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A Nuthatch, A Martian, A Haitian

There’s something thrilling, affirming, even epic about saving a life. Perhaps it’s that feeling of hope you get afterwards, or a sense of personal power. Maybe just knowing that you did something that 
mattered to someone.

On Thursday I was working in my home, when I heard a distinctive “this-doesn’t-sound-right” squeak. A pet owner for 21 years, I knew that sound, and descending the stairs, saw my cat Tina with a nuthatch in her mouth. A quick hiss from me and she dropped it. The poor little bird: it was in shock. Mouth gaping, gasping, eyes blinking furiously, one leg twisted. I cradled it in my hands for a while to warm it, then hauled out the very handy and well used “critter keeper” plastic box, where all injured wildlife goes. I left the bird alone for two hours. When I returned, it was standing, flapping its wings, eyes bright and eager. Best of all, both legs seem to be functioning. I took it to the back door and opened the top. She flew immediately to a tree, upside down, which is what they do. 
I felt so serene, at peace, so happy that I didn’t have to decide the fate of this miniscule, delicate fowl.
That night, I went to see the movie The Martian, starring Matt Damon. (My ex-brother in law was his math teacher in high school–just a little personal trivia) It’s a survival story (my favorite genre) and sci-fi (also a favorite), but more than that it was a human interest story. It’s about an astronaut who is accidentially left behind after a wild sandstorm causes the rest of the crew to abandon the mission on Mars. His team is in the process of returning to Earth when they realize he’s still alive on the hostile planet. 
The real story is how everyone rallies to save his life, no matter the cost. At the high point of the movie, with David Bowie’s poignant and heart-warming song “Starman” playing in the background, you see everyone on earth watching the drama unfold, glued to their TVs and cell phones, while a space crew volunteers another 18 months of their lives to return to save the one they left behind on Mars. The Chinese sacrifice a proprietary and secret space project and offer it to the Americans to help rescue the astronaut.  In this massive global effort, you realize NASA will be spending millions, if not billions of dollars, time and energy to save this one person. Just one man
Why?
It’s worth it. You realize that you cannot put a price on one life. People will sacrifice sometimes their own lives to save others, will sacrifice money, time, personal pleasure. We somehow rise above our own needs and wants, above our differences, to something that we think is bigger than ourselves. 
It’s almost a challenge to be a better person  tomorrow than who we are today.
A few weeks ago I heard about Jamesley, a 16-year-old with hemophilia in Haiti. He lives in a home for children, a place where children are placed when the parents can no longer care for them. He has an open, suppurating wound, the result of an operation. He needs factor. Project SHARE has sent factor to Haiti before but the problem is, we don’t know what factor deficiency he is. And he lives in a rather remote place. Haiti has poor infrastructure and many hills.
This was beyond my problem-solving skills so I sent a mass email out to all the people I have met since I first went to Haiti in 2002. Together, we rallied. What can we do? Bring Jamesley to Cap-Haitien in the north, where there is a doctor I know? No, there are no labs for hemophilia testing there. Should we bring him to the Dominican Republic, where he can be tested at the Robert Reid Cabral Hospital? I have many friends there. But he doesn’t have a passport, and the 8-hour bus ride would be difficult; who will accompany him, who will pay for him?
Enter Dr. David Andrews, a pathologist from University of Miami, who knows a lot about hemophilia and testing for hemophilia. Bring a sample of the blood to Miami and I’ll test it, he said.
How to get the sample to Miami?
Granted this isn’t like rescuing someone stranded on Mars, but then again, this is real life. 
Yesterday, a medical volunteer team from the States just happened to be nearby his village. They took Jamesley’s blood sample at 10:30 am, packed it up, and by 6:30 pm landed in Miami. Dr. Andrews, on his day off presumably, drove to the hotel to pick up the sample and should have an answer by the time you read this blog posting.
It seemed to difficult at first: so many options and so many obstacles. Then, it suddenly seemed so easy, when everyone worked together… all for the sake of one orphan. So worth it.
When I know what his factor deficiency is, then I can send the factor to the orphanage, under the supervision of the attending physician, and Jamesley can heal.
There are wars raging, natural disasters, a massive refugee crisis…. often the news is overwhelming. I think for me this is why focusing on one life is so fulfilling: we helped one. We saved one. We did something. Instead of feeling powerless, we felt useful, needed, fulfilled.
I went to bed last night happy as a lark… or a nuthatch.

Great Book I Just Read

To Reach the Clouds: My High Wire Walk Between the Twin Towers [Kindle]
Philippe Petit

The book on which the excellent movie “The Walk” is based, Petit provides a breathless narrative, as if it is happening right now, about the inspiration, the intricate and complex planning and the execution of the most daring high wire act in history. The planning–with myriad things that could go wrong and did go wrong–which took months, tremendous dedication and stealth, is so in-depth and exhausting, it makes the high wire walk look like– well, a walk! A must read for those who want to see how a vision can motivate others (who have nothing to gain) to action, how strategy can lead to perfect execution of plans. The writing is entertaining, witty and past faced. Petit is a creative genius in many ways, Five/five stars.

Pfizer’s New Video Series Can Help You Have More Constructive Conversations

Dawm Rotellini of the NHF introduces Constructive
Conversations Video

Have you ever had a difficult discussion about your or your
loved one’s hemophilia? Have you gotten into a heated dialogue about
restrictions? Do you wish you had some strategies to have more productive
interactions with your physician or hemophilia treatment
center?

Effective communication can play a large role in
successfully managing hemophilia, navigating difficult discussions during times
of transition and building strong relationships between patients, caregivers
and healthcare teams. 
A new educational video series from Pfizer Hemophilia
called Constructive
Conversations
aims to provide the community with tools and resources to
encourage more caring, constructive, and effective conversations among those
impacted by hemophilia.
Originally introduced by Pfizer at the NHF annual meeting,
the Constructive Conversations video series allows you to review tips on
communicating more effectively in the comfort of your home. The videos portray
real-life scenarios that you may face, and show you how to construct a
conversation differently to help achieve a better outcome. Each video uses two
different approaches: one conversation using a more commanding style also known
as a “directive” approach and the other conversation using a more caring,
enquiring style also known as a “constructive” approach.
Visit www.HemophiliaVillage.com today to watch the videos
and sharpen your communication skills! 
And check out Our Hemophilia
Community
on Facebook to learn about Pfizer offerings.
The content of this post is provided and sponsored by
Pfizer.

Good Book I Just Read

The New Single
Tamsen Fadal 

My teammate Zoraida bought this for me as a present. An easy read, snappy and filled with good advice, Emmy award-winning TV

producer  Fadal assesses her life pre-and post-divorce and what she has learned. While mostly geared, I think, for someone new to self-assessment, probably for the 20-30 year old crowd (sad to think they would be divorced then!) as some concepts are really obvious (eat well, get enough sleep) it’s still a great reminder on how to be yourself, care for yoruself, develop yourself and not lose your self in a relationship. Women try way too hard to please, sacrifice a lot in the name of relationship, and maybe that needs to change? Two/five stars.

Mountains of Music

I love music of all types: from Moussorgsky to Metallica, Bach to Bee Gees, Disney tunes to the Doors.  I learn more and more how musically talented are so many members of the bleeding disorder community. Perhaps music becomes an escape or a way to express deep feelings? Below, Richard Atwood of North Carolina, who does “Richard’s Review” in our newsletter PEN, profiles a talented family from West Virginia, from a book he’s uncovered.

Richard writes:
For 5 generations, the Currence
family lived in High Germany on the Randolph-Upshur county line in West
Virginia. Jimmie Currence (1932-1992) and Loren Currence (1934-1987) grew up in
a six-room house that was over 4 miles from a hard-surfaced road. The nearby
one-room school house in High Germany housed 45 students over 8 grades. 
There
was no family history of hemophilia until an older brother died when 2 years
old after he bled out from a bumped nose. Jimmie and Loren also had hemophilia
but were not diagnosed until their twenties. They had 4 normal brothers and 5
sisters. Jimmie and Loren never even visited a doctor until their teens. They
had no ice for treatment and nothing for pain. For treatment, the brothers used
high-powered liniments from Blair products for hemorrhages into their joints.
Before factor VIII, the brothers received blood transfusions. Loren once
received 16 pints of blood in 36 hours for a kidney bleed and Jimmy, as a
teenager, was given a pint of blood from his brother-in-law to treat a stomach
bleed. 
After Doctor Mabel M. Stevenson, a hematologist at Morgantown University
Hospital, examined their blood, the brothers received a diagnosis of severe
classical hemophilia. The brothers considered themselves to be severe
hemophilic “bleeders” with near zero clotting factor levels.
Jimmy Currence explained his bleeding episodes: “We would get all hemorrhaged in
the joint. We would be swollen up till we couldn’t do a thing, just couldn’t walk. Even take spells of bleeding internally. Internal
bleeding could be either inside you or it would be internally in a joint or
under the skin—caused
hemorrhaging like that. And then that way it would lay you up.” (p. 198).
Every member of the Currence family was musical, either playing
musical instruments or singing, though none were trained. The children would
listen to the battery radio, or hear live entertainment, and then pick out the
tune on a guitar, fiddle, or mandolin. The brothers Jimmie, Loren, Marvin
(called Shorty), and Buddy, along with Malcomb Pastine, a nephew who also had
hemophilia, formed the Currence Brothers Band. The band played gospel and
bluegrass music, and even produced six long-playing recordings of their music.
Loren played the guitar, sang, and managed the band. Jimmy played the fiddle,
and was even a four-time fiddle champion at the Mountain State Forest Festival
in Elkins, before elbow bleeds forced him to play the banjo.
Jimmie and Loren could never find full-time employment or get
insurance. They received Supplemental Social Security and the state paid for
their medicine as they could not afford it. Both brothers married, and each had
three daughters.
The family was profiled in Goldenseal magazine in the 1980 article ‘The Currence Brothers: “The Spark to Play Music,” written by Jack Waugh and Michael Kline.The profile of the Currence brothers is augmented
with 5 photographs. Begun in 1975, the magazine Goldenseal is published
by the West Virginia Division of Culture and History. It is a journal for local
cultural traditions and life experiences, including music, in West Virginia. 
John Lilly, editor, 1999, Mountains of Music: West Virginia Traditional Music from ‘Goldenseal. Urbana, IL: University of Chicago Press. 235 pages.

You Can’t Always Get What You Want

That was the tune sung at the latest Pulse on the Road in Baltimore,
Maryland on Friday, October 2! Speaking at the 12th Annual Insurance and Reimbursement Conference—an NHF gathering of social workers
and executive directors of local hemophilia organizations— speakers Laura Summer,
health care policy consultant, Michelle Rice, vice president of public policy
and stakeholder relationships at NHF, and yours truly spoke to this group of our nation’s
frontline defense, the people who handle insurance issues every day. Indeed,
when I asked the social workers how much of their time do they spend on
insurance issues, even I was shocked to hear “75%.” Health care is complicated
and complex; workshops like these help everyone share the journey, learn from each
other, and learn new things.

One way we learned was from role playing! We had two volunteers pretend to be consumers calling the payer (Michelle). Michelle tested them by deflecting their questions, providing wrong information and putting them on hold–a lot. 
Michelle really
set the tone. “For years we’ve been asking to be treated like everyone else.
Well guess what? Now we are!” Payers now look at us not the helpless victims of
a genetic disorder, but as patients with medical needs who have bills that must
be paid. Unfortunately, our former reasoning of “But, we have hemophilia! We’re
special!” is not going to work anymore. We need to get smart, savvy, and
strategic.
Michelle asks: Is
your request to the payer a question of access [to a particular brand of factor
or HTC or home care company]? Or is it a preference issue? “We can’t spend time
on preferences anymore. If you want homecare company A and not B, and B is not
in network, then you must use A, or pay a lot more for B.”
She reminded us
that if your desired factor brand is not on the formulary (the list of drugs
that the payer will cover), that doesn’t mean you aren’t going to get your drug;
you’ll need documentation from your medical provider, and it will cost you
more. And if your factor is not on formulary, check the major medical side of
our policy—it might be there, and might be covered.
Bottom line is
we need to accept a new reality in insurance.  We need a personal budget for out-of-pocket expense each
year. We need to read our insurance policies carefully and completely, each
year. We need to open and read those letters from the insurance company. No
short cuts!
Michelle
stressed that we must take responsibility for our own insurance situation, even
as the NHF, HFA and our local organizations continue to advocate for us on many
levels. It starts with each of us first and foremost. Start with your policy:
if you have private insurance, speak with your human resource department to get
answers. If on Medicaid or Medicare, visit your social work at your HTC.
You can’t always
get what you want, but you can read, document, question and hope! Working
together, we will get many things need and maybe even want.
                                                                                                                                               

Good Book I Just Read
Selling the Invisible by Harry Beckwith

Written in 1997, this book is a bit dated as it doesn’t mention email, cell phones or social media. But still, there are many good lessons to learn that are timeless classics. This quick read teaches why focus groups, value-price positioning, discount pricing, and being the best can fail; the vital need to focus on one message; the one emotion that most influences why your prospects will buy from you. Three stars out of five.

Nepal Part 3: “You’ve Been Saving Us”

Was it the
altitude? At 4,430 feet, being in Kathmandu, Nepal is  like being in Denver. It’s enough to slow you
down and dehydrate you if you are not accustomed to it. But I thought just do it. Go to see the famed “Monkey Temple.” Wednesday, September 2, was my day off.
I took a taxi over very bumpy, twisting roads where vehicles darted madly around us like metal dragonflies. Cars and motorbikes come
within inches of one another and somehow avoid accidents. The driver offered to
stay and wait an hour, which is all that it took. I recall being here in 1999, but with the April 25 earthquake, this World Heritage Site is in shock. The earthquake caused extensive damage to the temples and buildings. Dusty red bricks were piled up, or avalanched down stairs. Temples had huge cracks
in them, with plaster curling off them. Rhesus monkeys scooted up the sides of the
temples and into the doorways to steal the food offering left by pilgrims. Incense
mixed with acrid odors. And above it all, the eyes of Buddha stare down placidly and eternally from the highest temple.
Thursday September 3, 2015
Today I met
with the beneficiaries of Save One Life and presented their money to them.  The families were waiting for me and Laxmi, and I
smiled and waved at them when I entered, being casual so they would feel comfortable. Many
smiled back. The logistics were wonderful: a beautiful small stage,
bedecked in red; a big sign announcing Save One Life Fund Distribution. So many
young boys and older boys and families showed up.
We finally got settled, and the
ceremony began; there were many speeches and welcomes. I recall
Beda, man with hemophilia and president of the Nepal Hemophilia Society, said to the audience, “Pain and hemophilia are synonymous.” And then, “My mother used to
weep a lot,” as he
recounted his own childhood without factor.
Eventually we had the families
speak, and they did, from their hearts.
Mrs. Chaulagain gave a speech about her two sons with hemophilia, Pranit  and Pratik. There was domestic violence,
Laxmi translated for me. Her husband used to beat her; how
dare she provide not one but two sons with a chronic disorder for which there was
no treatment! He eventually left. They lived in poor conditions, and she
struggled to raise two boys. She thanks Save One Life and said she benefited
from the program and to keep it going a long time!
One father stood
and said, Our government won’t give treatment to us!  He said all
the hemophilia families are happy with Save One Life. They use the money for
school fees.
Mina has a son
with factor VIII deficiency; she is very happy with the support from SOL. Her
husband lives in another country, trying to earn money to send to them. So this
really helps her.
Then Nawraj, a
young man, 18, spoke: he said it was difficult to have
hemophilia during exam time (which is much more stressful in these countries
than in the US). He thank us for  Save One Life. He described his
pain, bleeding at night, and sometimes felt it was better not to have been born
than to be born with hemophilia. He lost a job due to so many bleeds. “Our
government has not recognized us,” he lamented, “because outwardly we look normal, so they
don’t pay us attention.” His speech was so impassioned about suffering. “You’ve been saving us,” he said. “It’s
because of you. I want to say more, but I cannot express it, the level of pain
I felt.”
Then Nawraj sang
a song that he composed. It was mournful, deep. Loosely translated, he sand, “I’m living alone, crying alone. Because of you, hemophilia…the pain is too much to bear! I’m sad, crying!”
And remember, on top of all this, these families have suffered through a tremendous earthquake that destroyed many of their homes! 
After all the
speeches came questions about hemophilia, which Ujol kindly answered. Then the ceremony:
we had gift bags for all the kids, courtesy of all the give-aways from NHF just
recently. Yes, I shamelessly confiscated about 50 bags from one homecare company, squeezy
toys for the kids veins from another.
The kids loved their
gifts. The older ones got t-shirts with hemophilia slogans on them (another involuntary
gift from yet another homecare company!). And each child received their annual
funds from Save One Life, about $240. For some this is a lot of money.
Then I gave a
speech! I started by asking what the highest mountain in the world was. Of
course they knew; it’s right in their country! Sagarmatha, better known in the
West as Mt. Everest. And I shared the story of a young American man with
hemophilia (Chris Bombardier) who plans to climb that mountain. We talked about
what’s possible, even without factor, and what’s possible with factor. Dreams,
goals… and never give up. I asked many children, What’s your dream? We went around the room asking each child: Engineer,
musician, teacher… they all had dreams. I told them we want to help make their
dreams come true.
Lunchtime was a
buffet of delicious local food: rice and chicken. The children played with
their new toys, and soon, the families dispersed happily. I too went back to my
hotel, happy, moved. Dedicated to these fine families.
Friday September 4, 2015
Today Laxmi
picked me up and we drove back to the NHS office, through the blackened air. The pollution in Kathmandu is deeply unhealthy; I often felt like I was hitched to an exhaust pipe. About 33% of the population wears surgical masks outside, and eventually I did too.
Inside the office was
a room full of wonderful, handsome young men, all ages 21-35. I was surprised
to see Deepak Neupane present; his eyes lit up when he saw me. I first met him
in 1999, when he was only 12 years old, and severely crippled. He became the
poster boy for WFH, and to this day they still use his image. He has
his hurts, is stoic, not overly friendly.  But Deepak is married. It was a happy reunion and he says he
remembers me.
One of the boys,
Raju, with a shock of dark hair, said, “Ma’am, I have to tell you this. You look like Barbie
doll!”  The boys all laughed.
I furiously took
notes as they spoke, while Laxmi recorded their names and ages. At the end,
when they had finished, I told them my name (they all knew) and said, And I am not going to tell you my age! And the
laughed in return. 
Durga Datta
Lamsal, age 27, a government employee, is the chair. He’s an impressive young man , soft spoken, a rising leader,
mature and responsible. I met Ashrit BK, who has an  inhibitor, 26 years old. He received a scholarship from us but is not attending now due to
bleeds. His left hand appears to have Volkman’s contracture.
John Bhuyel–who dared to sit in front of me with a NY
Yankees hat on–dreams to be a computer engineer and used my analogy from my speech about having dreams.
 I
learned that the Youth
Committee members are elected  with two-year terms. They organize a blood donation
camp twice a year. They are primarily social: sharing each other’s pain and what happens to each
other. They hold a Youth Camp annually, just the guys, usually for 5 days, and
they have lectures and do social things. This year they visited the mid-Western
region and had medics come lecture. 

 
When I asked if they did physical therapy at home, the whole room groaned and
eyes rolled. Oh, I hit a nerve. I felt like the mother asking her sons if
they made their bed or did their homework. Yeah, they know what to do but often “forget” to do it. Boys are the same the world over!
One sensitive
subject was marriage. In Nepal, arranged marriages are still common. What prospect
does a young man have to marry, when he is poor and disabled?  Jagatlal (“Monsoon”) is married but his was a love match.
They all agreed it was difficult; the girls often leave them when they see how
hard it is for them to have hemophilia. Krishna, a handsome young man with
large, soulful eyes, told me his girlfriend left him. It hurts a mother, all
mothers, to hear this about a young man.

To break the
increasingly somber mood, I brightly suggested a “Love Program” for the Youth
Group and they burst out laughing. How the Nepalese love to laugh!

Raju said Save One Life  helped him a lot. They were all very grateful for our
help.
At the end, we
shot some video of the boys telling their story of the earthquake, which was
emotional. Raju confided he was nervous (I think afraid of becoming too
emotional) and he talked on and on cathartically. His parents are
still living in a tent four months later.  
I learned that
they were coming back from camp when the earthquake struck. On the bus, they were
frightened; they saw people crying, and weren’t sure at first why. 
Then we did a
group shot, me and the boys. I gave them all my business cards, told
them they were the future leaders of the Society so learn leadership! And to be
mentors for the young ones, who need them. They presented me with a beautiful wall hanging of Buddha.
The NHS and I had a farewell dinner at 7:30 pm, and it was a relaxing end to the work week.  By 9 pm I was tired; we exchanged the gifts, and
Beda walked me from the hotel down to the main street so I could get a taxi. He
is disabled, and yet never complains. He rode in the taxi with me, so I would be
safe. He is a man of few words, but confided, You inspire me. I admire all your
work for all the people with hemophilia around the world.
Coming from him,
it was one of the highest complements I had ever received.
Saturday September 5, 2015
I awoke at 4:15
am, after waking up off and on since 10:30 pm, but it was overall a good sleep.
I hurriedly dressed. I pride myself on being
punctual and responsible. I tiptoed to the lobby, awaking the poor guys on duty
who were flopped on the lobby couches. And waited in the lobby for my ride. One
of the young managers, tall, thin and bespeckled, asked who I was waiting for? When
I replied The Mountain Flights tour, he said the ride was coming at 5:45
am
. I could have slept another whole hour!
Mt. Everest (Sagarmatha) in the background

I went back to
my room sheepishly, lay down and actually fell asleep at some point.  At 5:30 am,
back in the lobby, and the ride appeared. The trip to the airport was fast, and
the wait was until 7:15. Finally they
called our flight– Buddha Air 101, and I was hurried to the crowded bus which
took us to our plane. I didn’t expect much from a quick chartered flight but
the plane was pristine. We each got a window seat. Soon
we were aloft, and as we pulled away from Kathmandu, I saw the gray, dirty air,
which left the surrounding hills only blue silhouettes, become clearer and
cleaner, and the land becoming green with rolling discernible hills, dotted
with colorful pillow-candy colored houses. We were finally aloft, 22,000 feet
and within 20 minutes the Himalaya were in view.
There are no
words to describe how you feel. Your heart leaps with awe, with love for these antediluvian
guardians of the world, formed in the violence of the birth of a planet. The
first jutted straight up above the clouds like a sentinel, far away, like a
warning to be careful of the approach of the others. They almost seemed to have
personalities. They were majestic, powerful, magnetic. Then there were more and
more. I felt like I
was gazing upon the Gates of Heaven. 
A silence fell on the
plane as we stared at the snow giants. Soon, mighty Everest itself. Distant,
remote. I cannot  imagine what it could take to climb it and felt the urge to go to base camp some day!
When the mountains all
came within distance it was too much to process. The sharp drops, the edges, the
crevices, the seracs. One after another and another. Oh, they are just rocks,
but what beauty! What
spells do they cast over us that suddenly make us want to be there, climb them even
though we know we would put our life at risk?

All too soon we
had to return. That evening, I boarded Qatar Airways and left Nepal for the other side of the world.

See the full Gallery of photos of Nepal:
https://lakelley.smugmug.com/InternationalTravel/Save-One-Life/Nepal-2015/51907135_ww8cL6#!i=4344863638&k=3hmP65P

Great Book I Just Read
Savage Summit [Kindle]
Jennifer Jordan
K2 remains the most dangerous mountain in the world, with a death rate of 25%. Until 1986, only men had summited the Savage Summit. In this book, Jordan chronicles the lives of five women who made mountaineering history: the ones who summited K2. Ninety women have scaled Everest; of the only six women who summited K2, three lost their lives on the way back down. I worried about this book being a glorification of women who climbed K2 (Alison Hargreaves was mother of two children under age 6 who died after summiting), as her sympathetic and rather feminist intro set the tone. But I was impressed that Jordan shifted into journalist mode and objectively examined the lives, loves, passions and mistakes of these unmistakably courageous, complex and yet sometimes myopic, women who were compelled to risk their lives… and often lost their lives in pursuit of a dream. Four/fives stars.

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