Let's change the Face of health care

On May 27th 2009, I met a group of amazing people. We had a health 2.0 meeting hosted by Christine Kraft. On that day Fred was in hospice and my life was at a crossroads. I was still a wife, a toy store clerk, and a sometimes artist. In three days I would be placing my first mural in the medical advocacy series. I met that day a group of people who would support me as I entered a new life of an art/health activist widow. I met Cindy Throop, Susannah Fox, Claudio Luis Vera, Nancy Shute, Dave Debrokart (By phone), and Ted Eytan, MD.

And that made me think about Stephen King’s Dark Tower books.

If you have read the Dark Tower series you are familiar with the concept of Ka. It is described as a controlling force in our lives. Call it destiny or fate, or even call it God moments. It is the energy that brings us together on the path of our life. My husband Fred loved this concept so much that his screen saver on his computer endlessly scrolls, ”All things serve the Beam.” And within in the concept of Ka, exists the idea of Ka-tet. A Ka-tet it a group of individuals brought together by Ka. They walk same path of the beam towards the Dark Tower. They are one from many. In Stephen King’s Dark Tower books his Ka-tet consisted of Roland- the Gunslinger, Jake Chambers, Eddie Dean and Susannah Dean. They are on quest together. They are Ka-tet.

On May 27, 2009 I found my Ka-tet and the quest was called 73 cents. Towering on the table was my husband’s medical record. This was a very important book, for on the table lay the story of Fred. Here began our journey. How could we change the world and create patient centered care. How could we access the data silos that seemed do distant and inaccessible to patients and their caregivers?

For the past year we have all worked on this goal using our many talents and abilities. I have had the pleasure of speaking on panels with Ted several times. We are great together. The energy of the other makes both of us better. When the patient and the doctor work together as a team great things can happen. Last night I had the opportunity to co-present with Ted at Health 2.0 Stat in Bethesda. We spoke about the importance of the patient and goal of patient access. And reminded those attending that when we speak of patients we must not forget “the face of our father.” I came to speak about the ways art can effect change within medicine. I also came to talk about how books can save lives. And if failing that goal, how books can help a life have meaning.

Do you know this face? Do you know this name? He is not the patient in room 6218. He is not “unfortunate ym 39yrs old..” He is Frederick Allen Holliday II, Phd. He was a loving husband, a devoted father, a professor of film studies, and a great friend. He was hospitalized for 79 days with a diagnosis of kidney cancer.

I had the honor of being Fred’s wife for almost 16 years. He fell in love with me at first sight… twice. He first saw me painting a flat at OSU in the fall of 1992. He saw me from behind and my long hair was trailing down my back. He thought I was beautiful. I did not see him, and cut my hair short the next day. He met me again about a week later and we talked Stephen King. We both loved horror stories. My favorite was The Stand, and he loved the Dark Tower books. We were meant to be.

Do you know this face? Do you know this name? She is not “the wife in room unhappy with progress.” She is not “little miss A-type personality.” That is what Fred’s oncologist called me as I spent days trying to get access to the medical record. He told Fred, “that if little miss A-type personality wants information she should come to his office hours.” I did. He never stopped answering the phone, talking with his nurses and he never closed the door during my one appointment with him. This face is Regina Holliday. I paint myself in the picture. I am loving mother, an artist, and I was the wife to a great man.

I asked for weeks for access to my husband’s medical record. I was allowed to view an imaging report for three minutes by an internist. I am not sure I got much out of my three minutes, and he told me he wasn’t supposed to let me see the information at all. I went down to medical records to ask for a copy and was told it would cost 73 cents per page and I would have to wait 21 days. I have spoken about this event and blogged about it. I have often seen comments saying I must have not tried very hard to get the copy. I have something to say about that.

There is always a B story and an A story. My husband studied narrative and would have told you that. All the while I was trying to get access to Fred’s record I was trying get another very important book. When I realized the advanced nature of Fred’s cancer I began emailing my friend Deborah about Stephen Kings’s new book that would release in November- Under the Dome. She emailed the publisher’s rep, and he emailed the publisher. They got permission from Stephen King to print an advance galley. Fred was told he had tumors and growth on March 27th 2009. On April 7th 2009, I handed Fred a copy of a book that would not be available to the public for six months.

Thank God for that book. Fred read it during every transport for radiation. It helped him in his darkest hour. And thank God for the Dark Tower, for I would scream the words of those books over the train-rushing roar of the MRI machines. I was unable to get a copy of Fred’s record for many weeks to come. Once I had access to the record, I used it to create an easy to understand “facesheet.” That became the design of the Medical Facts mural.

Then three days after meeting Ted and all the rest of my new friends, I painted Fred’s Medical Record on a wall in a local Deli for all of our neighbors to see… Next, my new friends in the world of Health 2.0 began blogging about the mural. You can see their posts here, here, and here.

After spending a few weeks in hospice Fred was told he would need to go home. Our one bedroom apartment was too small for five people and a hospital bed so we would have to move. With the help of friends we moved on June 10th. Fred came home on June 11th. All of his Stephen King books were arrayed beside him. On the day he died we were still talking Stephen King. On June 17th he died. I thought of the Dark Tower and what Roland had said:

"I do not aim with my hand; he who aims with his hand has forgotten the face of his father.
I aim with my eye.
I do not shoot with my hand; he who shoots with his hand has forgotten the face of his father.
I shoot with my mind.
I do not kill with my gun; he who kills with his gun has forgotten the face of his father.
I kill with my heart."
— Stephen King (The Gunslinger)

On June 23rd I began painting 73 Cents- my personal Guernica, and no one would forget this face. I would use my eyes, my mind and my heart and vow to make health care better for us all. I painted 73 Cents from June 23rd to September 30th 2009. It is still there today, at 5001 Connecticut Avenue in Washington, DC. It is a monument to Fred and patients everywhere. And just like the internet, it advocates 24 hours a day, and you cannot tell it to shut up.

Soon you will see my newest painting Give Us Our Dammed Data at the Clinovations Gallery Show on 7-29-10. It shows 19 authors, and I wonder if you know their faces. I wonder if you know their names. I wonder… can we use our “Cognitive Surplus” and activate our “Consequential Strangers” to help “The Empowered Patient?”

These are the authors:
1. Sanjaya Kumar, Fatal Care
2. Jari Holland Buck, Hospital Stay Handbook
3. Janet Mitchell, Taking a Stand
4. Michael Millenson, Demanding Medical Excellence
5. Margo Corbett, The Savvy Patient's Toolkit
6. Sandra Gilbert, Wrongful Death
7. Trisha Torrey, You Bet Your Life, The 10 Mistakes Every Patient Makes
8. Dave DeBronkart, Laugh, Sing, Eat Like a Pig
9. Julia A. Hallisy, The Empowered Patient
10. Carolyn Oliver, MD, Cautious Care: A Guide to Patients
11. Elizabeth Cohen, The Empowered Patient
12. Sorrel King, Josie's Story
13. Lisa Lindell, 108 Days
14. John James, A Sea of Broken Hearts
15. Melinda Blau, Consequential Strangers
16. Clay Shirky, Cognitive Surplus
17. Martine Ehrenclou, Critical Conditions
18. Patrick Malone, The Life You Save
19. Evelyn V. McKnight, A Never Event

I have read many horror stories in my life, a lot of them were written by Stephen King. But these are the true horror stories. These people have taken their pain and anguish then condensed it into a book so others do not have to suffer as they did. In each book, you read about that horrible moment, when if only these people could have had real time access to the medical record, someone would not have had to suffer or die. It reminds me so of Stephen King. It happens often in his work. He warns the gentle reader, you could stop reading right now and pretend the story ended well, but often it does not end well. I have communicated with all of these authors via email. They want you to know their story. They want you to see their faces.

Do you wonder if it matters if someone hears the patient’s story? Do you doubt that working together we can create a better medical system?


On Tuesday the 13th 2010, I presented a speech at Health and Human Services about the importance of patient access to the electronic record during the announcement of the definition of Meaningful Use in the final rule. Politely, I echoed e-Patient Dave’s call to action- Give us our data. How did I get to speak? I spoke because a husband and wife who own a deli gave me a wall. A man who owns a gas station gave another wall. I painted and you blogged, tweeted, and posted on Facebook. We are all patients in the end. Together, let’s change the face of health care.


Check out this SlideShare presentation:

Let's change the Face of health care

View more presentations from Regina Holliday .

Better Care

Painting the piece: "Give Us our Dammed Data."
Originally uploaded by Regina Holliday

On Sunday morning, my son asked, “Mommy, are we going to Church today?” He looked around our living room at all the half-finished canvases and doubtfully said, ”We probably should stay home so you can paint.” Though I try to make it service most Sundays, sometimes I do stay home so I can finish a project. So Freddie’s question was not overly manipulative. But my defiant Mother gene kicked in and I said we were, indeed, going to Church.

I am very glad we did because the Gospel lesson was about Martha and Mary during a visit from Jesus. Here is the passage:

Now it happened as they went that He entered a certain village; and a certain woman named Martha welcomed Him into her house. And she had a sister called Mary, who also sat at Jesus’ feet and heard His word. But Martha was distracted with much serving, and she approached Him and said, “Lord, do You not care that my sister has left me to serve alone? Therefore tell her to help me.” And Jesus answered and said to her, “Martha, Martha, you are worried and troubled about many things. But one thing is needed, and Mary has chosen that good part, which will not be taken away from her.” Luke 10:38-42 (NKJV)—



It was very good to hear this lesson because it reminded me it sometimes important to stop the frantic doing and listen to what others have to say.

If you have been following my posts on Facebook or Twitter or have run into me in person in the last three weeks, you probably know I am preparing for my first Gallery Show at Clinovations in Georgetown (Please RSVP here http://clinovations.pingg.com/73cents ) The show is on July 29th, 2010. Currently, I spend everyday painting as I prepare for this event. I am running out of time, and yet I will stop work on July 28th to attend a forum. I will delay setting up my show to listen to some special people who are working to provide better care for all of us.

On Wednesday June 28th, The National Partnership for Women and Families and their Campaign for Better Care will host a Forum with of speakers. The event will be at 8:00 AM - 11:00 AM 
at
529 14th Street NW
13th Floor
Washington, DC.
If you'd like to attend this event you can RSVP online at http://www.nationalpartnership.org/site/Calendar?view=Detail&id=100323.

Here is a description of the event from their site:

“Improving the System for Delivering Health Care to Older Adults and Their Families
Join us on July 28 for breakfast and an enlightening and inspiring forum discussion among caregivers, patients, thought leaders and policy makers on how to best implement health reform and delivery high quality care to our most vulnerable patients older adults with multiple health conditions.
Special guests include keynote speaker Senator Sheldon Whitehouse, award-winning author
Gail Sheehy, UCLA Geriatrics Division Chief David Reuben, journalist and activist Jonathan Rauch, HHS Director of Delivery System Reform Peter Lee and heads of the three Campaign partner organizations: Debra Ness (National Partnership), Rob Restuccia (Community Catalyst), and Emily Spitzer (NHeLP). Other panelists include health care providers who are solving critical challenges and ordinary people with experience trying to navigate our health care system as patients and caregivers.”

I will be there. I will set down my brushes and I will listen. If you cannot make it in person please listen to the LIVE WEBCAST, July 28 at 8:30 at
www.CampaignforBetterCare.org.

There will be an author speaking from the heart about her own personal tragedy and there will be “ordinary people” speaking out about their trials and tribulations in the hope, that in so doing, they can effect change.

I have chosen the good part. I will listen at their feet.

I hope some of you will do the same.

"Meaningful Use"

On Tuesday July 13th, 2010 I was asked to present a speech at the Department of Health and Human Services representing the patient voice. This is the text of that speech.





I am artist, a mother and I was the wife of a great man. I know in a very personal way why patients need access to the electronic medical record. Last year at this time, I was painting a mural on a wall in northwest Washington, DC. I was a new widow, my husband had died of Kidney Cancer on June 17th. The painting was called “73 cents.” It depicted our family lost within a closed data loop, without access to information.

From January to March of 2009, my husband, Fred Holliday, went to his doctor a dozen times for pain. Each time he was sent home with pain meds and he never received an after-visit summary. He visited 2 ER’s with extreme pain and was sent home with pain meds each time. By mid March, Fred was taking four types of pain medication, two types of muscle relaxants and four types of laxatives and we had no diagnosis.

On March 25th, Fred was hospitalized for tests.
On March 27th the oncologist told my husband while he was alone that he had tumors and growths.

The oncologist then left town for four days.

My in-laws and I spent the next days begging for information from Fred’s doctors.
We were continually hospitalized and had no access to the written record. Fred suffered additional injuries due to a lack of communication between staff and a lack consultation with his record. After four weeks of enduring the utter horror of not knowing what is going on. I went down to medical records and asked for a copy of the electronic medical record. I was told it would cost 73 cents per page and there was be a 21 day wait. I was astounded. This was a state of the art hospital, yet they were asking us to wait 21 days and spend hundreds of dollars just to read Fred’s record.

The next day the oncologist said, “We are sending you home on a PCA pump.” The doctor left and we burst into tears. Fred turned to me and told me go after them and to try to get him care. We were transferred to another hospital five days later, with an out of date and incomplete transfer summary and records. Fred was denied food and pain meds. for six hours while the staff of the new facility tried to cobble together a medical record using a phone and a fax machine.

I eventually got a copy of Fred’s record and –despite its many errors– it became a virtual bible that we used to guide his care for the last 56 days of his life. There was not a day I didn’t reference it, and that information extended Fred’s life helped create a fragile peace within our hearts; for there is no greater sorrow then watching your loved one suffer while you feel helpless because you don’t have the information to know what’s going on. I don’t have a back ground in medicine, but I know enough to help. With access to his record, I could explain treatment options and help ease his mind.

This is why I paint. This is why I speak, so others will not have to suffer as we did. We are all patients in the end. We all deserve to be treated with dignity and respect. I will not stop, I will not give up, until we get change in this nation, until people get taken care of, and we all have the right to access our own information. Thank You.

e-Patient Ephemera

I will have an exhibition of my work on Thursday, July 29th at the Clinovations office in Georgetown. The Clinovations' mission is to: “Convene clinical leaders to share and create innovative solutions that improve the health of patients and support the healthcare system in the delivery of optimal care.”-(Clinovations website.) Not long ago I had the pleasure of speaking with some of their team, Dr. Ted Eytan, Dr. Trenor Williams, Anita Samarath, and Lygeia Ricciardi, about the blank white walls in their office. They inquired about the potential of hanging one of my patient-centered paintings in their space. The idea being that this would “incubate ideas for more regular patient involvement on the part of the consultancy as well as the clients”-(Dr. Ted Eytan.) I was all for hanging a piece in their space, but as we continued discussion the vision grew. We were all purveyors of social media: we like to share. Why just one piece, why not many? Why limit this to only Clinovations’ staff and clients? We could invite people from Gov 2.0, Health 2.0, the e-Patient movement, social justice groups and representatives from the arts community, as well as friends and family. A one-night art show was born. And what do you name a gallery show with the lifespan of a mayfly?

e-Patient Ephemera: 73 Cents meets the world of data capture.

Imagine an office suite usually filled with white boards, laptops and mobile smart phones, filled instead, with the 20 paintings depicting the current memes within health information technology. Imagine the ephemera of a life forming a brilliant mash-up of health information technology mixed within vibrant patina of patient rights.

I love the word ephemera. It feels like poetry upon my tongue. I love what it means: printed material not intended to be kept. Items of ephemera fill our life even in a digital age. We have ticket stubs, flyers, greeting cards, brochures, and business cards that we retain far past the point of their intended lifespan.

Anyone who has seen my art classroom knows that I keep everything. I am a collector of ephemera. I have every debate ballot I ever received, all of the letters my husband sent me while we courted, the playbill of every play we performed in, and a pile of paper bus transfers that span years. I love the ways ephemera can be incorporated within art to make a composition that touches an audience and depicts the meaning of a life.

I have a very important piece of personal ephemera. I have the medical record of my late husband. Sadly, from an institutional standpoint, it functioned as ephemera while he still lived. After I read my husband’s record, I asked the nursing staff, “Who reads this entire document?” “No one,” they said. “We only we only read the face sheet and most recent pages. “

For too many years the medical record has been viewed as only a billing document and a piece of daily medical ephemera. Hundreds of pages of vitals, imaging results, medical reconciliation and surgeries are distilled into the few pages that form a transfer summary. At each facility this process continues; each set of daily records entering the ether of a payment structure. A daily accumulation of data that will remain untouched by many if a lawyer and a potential lawsuit is not involved.

How did a document originally intended to facilitate communication and the medical history of a patient become a piece of billing ephemera? How dare institutions consign this living document a role as nothing more than a receipt of services rendered? With the advent of health information technology, the electronic medical record has the potential to leave its old role of medical ephemera and enter the virtual eternity of cloud based computing. Ah, the ability to create a lifetime electronic medical record consisting of transferable and actionable data is within our grasp. Or does this really matter?

Here is where that pile of bus transfers comes into play. From 2003 to 2008, I collected bus transfers as one of many types of ephemera in my life. My husband wondered at my behavior, but I told him I planned to do an art project with them. In January of 2009 my collecting stopped. The DC metro had decided to use to smart card technology for all transfers. No more free rides due to fingers covering the time expiration, no more handing off a transfer to a thankful stranger. Billing fraud was being dealt a heavy blow by technology. But in addition to facilitating better fiscal responsibility, Smart Card technology allowed Metro transit to easily track and study usage of transfers. The bus transfer had left the world of the ephemera and had entered the world of data.

We are on the cusp of that world within health information technology. As meaningful use is defined and people begin to adapt, we must guide these adapters of electronic medical record technology through the process and take great care to explain in such a way as to leave no one behind.

That is where the e-Patient enters the world of ephemera. An e-Patient is engaged, empowered, equipped and is an equal. E-Patients will take every tool available, be it information technology or medical ephemera; they will use these tools to change outcomes for the better. They are a bridging population that has a foot in both worlds. They are an amazing force that can effect adoption during this transitional time.

Today I experienced this struggle of transition within the microcosm of creating a post card invitation to my upcoming art exhibition. I spent the early morning talking back and forth within an email thread about the exact text and design of a paper post card. As we went back and forth on details, one person questioned why was I doing this in the first place. Was I actually going to mail this? I assured them I would mail some but I also wanted to post some in the neighborhood. Not everyone is using online communication.

This is a vital consideration as we push for access to the electronic medical record. We must communicate the need for a adopting this new technology in many ways. I paint to draw attention to the importance of adopting a transparent and accessible electronic medical record. Another way, I spread the word is by creating a postcard for this upcoming show. I am making a piece of e-Patient ephemera. I hope you can come to the show and see the art for yourself. And don’t forget to pick up one of the postcards while you are there--it will remind you of the importance of ephemera.

Rescue Me

Murch Elementary 5th grade Project Class of 2010
Originally uploaded by Regina Holliday

On Saturday, June 12th, I got the call. Could I help Murch Elementary Class of 2010 create their end of class project? Each year the departing class creates a gift for the school. It is often a painted bench or some type of art piece. The time and budget was severely limited. I would have to work with the children and create a piece in a scant three days. And these were not traditional days. These were the last days of school. They were filled with graduation rehearsals, field days and summer vacation induced absenteeism. This was an eleventh hour project. Would I be willing to help? They were crying, “Rescue Me!” at the proverbial last minute. But, I wonder if they knew I was the one being rescued? June 17th 2010 was the one-year anniversary of my late husband Fred’s death. Instead of pining or wallowing in sorrow, I was up to my elbows in paint and gel medium surrounded by happy children who had been classmates of my son Freddie.

Oh, I well know that can art assuage sorrow. I have had a hard life. It has never been easy. As child in fear and sorrow, I begged God to help me. “Please, rescue me,” I prayed. He did not take away the causes of my sorrow, but instead sent me Art. I painted, I drew and I coped.

I struggled in school. First grade was a blurry lack of understanding. I vividly remember my confusion about letters and numbers. I could not understand what they wanted. The teacher told me “A” was for apple. Great, I get it. A=Apple. No, I was wrong. She tried to explain phonics to me and I didn’t comprehend. I could not read nor write well, but I could draw. I would draw an apple and then she would understand. That plan didn’t work. On the last day of school she gave me a card with the pictures of bees buzzing by. It was a note that said I would have to return and repeat first grade. “I would bee back.” Even as a child, I abhorred the cheery monstrous tone of this note even though I could not puzzle out all the words.

I had flunked. My few friends were now in a second grade. This year my class was the over-flow first grade in the basement of the school. It was one of very few classrooms at that level. It was dark and smelled of must and mold. I could not help but feel this was some kind of punishment. Mid year our room was vandalized. The vandal that broke in poured endless ribbons of our school glue throughout the room. For the rest of the year, the chalkboard was challenging to use due to all the raised lines from adhesive. I still did not really understand reading and math. I would draw elaborate pictures of the concepts that the teacher spoke of. Perhaps if I could draw it, she would be pleased. She was not. I spent endless hours in the principal’s office … drawing.

When I would be released to recess, I would run immediately to the far corner of the playground. I would pick up the pieces of Oklahoma sand stone and methodically rub them against the concrete wall. At first, they were an inexpensive chalk. As rubbed longer, I realized I could sculpt the stones by rubbing them. I made primitive carvings this way. I still have one of them today. When I watched Steven King’s “The Shawshank Redemption” in 1994, I thought of the seven year old me trying desperately to stave off the loneliness and feelings of imprisonment by carving stones like a little Andy Dufresne. Stone carving takes a long time. It is an art form adopted by those who measure time in weeks and days not minutes or hours.

As if school was not enough anguish, my father was torturing me at home. With words and belts and switches, he was making every day a private hell. I wondered what I had done wrong to suffer so. It is hard to be seven years old and wonder if you were going to die. Yet, I could draw, and God sustained me.

The years past and due to the amazing work of my fourth grade teacher, I began to read at grade level. Now my paintings would often accompany writing. I was discovering prose and poetry. In each piece I would try to place a subtext that was a cry for help. I loved poetry and paint. In these art forms you can tell people again and again that you really want to die, and the audience sees the beauty but not necessarily the despair. I loved subtext. It was a great way to avoid making a clear declaration of pain. Occasionally, I would have a teacher who would read my journals and wonder. They would write comments in the margin, but would not follow up. It was easier, I suppose, to let sleeping subtext lie.

Again and again throughout my life I would turn to art to rescue me. When the sadness became unbearable I could paint a picture, write a poem or perform dramatic piece. I could let all the anguish inside of me pour into the action of creation, and it was beautiful.

I began to working in retail in the early 90’s. I sold art supplies, books and toys for 15 years. I worked twelve years at Barstons Child’s Play in Washington, DC and three years at Jayhawk Bookstore in Lawrence, Kansas. Each a student or parent would come into my art section and say, “Rescue me.” A project would be due within hours the customer would need my expert advice on how to finish or salvage their work. This was not active art on my part, but I loved helping them. I loved building up the work inside my head seeing all the potential pitfalls and helping them avoid them. They were anguished, just like I had been and I was happy to have the chance to help them through art.

As the years past and word of mouth grew, people would call Child’s Play just ask me about school art projects. My boss, Steven, would show such patience with customers whom would talk to me for thirty minutes buy a few items and leave. He understood that the customer would remember we had helped them out in their time of stress. We had listened, asked questions, made eye contact and gave the customer options. I do believe that part of my horror at the way my husband was treated while hospitalized was due to all the years of excellent customer service by the staff of Child’s Play. We were treated very often with neglect and avoidance while Fred was dying. I would never have treated a customer buying a toy in the way we were being treated.

After years selling art supplies, I began getting requests to help with school auction projects. In DC, most schools have an annual auction in which class creations can raise money for the school. I was sometimes called to help with this process. At first it was just a couple schools that asked for help, but the spring of 2010 was the year I had the most requests. In the months of January, February and March of 2009, I helped five schools. I was doing projects at CCBC, Temple Sinai, Murch, Little Flowers and St. Bart’s. Our tiny one bedroom apartment was covered in art supplies. In total I was working on 19 different canvases with hundreds of different children. In addition, I drew 150 close to life-sized body drawings of all the students of CCBC depicted as Circus performers. It was a frenzy of art. I had never done this level of art out-put at any other time in my adult life.

I guess God was preparing me for what was to come next.

On March 27th, 2009 we found out Fred’s body had tumors and growths. He was in the hospital. I still had several pieces I need to finish that I had begun. The night of the 27th I needed to finish the piece for Little Flowers. It was a Warhol inspired self-portrait series of the entire kindergarten class. The Auction was the next day. There was no more time. I heard later that that piece went for several hundred. I wonder if they owners have any idea how valuable it really is? Normally, when I adhere rice paper onto canvas I use a lot of water and gel medium. This time I used gel medium and tears. I cried for all of our lost tomorrows into that bright canvas. Art and sorrow were so intermingled within my life.

As the weeks past by Fred grew worse. He lay in his hospital bed. He could no longer walk. I sat beside him and began to cut out the cherry blossoms that Mrs. Schaffer’s 2nd grade class at Murch Elementary had painted onto rice paper. These were part of a composition that framed an acrylic painting of the Washington Monument in cherry blossom branches. It had been a cool spring. Outside the cherry blossoms were just beginning to unfold. Fred looked over at me. My lap was filled with painted paper cherry blossoms. “I guess I will miss seeing the cherry blossoms this year,” he said. I looked up at him. He continued, “I hope I am here to seem them next year.” I looked down quickly and continued cutting so Fred would not see my eyes fill with tears.

The next day I brought the finished painting to Mrs. Schaffer’s Class. The teachers circled around me and held me close as I sobbed. Other than the few glimpses Fred would see during his ambulance transports for radiation, Fred would never see cherry blossoms again.

As Fred was dying, I would sit beside him. I would write complaint letters, and poetry and I would paint. I would pour my anguish into a palette and create the concepts that would soon appear on walls. Fred would look at my work with pride, but he would worry. “How will you manage when I am gone?” He would look at me. His face drawn and yellow tinged from cancer and failing kidneys. I told him I would be okay. I was going to change everything. Nothing would be as it was. “But, Regina,” he said. “You are not very good at being alone.” He was right. I wasn’t good at being alone. Loneliness had driven me close to edge before. “Fred, I will not be alone. I have my friends and family…. And I will paint.”

Fred died and I began to paint. I painted and blogged and wrote speeches. I never stopped doing creative endeavors. In a frenzy of creation, I didn't feel so lonely. God was with me and filled me with a sense of hope. I was in his arms. I was not alone.

So when the parents from Murch Elementary called me with their plea for help, I could not help but say yes. They had not dropped ball, they had merely thrown it to me. Each toss affected lives and hearts, until 61 fifth graders and a widowed artist and a fellow art teacher had created a thing of beauty. I found the peace that surpasses all understanding, while gluing row upon row of mustang head paintings onto a canvas. There are 66 Mustang heads on this piece. 61 of them represent the students who graduated. Five have no names upon them. They represent the ones that moved away, the ones that started the journey with us and are with us no longer. But in the creation of art they are with us still, and we are not alone.

That is the power of art.

Regina Holliday -- Caregiver, Patient Advocate, Artist

This is the speech I gave At the National Partnership For Women and Families on June 24th

Thank you, Debra, and thank you to everyone at the National Partnership for inviting me here today. I am an artist, a widow and the mother of a child with autism – and, like all of you, I am an activist for better care.

From January to March of 2009 Fred went to his primary physician a dozen times with complaints of pain. He visited two ER’s with severe pain and was sent home with pain med’s each time. After two months of this, I demanded a diagnosis.

On March 25^th he was hospitalized for additional tests.

On March 27^th the oncologist told my husband while he was alone and told him he had tumors and growths.

The oncologist then left town for four days.

We had no access to the written record and were given brief verbal summaries by the on-call doctors. We were continuously hospitalized in five different facilities in what would be the last three months of Fred’s life. Fred had a broken hip because a careless shove on a point of metastasis during a transfer for radiation, skin breakdown because of inconsistent bedding changes, and avoidable complications because nobody was communicating.

No one had all the information they needed to see the whole picture of Fred.

This experience was horrible that I became and advocate for patient access to the electronic medical record.

Perhaps our worst experience was his transfer to a new hospital with an incomplete and out-of-date transfer summary. As a result, Fred was denied pain medication and food for six hours as the staff at the new facility tried to cobble together his medical record using a phone and a fax machine. When I had asked for his electronic medical records 6 days earlier, I was told that it would cost 73 cents per page and that there was a 21-day wait.

I was astounded. This was a hospital with fully functioning electronic medical record system, yet they were asking us to wait 21 days and spend hundreds of dollars just to see Fred’s record.

I eventually got a copy of Fred’s record and – despite its many errors– it became a virtual bible that we used to guide Fred’s care for the last 56 days of his life. There was not a day I didn’t reference it, and that information extended Fred’s life and helped create a fragile peace within our hearts; for there is no greater sorrow then watching your loved one suffer while you feel helpless because you don’t have the information to know what’s going on, what he needs or how to help.

That is why I am working so hard for clarity and transparency of electronic medical records. I may not be an expert in medicine, but I am an expert on my husband. With access to his medical record, I could explain his treatment options and help ease his mind.

When I speak, I’m often the only person in the room without a degree after my name. I am glad there are so many educated professionals working on health information technology, but it’s also important for patients and caregivers like me to be heard. Thank you for organizing the Campaign for Better Care, to give us a voice.

I said when I began that I am an artist; I paint images of data. I depict silos and closed data-loops in an effort to warn others of what can happen when patients are left out of the solution. That’s one of the ways I speak out for Fred. I am his voice and, I hope, your voice. We are all be patients in the end. We all have the right to be treated with dignity and respect. Thank you.

Michael Wenthe: The Visitor

Michael Wenthe: The Visiter
Originally uploaded by Regina Holliday

This is a guest post By Michael Wenthe. Michael was one of Fred's friends and also a professor at American University. He visited Fred in every hospital setting and hospice. His last visit was the day before Fred died. You can read Michael's own blog posts about Fred and "73 Cents" at http://satisfactorycomics.blogspot.com/2009/12/regina-hollidays-mural-for-health-care.html.

On the anniversary of Fred's Death I thought Michael's writing was the perfect way to commemorate this day.

Thank you, Michael.

June 16, 2010: in memory of Fred Holliday by Michael Wenthe

"Since I first read James Joyce’s Ulysses in 1994, I have joined other readers of that work in thinking of June 16 as Bloomsday, a celebration of the novel’s achievement in chronicling a day in the life of Leopold Bloom, fictional Dubliner, in 1904. Of course, Joyce had other reasons for choosing that particular date, for it was the actual day, not fiction, when he and his future companion and eventual bride-to-be Nora Barnacle “went out walking” for the first time. For an atheist author who refused his dying mother the consolation of pro forma Catholic piety, the choice of June 16, 1904, as the temporal setting of his magnum opus seems a remarkable bit of sentiment on Joyce’s part.

For all that June 16 is widely celebrated as a day for reading Joyce, others have a part in it, too. Just last year, fifteen years after I first read Ulysses, I learned that another novel of epic scope begins its main action on June 16—not a novel about Stephen Dedalus, but a novel by Stephen King: The Stand. I’m not aware of any groups that celebrate June 16 as Tripsday, but I’m convinced that King dated his own magnum opus with a winking eye at his Joycean predecessor, a direct allusion to the odds-on favorite for greatest English-language novel of the twentieth century.

I finally read The Stand last year on the recommendation of Fred Holliday, whose defense of Stephen King against the denigrations of high-culture snobs, won my admiration not just for King’s power as a writer but for Fred’s independence and judgment, his refusal to let the academy’s tastemakers and self-appointed guardians of culture distort his own sincere but by no means naïve love for the work of such popular artists as Stephen King in fiction, or Steven Spielberg on film, or Joss Whedon on TV. Fred wouldn’t have had to make excuses for so-called low or popular culture against high culture, anyway, because he knew enough of the highfalutin material to hold his own in discussions of “canonical” work. His dissertation, The Long View, may have focused on Buffy the Vampire Slayer, but he nearly wrote on the seemingly more difficult and esoteric traditions of Chinese cinema, about which he could hold forth at length with the same knowledge and passion that he brought to conversations about Buffy or The Stand.

And it was in order to take a bigger part in those conversations that I took the time (during my Passover holiday, no less) to read King’s mammoth book, and why I kept borrowing Buffy DVDs from Fred and Regina so that I could enjoy more of Fred’s insights about these works that he loved and that engaged so much of his personality, his intelligence, his enthusiasm. (As it happens, there’s a love story hidden in the June 16 of The Stand just as there is in the June 16 of Bloomsday, for some of Fred and Regina’s first conversations after they met turned on their shared appreciation of King’s novel—evidence enough that it must be worth spending time with and talking about.)

As it also happens, I have my own June 16 to commemorate, though I’m too subdued by it to feel much like celebrating. June 16, 2009, was the last day I saw Fred, the day before he died. I had just come back from a family visit to Vermont, and I had a present for Fred that I’d picked up in the airport: the latest issue of Esquire with a brand-new story by Stephen King. I doubt he got a chance to read it, given how tired he seemed during our visit. But despite his weariness, Fred gave me a lot of his energy and attention, and we had a conversation that has remained with me vividly—perhaps because I think about it often. He asked about Rebecca and the progress of her pregnancy; our daughter-to-be, Shira—still known only as “Juniorina”—was due about five weeks hence (and one of my greatest regrets is that Fred never got to meet her, nor she him). He also asked me, for the first time, about my conversion to Judaism. I’m not sure when, exactly, I let it be known that I had in fact converted, and from Catholicism, no less—the native religion of the atheist James Joyce as well as the uncertain Fred Holliday. It’s hard not to speculate about Fred’s state of mind in asking about religious matters on what turned out to be the eve of his passing, but that’s another matter on which I must remain agnostic. I had nothing especially helpful to say on the question of certainty; precisely what appealed to me about Judaism, or at least the version that I practice, was its openness to theological questions and existential struggles as against the dogmatic certitude that characterized the Catholicism I’d been raised with. That’s what I told Fred, at least, though I wished I had more to offer.

We also talked about books and movies, as usual. In Vermont, I’d made a start on World War Z (“An oral history of the Zombie War”) after my brother-in-law finished reading it; I’d remembered that Fred had both read the novel and listened to the audiobook back when he was first being treated (if that’s the word) at Holy Cross Hospital. Now, incredulous that the only zombie movie I’d seen was Shaun of the Dead, Fred insisted that I borrow a film from his personal collection before I left: Zombi, Dario Argento’s European cut of George Romero’s Dawn of the Dead.

Now, it took a while for me to watch Zombi. My priority had been Buffy the Vampire Slayer, since I loved comparing notes with Fred about the series—hearing his expert take on characters, events, narration, and framing—and I was still well behind where I wanted to be when we lost Fred. I’m especially sorry that I didn’t get to compare notes with him about Season Six of Buffy, which might well be my favorite of the series. That season offers a curious analogue to Zombi, however, which I did finally see some while after Fred’s funeral; for Season Six of Buffy begins with the resurrection of the recently-departed Buffy Summers. Buffy’s no zombie when she comes back; but like the reanimated beings of Zombi, she was better off between her lives, having apparently been in Heaven when her friends, at a loss without her, contrived to bring her back to earth with dark magics.

It’s a painful irony to me that the last movie Fred recommended to me was a chronicle of how the living need the dead to stay dead; and it’s another painful irony that my favorite season of Fred’s favorite television show offers the corollary lesson that the dead may need the living to preserve them as they are, not to seek their return—as the only way of honoring them as they were, in life, without risking unknown damage to the person who was loved and lost.

I write this wishing so very much that Fred were still with us; but if these movies and films teach us something important about existence, it’s that there’s a crucial difference between still with us and again with us. We can’t have Fred back again as he was, but he still is what he was when we seek him in our memories, where he is always to be found. In that sense, I feel like my memory of Fred, replaying the same scenes over and over, is like reviewing film of beloved stories whose meaning is inexhaustible even if the narrative is now at an end. For me, it’s not so much that Fred is “back on the show,” as Jeff Middents suggested last year, as that he’s never left.

On that note, I want to mention one more movie that Fred recommended to me before I close with another reflection on today’s date. During one of our conversations about his work, Fred spoke of his love for the Chinese director Zhang Yimou’s film To Live. Rebecca and I finally watched To Live some months after Fred’s funeral; the film was profoundly moving, not least as a testament to the need to persist in life despite loss. For the film is shattering in the privations and heartbreaks it deals out to its protagonists, who grow and develop in utterly unpredictable but ultimately convincing ways, not despite but because of their terrible losses and hardships. The film somehow concludes on a note of optimism without either ignoring or forgetting the worst of what had led to its hopeful ending. Against the supernatural horrors and unrealities of Zombi or Buffy the Vampire Slayer, To Live shows us what we face and what we have; and although I cannot thank him now for having recommended it, I remain grateful to Fred for affirming life through the medium that he loved, even after death.

A year ago today I saw Fred alive for the last time. Tomorrow, July 17, marks the first anniversary of his passing. In traditional Jewish practice, a candle is lit on the anniversary of a death, in commemoration of the life that was—not unlike the way that the Catholic Church celebrates saints’ days not on the birthdays of saints but on the days of their martyrdoms or deaths, when they awoke to a new life—albeit a different and mysterious life, one that still seems unknowable to me. But there is one conditional wish that I know I can render in the emphatic indicative mood. The traditional Jewish phrase to accompany the news of a death or the mention of a lost beloved is to say, for a man, zikhrono livrakhah—may his memory be for a blessing. I have remembered Fred every day of this year now past, in fondness and in longing; and I know with the certainty of experience that his memory is and has been a blessing, and it will remain so as long as I have the capacity to remember."