t believe the balls and the guts and the strength he had to just go again and again. We crashed, and he was underwater, and I pulled him out and I thought for sure he’d be like, “I’m done.” But instead he was like, “Let’s go. Let’s get another one. That one was lame.” And I thought, “Jeez, this guy has just got heart.” Cooper: So you have to be a lifeguard at the same time? After you wipe out, you’ve got to grab them and get them back on the board? Caan: Yeah, but they do it pretty well. I mean, for Jesse’s events, there are usually people stacked up every 10 feet. You have the on-shore team, the knee-high team, the middle team, which is in waist-high water, and then you have the deep-water team. Cooper: So you only go out with them on a certain size of wave? You can’t really do it on really—

Caan: Miss Wheelchair, yes. And she looked at me and she was kind of nervous. She was like, “How is it out there?” And I was like, “It’s fine. It’s nothing.” And then I turned to the main instructor and said, “We’re not doing it. We’re not taking them out.” I didn’t want to go out there. I was worried about getting sucked into the pier myself, let alone having to deal with Alyson. But we got Alyson into six waves. Angeles: Is it all done in the same manner with everybody when you guys take them out there? Caan: Yeah. But some guys have different approaches. Like, there’s this one guy, he’s paralyzed from the waist down, so he can paddle, and he doesn’t like you to help him paddle, he just likes you to help keep him lined up. But it’s different with everyone. Kandell: And in a place like Malibu, it’s more satisfying, I think, to take people who wouldn’t be able to surf on their own. The people who surf in Malibu are sort of a privileged lot, generally speaking, because you’re out in the middle of the day and there’s a hundred guys, and they all feel like it should be their wave. But that state of mind totally changes when you have ABILITY 35

someone with you that couldn’t be out there on their own, and they’re so happy. And it’s so much more rewarding. Also, when you’ve been surfing for so long that the initial thrill of riding a waist-high wave kind of goes away, you relive it all over again when you’re surfing with someone who doesn’t get to do it often.

Angeles: Do you guys get on the board together? Kandell: Yeah. I stay on the back of the board and they lie in the front. You kind of put your chest on their legs or their butt, depending on how they’re— Angeles: Wait. What? You put your chest on their butt?

Angeles: You probably have a lot of great memories with the people you take out there to surf. Kandell: Yeah. There’s this girl that I take, her name’s Alexandra. She’s the sister of someone that I know. They were there one day for Surfers Healing a couple years ago, and Alexandra had so much fun that her mom got in touch with me and wanted me to take Alexandra surfing, which I did. During the summer, I was out of town a lot, and I missed surfing with her. When I got back to Surfer’s Healing, I caught a couple of waves with her, and we were on the beach afterwards and she was kind of grabbing my hand. After we would surf, she loved to just swim with me in the ocean, and so she yanked my hand and kept going, “Surfing with Keith! Surfing with Keith!” And I was like, “Sorry, I have to go, I have to catch an airplane.” Her mom said, “No, Alexandra, he has to go.” And then Scott came by and she saw Scott and she turned to her mother and said, “Surfing with Scott! Surfing with Scott!” (laughter) She just wanted to be in the ocean. It was not even about me.

Caan: Do you want me to show you? (laughter) Get on the table. Come on, I’ll show you. Cooper: Do you use your own boards for this, or their boards? Caan: You’ve got to use big boards. I have a board that I use for kids that are under 50 pounds. I also have sort of a stand-up, paddle board. It’s really wide and has big thick rails. Cooper: So you’re not using the foamy boards, which are a little bit more difficult to maneuver? Caan: No. The smaller the board, the better. If the board can hold two people, that’s good enough. The boards we use for Surfers Healing are basically tandem boards. For Life Rolls On, Jesse has a special board that he uses. Those boards are set up kind of differently because, like I said, we don’t really ride the waves with those guys. They’ve got stand-up bars on the side to keep them on the board.

Cooper: But you thought it was at first? Kandell: Yeah, I did. She drew a picture of me. She would wear her hair up in a bun, too, like mine, and she drew a picture of us on a wave at Malibu for my birthday one year.

Kandell: Depending on how much ability the surfers have, they can either grab the board and turn or they can kind of lean with their weight to turn. The Life Rolls On surfers really go on their own. Angeles: What does someone have to do if they want to

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go? Just show up at the beach? Do you have to sign up? Caan: Surfer’s Healing holds events— maybe 10 events all year—all over the country. They do only a couple in Malibu every year. Sometimes at Surfers Healing events I’ll talk to parents, or to kids who are really stoked and really into surfing. I’ll go to their parents and say, “Look, here’s my phone number. Any time you want to surf when there are good waves or there’s a swell, call me. Or I’ll call you and let you know when there’s a swell and you can bring your kids down.” So I have two or three kids right now that call me a couple times a month during the summer and say something like, “Hey, can you take Olivia surfing tomorrow?” Cooper: We’re going to put your phone number in the magazine. (laughter) Caan: I would do that. I know it’s a bad idea, but you definitely can go onto surfershealing.org and check it out. They do events all the time. Sometimes there aren’t a lot of waves to go around, so you’ll find these hard-core surfers getting frustrated if a lot of people descend on the beach. That’s a part of surfing that’s really ugly, and at the same time I understand it and sometimes feel it. Cooper: That’s why you volunteer! Caan: (laughs) Yeah. To get waves. There was this one guy who was super angry all the time, and the other day, he came down to the line on a big set wave. I was out there and had a little girl on my board, and he kicked out, swam in, and was like, “That was so awesome.” So even the angriest, meanest guys get turned on by what we’re doing, they’re so stoked on it. This guy, who I’d thought didn’t have a heart, came in and enjoyed seeing us out there. It was so cool to see that. Angeles: Surfing is really your kind of thing, then. Caan: And fighting. I like to fight, too. Angeles: And acting. And photography. And writing. And directing. And producing.

Cooper: How long have you been doing that? Caan: On and off for 10, 11 years. I train jiu-jitsu regularly, three times a week. Cooper: How did you know you were going to get into acting? Was that something your father was telling you not to get into? Caan: Yeah, pretty much. He said not to do it. But I wasn’t into school, and I could never imagine myself in a regular job kind of situation. I always felt really creative, whether I was taking pictures or writing. I ended up doing a movie and after I was on set, it was like, “Oh, this is my life.” I didn’t know if I was going to be a grip or a cameraman or an actor, but I was 18 years old and on a movie set, working. Cooper: You hadn’t been on a set before with your father?

Cooper: You’re into martial arts?

Caan: I had been on a set, but as a kid, just checking my dad out at work. When I was younger, I wasn’t into movie stars or movies. It wasn’t something that impressed me. I was way more into skating and surfing.

Caan: Brazilian jiu-jitsu. There’s a lot of judo and wrestling in jiu-jitsu, mostly it’s ground fighting.

Cooper: Tell me about The Dog Problem. Did you write it, or did you adapt it from the play?

Caan: (laughs) Right.

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Caan: No, no, I wrote it. The similarity to the play is just the title. I sort of stole the title on purpose by accident. I had worked on the play and a year or so later I was writing the movie, and I was like, “God, this is such a perfect title.” Angeles: So the play didn’t have anything to do with the film? Caan: Nothing. The play is about these guys from the East Coast. David Rabe, who wrote it, is one of my favorite playwrights. It’s guys from the East Coast, and one of them thinks that this guy made his sister sleep with a dog. Cooper: Okay, that’s really different! Caan: So yeah, mine has nothing to do with the play. It just shares the title, which I admit to stealing. Cooper: How did you come up with the idea? Caan: The story actually happened. A friend of mine was going through a really rough time, and he was spending a lot of money on therapy. Every time he called me, he would be really bummed out and depressed. And then one day he called me in a really good mood, and he’s like, “Come pick me up and let’s go to the Beverly Center.” And he literally went to the Beverly Center and bought a dog. That was his solution 38

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to hard times, to buy a dog, and I thought it was genius. I thought, “This is a premise for a movie.” And then I just went and wrote it. But I also just recently wrote and produced a movie called Mercy, which I’m really excited about. It’s going to come out in 2010. Angeles: What’s that about? Caan: It’s about a writer who falls in love with— Cooper: —a dog? Caan: (laughs) No, it’s about a writer who writes these romance novels, but is totally scorned by love and doesn’t buy it and is never really— Cooper: He can write it, but he can’t live it? Caan: Yeah. And then he falls in love for the first time and has something really tragic happen to him afterwards. It’s about him putting his life back together. Cooper: How did you come up with that idea? Caan: I was living in Texas with a friend. There was this movie, Tender Mercies, that Robert Duvall did—a really good movie. We were obsessed with it, and we thought, “Let’s write a movie about a guy that’s obsessed with the movie Tender Mercies and falls in love with a girl

Scott’s writing wall for his movie Mercy

named Mercy.” To me, the idea of love and relationships is such a tricky—there’s no science to it that can be analyzed and you can make art about it forever. What happens when you have it and then it’s gone?

darkroom—it sounds slightly pretentious, but I just like everything about it.

Angeles: Tell us about your photography book.

Caan: He’s in Mercy with me.

Caan: You should go buy it. (laughter) Caan, Vol. 1, Photography. The subject is really LA street life and women. But I’ve taken lots of pictures of things that didn’t end up making the book, and that’s why we called it Vol. 1. But the theme of the book is along the lines of celebrity and pretty women and stuff like that. Because I’ve been lucky.

Cooper: Do you see yourself leaning towards writing, acting or directing?

Cooper: Have you done any projects with your father?

Caan: I’ve been lucky that I’ve been able to do all of it. The last year’s been kind of tough, so I’ve had to do some work that I don’t know I would have done if I’d had my choice, but I think I’m ultimately aiming to stay creatively fulfilled and to make money while doing it.

Cooper: This is your first book? Caan: Yeah. Cooper: And you’ve been taking photographs for a long time? Caan: Since 2000. I use all kinds of different cameras, but mainly a Nikon FE. I also use a Leica, an M6. I don’t like digital. I love everything about shooting on film. I love loading a camera. I love not knowing what I’ve got. I love wondering if I underexposed or overexposed. I love flying home with 20 rolls of film and wondering what’s on the film. Angeles: It’s like opening Christmas presents. Caan: I love the smell of the lab. I love the smell of the 40

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After our interview with Scott Caan, ABILITY Magazine was informed that Olivia’s school has noticed she’s made dramatic improvement both socially and in her studies. Olivia’s mother attributes this growth to the confidence Olivia has been building from surfing with Scott. surfershealing.org liferollson.org

L to R: Chet, Liz, Scott and Keith

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ealth care coverage in America is dominating conversation nationwide, becoming a defining focus of the Obama administration, and registering as an issue of contention across political parties. With the country largely divided about the proper role of government in health care coverage, ABILITY Magazine’s Chet Cooper sat down for a talk with Leslie Margolin, President of Anthem Blue Cross, the largest health care provider in California. Cooper: When we first met, I heard Maria Shriver describe you. Do you remember that?

Leslie Margolin: Yeah, she had been teasing me. I had had dinner at her house the night or two before, and I asked her if she had ever done a spin class. She hadn’t and I was so glad, because I’d never done a spin class either. When Maria asked about my biking, I told her I’d done several of the AIDS rides and had biked across country, but I’m embarrassed that I don’t know how to spin. So the night I met you she proceeded to tell the story, “Leslie said she doesn’t spin, but she rode 4,000 miles across the United States, the northern route, through the mountains!”(laughs) “And she’s run nine marathons.” She just sort of went on and on. And then when I was sufficiently embarrassed, we got on our bikes and did some spinning. (laughs) Cooper: How did you like the spin? Margolin: I enjoyed it. I had injured my knee at the time, though. Cooper: Motocross? Margolin: (laughs) I wish! No. Taking a misstep off a little shuttle bus. That was my first day back on my bike after my injury. I hadn’t done anything before that. Cooper: Fortunate thing that you work for Blue Cross. What are your views on universal health care? Margolin: Well, first off, I think it’s an embarrassment that we have 45 or 46 million people who don’t have coverage, and for years I’ve worked trying to address that issue. For all of the controversy and all of the areas of additional work and additional refinement, on the core health care issues, there’s great alignment within the health plan industry, with hospitals, doctors, and with the President. I think there is agreement that parts of the system are not working, that change is needed, that we have to find a way to have universal access or near-universal access, and that there is a way to get there. But we haven’t figured out the details of the financing, and that’s a very important, very complex part of it. The key to success here involves working together— between the government and the health plans, hospitals, and physician groups—to make sufficient strides in simplifying administration on the insurance side, and to

address, in a systemic way, issues of quality and safety, so that we have improved health care but so we also have tremendous savings that will be able to finance the expansion of it. Cooper: And those savings will come from where? Where is the fat? Margolin: Roughly a third of health care dollars are spent in areas that have to do with medication errors, redundant testing, redundant medicine, medicine that’s practiced defensively, safety issues in hospitals and incare settings. But one of the things that have happened in the past is that everybody has blamed everybody else for the problem, and we’ve become crippled by that debate. We need to bring in data and technology, so we can look at every single hospital and medical group and determine what its experience and outcomes have been. Then we can look at comparisons between systems. If we do this in partnership with hospitals and with medical groups, we can use that data to drive towards systemic improvement. I’m working on this strategy in California right now with the leaders of the hospitals associations up and down the state. If we, as the largest health plan in California, could partner with the associations representing 95% of the hospitals in this state, if we could pick two or three issues and make a commitment based on our data and some of our technology, we could basically wipe out hospital-based infections or reduce them to minimal numbers. In the past, people have figured out solutions to those problems in an ad hoc and kind of onoff basis. What haven’t happened are commitment and collaboration between and among all involved in driving these systems of care and safety across the whole health care delivery system. When you look purely at the dollars—if you look at medication errors, wrong-site surgery, neonatal intensive care—issues of concern are two-fold. Some are safety issues, and some are issues that have to do with, for example, voluntarily inducing labor before the full term. The difference in the health of the child who goes to full term at 39 weeks, versus the child who is born at 38 or 37 weeks, is stunning. If we could just— Cooper: How would you create a system throughout your vast network to say that something like early inducement is a practice they shouldn’t allow? Margolin: I tend to approach things through education. If people understood, if parents understood, if physicians and hospital leaders were all uniformly aware of the statistics of the data— Cooper: So you propose a health literacy program for educating parents? Margolin: An educational program, yes. And commitments ABILITY 43

from doctors to offer that health literacy so it’s really about helping people, doctors and hospitals understand systematically what the odds are, what the expenses are, and what the safety improvements are for a given procedure. And to go back to your original question, I don’t think that all this will fully fund expanded access or universal access, but it will provide a pretty big chunk of the funding. The issues around taxes are quite tricky. But, being an optimist, I do believe that if we have a common interest in improving quality, safety, and cost, and in expanding access, we can figure out the funding for this. Cooper: In the work that I do, I get to see and talk to really different groups that are actually sometimes working in the same arena, but there are silos that exist to keep them from communicating with each other. It’s almost like I’m working for them, trying to be a kind of silo-buster. “I know you’re doing this over here and you’re doing that over there, but if you could start communicating, you’re actually doing things that will help you both.” Margolin: I love your term, “silo-buster.” That’s exactly what it is like when every hospital or hospital system goes off and does its own thing. It doesn’t make sense. I fully recognize and appreciate the need for us to compete, but I don’t think we have to compete on everything. I serve on the board of the California Association of Health Plans and have gone to the board and I’ve said, “What if we as an industry thought about the things that are the greatest obstacles to accessing care, the greatest dissatisfiers for hospitals and physicians and members? And what if we as an industry made a commitment to address those obstacles? What if we went to common claim forms and common applications? Think about the difference it would make in every physician’s office across the state of California if there were only one form that clients had to understand. What if we made our data universally available across the system?”

doing,” someone is still going to say, “These are my marbles and I’ll use them over here and I’m not gonna share.” So it seems that you almost have to have a higher power to say, “This is a mandate here. ”Have you taken your suggestions to the government? Margolin: I have, although I would like to see the industry come together and do this modification on a voluntary basis rather than having to be told to do it. I guess my judgment is, if enough of us do this, if Blue Shield and Blue Cross and Aetna and Cigna all came along, few would want to be an outlier. But if government regulation is required, ultimately I’m okay with that. I just don’t think it should be necessary. We met just last week with the Department of Managed Health Care to talk about this issue of health IT and possibility for a common web portal. Cooper: What happened? Margolin: There was great excitement about it. Several organizations have bought into it already. I think the problem, though, is that if everybody is developing a common portal, we don’t know which common portal is going to win. Cooper: I visited Doha, in Qatar. It’s almost growing faster than Dubai. Every building there is a double building—there’s so much growth that every building has a mirror image building of itself. So I asked around, “Is everything accessible?” They have the opportunity to build the most accessible city in the world with all of this construction going on. But most people there aren’t thinking about disability issues, even though several top officials are saying, “We care about people with disabilities, about getting them the best education, getting them employed and independent.” They’re saying all the right things. But they just don’t seem to think about it in a larger more universal way. They are so close. It’s frustrating. Margolin: It’s not at the top of people’s minds.

I will continue to try and drive that effort, because I think it’s where the answers lie. We’re not going to compete on having the best application, the best claim form or the best web portal. Technology is a perfect example: there’s so much opportunity in health IT to consolidate our systems and our paperwork.

Cooper: It’s not. The architects and city planners have this great opportunity. Doha is contracting the best architects in the world to create these elaborate designs.

But it’s going to require a very different approach from the health plans, and from the hospitals, frankly. Everybody’s going to have to agree that this is an area in which, rather than spend the money and develop our own systems, we ought to have a common portal and we all ought to work on refining and expanding that technology.

Margolin: But you don’t fully appreciate the problems of a person with a disability if you’ve never had that disability. We’ve all had that experience, when you break your arm for the first time, of trying to do everything with your other hand. I was on crutches a year or two ago, and just to get from the sink to the paper towel dispenser with wet hands was an effort. You just don’t think about these things until you’re put in someone else’s shoes.

Cooper: That’s going to be the challenge. Unless you have government regulation that says, “This is now the standard by which to operate and do the business you’re

Cooper: Often I’ve seen people with specific disabilities lobby for that disability and ultimately forget the others. I was talking yesterday with Jerry White, who has a

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prosthetic leg. He was saying, “There’s a pecking order. Oftentimes, unless I pull my pant leg up, the disability community won’t accept me.” I think it’s very much like other civil rights movements or race. “He’s not black enough. He’s too white.” There are the little issues of what they’re experiencing as discrimination. But until, like you said, you’re in their shoes, you don’t get it. So how do you really get people to experience something else that’s not part of their daily lives, or that which they don’t think is part of their daily lives? Even though we say that disability is a part of the fabric of all our lives, we don’t look at that part of the fabric all the time. But on the average, a person experiences 13 years of one or more disabilities in their own lifetime. Margolin: I hadn’t heard that.

Leslie Margolin, President of Anthem Blue Cross, speaks with ABILITY’s Chet Cooper

Cooper: As you know many of the health conditions which cause some disabilities are preventable. So maintaining a healthy lifestyle can reduce the likelihood of that sort of outcome. Margolin: Right. Personally, I try to stay fit enough that at any given point in time, I can run a marathon—with two or three months intensive training. So I try and keep a base of five or so miles a day, running, and then I try and walk another three to five during the day. And on weekends I try to get a 10- or 12-mile run in. Cooper: Is that why you’re wearing those sneakers around you neck? (laughter). With all that’s going on with the economy and health care reform right now, how does Anthem Blue Cross distinguish itself in the marketplace? Margolin: We’re leading this effort. We’re leading the development of systems of care and quality, and we’ve got the courage to call the whole industry out and say, ‘We can make this different.’ One of the efforts that I’ve been encouraging on the board of the California Association of Health Plans is not to wait for legislation or regulation, but just to look at ourselves and at what’s broken in the health care system and at what parts of it we could fix tomorrow. We need hospitals and doctors to contribute because we can’t fix the whole thing alone. But there are so many parts that are quite within our control. We could, for example, move to a common application and just make the paperwork simpler, cheaper and easier to understand. There’s expense involved in credentialing for physicians or credentialing for hospitals and every health plan has its own system. Many things make Blue Cross different, but one of them is our willingness to stand up and lead efforts like this.

Cooper: I know that the government is putting forward money to try to streamline things. For instance, the single application situation. What do they call it? EHR? Margolin: Yes, the Electronic Health Record. That’s one of the key areas that we’re leading. We have a pilot going with Cedars-Sinai here in LA, and in Northern California. It’s our electronic medical record deployed to emergency rooms so that when the patient comes in in an emergency situation, the emergency room doctor can look up his medical history, medications and previous health issues. One of the things that we’re working very hard on is figuring out how to perfect that system, how to deploy it across all hospitals in the state of California and beyond. We’re trying to make a health records system that works for all health plans, so you don’t have to go to a hospital that specifically has Anthem Blue Cross’s medical record or Cigna’s or Blue Shield’s. All records can just be plugged into one system. The things that are competitive advantages between insurance providers include cost, product, service, leadership and relationship. But there are a number of things, like EHRs, that we should all be figuring out how to make work for everybody. And I think Blue Cross has stepped out in front of virtually everyone else to accomplish that. One of the things that brokers have talked with us about is bringing employers and brokers into that mix. It makes a lot of sense, when you think about what they need in terms of affordability of coverage for their employees, help with programs around health, wellness and prevention. We design those programs. We’re working really hard trying to lead the industry in that area. But we do it in partnership with employers and by figuring out exactly what would make a difference for them. ABILITY 45

Cooper: Ironically, it’s actually a life-or-death situation for people, even though you’re looking at it so much differently in structure. But when you peel it all back, it gets right down to a point of dealing with an individual’s health care. Margolin: Absolutely. Cooper: And that is a life-or-death situation. Margolin: It absolutely is. It requires partnering across the hospitals on the safety and technology issues I was just describing. How can we work together to bring care to a rural community that is currently underserved? There’s a real crisis in health care. There is a nursing shortage. There’s a shortage of primary care physicians. And we are each trying to tackle it on our own. What if we came together and thought about all that each of us is doing and what we could each do to leverage that? Some of it is about just leveraging the spending in scholarship programs or about creating training programs. How do we think about the career path of a nurse? How do we work together to make that a more attractive career so people want to come to it in the first place? And what if we thought about what changes in legislation or regulation might relieve some of the burden? Is there a way to more broadly use nurse practitioners? Those are very controversial topics, but if you’re bringing alliances of people together— Cooper: In this collaboration that you’re envisioning, do you see bringing in issues that physicians have with their malpractice insurance? Margolin: Absolutely. Cooper: If they have certain caps, their insurance will go down. Then you have to go into that other arena in which the attorneys are going to fight reform because they’re making so much money on certain kinds of claims. Margolin: That’s certainly on our drawing board. One of the things we have to do is think as expansively as we can to come up with all the areas where we could make a difference and then choose carefully a few targets for our efforts. But right now Blue Cross is kind of in a brainstorming mode, thinking up the areas we could influence. One is the judicial system and malpractice awards. One is malpractice coverage. On the coverage issue, could we do something as simple as try and pool the risk for all physicians? These are the questions we deal with. Cooper: When President Obama and other public officials say, “I’ve got good health insurance, and we’re going to open it up to everyone having a similar kind of 46

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pool,”how does that affect what you’re doing? It’s often mentioned that Congress has great health care. Margolin: If we can get those reforms, and if we can achieve a guaranteed-issue insurance environment in which everybody has insurance and in which there’s a mandate that people have insurance, that would be a strong accomplishment. The mandate is important. We are not supportive of a government plan. And the most significant concern we have is that we don’t think it’s necessary. We think if there are appropriate reforms in the care delivery system and in the insurance system, we all own part of the problem and we all own part of the solution. Cooper: To ensure an even playing field, in that sense? Margolin: And then the private industry is perfectly able and capable of providing the products and services needed to serve that whole group. A government plan is not necessary. It adds a level of expense and complexity, and it also creates an unlevel playing field. The government plan, at least in most of the iterations that have currently been proposed, would utilize Medicare rates, which would give the government plan a distinct advantage over all private insurers. There are several problems with that. One is that the government has a distinct advantage, so all of the good risk will go to the government plan. There would be adverse selection against all of the private plans. And Medicare rates are so low that the only way they can be successful is if they turn to the private sector. Cooper: Do you think there’s always going to be a difference in costs, and that if it’s too low a rate, somebody will have to pay the difference? Margolin: In virtually all of the proposals to date, that’s how it’s structured. There has been discussion of what might happen if the government has to compete on an equal playing field with all of the private plans. But I haven’t seen it actually appear in any of the proposals. The bigger question is, why go to that expense? What problem are we trying to solve? If there is coverage available for everyone, and if we can improve cost, quality, safety, affordability of that coverage, why do you need a government plan? What end does it serve? Cooper: In what you’ve been reading so far, are they suggesting that this would be the same type of insurance that Congress gets but at Medicare rates? Margolin: They have a very rich benefit plan: the Federal Employees Benefit Health Plan, (FEBHP). And we all at Blue Cross, many of us, administer that program for the government. So we have a piece of it, as do Cigna and Kaiser. So we pay claims and we insure parts of that coverage.

Cooper: Do you have any idea what the government’s cost is for that? Margolin: I don’t. I know it’s a very expensive plan, a very rich plan. Cooper: How does it work with other countries that have more socialized medicine? Don’t they have a mix there, even though they say it’s socialized? Margolin: It’s different in every other nation. Most other nations that have broader coverage have both public plans and private plans. The public plans are paid for under a pretty extensive tax system. This government plan is such a divisive issue. There are the factions who absolutely believe it must be part of the offering and that it is what is required to “keep the health insurance companies honest.” There are the factions—and among them are hospitals, physicians, health plans, and I believe the entire Republican membership of Congress—which are opposed to a government-run plan. What are the parties hoping to accomplish, and is there another way of accomplishing it? My judgment is that there is. We can focus on insurance market reforms, the guaranteed issuance of coverage, the mandate for coverage, the rating regulations that would apply, so that there’s a fair and reasonable way of collecting premium. If you have that and you have reform of the delivery system, so that we are attacking the issues of cost, quality, and safety, that’s all anybody really wants to achieve. I personally believe we need reform, and I believe we need it at a federal level, and I’m very worried that if we stay locked and loaded on the idea of the governmentrun plan, it will blow up the opportunity to have broadbased federal reform. And I think that would be a real tragedy.

Leslie Margolin, President of Anthem Blue Cross, bikes along the California coast for a Best Buddies fundraiser

Cooper: Somebody told me, I think it was when I was in DC, that the major insurers came together and talked with Obama or Obama’s team and said, “We’ll give you $80 billion.”Does that ring a bell?

We will have added a lot of cost and complexity without really solving the problem of bringing coverage to the 46 million people who don’t have it. We won’t have solved the problem of finding a way to improve care for all people currently in the system, or to make that care more affordable for them and for those coming into the system. We won’t have solved any of those problems. We will have only created a patchwork of legislation across 50 states that makes it really expensive for employers to provide coverage for their employees. That makes it really expensive for a company like ours to do business across state lines, and that has spillover impact on individuals who are trying to get insurance in the market, because those costs get spread.

Margolin: There was a number that was given. We could give you that letter. AAIP, the American Association of Insurance Plans, did meet with Obama and followed up with a letter and made commitments around what cost savings could be. I just so believe that we need federal reform. And I say “federal reform” because I believe there are parts of the system that are broken. I believe it’s a tragedy that 46 million people don’t have coverage, and we can and should do better than that. But I don’t believe that that sort of reform can be done state by state. And if federal reform fails, I believe what will step into its place are efforts across our 50 states to try and fix what’s broken. And everybody will have

their own idea of how to fix it. We saw it after Governor Schwarzenegger’s plan failed here in California: there was a multitude of bills that came forth. And unless there’s a unifying principle and a coherence to it, you just end up with a bunch of bills. You get your favorite fix, I get my favorite fix.

In actuality, I think the profit margin is three-to-five percent, after you pull out what goes to physicians and hospitals.

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Cooper: I think if more people knew that, they’d feel a little bit more comfortable. Margolin: We, all the people involved in health care, have spent so many years pointing fingers at each other. We say the problem’s with the hospitals and doctors and they point at us and our profits. Cooper: Of course the janitors are always cleaning up. Margolin: (laughs) What makes me so optimistic about the reform efforts this time around is that it’s the first time in my lifetime I’ve seen all the constituencies coming together and admitting that they own part of the problem and have committed to fix it. And that’s huge. Because certainly, you can get two opinions on whether any given executive makes more money than he or she should, or whether a physician’s office should own an MRI machine, or if there is an unfair inducement to use more MRI than you might need. But those aren’t the big issues. Those are dollars, and those dollars should be addressed at some point in time. But that’s not where the big dollars are. The big dollars have to do with the systemic issues that we were talking about. If you take a look at the millions and millions of dollars spent on defensive medicine, medicine the doctors practice to avoid malpractice liability, if you look at the costs of medication errors, if you look at the costs of surgical errors, if you look at the costs of preventable infections, those areas are where the problems lie. We’re working now with the hospital associations across the state of California to try and look at the impact that we could have if we could convince and could educate all hospitals and physicians and families about the costs of voluntarily choosing to have a child before the child has been carried to full term of 39 weeks. An enormous number of voluntary deliveries happen between 37 and 39 weeks that are simply done for the convenience of the parents or if there’s a level of discomfort in the mother. If people had the right information, in all likelihood most people would make a different choice. If you think about the health impacts, it’s huge. Cooper: You’re right. Health literacy should be important both to the physician and to the family members themselves. Margolin: Of course, none of this is as sexy as simply saying that the insurance industry makes too much money and that the profits are too big. It’s not as sexy, but it is where the dollars are. We should be looking at systems of care and trying to identify major and avoidable costs. That’s evident in an area like this. The avoidable costs of complications resulting from earlier delivery are just astronomical. Cooper: You could get health literacy into the curriculum 48

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at school level, so kids at least start understanding. There are all kinds of issues like obesity and diabetes, that cause such a problem as we get older and as we do these bad things to our bodies. Margolin: Right. You can make those positive kinds of impacts through health literacy, through trying to help kids develop healthy habits. We do a ton of work with the Boys and Girls Clubs across the state, with the Governor’s Council on Physical Fitness, with the LA Unified School System, and with school systems all across the state of California, on a whole variety of levels. We fund healthy meal options across the school system so that kids going to school have healthy choices. And you know, in many underserved communities, families don’t have access to those kinds of choices. We also have a health fair bus six months of the year. We send it up and down the state, doing preventive health screenings for people. We do them pretty equally for our employer group customers, for their employees, and we make the buses available out in the community. We parked it at the March of Dimes. I serve on the board of the LA Urban League, and we parked the bus at their farmers’ market for three or four days. We send it to Aid Project Los Angeles. We also send it to our medical community resource centers. It’s so gratifying. We do lipid screenings, cholesterol screenings, body mass index analysis, and there are lots of good things that come of this. People become more aware of potential problems before they turn into big problems. About 85% of the people who come to our bus for screenings commit to making healthier lifestyle choices, or commit to seeing a doctor to investigate a situation further. For people who don’t currently have coverage, we make information available through a notfor-profit organization that lets them know where they can receive coverage through the private sector and through various government programs. It’s a wonderful, wonderful array of services that we provide. We also negotiated a deal with the Lakers basketball team to create health and fitness programs for kids in the school system. We have a website up with our material on healthy habits and healthy eating. It has recipes and exercise tips. It’s things that kids will look at and be interested in, because maybe Kobe Bryant eats broccoli, or Lisa Leslie of the Sparks likes eggplant, I don’t know. And because these athletes say something like, “The way I got into exercise was by playing dodgeball in my neighborhood.” What we’ve done is, we’ve negotiated these sorts of deals with various teams and players so that the players actually come with us into the school system and meet the kids they’re influencing. This all gets the kids really involved in thinking about healthy lifestyles. And it’s a good way to leverage our

dollars to have an actual impact on health in kids’ lives. Maybe we’ll get them exercising at an earlier age, dealing with issues of fitness and good eating I don’t know that any one of these things is the answer. What I know is that somewhere in this mix of farmers’ markets, the health fair bus and sponsoring the Governor’s Council on Physical Fitness, positive results can emerge. Cooper: Are you partnering with other entities that can help you with the cost of these projects? Companies that are out there doing good work in their own missions? Margolin: We have a partnership with Dole Foods. We are exploring one with Kraft Foods, actually having some exciting discussions at a preliminary stage. Cooper: They talked to us, too. For the longest time, we had a recipe section in our publication, and they were going to sponsor the recipe page. We were just having some problems with some people who were doing the recipes: “Does that mean we always have to have Kraft Food products in the recipes?” That sort of thing. Margolin: Yeah. The lead guy at Kraft changed jobs, so we had a couple of meetings. I met him a year ago at a big think tank about how to help improve the environment. He and I hit it off. We brought our whole team together, from Chicago and California. We’re quite far along in the discussions. And then he moved on and I’m afraid it took a bump. But the team is still really excited about it. We do try to look for key strategic partners in a variety

of these areas. But we don’t want to dilute our efforts with a whole bunch of partnerships and have everybody else competing right now. All the health plans are already competing in the space of health, wellness, and prevention. We all have products and services that we offer to our individual members and to employer group customers. But the take that I have on these objectives is a more expansive one. It’s about marrying all the work we do in the community, the things we’re talking about here, with some of the collaboratives. Where are we having the greatest positive impact and how can we leverage that across all the other programs? So we’re trying the health fair bus, we’re trying the Live Like a Champion program, where kids play alongside athletes in their sport. We’re trying a partnership with Kraft. And all of those have success factors, but nobody has yet said, “Let’s look across that whole spectrum and see if we can drive health improvement up for a whole community, not just for our members.” We’re doing this now, all of this, for our own associates as well. That’s good for the health of our organization, and it’s good as a model for the organizations that we sell our products and services to. But it’s also just really good because we’ve got 44,000 associates across the country, and as they feel better about issues relating to health, wellness, and prevention, they, I believe, will introduce it into the work that they influence. And so we can have a much broader reach and can really change and improve lives. Everybody comes out ahead. anthem.com/ca ABILITY 49

bout 66% of adults and 31% of children in the United States are either overweight or obese. This has led to a rise in obesity-related conditions such as type 2 diabetes among adults and, increasingly, among obese children. While being obese can change how we look and how we fit (or don’t fit) into our clothes, it can also lead to serious medical, psychological, and social problems. Obesity can impact our overall quality of life. Simply defined, obesity is the result of an energy imbalance over an extended period of time. If we have a pattern of taking in more calories than we can burn off, our bodies store the extra calories as fat, increasing our risk of health problems. Genetics also plays a role, since obesity tends to run in families. Our environment and the choices we make every day are additional factors–choosing unhealthy foods (fast food, sugary beverages, high-calorie/lownutrient snacks); eating large portions (super-size meals); and leading less active lifestyles (driving, TV, video games, and computers) can all contribute to obesity. Stress, depression, and boredom can often lead us to reach for “comfort foods” like potato chips or ice cream, resulting in intake of “empty” calories. Your doctor uses a measure called body mass index (BMI) to determine if you are underweight, normal, overweight, or obese for your height and weight. BMI Categories for Adults

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BMI

Classification

< 18.5

Underweight

18.5 – 24.9

Normal

25 – 29.9

Overweight

> 30.0

Obesity

BMI percentiles are obtained by plotting a person’s BMI number on CDC’s (Centers for Disease Control) BMI growth chart, taking into account the person’s age and gender. BMI Percentiles for Children BMI

Recommended Classification

< 5th Percentile

Underweight

5th – 84th Percentile

Healthy Weight

85th – 95th Percentile

Overweight

> 95th – 99th Percentile

Obesity

> 99th Percentile

Severe Obesity

AMA Expert Committee Recommendations, 2007 If you or your child are overweight or obese, you may be at risk for certain health conditions and should consult your physician or pediatrician. It’s never too late to start making positive changes and to take simple steps towards a healthier you. by Harvinder Sareen, PhD To calculate your child’s BMI Percentile, go to http://apps.nccd.cdc.gov/dnpabmi/Calculator.aspx and www.cdc.gov/healthyweight

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tus quo, they began to question their beliefs and habits. Around the world, it seemed as if people were awakening from a deep sleep. I, too, awakened and became swept up in the winds of a cultural and spiritual revolution that carried ideas from east to west. I felt inspired to study psychology and Buddhism at the University of Massachusetts, Amherst; California State University, Sonoma; and the Humanistic Psychology Institute. In 1976, I began my career as a psychotherapist. In my first year of private practice, I founded the Center for Health and Healing at Cedars-Sinai Medical Center in Los Angeles, and soon was treating a flurry of creative clients, ranging from writers, painters, directors, producers, actors, and musicians to executives in development, marketing, advertising, and promotion within the television, film, and music industries. Working with them helped me hone my ideas about how to use mindfulness and creativity to deal with unexpected changes and to break out of stagnation.

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...if you believe in turning to God for guidance, you can use mindfulness meditation to set aside distractions and listen to the divine wisdom...

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Creativity, Mindfulness, and Change (Introduction)

s a young man growing up in Boston in the late 1960s, I spent much of my time in Cambridge’s Harvard Square, where tattered paperbacks on Zen Buddhism and existential philosophy were commonly seen in the hands of students and professors alike. Cambridge also seemed a natural hub for many of the great musicians of the era, including Bob Dylan, Joan Baez, Joni Mitchell, Simon and Garfunkel, and the Byrds. It was the place where the British bands first landed and rehearsed for their national tours. The Beatles, the Rolling Stones, the Who, Led Zeppelin and Van Morrison, played the local clubs, from Boston’s Psychedelic Supermarket to the Harvard Bowl or the Boston Garden. Like many of my peers, I bought a folk guitar, joined a local band, and imagined that my music would change the world. The connection between creativity and transformation intrigued me. I was fascinated to see so many people around me opening themselves up to new influences and new ways of thinking, transforming not just their art, but also themselves. Instead of simply accepting the sta-

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Soon, I began teaching and leading workshops on the creative process of change, helping people explore what sparks an interest in change and why it’s often difficult for people and organizations to transform themselves. I believe that within all of us lies dormant the potential for tremendous transformation that can lead to great happiness. In my graduate work in counseling psychology, I’ve helped thousands of individuals and companies set off on their own artistic journeys and reinvent themselves. Cultivating mindfulness, they were able to begin seeing their lives as a canvas for self-expression that could, and should, reflect their personal passions and values. Even when their lives shifted abruptly and caused them great suffering, they were able to feel their pain and allow it to dissipate as they let go of the past and attained what the Buddhists call “open-mind consciousness.” This is the creative state artists immerse themselves in, an almost magical state of being in which you can tune in to the unconscious and even the collective unconscious, emerging with fresh and original ideas, passion, and inspiration. Just as a painter’s heart begins to beat faster as the paintbrush takes him to places he hadn’t imagined going, or a photographer discovers an extraordinary texture in an everyday object, when you attain the state of awareness known as “open mind,” you’ll discover myriad possibilities for your life. Wise Mind, Open Mind will teach you the all-important three-step process anyone can use to navigate change: 1. Let go of resistance. 2. Tune in to your creative unconscious, experiencing open mind. 3. Move forward with a practical plan for transformation. Whether you know you’re ready to change or sense that you should, it’s important to recognize that change is unavoidable. Life is continually in flux, and even that which seems immutable can be destroyed or altered in an

instant. The Buddhists refer to this as “the law of impermanence.” Nothing stays the same, not even the rocks and the mountains, which rain, snow, and rivers sculpt over time. Each day, millions of your body’s cells die while millions more are born. Stasis is an illusion our egos create to fend off the fear of change. When change is not your choice, you can’t avoid suffering, but you can choose to view the change as an avenue to personal evolution. You can push aside your perceived limitations and let go of the habits that have provided you with comfort, familiarity, and a false sense of safety, and go forth with fear in check, using creativity to illuminate new paths. Clinging to the familiar also breeds boredom and discontent. It prevents you from fully inhabiting your life and keeps you mired in regret. It keeps you small. When it’s time for change, whether you’re losing a loved one, your perfect health, the job you loved, or the lifestyle you enjoyed, you have the opportunity to make your life even better than it is, as unfathomable as that may seem at first. Whatever your vocation, you, like all people, are an artist, and your masterpiece is your own life. In my many years as a therapist, I’ve found that most people wish they could be an actor, painter, singer, or other type of artist, and I encourage them to find ways to express themselves in the arts, because I believe that all creativity is vitalizing. Artistic aspirations are often a metaphor for the desire to live more creatively and authentically, according to the dreams of the soul instead of the expectations of society. I have a physician whose approach to interacting with patients is very different: When he asks how you are, he genuinely listens to the answer; if you mention that you’re feeling emotional pain, he empathizes by telling you about something that caused him emotional pain; and if you say you have a physical ailment, he often says, “I wonder what your soul is telling you.” His approach is creative and authentic, because he has a passion for healing. I also have a financial-planner client who’s in touch with his own passion and creativity, and very happy in his work. For many years, he was a film director whose animated short films were shown at film festivals around the world, but he discovered that he truly loves investing. He has crafted a life as a financial advisor who truly listens to the needs of his clients and helps them invest their money in ways that are meaningful to them. He guides people in becoming mindful of their feelings about risk and security, and in doing so, he inspires them to be more self-aware in other areas. Where once his interactions felt boring and businesslike

to him, now he’s enthusiastic about talking to his clients. That attitude affects them as well, because they leave his office feeling infused with excitement about how they can use their money and investments to meet their personal goals. When you tune in to the endless source of creativity that’s available to you in open mind, to master the art of creative transformation, you must accept that there are no shortcuts for avoiding discomfort and suffering. The secret to crafting a new life that’s fulfilling is twofold: First, develop a mindfulness practice. Then immerse yourself in the three-step art of creative transformation whenever you’re faced with crisis or a stagnant situation that you know must be changed, refreshed, and enlivened. CREATING A MANDALA FOR YOUR LIFE “You see things, and you say ‘Why?’ But I dream things that never were, and I say, ‘Why not?’” —George Bernard Shaw In Buddhism, a mandala is a beautiful, intricate, circular sand painting of many colors that depicts the relationships among the celestial bodies in the cosmos and represents the turning of the wheel of fortune. Yet, after spending countless hours creating this work of art, the one who has designed it and meticulously laid the colored sand will sweep it away, obliterating the carefully constructed lines. As the image of the mandala fades into memory, its creator reflects on the impermanent nature of everything we experience. When dramatic shifts occur in our lives, we can become ABILITY 53

conversation. Mark and Selena recognized that their son and daughter would tell them to continue living, rather than compound the tragedy by sleepwalking through life and feeling too guilty and afraid to move forward. Only when they fully embraced this step of letting go—of the past, their guilt, and the old dream of watching their two children grow up—could they begin to take the second step in the art of creative transformation: tuning in.

nearly paralyzed with fear, anger, grief, and resentment. We enter a state of shock and forget that with loss comes rebirth. Clinging to the past, we resist the opportunity to embrace the creative process that requires us to let go of the mind’s limited way of thinking about ourselves and the situation at hand. But if we can find the courage to enter this process, to experience the state of consciousness Buddhists call “open mind,” accessing our deepest, or core, creativity, we can begin to tune in to what we most want for ourselves. CREATIVE TRANSFORMATION FOLLOWING A TRAGEDY A few years ago, a couple named Mark and Selena came to me on the advice of friends, asking me to be their therapist and help them cope with the most devastating of losses: their two young children had been killed in a car crash when their teenage babysitter, who was driving, took her eyes off the road, crossed the centerline, and caused a head-on collision at 60 miles an hour. The babysitter had somehow survived, but Mark and Selena were overwhelmed with guilt, anger, and feelings of loss. They could barely function and couldn’t begin to imagine how they could go on without their children or why they would want to. They felt crippling guilt, profound sorrow, and bottomless grief. They revisited that fatal day over and over again in their minds, obsessing about what might’ve been if they hadn’t left the children in the babysitter’s care. I knew that to help them begin healing, I needed to guide them in letting go of their resistance to this change that had been forced upon them so dramatically. Both Mark and Selena had to give up their feelings of guilt and the unconscious belief that if they were to enjoy life again and make new plans for themselves, they would be bad parents, betraying their children. To help them stop embracing this belief that kept them focused on their loss, I explored with them what their children would say to them if they could have one more 54

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“Open mind” is a state of creativity that’s very familiar to artists, one that all of us experienced as playful children, but many of us have forgotten about. It’s also known as “the field of possibilities,” “the creative void,” and even “the creative soup.” It’s the state of awareness in which we feel a sense of timelessness, openness, and unlimited possibilities. In this state, we can begin to imagine situations and opportunities that would never occur to us in our ordinary consciousness. As Mark and Selena’s therapist, I decided to meditate on their situation, and in doing so, attained “open mind.” What came to me was the visual image of the subcontinent of India. “That’s curious,” I thought, but I sat with it, rather than dismiss it, as the product of an overactive mind. Soon, I had an inner knowing that I needed to suggest to Mark and Selena to take several months off from their jobs and go to India—to a city called Varanasi. Varanasi is known as a holy place where the dying go to prepare for death and where bodies are prepared for the traditional cremation and return to the sacred Ganges River. Rather than talk myself out of what my intuition had told me, I discussed it with several of my colleagues. I knew they would carefully consider what I was presenting and give me honest, helpful feedback. The verdict was unanimous: it was a terrible idea. I took in their words and valued their opinions and insights, but in my mindfulness meditation practice, my intuition kept telling me the same thing: encourage Mark and Selena to go to Varanasi. Finally, one of my old teachers and mentors, Ram Dass, told me, “I think you may be on to something. They need to immerse themselves in their grief instead of denying it. Where better to do that than India?” Although they weren’t sure how they would benefit from a trip to Varanasi, they meditated on it and told me that taking the trip felt “right” to them. In India, Mark and Selena connected with their grief as they observed the dead and dying, and they started to feel a sense of connection to other people and to a world in which suffering is inevitable. They didn’t know the language and couldn’t converse with most people there, but their eyes expressed compassion toward parents who stood by the river, ready to undergo the sacred rites

for their children who had died. Mark and Selena spent a couple of weeks working with a humanitarian who invited them to join her in her everyday work of attending to the sick and dying. When they returned, Mark and Selena told me they had finally begun to heal. The deep compassion that had been awakened in them had eased their grief, and they felt they’d transformed from suffering parents who had lost their children, to people who reached out to other suffering parents. They no longer felt quite so alone. Over the next few months, Mark and Selena continued their mindfulness meditation practice and began to immerse themselves in the state of “open mind” often. Selena, who had always loved music and had earned a fine arts degree but never pursued art as a career, tuned in to her own creativity, taking the second step in the three-step process of creative transformation. She accessed her passion for playing piano and sharing her music with others. Selena soon returned to school to earn a master’s degree, and began to envision herself working with children as a music therapist. Mark went back to his work as an electrician, but he now approached it in a very different way. His time in India had inspired in him a sense that he had more to offer than simply repairing what was broken and doing whatever work his customers requested. Now, when he spoke to his clients, he suggested bold changes they hadn’t considered. He pointed out ways they could change the lighting in their homes to create a feeling of spaciousness or comfort and calm. He listened closely to their plans, asking them how they wanted to use their space and making suggestions for how he might rewire a particular room to better suit their vision rather than simply do what they’d asked. In time, Mark and Selena adopted two special-needs children and had another child of their own. They continue to talk about their children who died and keep photographs of them in their home, but they’ve now completed the third step in the art of creative transformation, moving forward into a new life and a new mandala. Mindfulness is an idea from Buddhism that’s central to meditation, a crucial tool in the art of creative transformation. You establish a practice of meditation in order to develop the habit of mindfulness so that your awareness remains engaged when you leave the meditation cushion and go out into the world. You’re able to act consciously instead of unconsciously. You may have had a recurring dream with a symbol that appeared to you night after night until you finally took the time to contemplate what it meant. With regular mindfulness practice, such symbols and messages will come to you when you’re ready to receive them and act on them. If you’re like most people, you often become

extremely distracted by myriad sensations, feelings, and thoughts that drag you away from the inner self and its wisdom. You hear conflicting opinions, feel anxiety about the changes in your life, and focus your thoughts on mundane tasks such as fixing dinner or making phone calls. Too often, our lives become all about our distractions, and in quiet moments, the thought occurs to us that we’re not living authentically, in alignment with our deepest desires. Some of us have an inkling of what we’d like to create but are unaware of it most of the time because of our distractions, and some of us have no vision at all. With mindfulness, we can begin to quiet what the Buddhists call the “monkey mind.” When the monkey has been put back into his cage, we can begin the process of tuning in to the creativity deep inside of us. THE THREE-STEP ART OF CREATIVE TRANSFORMATION Whether you played an instrument in a garage band or never picked up a guitar, if you had a childhood dream of becoming a ballerina or imagined yourself in the NBA, you can still be a brilliant artist of life. You can open yourself up to the possibility of dramatic personal transformation by learning and using the three-step process of creative transformation available to all of us. Unexpected change often provides the impetus to realize this tantalizing and exciting, yet frightening, potential. People like Al Gore, who found his road to the White House suddenly blocked and chose to focus on educating people about global warming, and Christopher Reeve, who left acting behind after becoming a quadraplegic and went on to become a film director and advocate for those suffering from spinal cord injuries, are objects of admiration for many, because they were able to let go of the past and transform their lives. In America, we’ve made pop-culture icons of figures from Jacqueline Kennedy to Bono, because they seem to epitomize the promise of self-reinvention. We long for just a fraction of the courage to move forward without looking back in sorrow and regret, but fear we don’t have what it takes to rise from the ashes of our own loss. The art of creative transformation is a process for reinvention that you can use to free yourself from stagnation when the winds of change are blowing. When you begin to use this process, you stop feeling like the victim of circumstances and begin to transform your life in a positive and exciting way. “Like a dream, whatever I enjoy will become a memory; the past is not revisited.”—Shantideva Step 1: Let Go. The art of creative transformation begins with the willingness to be mindful of your hidden resistance, examine it, and break it down so that you can ABILITY 55

sweep it away like sand on a doorstep. If unwanted change has occurred, you’re likely to become angry and struggle to regain what’s been lost. This resistance blocks you from recognizing that what lies ahead for you might actually make you happier than you’ve ever been. If all signs point to the need for change, it’s important not to deny them and cling to the status quo even as it’s slipping away. Many of us insist on staying in a relationship long after a partner has given up and moved on emotionally, or try to hold on to a job after the boss has encouraged us to take long lunches for interviews with other companies.

To be successful at surging forward, you have to learn not to be sucked into the undertow, and instead to “surf with the saboteur,” that nay-saying inner voice. As a surfer, you remain balanced and continue moving forward even when, deep down, you feel unsure of yourself and long for the security of solid ground. Approaching the shore, you start to realize that you can manage the force of that uncertainty. THE BASICS OF MINDFULNESS MEDITATION

Step 2: Tune In. Listen to the wisdom of your soul by achieving “open mind,” the state in which core creativity takes place. Whenever you reconnect to this core, authentic self, the temporary circumstances of life stop distracting you. The soul, which recognizes its connection to the divine and to eternity, is quite different from your false, external self, the part of yourself that identifies with the temporary world of the senses. Your ego, or false self, will present you with a long list of arguments for fighting changes that you didn’t ask for and avoiding changes that require you to break out of your comfort zone—even if the cost is your own happiness. In a panic, the ego will try to figure its way out of a crisis, but the soul never becomes anxious. It simply allows itself to be aware of your unique gifts, and provides the passion and creativity needed for you to reinvent yourself.

“The way of the Buddha, is to know yourself; To know yourself is to forget yourself; To forget yourself is to be awakened by all things.”—Dogen

Your brave, authentic self urges you to let go of your fears, take risks to live more deeply and fully, and take the leap to achieve your destiny. By accessing your soul, you’ll unleash the driving force of your passions, and send yourself sailing into uncharted waters and climbing new mountains. Your egoic mind overly identifies with who you are as an individual. In open mind, you’re freed of the limitations of your egoic mind so that you can begin to imagine.

Most of the time, however, simply noting the thoughts or images and coming back to them later, after you come out of the meditative state, is the best course. It’s better to start by doing 10 minutes once a day than to aim for the eventual goal of two 20-minute sessions per day and fall short by meditating for 20 minutes one day and not again until a few days later, when you remember your promise to yourself.

What might your mandala look like? We’re often urged to “dream big” and to say, “the sky’s the limit” and “I can do anything if I put my mind to it.” This is a good first step in creating a plan, but you must also understand what’s involved in manifesting that dream, and be willing to work hard. This will prevent you from becoming stuck in the planning and dreaming stage. Using mindfulness, you can evaluate your plan from the level of the core self without becoming distracted by the distorted thoughts of the false self. Step 3: Move Forward. Accepting that discomfort and suffering are a natural part of life, you’ll understand that happiness ebbs and flows, and that you can’t be a Zen master at all times. You’ll never be able to fully eradicate the little voice in your head that harshly judges you with thoughts such as, “You’re no good” or “You’ll never succeed.” In many ways, this voice is like an 56

undertow in the ocean, trying to pull you out to sea and away from what you want.

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Mindfulness meditation practice is a commitment that many resist, but it requires far less time and effort than most people realize. For best results, practice mindfulness meditation for 20 to 30 minutes twice a day in a quiet room with a closed door and no distractions. I recommend having a pen and pad of paper nearby, in case you feel the urge to write down something that seems important, whether it’s a creative idea or the sudden awareness that you’ve left an important task off your agenda. If you complete your meditation session, you’ll actually have more energy and creativity to work, and you’ll be able to set aside any anxiety or frustration and explore your options.

Choose a time when distractions will be minimal. If you anticipate a stressful situation, in which it will be challenging for you to remain nonreactive, or in which you’ll need to access your creativity more than usual because you’re dealing with a perplexing problem, try to schedule a mindfulness meditation immediately beforehand. My clients reported that just five minutes spent in mindfulness practice makes a dramatic difference in their ability to remain calm, focused, and nonreactive before attending a late-afternoon meeting in order to refresh themselves creatively. HOW TO PERFORM MINDFULNESS MEDITATION Step 1: Get into a comfortable posture. Sit crosslegged on a meditation cushion or with your legs extended straight out, with your back against a wall for support,

or sit in a chair with a firm back, keeping your feet on the floor and your spine straight, and tucking in your chin slightly to keep your vertebrae aligned properly. If you’re sitting up, close your eyes, but if you’re lying down, keep your eyes half open to prevent yourself from falling asleep. Step 2: Focus your eyes on one spot toward the tip of your nose or on your “third eye,” the area in the middle of the forehead. Look straight ahead at the insides of your eyelids. Step 3: Pay attention to your breathing. With your eyes closed, fixating them on one spot, breathe in with awareness of your lungs and your diaphragm. As you inhale, say to yourself, “In.” Exhale from your lungs and then your abdomen, saying to yourself, “Out.” Do this each time you breathe. You can also use the words “rising” and “falling away,” or “comfort” and “letting go,” or “surrender” and “release.” Step 4: Place your hands in a relaxing and energizing mudra (hand position). In Buddhism, the mudra is important, because it affects the flow of energy throughout the body. There are three traditional mudras: (1) The first is to touch the thumb and first finger to each other, and then hold your palms up, with your other fingers relaxed and straight, and rest the backs of your hands on your thighs. (2) The second, which is more common in Zen Buddhism, is similar: you bring your gently cupped

hands together at your abdomen, thumbs facing away from you and palms up, with the fingernails of your first three fingers touching. (3) The third is to hold your right hand in your lap or at your navel, with the palm turned upward, thumb facing away from you, and other fingers straight; then place your left hand on top of the right hand, also palm up with the thumb facing away from you so that your two thumbs form a triangle with your left index finger. Step 5: Be aware. As you breathe in and out, mentally note the thoughts, feelings, sounds, tastes, smells, and physical sensations (itching, temperature, pain or discomfort, or feelings of heaviness and lightness) that you experience. Simply be present, open, alert, and watchful as you allow the witnessing mind to emerge. Observe the quality of the sensation if it has one, and categorize it: “heaviness in shoulders,” “bitter taste,” “lawn mower outside,” “painful thought about son,” “thought about that call I should make,” and so on. Don’t explore this thought or feeling unless it occurs more than twice, in which case, ask yourself, “Is this something I can come back to later, after I’ve meditated?” If you determine that what keeps coming up for you should be addressed right away, allow yourself to be present with that. At the same time, allow the witness aspect of your consciousness to observe yourself without judgment as the feeling, thought, or sensation fades away or lessens in intensity. ABILITY 57

Step 6: Slowly come back into ordinary consciousness. Take three long, slow, deep breaths, breathing in through your nose and out through your mouth. Rub the palms of your hands together to generate heat, and place the palms over your eyes and face. Open your eyes and slowly lift your hands away from your face as you return to awareness. Inhale deeply and stretch your arms up over your head, with your hands interlocked. Bend slowly to the right and then to the left. Do this several times, and then bend forward toward your feet. Reflect on whether anything of importance revealed itself to you that you wish to write about in your mindfulness journal. I suggest you create and work with a mindfulness journal, a blank book that you can use to record your sensations, observations, thoughts, feelings, emotions, images, creative ideas, and messages of wisdom from your mind and body as you become mindful of them. Recognizing that your experience bears a powerful emotional resemblance to a past experience can be a helpful and freeing insight, but in the end, the story of its origin is just a story that can distract you from healing. If you come to realize that your defensiveness around your gruff boss reminds you of the way you reacted to your highly critical father, the value in that insight is acknowledging how deeply your mind has been programmed to respond to criticism or abruptness with fear and defensiveness. Your friend may have communication problems that make it difficult for you to be nonreactive and remain the observer when he starts speaking flippantly to you. It’s helpful to explore what you can do to affect your friend’s communication problems, but you may soon realize that he isn’t willing to be mindful of his behavior and consider changing it. In that case, your own ability to remain mindful, a witness to the drama unfolding before you, will give you the clarity and courage to either accept the situation as it is (without being drawn into an emotional response) or change the situation by ending the friendship. As long as you remain in these stories, you create suffering for yourself. To change your life, you have to see the story for what it is: a way of framing events that doesn’t contribute to your happiness and holds you back from positive change. Holding on to your story, big or small, giving it life in retelling and embellishing it endlessly, will cause you pain. The point isn’t whether or not you’re justified in telling that particular story, or its veracity, but whether you’re suffering because of it. When you set aside your thoughts and feelings, you’re not engaging in avoidance behavior. It takes practice to develop the acceptance that most of the thoughts aren’t very important. The more you meditate, the more it will feel as if you’re simply sorting the laundry as you observe what your mind generates. The majority of my clients resist mindfulness meditation 58

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at first, although the time commitment is small and the payoff is enormous. One of my clients insisted that it wasn’t necessary and that she didn’t have enough time in her day to devote to a regular practice. She said that taking 20 minutes twice a day was a “virtual impossibility.” However, when she went through the loss of a parent, she had such trouble coping that she couldn’t even drag herself out of bed. After she’d called in sick to work for 10 days in a row, she called me to ask what she could do, because she knew she had to get back to the office. I told her to mindfully meditate while in bed. Terrified and bewildered, my client took this advice and, in a few days, found that she could face going to work again. MYTH ABOUT MINDFULNESS MAY CAUSE RESISTANCE Many are buying in to common myths that must be discarded because they create resistance to regular mindfulness meditation practice. One of the leading myths: “Practicing mindfulness meditation will conflict with my religious beliefs.” This practice for cultivating awareness is simply a part of good mental hygiene. Just as you turn the lights out before retiring for the night so that you’re prepared to shift into another state of consciousness, you can use mindfulness meditation to take you from one state into another. This form of meditation turns down the volume of the chatter in your mind and allows you to tune in to deeper wisdom and insight. As a method for developing awareness, mindfulness practice is free of religious and spiritual dogma. In fact, if you believe in turning to God for guidance, you can use mindfulness meditation to set aside distractions and listen to the divine wisdom that can be found only when you set aside the endless chain of thoughts your own mind creates. When you become receptive, you’ll find that you’re capable of cultivating silence and a deep, abiding sense of wisdom. Christian author and monk Thomas Merton, author of The Asian Journal of Thomas Merton (1968), had a deep appreciation for the overlap between Christian contemplative meditation and Buddhist mindfulness meditation. Mindfulness meditation is a core practice that’s referred to as Shamatha training in Buddhist meditation systems and Zen Buddhist practice. Zen actually means discovering and finding one’s own truth, and mindfulness meditation is focused on gaining experiential knowledge. ronaldalexander.com

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ACROSS 1 Top scientist who could not speak till he was 3 5 Crowd shock noise 10 "Move on up" singer who was paralyzed from the neck down after a stage accident and then recorded "New World Order" one line at a time, Curtis ___ 13 Twiddled one's thumbs 15 Disposed 16 Assistance 17 Two together 19 Cousin of a bassoon 21 "Miracle on Ice" winners 22 Stand-up comedian and actress who was deaf, Marlee ____ 24 Indian flat bread 25__ Lanka 26 Lass 27 This lady won 14 paralympic medals and broke over 20 world records, ____ Grey-Thompson 28 Actor in "MacGyver" who continued his role even though he became blind during it, Danny ____ 34 First person to compete in the 2000 Olympics as a middle distance runner when legally blind, Marla ____ 35 Def Leppard's drummer who lost an arm and continued as the group's drummer using one arm, Rick ____ 37 Complete 38 Late-night name 39 E-mail address ending 40 Wall ___ 43 Canadian's favorite question? 44 Smooth jazz artist who became world famous despite suffering from asthma 45 Meal extras 48 British man who was blind and rose to one of the top posts in the UK government, David ____ 50 Painter who became deaf after an illness and then went on to create some the most well-known Spanish art of the 19th century 52 Long stretch 53 Theologian's subj. (abbreviation) 55 Blind singing great whose life was made into a film starring Jamie Foxx 56 "My Guy" singer who had huge hits despite muscular dystrophy and throat cancer, __ Wells 57 Quadriplegic singer who was a member of The Blue Notes and sang "Joy" after the accident that caused his condition, ___ Pendergrass

DOWN 1 This famous inventor and entrepreneur could not read till he was 12, Thomas ____ 2 Disabled seaman who won many major naval battles for England against Spain 3 Guitarist Nugent 4 Santa Fe locale 5 Defraud 6 Toward the stern 7 ___, senor! 8 Joplin album 9 Totaling 11 Backrub response 12 "The One" star Jet 14 Modeling 17 Make, as a CD 18 British thanks 20 Window type 22 West of Hollywood 23 Everyone 25 Top French actress who continued acting after her leg was amputated, first name 29 Magazine commercial 30 Part of a bike 31 Evidence 32 "___ and the Family Stone" 33 Without giving up 35 Word to a doctor? 36 Rapper who sang "Who's that girl" 37 Canada or blow? 38 Joker 39 Ahead 41 "___ death us do part" 42 Steelers' QB who recovered from a motorbike accident and went on to win the Superbowl, first name 44 Beer holder 46 "Hit me with your Rhythm Stick" singer who had polio, Ian ___ 47 Touch the surface 49 Frisbee, e.g. 51 Away from home 54 Driver's __

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