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Saturday, August 17, 2013

The Walking Gallery Year Three: June 5, 2013- June 16, 2014


This is the third year of the Walking Gallery of Healthcare.  We now number 296 members walking around the world with patient story Paintings on our backs.  

This "walking wall" is changing minds and opening hearts.  They are attending medical conferences where often there isn’t a patient speaker on the dais or in the audience.   They are providing a patient voice, and by doing so, are changing the conversation.

An artist or artists will interview medical professionals and lay individuals to form a patient centric narrative. The artist will then create representational imagery and paint that picture story upon the business jacket of the provider of the narrative account. The provider of the patient story aka “Walker” will wear the jacket to medical conferences and events in order to disseminate the patient story to a large group of policy minded attendees and to represent the individual patient voice in venues where they are underrepresented. Further, both artist and Walker will support the spread of the story and image via social media.


As of July 2014 , 296 unique Walkers have joined the Gallery wearing 328 jackets.  The Gallery has representatives on five continents, but the majority of Walkers reside in the US. One artist creates the majority of the art, but new artists are joining the movement.  The Gallery is promoted heavily on twitter, facebook and personal blogs.   Its widening appeal within the health conference community is creating a new space for patients at such events.


Year Three

328."Staying on the Path" a jacket for Tom Krohn
























327. "Grapefruit" a jacket for Angela Radcliffe

























326. "Reaching the 1/3" a jacket for Susan Cantrell
























325."Questions" a jacket for Harlan Krumholz
























324. "The Depth of Understanding" a jacket for Fred Masoudi

























323. "Question, Measure, Personalize" a jacket for John Spertus

























322. "Blended Hearts" a jacket for Melissa Ariate Jarvis
























321."Superheroes" a jacket for Jane Englebright


























320. "Hospitality" a jacket for Richard Corder

























319.  "In Need of Traction on the Slippery Slope" a jacket for Mary Beth Navarra-Sirio
























318. "Connected" a jacket for Todd Rowland

























317. "Open Minds" a jacket for Amy Fellows


316.  "Shared Decision Makers" a jacket for Marilyn Mann



315. "Quantified Truth" a jacket for Rajiv Mehta

314. "UPP" a jacket for Melissa Stewart




313.  "Whole Cloth" a jacket designed and painted by Courtney Mazza and Regina Holliday for Christine Bienvenu. 



312.  "Six Until Me" a jacket for Kerri Sparling



311."The Hats we Wear" a jacket for Danny van Leeuwen 


310."Wounded Healer" a jacket for Susan Eller


309. "We Got a Mystery to Solve" a jacket for Mary Anne Sterling






308. "Loving Father" a jacket for Leila Samy




307. "This is Personal"  a jacket for Brian Dixon


306.  "Training the Brier" a jacket for Catherine Costa





305. "Pop Pup EMR" a jacket for Kim Ball



304. "The Secret Garden" a jacket for Getta Nayyar






303. "The Shepherdess Path" a jacket for Karen Hein 




302. "Rx Redux" a jacket for Loran Cook by artist Jessica Nicula





 301. "Surmounting the System" a jacket for Troy Abshire, Sr. Artist by artist Jessica Nicula



300. "The Rolodex" a jacket for Cathy Collet



299. "65 Roses" a jacket Erin Moore





 298. "Analyzing Whispers" a jacket for Suzanne Carter



297.  "Gown of Tears" a jacket for Amy Edgar



296.  "Regrounding" a jacket for Lori Marx-Rubiner



295. "Passing Notes" a jacket for Wendy White




294. "Fixing Isolation with mobile." a jacket worn and painted by Vera Rulon



293. "Happiness" a jacket for Mike Riz

"Happiness" a jacket for Mike Riz


292. "Pieces Falling Into Place" a jacket for Mary Cattolico Camp

"Pieces Falling Into Place" a jacket for Mary Cattolico Camp

291. "From Sacred Vows to Cash Cows" a jacket for Laura Kowlaczkowski

"From Sacred Vows To Cash Cows" Laura Kolaczkowski

290. "Connector Man" a jacket for Jerry Matczak

"Connector Man" a jacket for Jerry Matczak


289.  "Listen" a jacket for Catherine Wilhelmy

"Listen" a jacket for Catherine Wilhelmy


288.  "Beyond the Business Suit" a jacket for Gillian Cappiello

"Beyond the Business Suit" a jacket for Gillian Cappiello



287. "Apples to Oranges' a jacket for Jim van den Beuken

"Apples to Oranges" a jacket for Jim van den Beuken



286. "Threshold Choir" a jacket for Ellen Rose

"Threshold Choir" a jacket for Ellen Rose

285. "Growing This" a jacket for ken Dobuler

"Growing This" a jacket for Kenneth Dobuler

284. " Where it all Began" a jacket for Jim Kinsey

"Where it all Began" a jacket for Jim Kensey


283. "The Path We Choose" a jacket for Marie-Michele Brodeur

"The Path We Choose" Marie-Michele Broduer



282. "The Rod at Our Back" a jacket for Catherine Crock

"The Rod at Our Back" a jacket for Catherine Crock


281.  "Anything I Put My Mind To" a jacket for Cathy Desautels

"Anything I put my Mind To" Cathy Desautels



280. "Missing You" a jacket for Carol Wahl

"missing You" a jacket for Carol Wahl


279."A Note at the Close" a jacket for Sue Ribaudo

"A Note at the Close" and jacket for Sue Ribaudo



278. "Presence" a jacket for Marie-Claude Poulin

"Presence" a jacket for Marie-Claude Poulin


277. "The Story of David and Annie" a jacket for Rob Sharrow

"The story of David and Annie" a jacket for Rob Sharrow

276. "The Pattern of a Life" a jacket for Kate Munger

"Pattern of a Life" a jacket for Kate Munger


275. "This is Love" a jacket for Susan Frampton

"This is Love" a jacket for Susan B. Frampton



274."Leading the Way" a jacket for Alex Fair
'Leading the Way" a jacket for Alex Fair



273.  "Round and Round and Round" a jacket for Richard Anderson

"Round and Round and Round" a jacket for Richard Anderson



272. "Zoe's Dream" our first honorary member of The Walking Gallery: Zoe
"Zoe's Dream" a jacket for Zoe

271. "Hospice Road" a jacket for Camea

"Hospice Road" a jacket for Camea

270. "Naked Thoughts" a jacket for Dana Lewis

"Naked Thoughts" a jacket for Dana Lewis


269. "Solving for X" a jacket for Catherine Rose
"Solving for X" a jacket for Catherine Rose



268. "Graduations" a jacket for Denise Theil
Denise Theil's jacket "Graduations"


267. "Following Orders" a jacket for Phyllis Goetz
"Following Orders" a jacket for Phyllis Goetz

266. "Save Me" a jacket for Danielle Swift
"Save Me" a jacket for Danielle Swift
265. "Hero's Journey" a jacket for Eileen Propp painted by Amy O'Hanlon

"Hero's Journey" a jacket for Eileen Propp painted by Amy O'Hanlon
264. "Banksy Heals Max" a jacket painted and worn by Chris Chan

"Banksy Heals Max" a jacket painted and worn by Chris Chan


263. "Making Me Believe" a jacket for Tracy Walsh

"Making Me Believe" a jacket for Tracy Walsh

262. "Drawing to a Close" a jacket for Alan Manning

"Drawing to a Close" a jacket for Alan Manning

261. "Helping Him to Fly" a jacket for Kimberly Gould Crawley

"Helping Him Fly' a jacket for Kimberly Gould Crawley

260. "Better Together" a jacket for Bruce Ramshaw

"Better Together" a jacket for Bruce Ramshaw
259. "Picket Line" a jacket for Steven F. Horowitz

"Picket Line" a jacket for Steven F. Horowitz

258.  "The Landscape of a Life" a jacket for Donna Cryer

"The Landscape of a Life" a jacket for Donna Cryer

257. "Lab Power" a jacket for Lisa Donnarumma

"Lab Power" a jacket for Lisa Donnarumma
256. "Silent No More" a jacket for Alice Mwongera
"Silent No More"a jacket for Alice Mwongera


 255. "My Chickens" a jacket worn and painted by Adalyn
"My Chickens" a jacket by Adalyn

254."Fly Space" a jacket for Colin Hung

"Flyspace" a jacket for Colin Hung

253. "The Highest Double" a jacket for Ian Eslick

"The highest Double" a jacket for Ian Eslick

252. "Shift" a jacket for Nick Van Terheyden

"Shift" a jacket for Nick Van Terheyden

The Artists of The Walking Gallery:

1. Regina Holliday 295 jackets
2. Isaac Holliday 6 yrs, 1 jacket
3. Becca Price, 1 jacket
4. Miriam Cutelis, 1 jacket
5. Ess Lipczenko, 1 jacket
6. Ben Merrion 1 jacket
7. Courtney Mazza 6 jackets
8. Michele Banks 1 jacket
9. Megan Mitchell 15 yrs 1 jacket
10. Robert J. Filley 3 jackets
11. Anita Samarth 1 jacket
12. Mary Welch Higgins 2 jackets
13. Richard Sachs 2 jackets
14. Jonah Daniel 5yrs  1 jacket
15. Fred Trotter 1 jacket
16. Leela 7yrs 1 jacket
17. Gayle Schrier Smith 1 jacket
18. Moira Simms 1 jacket
19. Joan Holliday 1 jacket
20. Adalyn 1 jacket
21. Chris Chan 1 jacket
22. Amy O'Hanlon 1 jacket
23. Vera Rulon 1 jacket
24. Jessica Nicula 2 jackets

If you would like to join the Gallery please find further instructions below the pictures of jackets of year three.

Here is a short film on the DC inaugural Gallery event:

to understand the origin of the idea.

http://reginaholliday.blogspot.com/2011/06/walkers-oath.html to understand the sacred nature of this path

To view the jackets in year one 1-162

To view the jackets of year two 163-251

Logistics of the Walking Gallery:  What you need to do to be a member: 

1.  Promise that you will wear this jacket to conferences and public events at least 2-3 times a year in order to spread awareness of the power of the patient voice.

2.  Send a business jacket. Please do not send jackets made of seersucker, corduroy, knit, denim, leather or stretch fabric, as they are hard to paint on.  Also this is a business jacket on purpose, we are painting on the “uniform” of the conference attendee.  Fabrics that work well are poly-blends, linen, cotton and wool. Also you might want to by a jacket a size larger than you usually do as the painting will stiffen the back and make it harder to close the buttons. 

3.  Tell me your patient story or patient-centered concept that is the center of why you work in health and medicine. Please send via email with some pictures if possible of yourself or the people in your story.  If you don't want to provide a picture, that’s okay, I have a vivid imagination.  Also please print it out and send with jacket so I can keep track of jackets and their stories.

4.  Artists can participate by painting their own jacket or another's or both.

5. This movement is spread through social media you will need to use facebook, twitter, LinkedIn, etc. to support the mission. I am using Twitter hash tag to link us all together so please tweet about your jacket appearances under #TheWalkingGallery

6.  You are free to use the image in your own advocacy mission; I also retain the right to reproduce the image for advocacy purposes. 

7.  Donations are welcome to offset the cost of paint and shipping, but are not required and you cannot buy a jacket painting.  You are joining a movement and this is a sacred oath to walk the walk and spread the word.

Welcome to the Gallery.

Any questions?


Wednesday, August 14, 2013

#MergeLive


If you visit the corporate offices of Merge in Chicago you will see a well designed space with a touch of candy.  You will see modern tech next to vintage video games.  As wandered around their offices I made the connection, “Oh, I have been in your booth at trade shows!!! You have the candy and the games!  You are the ones that just offer a space to eat and play rather than the hard sell.”

I wondered aloud if they understood the feeling they were evoking in attendees.  Patient or provider, we were once all children.  We once had very little freedom and very little money.  When we infrequently had the freedom and opportunity to spend what little we had our choice was usually between video games or candy. 

So within Merge, a company that specializes in the exchange of digital medical images, we are reminded of the freedom and choice of youth and to choose wisely.

I feel like I attended the Merge conference twice because of the novel way the event was created. 

I flew to Chicago and on August 5th presented a keynote speech in front of the Merge internal staff.  My speech was filmed and edited to include the slides. Then the speech was presented during #Mergelive via live stream on August 13th.

Now if you follow my work, you know I paint the conferences I attend.  This was the first time I live-painted a live-stream.  I painted throughout the morning while listening to the other speakers. 

I heard about the Merge Honeycomb Image Sharing and pondered the deep symbolism within that image.  Merge works with radiology departments to quickly and securely transmit images.  This is a big deal for patients.  All too often over-testing can occur when images are not quickly made available within the care environment.  Patients are exposed to additional radiation through unnecessary tests without timely access to such data. 

If we are watching for the first signs of radiation harm, we need look no farther then the bees. 



So within the painting #MergeLive I painted honeybees upon the honeycomb.  I placed a patient in the center.  Her back is to the viewer as she ponders her few coins and looks upon candy machines.  These machines rest upon the spiral of a DNA double helix. 


To our patient’s right a series of video games are displayed with names like Cerner, Surescripts and Epic.  Here is the background service provider the patient does not see; but these venders are a large part of making image access a reality.

After my speech was streamed, I took part in a 40 minute QandA in the internal chat network.  I also tried to tweet as well.  There were very few people tweeting and that made me somewhat sad.   The reason given was many of their facilities blocked social media sites.  So I tweeted:

This caused a rousing debate on privacy and security vs. sharing in the internal chat.  I think a lot of the IT folks did not know what to think of me and my e-patient brethren.  How could we assign such low value to keeping our data private?

I wish all of my twitter friends could see the comments back and forth upon that topic, but it was a private chat.

I enjoyed #MergeLive, but next year I hope they jettison the internal chat and embrace the hashtag. 

Let’s open up, let’s share and let’s do that publically.



Monday, August 12, 2013

Patients Included


Patients Included

In September of 2011 ePatient Dave asked me to paint a painting depicting his concept of "let patients help."  I painted a painting of patient on stage before a crowd.  This was a nameless patient that existed in my mind.  The painting was not a good fit for Dave but upon second and third glance I realized it looked a lot like Lucien Engelen.  

I learned about Lucien’s campaign to include patients at every conference back in 2012.  He wants patients included in the design phase, attending the event and then on the stage.  If a conference is willing to do that they can use the patients included logo on their event. 

Today I read that through Lucien’s tireless efforts and others like him a Dutch conference was held at which 100 of the 600 attendees were patients!

I salute you Lucien!! So I updated this painting to include Lucien's current beard and glasses and will happily send it on to his home in the Netherlands.

Patients Included

Thank you Lucien from all of us!

Saturday, July 27, 2013

Power Suit


The other night at dinner my youngest son Isaac said from the depths of his seven year old wisdom, “A human is the only animal that wears clothes.”  He then went back to chewing his food as I nodded in agreement.  Clothes and the adornments we place upon them say so much about the person.  They can place a person on an economic scale and give a sense of belonging.  Clothes can mark us as different and rebellious.  If an outfit is strong and becoming it may be called a “Power Suit,” as though the clothes can make the man.

I think its works the other way within The Walking Gallery.  Recently I painted a jacket story for Ian Eslick.  Ian plans to wear that jacket for his dissertation defense at MIT.  Ian is really smart, as in getting a doctorate from MIT smart; but Ian does not flaunt his mental abilities.  He speaks from a patient view as he talks of data aggregation and the possibilities if we harness the power in patient reporting within scientific research.

The painting for Ian is entitled: “The Highest Double.”

"The Highest Double" a jacket for Ian Eslick

In this painting, I placed Ian, his mother-in-law and his two twin daughters.  They are playing a game of Mexican Train.  Have you played Mexican Train?  I love it.  I love it because it looks so hard at first but it is so easy.  Someone had the brilliant idea to color code the dominoes.  Each color is also a number, so seniors, children and parents can all play.  I learned to play this game with my in-laws.  I told my boss at the toy store we should carry it.  He brought it in reluctantly.  He said it wasn’t a very hard game, why would anyone want to play it?  I told my boss it had some good addition drill and it was fun, but most important of all anyone could play.  So if you look closely at these dominoes you will see they begin to morph from regular dominoes into patient reported diagrams.  How can a chronic condition be affected if we remove one agent of causation and compare outcomes?  What if we start comparing patient populations and look for doubles?  Look for patterns? Think of that train of knowledge. 

You see Ian is looking for that highest double.  He is looking at entire patient populations just as you or I would look upon a pile of dominoes.  He is looking for the match, the pattern, the train.

You might notice coins are laid upon this table (you also might notice they equal 73 cents).  My family uses coins as markers when we play Mexican Train.  If a coin is placed upon my domino track, I am unable to play on it and it becomes a train held in common.  Anyone can play on it.  In the game upon this table all trains are private.  Ian has a train and his two daughters have trains.  That final train with its foreshortened perspective facing the viewer; whose train is that?  It is yours.  It belongs to all of you who look upon Ian’s jacket.  You are welcome to join this game of data. 

Finding a match

Ian wants you to play.  

Sunday, July 7, 2013

The View From Below


The public comment of Regina Holliday on 

“A Prototype Consumer Reporting System For Patient Safety Events”
(I have placed the slide image below in many of my speeches since September to encourage people to follow your work on this.)





Dear AHRQ Desk Officer and Doris Lefkowitz,

I have spoken at length these past four years since the death of my husband Frederick Allen Holliday II about the need for the patient/family caregiver to have real time access to the electronic medical record and the need for a national abuse telephone number/website for the reporting of harm.  We desperately need this because there are always two sides to every story.   As today is Sunday and the last day to report comment I will tell you this story.

As a child I would sit beside my mother in Church and draw. I know it is important to pay attention in Church, but I thought God would not mind if I drew pictures from the Bible.  Eight years ago my son Freddie began drawing in Church. During one service, I looked down to see a peculiar picture on his drawing pad. The picture consisted of a series of small houses lined up along the bottom of the paper. Above the houses stood stick people and fish in the sky. Along the very top of the page was an elongated oval. I was stumped trying to figure out the meaning of this image. In my best Church whisper I asked, “What are you drawing?”

He looked at me as though I was being particularly dull and said, “Noah’s Ark…from below.”

I have seen many versions of Noah’s Ark in my life; but for the most part each picture contains a boat, animals, sunny blue sky and a rainbow. I never saw a picture of what lies beneath until Freddie’s drawing. I guess it is just a matter of perspective. Both images are equally valid and each focuses on a different part of the story.

Healthcare up to this point has been very blue sky focused.  I commend you for your attempt to help us show the view from below.

I thank you for your request for comment on a Prototype Consumer Reporting System for Patient Safety Events.  It is nice to be asked our opinion on such a important topic.  I read your proposal.  The language is a little hard to follow but to sum up:

The Agency for Healthcare Research and Quality (AHRQ) to request that the Office of Management and Budget (OMB) ask for approval of an information collection project: “A Prototype Consumer Reporting System For Patient Safety Events.”

Patient Advocates heard about this first in September of 2012 and had 60 days to comment, most of us missed this window, as it was not well publicized.  AHRQ did get 45 comments and 65 personal stories in those 60 days.   The project hopes to design and test a system that collects reports of harm using standard definitions and forms.  Local providers can then use this data “to create or enhance their own local reporting systems.”

Now that clause bothers me a bit because a lot of us have already been reporting harm to our local providers and either getting no response or getting the response that our harmed loved ones were treated “within the standard of care.”

You mention that most healthcare systems do not ask for nor promote patient reporting of harm.  I would respond it has been rarely in their financial or workflow interest to do so.  You mention AHRQ is aware of the important and unique perspective of the patient/family caregiver.  I would hazard to say that you recognize it because you are looking at the entire web of care throughout the US.  You see the value in data aggregation from a wide variety of sources.

So it is the best interest of this study to consider large regional or national harm reporting.  We have suffered through the voluntary local provider method for far too long. 

(According to your letter, this research has the following goals)

1. To develop and design a prototype system to collect information about patient safety events.

Great! Let us know how we can help!

2. To develop and test web and telephone modes of a prototype questionnaire.

I would highly recommend you look at what Traitwise.com is doing in the survey world to see a system that has ease of use foremost in mind.  Also please get some folks that are well versed in plain language to look at your word choice.  The problem of being so well staffed with academics and researchers is that your word choice often reflects your worldview.

Also pictures and visualizations can be very helpful in creating greater understanding of the event intake form online.

3. To develop and test protocols for a follow-up survey of health care providers.
This demonstration project is being conducted by AHRQ through its contractor, RAND Corporation, with Brigham and Women's Hospital, Dana Farber Cancer Institute, and ECRI Institute…

Now, I am a mite concerned about the part where you talk about checking a patient report of harm against provider’s incident log. I personally saw a great many incidents of harm that occurred to my late husband while hospitalized but were not reflected in his medical record.  In some cases this was omission in some cases blatant falsifications were recorded.  Are you using the medical record to substantiate reporting of incidents?  If so are you enquiring whether the patient and family caregiver were able to read the record in a real time fashion and able to amend errors in the record?

Those are my most pressing concerns right now.  Please do reach out to us in the world of patient advocacy to help in the next phase of this project. 

I must confess when I think of your organization in my mind I do not see AHRQ but an Ark.  I see a promise to gather data in a kind of binary 2 by 2.  I see a willingness to spread the knowledge that comes from that data.  

Thank you for reaching out to all of us known as “the harmed.“  We will willingly share our saddest moments, our deepest hurt if by doing so you can promise it will never happen again.  

We want to join you in building a rainbow, a spectrum of the many views in health care.

Regina Holliday,

Patient Activist and Artist, Founder of The Walking Gallery in Healthcare




Thursday, July 4, 2013

Thank God for Mississippi


I have attended quite a few medical conferences over the years where health professionals from states that are struggling to improve their healthcare ratings remind the crowd that they may be bad, but Mississippi is worse.  They may be 48th out of 50 on obesity levels, diabetes care, low birth weight; but they end their speech with: “Thank God for Mississippi!” 

These words draw a chuckle from the crowd because Mississippi ranks last or ties for last on rating systems.  United Health Foundation and The Commonwealth Fund both place Mississippi as having the worst score on numerous measures and Mississippi has held this position for over 10 years.

So I was very glad when Cheryl Hamill, RN MS Clinical Outreach Coordinator from UMMC School of Nursing in Jackson, Mississippi reached out to me.  Dave DeBronkart recommended me as a good choice of speaker for a potential keynote speech.  The focus of this event would be heath literacy. She thought my background and health mission focus would be a good match for the needs of their mostly rural and very underserved population.

Now with most busy conference planners after this initial outreach and securing my agreement to present, the planner would hand me off to a subordinate.  Cheryl is not like most conference planners.  She kept me in the loop through two very informative planning conference calls with the speaking team.  She communicated changes and new ideas through 177 emails in a six-month period.  She friended me on Facebook and I began to know her as regular person.  She joined twitter and began to tweet.

She was very organized and willing to try new things, which is such an unusual combination.  Upon hearing my explanation of the importance of twitter in patient advocacy and the power of using twitter hashtags in communication during a conference, Cheryl decided to encourage all attendees to open twitter accounts prior to the event and raffle several prizes only eligible to those who “live-tweeted” the event.  She even helped organize a pre-event tweet chat focused on how to “live tweet” a conference.  I provided twitter guidance online as well as through a 1(800) number Cheryl set up just to facilitate tweeting.

Cheryl did not stop there. When I suggested we complete the conference by hosting and “unconference” session, she wholeheartedly endorsed the idea.  So Bonnie Westra PhD, Associate Professor University Of Minnesota and I would teach the concept of open space to 89 unconference virgins in a little less than two hours. 

That is what I call a brave conference planner.

On Monday June 17, 2013 we would meet just outside of Jackson Mississippi and discuss health literacy in this state.  Our day began with Libby Mahaffey, PhD, saying opening remarks focusing on Cultural Awareness & Health Literacy...the Journey Continues. Next we would hear from Deb Washington, PhD, RN, Director of Diversity-Patient Care Services, Massachusetts General Hospital. Deb was an amazing speaker.  Her power point deck had a crisp easy to read large font and she expounded on the difference between the Democrat belief in system design and Republican philosophy of individual responsibility within healthcare.  She also showed us an advertisement from her Sky Mall magazine that informed travelers how to pack a suitcase with a built in compartment checklist for every need.  We need this kind of organization in healthcare, she told the crowd.

Next Tonya Moore, PhD, RN, Chief Learning Office, UMMC spoke about Mississippi county health rankings and spoke in-depth about internet access within the state.  She would soon introduce me and I would find out that she is the grand niece of Medgar Evers.  She mentioned my mission focus of improving patients’ rights in relation to the history of civil rights.  I was so very honored.

This was a special day for a keynote.  This day was the fourth anniversary of my late husband Fred Holliday’s death.  I could think of no better a crowd to share our personal story with on such a day, for I was in a room of those who had suffered and they understood pain.

When Terry Davis, PhD, Professor LSU Health Science Center began to speak she had the most amazing videos to share of patients with low health literacy being interviewed.  One of the most poignant was of a young mother who did not know what a milliliter measurement was when dosing her children with ibuprofen.  We also heard an elderly lady tell us she never bothered to read the warning labels.  (On one of her bottles of medication she was advised not to drive and she had driven to the appointment)

Then I began to paint “The View From the 50 Foot Patient.”

The view from the 50 foot patient

The title of this piece was based on a corporate phrase and a B-movie title.  I have been to quite a few events where I hear the phrase “Let’s take the 50,000 foot view.” I must admit I want to roll my eyes, because if you are taking this view you are in a highflying jet and way out of sync with those of us living in the daily grind of healthcare.  I also felt a kind of exploitation of the b-grade movie when we watched the videos of those with poor health literacy. It made me think of the poor heroine of that film when no one would believe her due to her past history of alcohol abuse.   So our lovely patient kneels down dressed only in a banner of drug warnings like some contestant in a pageant no one ever wishes to enter.

 this banner

Behind her is a cloud of warning based upon the presentation of Melissa Stewart, DNP Faculty of Our Lady of the Lake College.  She showed us her UPP (Understanding Personal Perception) to gauge a patients understanding using the image metaphor of a range from a bright sunny day to a deeply cloudy sky.

Melissa's clouds

The second painting is based on the presentations of the second day especially Jonathan Vangeest, PhD, Chair Department of Health Policy and Mgt., Kent State University College of Public Health.  This painting is called “Altar Call."

  Altar Call ”

In this conference, unlike may others, the conversation of faith in was concert with questions of health and we benefited greatly from such dialog.  We also heard the powerful story of Jonathan’s medical history.  He was a promising student with an engineering bent when he was working in a workspace that all equipment was being sealed with a toxic sealant.  Due to his hours spent in such an environment Jonathan suffered frontal lobe damage, which resulted in life long epilepsy.  So within this painting a young Jonathan stares out of a stained glass window with the supervisor wearing a gas mask.  Jonathan also spoke about the marketing of McDonalds and how they used a friendly clown to convince children to come and bring their parents to eat at McDonalds.  So within the painting’s shadows I worked in an arched M and the clown’s face.

  the clown

To the left is another M.  It came from a speaker’s story about a local public health group that wanted to reach out to the “Mexican” population in their community.  They built an entire health literacy program in Spanish.  When they went to the community they realized the residents were Mayan not Mexican.  I finished this painting quickly as I need to help Bonnie host the unconference session.

Mayan

The unconference session was marvelous with 9 different individuals pitching sessions. I was able to host a session on how to crowd fund in healthcare, introducing the attendees to the wonders of Medstartr and HealthTechHatch.  It was great.  Bonnie was a wonderful facilitator making sure every session concluded when it should so the next could begin.

  Unconference

 But everyone in the room learned it is not over until it is over.  Then the raffles were won and I looked at the amazing reach of the hashtag on Symplur.  You can see the analytics here and the transcript here.

Cheryl

The conference day finished and I thanked Cheryl for inviting me and I thanked God for Mississippi, not as some trite phrase or laugh line within a speech to inform.  No, I thank God for Mississippi.  I thank God as Jesus would.  For in the parable of healthcare Mississippi would be the tax collector, the poor widow, the leper and Jesus saw the greatest hope with such as these.   

The folks in Mississippi know what it feels to be the lowest of the low and from there anything is possible. Thank God for Mississippi.

"Independence Day"


My children often laugh at my rather empty cache on iTunes. For a very long time I had downloaded only one song and that was Martina McBride’s “Independence Day.” If you need a refresher on that song you can hear it here and the refrain is written below:

“Let freedom ring, let the white dove sing
Let the whole world know that today
Is a day of reckoning.
Let the weak be strong, let the right be wrong
Roll the stone away, let the guilty pay
It's Independence Day.”


Last 4th of July, I listened to that song in continuous rotation all day as I painted Julia Hallisy’s jacket: “Independence Day.”

Independence Day a jacket for Julia Hallisy

Julia Hallisy is one of the stalwart defenders of patient safety in this nation.  Today I want people to realize how much she and her family has been hurt by the current care system.

Julia’s Father’s Death:

Tony Bajone

Julia’s journey into healthcare harm began with her father Tony Bajone (legal name was Julius George Bajone) in 1988.  Kidney stones were bothering him and went to the VA in San Francisco for treatment.  It was determined that he needed surgery and pre-op studies were done, including a chest x-ray. Since he was a smoker, Julia asked his doctor if the chest film looked ok and was told the results were fine.

Nine months later Tony started coughing up blood.

A first year resident told the family that it was shame that they hadn't followed up with the chest film results. Julia was stunned and asked what the film had shown.  The results had shown a large mass in his lung. The radiologist had written a report saying follow up would be needed immediately.  Tony’s lung cancer that had gone untreated and at this point was terminal. Julia requested Tony’s medical records and the radiology report was not included. The VA said it was "missing" or didn't even exist. Julia went to the medical records department and told the staff that it did indeed exist.

They miraculously found it.

Julia’s Sister’s Death:

Donna Bajone

Donna Bajone, Julia’s sister, was born with a congenital heart condition that required surgery as a child. At the age of 25 she developed an irregular heartbeat. Donna went to Stanford University where she had been receiving care since she was 2 years old.  She had no health insurance.  Donna was too old in 1992 to be on her parents plan. (This lack of access has been addressed in the Affordable Care Act or what some folks call Obamacare) The bank she was working in kept her work schedule just below the number of hours to get insurance.  Stanford did place a pacemaker in Donna on an emergency basis, even without the insurance. They released her in a few days and the facility requested she get on welfare if she wished to receive any additional care. Donna continued to experience an irregular heartbeat and several calls to Stanford did not help. They would not see her until the insurance or Medi-Cal coverage was available. 

She died in her sleep less than a week later.  Julia and her family tried to get access to Donna’s medical records after her death and they did not receive them for months.

Julia’s Daughter’s Life and Death:

Kate Hallisy

Kate Hallisy died of Cancer at 10 years of age.

In 1989 five-month old Kate was diagnosed with bi-lateral retinoblastoma, which means she had malignant tumors in both eyes.  This is usually a very treatable form of cancer, but things did not go well for little Kate.  At 18 months Kate underwent surgery to remove her right eye.  She had her right leg amputated in 1997 due to bone metastasis.   In her last months the cancer spread into her brain.  All throughout the family’s 10-year struggle they fought for appropriate care often finding themselves at odds with their insurer.  In addition to being the caregiver of a very sick child, Julia would become the communication channel between the doctors and insurance; all while maintaining her dentistry practice.  As the cancer spread they would have to fight for appropriate drugs to maintain a quality of life as Kate’s small body filled with cancer. 

They even had to fight for access to an oxygen machine in Kate’s last months.

Julia wrote a book detailing her struggle to provide care for her daughter and to help others in their fight entitled The EmpoweredPatient.

For this is a fight.

There are folks who wish to join The Walking Gallery and hope to get a “pretty jacket.”  Julia has this one.  It is filled with beauty and pain.  She has the weight of her family on her back.

I listened to “Independence Day” while I painted this because the pain she suffered is the same kind of terror as living for years in a home filled with abuse.  Trust me, I know, I have suffered through both and they feel much the same. 

Today is that day of reckoning.

This painting and my mural 73 Cents both contain the same quote from the Declaration of Independence:  “Experience hath shewn, that mankind are more disposed to suffer, while evils are sufferable, than to arm themselves by abolishing the forms to which they are accustomed.”

To suffer

I ask all who read this blog to write in your public comments supporting a need for 

A Prototype Consumer Reporting System for Patient Safety Events here.

We need a safe way to report harm and abuse in they system.  Please comment before July 8th.

Do it for me. Do it in the memory of Fred Holliday II. Do it for three generations of Julia’s family who did not get to celebrate this Independence Day.