The Witch Helene

I have written a great deal about hurricanes. Some might see in that an attraction to them. The opposite is true. I have spent decades worrying about these monsters as they potentialize in the Atlantic and Gulf, form, strengthen, and strike. Too often (way) they have implications for Florida and the many people I have come to know across it. The breadth of concern is often surprising to some.

Five months out of the year (I don't worry so much in November), the NHC NOAA website is the first I check each morning. Ritualistically, persistently, every morning. When I am on vacation a world away, that does not change. 

Helene is a good example. From the first announcement of its existence, I began to watch. I began tweeting about it the Sunday before (below - I know it is not "tweeting" anymore, but I am not going to be Xing.") When I mentioned to a friend last Monday that I was watching it, there was incredulity. The simple question was "Why." His point was that there was no apparent Paradise implication, and so why the interest?

The Florida OJCC is spread hither and yon across this incredibly diverse peninsula. With any depression threat, there is likely to be somebody in the OJCC in harm's way. This Office services thousands of professionals whose efforts benefit employers and employees: lawyers, doctors, adjusters, nurses, risk managers, and more. I have met many of them over the decades, and even when the OJCC is not threatened many of them nonetheless are.

These storms are not "a Florida thing," but too often this is the destination. Time and again, we have been "lucky" with a turn or shift, and that "cone of probability" ("cone of uncertainty") has shifted to our neighbors. A minister told me years ago that he felt "unchristian praying for storms to hit his neighbors, but felt compelled to it anyway." He is not alone. There is some degree of survivor guilt that is experienced from these impacts. I have breathed sighs of relief over the years when impacts have been in the Carolinas, Mississippi, Louisiana, Texas, and Mexico.

Those occasions are not escapes from the destruction and the death, but merely deflections. The damage and devastation still occur in each instance, but it is not here. There is some classic NIMBY in our reaction. That is "not in my backyard." So often the "cone" shifts, the storm strikes elsewhere, and we breathe a collective sigh of relief and move on. We return from the angst and anxiety of storm watching and potentiality fear and move on. And, too easily, we forget that someone, somewhere was struck.

Inevitably, there is damage and devastation. That evil witch Helene is no different. Most recently, the death toll over 60 and predicted to rise. The social media images of destroyed homes in Florida have been heartbreaking. In some ways, the advent of social media sharing has made these events more real, more striking, and more depressing. Make no mistake, these monsters were killing and destroying all along, but we get more immediate and powerful images of the devastation now.

And the breadth has changed. No, not the breadth of the storm but of our consciousness. Today we see social media and news coverage of destruction and death in a far broader scope. The impact of this particular scope on Georgia, the Carolinas, and Tennessee in particular. We see and absorb the misery, death, and destruction. Some is focused on a person or a house, and some implicate desolation of entire communities.

And we sit in the aftermath and face the angst and anxiety that is "survivor guilt." But those who were damaged by Helene were in a path we neither controlled nor instigated. Mother nature can be a hideous and hateful force sometimes and these witches she sends will land somewhere. That we hope and pray it will not be "here" is never a factor. The storms go where the storms go. They don't follow our hopes, prayers, or pleas. There is, in short, nothing about which to feel guilty.

The aftermath brings opportunities. There will be many that will travel to the affected places. I have been to communities after Katrina, Michael, and Zeta. I have lived through Floyd, Ivan, Dennis, and Sally. There are opportunities to pitch in, commiserate, and comfort. There are many in need, and there is much to do. There are people you know, and others you might come to, who will be blessed with the arrival of church groups, civic organizations, heavy equipment, and the inevitable parade of power trucks. Who knew there were this many power trucks in the entire world? Amazing. 

There is presently a disconcerting level of societal disconnect, anger, vitriol, and worse, in America. But in these moments, there is opportunity for commiseration, consideration, and community. People will come together in the aftermath, as they always do. Neighbors, strangers, and visitors will gather, and coalesce, and progress will result. Wounds will heal, recovery will proceed, and communities will rebuild. There will be millions of minor kindnesses and contributions.

The church and civic groups and their food are always welcome. A hot meal is real comfort in times of recovery. The visiting police and national guard are a sight for sore eyes in the aftermath. I will forever remember the Sarasota County Deputy who guarded the neighborhood of our Paradise District Office for weeks after Ivan. He became a familiar daily site. I stopped to chat long after he became comfortable with waiving me through the checkpoint. Then one day, he was abruptly gone. The recovery, you see, progresses. 

Unfortunately, in each recovery, we will also see memory fade. Those who survive these storms are too quick to forget. Those who are uninitiated are too ready to discount or disregard. Too many disregard the good advice to evacuate to higher ground. A sheriff suggested before Helene that those refusing to leave should write their name on their own body to aid in the aftermath. There will be much confusion, searching, angst, and worry in the wake of any storm. The bigger and badder, the more the worry.

The fact is, Helene will not be the last. They will add her to the list of the "worst." There are more than one list. There is the death toll list of which she will certainly become part (the lowest on that list is 53); AP reports the current loss of life is more than 64.  The news is full of stories memorializing heroes who have kept that list so low. There is the economic loss list. There are many familiar names there; Ivan and Katrina will forever stick in my mind. I am confident the wicked Helene will take a spot there at least for a time. But, she may nonetheless one day be displaced from that list by some worse witch.

Her name will be forever retired from the NOAA rotation (click for list; some will reminisce over years that are etched in memory like 2004 when FOUR storm names in Florida were retired: Charley, Frances, Ivan, and Jeanne). Like so many before her, the wicked Helene will be the last of her name, just like Ivan, Katrina, Ian, Betsy, and Andrew. It will take time, but her wrath, vigor, insolence, and indifference will fade from memory and become legend. 

People must strive to remember and to remain conscious. When the threat comes, they need to listen. When told to evacuate, they need to go. But many will not. They will say "It won't happen here." They will believe that Atlanta is "safe" or that Tennessee is "safe." Some will even delude themselves into believing their coastal home is "safe." Many times they will be absolutely right and occasionally, someone will be dead wrong. If you missed that entendre, "dead wrong" is nonetheless "dead."

There will be lessons learned from the witch Helene. Some will be new, but most will be recycled. Ritualize your annual May preparations, watch the tropics, plan for the worst, follow instructions, put your safety first, and strive to pitch in for the damaged and displaced when you are lucky enough to avoid the direct hit. Simple lessons. Simple humanity. Simple sense. 

And, if you are out there reading this by generator or car inverter, know that it will get better. Know that recovery is as inevitable as the storm itself. Know that you have the strength and the spirit to recover and rebuild. Many have doubted they did, and they were each wrong.

Kiosks and Expectations

I have often written about technology, robots, and AI. See The Coming Automation (November 2017) Technology Changing Work (November 2018) and The Gig of Participatory Democracy (December 2020). I have predicted various cost-benefit analyses impacting the workplace as tech is adapted and adopted. The self-service kiosk was one of the earliest of these. I anticipated that in the ordering paradigm (food), jobs would be lost to these wonders.

Yahoo News recently republished a CNN piece that takes issue with my fears. The analysis is in from one fast-food organization that shifted significantly to the kiosk model. Its data does not support my fears. The kiosks have supplemented human labor, and altered assignments, but not eliminated jobs. At least, that is, as of yet. It notes similar outcomes in the past with adoption of such tools as automated teller machines (ATM) and other technology. 

The authors note that the result is surprising. I am apparently not the only one who suspected or feared coming job loss. The data apparently supports that kiosks are better at selling the product than a person has proven to be. They are not troubled by the long line at the register and so the kiosks strive to upsell a shake or side to go with that burger or meal. That, the authors note, drives up sales, and there is more preparation and serving work to be done as a result. 

As a result of business evolution, the article says that those no longer needed in the order-taking are involved instead in the preparation of orders, delivery or serving, and facility cleanliness. The suggestion is that "fast food" will now be even faster due to the streamlining of these functions. 

But, there remain critics. One cited by the Yahoo article says that kiosks don't always speed the process or encourage the "upsell" (that extra shake or side). The authority there says that when people have someone behind them at the kiosk, "they experience more stress when placing their orders and purchase less food." I have personally experienced that anxiety.

There is, it seems, both good and bad. Some of the kiosk "stress" may be lack of familiarity. Perhaps as we all become more kiosk-acquainted we will become more kiosk-comfortable? And, as we become more calorie conscious, perhaps the milkshakes will not be so alluring regardless of whether a man or machine is suggesting it? That said, the ice cream does look great in the pictures on the kiosk. Can the kiosk tell us, again and again, “sorry, the ice cream machine is down?” (Asking for a friend).

I was pleased recently to find myself at such a fast food outlet in Poland. After monotonous days of the challenges of a diet replete with European continental delicacy and treat after treat and delicacy, there was some admitted desire on my part for a return to the American fare. A particular soda on ice with a side order was truly appealing. (FYI, finding a cold, iced, soda in Europe is right up there with winning the lottery in my book). 

I placed my order at a kiosk. I had to put in my name so they could call me to the counter for payment and pick up. I waited. Then I waited some more. I became weary of waiting, so I merely paused persistently in expectation of my order. 

Eventually, I put the Kiosk-generated receipt in a trash bin and hit the highway again. I suspect that order has still not been called by the counter help in that particular store. In fairness, that place was immaculate. But what good is clean if you cannot get a soda and fries in fifteen minutes?

The Yahoo article notes that many Kiosks are equipped to do more than take an order. Some "are now rolling out kiosks that can take cash and accept change." So, had I been at one of those, my choice would have been harder - abandon my already-paid bill to hit the road or remain standing there. For the price of fries and a soda, over $6.00, I might still be there even today. $6.00? This inflation is really something. 

So, the article supports that we critics and naysayers were not necessarily "right" about the consequences of kiosks on the fast food environment. However, I remain unconvinced I was wrong either.

I see a day with increased kiosk capability (taking the payment in card or cash or app). I see a day when a QR code dispensed by that kiosk gets me the cup for a self-serve soda. I see a day when the trip from the make table to the counter may be roboticised as a matter of course. 

But, on one point, I agree wholeheartedly with the article's sources. The key to the success of any adaptation is communication and familiarity. No change is going to be instantly adopted and adored by the masses. People hate change. Period. End of discussion. 

That said, some are more amenable than others. Some are more adventurous. The change will come and through evolution rather than revolution, we will find ourselves one day content with kiosks, robots, and more. 

Our acceptance or resistance will influence the marketplace of products, services, and ideas. We will be given opportunities, and some will thrive. Progress will come whether we like it or not, much like Christmas came to Whoville despite the dedicated efforts of the Grinch (How the Grinch Stole Christmas!, Cat in the Hat Productions, 1966). 

There, the Grinch was disappointed his prognostications and predictions bore no fruit. Similarly, our anticipations and beliefs may or may not be accurate as this evolution proceeds. Nonetheless, the road will bring change. Adapt, avoid, or at least step to the curb so you aren’t hurt. 

Ultra-Processed and Science

There’s been a lot of discussion in the news regarding the onslaught of American obesity, and the potential health risks attributable to a variety of different causes. Obesity is a comorbidity and has a profound impact on the risk of workplace injury, the delivery of appropriate remedial care, and the amelioration of the effects, following injury or accident.

And one recent post, I noted the extent to which obesity and or diet may contribute to the likelihood of cancer. See Disparity and Evolution (August 2024). In another recent post, I noted the distinction between causation and coincidence. Challenges with causation are deeply ingrained in many states' conceptualization of workers' compensation.

A new story regarding the content of foods is interesting from multiple perspectives. The British Broadcasting Corporation (BBC) reports that some experts have concluded that it is highly impractical, and may prove impossible, to determine exactly what the impacts are of various components of the American diet. 

They note that we face a variety of additives and ingredients, and they express doubt that these can be each individually studied in a sufficiently controlled and significant manner such that the health impacts of each could be isolated, analyzed, and evaluated. The challenge is with variables, and in case you don't remember from high school, the more variables in the equation the more difficult it becomes. 

For example, in the equation 4 + x = 6, even I can cipher out that "x" has to be 2 (if it is not, show your work when explaining why). There is only one variable. So that one element, "x," can be teased out, identified, and solved. But, 10x+4y = 3 is more difficult. First, the impact of two variables has to be considered. And, the values assigned to each is codependent on the value of the other. In fact, there is a population of values for both "x" and "y," each of which is potentially correct.

The challenge is thus illustrated, but even with the large group of numbers that could satisfy "x" and "y," this does not begin to parallel the challenge of food additives. There are a multitude of chemicals being added to foods for the purpose of enhancement. Some are for taste, others for texture, others for preservation, and so on. 

Each of those additives may have the intended effect and yet also some potential unintended effect on our bodies. That result is reasonably easy to comprehend. But, how does that one chemical react to or interact with a second chemical in the same product? That reaches a bit deeper into the complexity, the two-variable equation. Next time you pick up a product, read the list of ingredients and you may appreciate the complexity of many variables. 

The scientists involved with the BBC article explain that there is some hope of identifying the impacts of any particular substance. They isolate that substance and expose us to it. Reactions and outcomes are measured, recorded, and reduced to data. Across large data sets, reactions and outcomes can be predicted for people generally, though individual reactions might still vary. 

The discussion made me think of the differential diagnosis, a process in which a medical expert arrives at a working hypothesis, and then through a series of evaluating tools, or testing, attempts to eliminate or establish indicia that support the hypothesis. So, when the complaint is knee pain, the doctor strives to identify the portion of the knee that is damaged and then assess the nature and extent of that damage. In this process, the physician is teasing out variables, and assessing what each may or may not represent. 

The challenge has perhaps existed since we began eating foods that have been processed. The idea of food additives is not novel. The challenge being discussed, however, is "So-called ultra-processed foods (UPF)," and our diets are increasingly focused on them. The article's authors assure us that such foods now "account for 56% of calories consumed" in general, and they are more prominent in economically challenged communities. 

In these UPF, the most recognizable ingredients may be the "fat, sugar or salt" that are predominant. The foods are perhaps convenient, long-lasting, and appealing. What they also are is complex in terms of how their contents may impact us. In that debate, various experts express opinions about the value of variables, but it is possible there are multiple solutions to the equation. There are actions and interactions. 

However, there is apparently some room for disagreement about what foods are in the UPF category. Some are studying simply the definition. Thus, while there is trepidation about these products and our consumption habits, definition, and comprehension might hinder even the most dedicated consumer.  The best definition offered is: "Generally, they include more than five ingredients, few of which you would find in a typical kitchen cupboard."

The second complication is ongoing debate as to whether UPFs are demonstrably unhealthy or problematic. In order to point to such a conclusion, one faces the challenge of the equation discussion above. If a particular food is or is not a UPF challenges study, and then the isolation of that particular UPF provides only more complication. 

The end result seems to be that UPFs may be "linked to" things like "cancers, heart disease, obesity, and depression." Those who eat large quantities of these foods have "a roughly 10% greater chance of dying early." That is a troubling solution to the equation. But which UPF, which ingredient or combination, is a more challenging question. And, one cannot ignore the "large quantities." What volume of UPFs is not indicative of an increased risk?

The analysis that could answer such questions is elusive. The results of eating these foods, the resulting "health problems would be extremely complex." And because that equation has so many variables, there are distinct challenges in isolating and studying any particular one variable, that is one UPF or ingredient. 

The experts suggest this would require studies in which people were in very carefully controlled groups. The people would have to start with reasonably similar eating habits. Their food intake would have to be measured, and "matched exactly for calorie and macronutrient content." The study would have to, effectively, remove all other variables so that only "x," the UPFs remained as a variable. 

In short, a study of that complexity and specificity is perhaps beyond our capacity, or at least our economy. The experts concede that such an approach "would be expensive research," and there are limited resources from which funding might come. One expert contends that anyone providing such funding would potentially be "motivated to run these kinds of trials" by a preconceived notion of "what they want the conclusions to be."

This admission by the experts should caution us all when there is discussion of "causation." 

Olympic Dream

What kid hasn’t dreamed of being in the Olympics? These games are a long-standing tradition of sportsmanship, competition, triumph, and sometimes disappointment. In a world of wars, strife, and struggle they perhaps bring distraction and rejuvenation to a periodically weary world. Though they have had their moments of controversy.

Nonetheless, amazing athletes gather quadrennially in competition. There are thrills, spills, triumphs, and disappointment. Too often there are distractions of politics, boycotts, and controversy.

Unfortunately, we are also periodically left to wonder if this is the fastest runner, or the runner (or any athlete) most successful at disguising the substance(s) that make her/him appear so? If you want inspiration, check the videos from the Paralympics. Those people are amazing. Check out the "Rocketman" victory here. 

There is also sometimes controversy regarding whether this or that contestant is appropriately categorized, or whether societal pressure is exerted somehow or somewhere to create favor or advantage? In that, there are controversies of gender, a topic in which various people see some or no room for debate and in which others see boundless breadth for conversation. Nonetheless, controversies bloom.

One of my earliest recollections of the Olympics involved overhearing hushed conversations between adults. I learned in my youth that a group called “Palestinians“ had attacked athletes from a place called “Israel,“ during the games in the city of “Munich.“ At the time, I was unaware of the meaning of any of these words. The import and gravity of that situation persisted over days, and forever marred these games.

Interestingly, there has not been a nation called Palestine. There was a territory with that name in the days after the Ottoman era, which came under the stewardship of Great Britain in the early 20th century. All of those territories except Palestine later became “fully independent States,” according to the United Nations.

Nonetheless, there are over 14 million people who identify as Palestinian, about half of whom live in Gaza, the “West Bank,” and the “1948 territories” according to the Arab Center in Washington DC. The remaining half live in Arab or foreign countries. Nonetheless, the news referred to those 1972 terrorists as “Palestinians.”

The implication of that terror was significant. A place of peaceful competition and interaction became a place of violence and politics through the efforts of terrorists. The venue, Munich, was already famous to many adults. It was home to annual frivolity and festival, as well as the first of Hitler’s concentration and death camps, Dachau. People identifying with a desired geographical dream, “Palestine,” killing Jewish athletes in that venue reverberated around the globe. Thankfully, though there have been controversies and complaints since, the Olympics have not returned to such infamy.

That was in 1972. In a notable addition to the 2024 Olympics, a shoe business hired a model who has reportedly been vocal about the creation of a “Palestine” country. She was hired in 2024 to market a shoe “inspired” by the terrorist-marred 1972 Olympics. 

Some clamored over perceptions of a tone-deaf German shoe company campaign. Others were supportive of the vocal model and critical of the ad campaign being truncated following public hubbub. In a word, "controversy" in 2024.

So there is a history of challenges and disparate perceptions and opinions. Perhaps the Paris rendition of the games would be controversial only for cocaine, sexual assault, and intriguing endorsement contract allegations, as reported by NBC.

But, the 2024 Olympics may be most controversial instead over the legalities, technicalities, and impartialities.

In the world of evolving technologies and persistent advances, the distance between victory and loss has become increasingly abbreviated. Contests are frequently decided by hundredths of a second. For most of us, a second is a minuscule measure, but in elite competition, it must be divided into 100 subparts to determine a winner in some instances.

Without a doubt, that has driven teams to “up their game.“ There are better shoes, better uniforms, scientific diets, and more. To be fair, the “more” has periodically included various drugs and substances, which have also fed controversy at times.

I have often thought that the only role I could ever play on an Olympic team would be of some passive nature (ballast in the rear of someone’s bobsled?) Athletic, I am not. I can “run," but not at a speed that anyone would find impressive. In fact, many would likely dispute my misappropriation of the word “run.“

But then comes the 21st century. In the 21st century, perhaps we will see an end to the “my runner is faster than your runner, or in colloquial terms, “my dad is bigger than your dad” arguments? Perhaps we can evolve beyond the competition regarding physical capabilities, and instead focus on what really matters: who has the better lawyer?

Finally- an Olympic event for those of us “less physically inclined.”

Following the “floor final” in Paris, the outcome appeared obvious. Ana Barbosu (Romania) had prevailed over Jordan Chiles (US). Well, mathematically anyway. But, by what formula? Chiles' team quickly appealed and noted that the complexity of her routine dictated a different formula and outcome, according to the British Broadcasting Corporation (BBC).

The chagrined judges had erred. They recalculated and Chiles prevailed (winning the bronze medal). But wait, there’s more. Romania’s team appealed that. Her team said the US appeal was untimely. It was asserted, they said, seconds (whole seconds, an eternity in sports) too late.

The judges agreed and re-awarded victory to Barbosu. Well, technically they “reallocated” the medal from Chiles to Barbosu? For all the innocuous tone of "allocation," that means took Chiles’ medal away.

In came the technology. Team US presented video evidence of timely appeal. The video was then disregarded as itself untimely. There seemed fair room for discussion and debate. However, the Olympic committee said it was powerless, according to The Hill.

In the hours that followed, it was revealed in the press that one of the judges in this competition (and controversy) earns a living representing Romania (Barbosu's home country). A conflict of interest? Some said so. Or perhaps an “appearance of impropriety?” But, those in charge said, essentially, that any allegations of conflict of interest were too late, according to CNN.

Technology is a challenge in the modern games. Definitions of identity may be dependent on competing scientific theories, tests, or opinions. Technicalities, rules, and conflict. This is a job for lawyers!

Is she or isn’t she? Did he or didn’t he? Was it or wasn’t it? Lawyer questions.

They have a televised clock for determining winners in events. Why not have one for the timeliness of appeals? It could be in hundredths of a second and the viewers could watch as the post-event lawyers sprint to the judge’s table to appeal?

There was a time when the fastest runner won. Then came the era of the coach and trainer; the best preparation mattered. Before long the team doctor was a necessary travel companion. But now perhaps comes the age of the lawyer, the appeal, the argument, and the spin.

CNN concluded about the Barbosu/Chiles situation that the "Olympic Games has been tarnished by confusion, heartbreak and allegations of incompetence.” Thus, now comes the age of the lawyer. It is troubling to some, but who else will manage the complexity of rules, competing priorities, scandals, and “incompetence?” 

Recently, attorneys for Chiles announced the commencement of a lawsuit in Switzerland to address the situation. History tells us these things can take years. Ask the skaters who received winter gold medals at the recent summer Olympics. And the Paralympic athletes might benefit from lawyers too. 

Ms. Chiles’ situation is not on the level of terrorists killing athletes. It is a tragic outcome nonetheless. Do we really need lawyers to sort out fair play, sportsmanship, and athletics? Is amateur athletics simply a thing of the past? Will lawyers take the medal stand?

Infantilised

There is a book out about the challenges of the "next generation." Author Keith Howard penned Infantilised: How Our Culture Killed Adulthood, and The Economist provided an informative review.

The book relates a conversation between two generations, an "older boss" and a "younger ... employee":

There is no P in ‘hamster’,” said the boss. But “that’s how I spell it,” the 20-something objected. The boss suggested they consult a dictionary. The employee called her mother, put her on speakerphone and tearfully insisted that she tell her boss not to be so mean."

Mean? The thought of using the right word is "mean?" Beyond that, an immediate thought is who would conclude that the best path forward in any dispute or disagreement would be a call to one's mother? The reviewer seemingly skips over the potential to discuss helicopter parenting, dependency, and apron-string cutting. We'll return to that.

The reviewer instead focuses on the "notion of 'my truth,' a popular phrase intended to rationalize the speaker’s beliefs and shield them from criticism based on facts." The point of "my truth" is apparently an allegation that we are each entitled to our own, and all that really matters is what we each believe. As the reviewer phrases it, "You may say that 1+1=2, but 'my truth' is that it makes three."

In fairness, this myth has roots in the counterculture of the 1960s and childish rebellion against many a status quo since. People holding different views is not new and frankly is not wrong. Views are opinions, and they matter. But there are facts in the world also. Those are not subject to views and perceptions. Protecting one's right to views and opinions does not extend to allowing us each our own "truth."

It may be difficult to hold a rational conversation with someone whose "truth" is contrary to facts. As I read the review, however, it occurred to me that almost everyone has embedded biases, which is likewise not a new or novel conclusion. Bias and predispositions have always existed and persisted. We see it frequently in the litigation realm, and not with any generation more so than another.

The "my truth" can be related to a deep-seated "relativism" that is well explained in The Conversation (The University of Waikato, May 2023). There are those who applaud people speaking "their" truth, and it is "fast becoming a part of everyday speech around the world." The Conversation notes that the phrase has been popularized by the media, noting various current event examples.

But, The Conversation questions, can we have "reasoned debate" in a world where "truth is relative?" Can 2+2 be 3 because I want it to be? Can the world be flat because that is "my truth?" Can I insist on spelling Hampster as I wish (note to reader, the AI super-suggester that I use has no problem with "hampster"). In fact, The great brains at Wiktionary have a definition for "hampster," which is an "obsolete form of hamster." Maybe the "younger employee," above, is not so much about "her truth" as she is about antiquated phraseology?

The Conversation concludes that hearing people's perspectives is positive, no matter whether they "may ultimately turn out to be false." There is a courtesy element there, and there is the chance that differing views may be both rewarding and stimulating to better debate. Nonetheless, while encouraging the expression of perspective and belief, it advocates for retaining some value for "truth."

So, as Joe Hallenbeck (Bruce Willis) reminded in The Last Boy Scout (Geffen, 1991): "Water is wet, the sky is blue." In that vein, 2+2 likely equals 4 (at least in the simple world of math in which most of us reside). 

Beyond the debate of truth, at what point is it appropriate to drag Mom into the discussion? Is such a reaction a sign of insufficient maturity? The author of Infantilised suggests that there is a maturity deficit in "young people today." He offers behavioral evidence that suggests some present tendency to cling to childhood and resist the perils of "adulting." 

He suggests that this impacts society in terms of various traditional rights of passage for adulthood like marriage, home ownership, and more. And, he seemingly lays some of the blame for immaturity on pop culture, the media, and acceptance or even celebration of such differences. The cited examples are interesting perspectives.

The Economist reviewer takes issue with Infantilised. The review suggests that immature behavior is neither new nor unique. The hypothesis is that today's world of "a camera in every hand" simply facilitates the recordation and sharing of such behavior. While that might resonate as to analogizing the actions of today's youth to the "idiotic things that the Boomers and Generation X did in their 20s," it does nothing to address the concrete example of maturity or commitment one might perceive in the tendency to remain in the parent's abode, the age of marriage, the purchase of homes, and beyond.

What is clear from the review is that the reviewer takes issue with at least part of "the truth" held by the Infantilised author. In doing so, the reviewer expresses his own "truth," at least for the sake of argument. In the broad context, perhaps neither is any more "right" than "wrong," and there is benefit in the open debate? 

But, in reality, the "truth" of the Infantilised author is backed by hard data as to milestone achievement (marriage, home ownership, moving out of the parent's house, etc.) Those are measures. They are facts. They are are not subject to a different "truth," though the reasons for delays might be. 

That said, beware that many will view your making a call home to Mom for support in a discussion as a signal of weakness, immaturity, and disconnect. Likewise, your dismissal of what the dictionary says regarding spelling or your argument that water is not wet may face significant resistance from various listeners. 

I am not saying you are "wrong," but that does not conversely mean that there has to be universal acceptance of "your truth," however absurd. Instead, some may conclude that you are delusional, disconnected, or simply not up to the intellectual challenge. 

In the end, know that there is also some potential that your credibility and gravitas may be impacted by the pictures you post to social media, your expressions of "your truth," and any propensity to call Mom to settle (from your perspective) a disagreement. 

While the world may patiently hear you out in these regards, and choose not to challenge you for fear of reprisal from a mass gaggle of equally discordant lemmings folks, that does not mean they necessarily buy "your truth" or even respect your thoughts. They may just go along now and tell their friends later about "that guy that needs a tin-foil hat."

Like it or not, there are many perspectives. Unfortunately or not, there has been too much accommodation to individual "truth." The world of law has many opportunities for perspective, argument, and debate; the world of science, perhaps not so much. Everyone knows those two worlds meet often in litigation, and our challenge of deriving the correct answers will be challenged by this "truth" divergence. It will also impact a great array of other workplace questions and concerns. It is worthy of study. 

Remembering

I am an irrepressible history nerd. That has driven my adult forays across Europe. Vacations are odysseys, not placid rests. I have been privileged to view amazing vistas, see astounding places, experience grand hikes, and interact with many interesting people.

My experiential trail includes a parade of museums, landmarks, and superlatives. Only one ever asked to be remembered. Days after my visit, its caretaker wrote to thank me for visiting. The writer reiterated:

Our mission is to get as many people as possible acquainted with the history of this place. If you would like to support our efforts . . ..

That is significant and singular. This place was depressing and draining. It touched me, and depleted me. Oddly, it later motivated and inspired me also. Its effect was similar to past experiences, but different. I struggle to describe how.

In 2019, I visited Munchen, a popular German city, famous for beer. I took a day then to visit Dachau, the first concentration camp of the National Socialists in Germany. That was a prison that evolved into an extermination site and is a place of significant suffering, cruelty, indifference, and death. Its impact on me was profound.

In 2021, in the midst of the Great Panic, I returned to Germany. There were no crowds, and society was more subdued. I found myself in Weimar, and visited Buchenwald. This was also a place of great evil, atrocity, and inhumanity. A camp zoo there was maintained there in the sight of prisoners. They were starved and dehumanized while animals were carefully tended feet away.

This network of National Socialist camps was employed for detaining, torturing, and murdering homosexuals, the Roma, captured soldiers, the Jewish people, the political dissent, and more. They were gathered, transported, dehumanized, and killed. 

These two camps were difficult environs to visit. My days there were challenging to the spirit. The mindset of the camp's conspirators was alien, and the impressions were permanent. But neither of them thanked me for coming, nor sought my help.

But in 2024, after a five-hour drive from Wien, I stepped onto Auschwitz Birkenau. Here, evil not only dwelt, grew, and festered, but emanated and expanded. This was not the first of the camps (Dachau), but it was the worst (my opinion). 

It lies remote in largely rural Poland. The town's name is Oświęcim, and it was invaded by the Germany of the late 1930s. Its name became the Germanic Auschwitz. Its rich local history became forever subordinated to the Socialist's evil. 

The camp was deceptively condensed when one views Auschwitz in isolation. One wonders, how could so many be persecuted and executed in this space? A tour of the horrors requires about two hours. That includes a theater movie, live instruction by a docent, and information from a lanyard-borne electronic device. 

 

I was surprised, plugging my headphones into the theater seat, to find the connection bore the name of a company that has been tied by some to the use of slave labor from this very camp system during that war. There are various businesses today that benefited from the cruelty and crime perpetrated on the various groups and individuals targeted by the National Socialists. 

After Auschwitz itself, one is bussed to Birkenau. Its scale is unfathomable. Birkenau itself has to be 60 acres or more. The estimate is that the entire two-camp complex infects over 400 acres.  Here, volumes of innocents disembarked trains, deluded and lied to, and most were exterminated within hours. The image of imprisonment here is overstated. Some were imprisoned and forced to labor, but vast numbers were exterminated within hours of arrival. 

How many? No one will likely ever know. The killing was too random, too rapid, too egregious. Keeping accurate records was subordinate to efficiency. 

There remains evidence. There remain memories. There remain testimonies. I walked for hours through the grounds. There are buildings still standing. There are foundations, scars, and remnants. There is a feeling of dread and depression associated with the premises. One wonders if that results from our knowledge of what occurred there? Is the place evil in its own right, or do we feel it because of our foundational knowledge?

I have been privileged to meet two who survived this place. I have struggled to appreciate their pain and loss. I have realized I can never grasp their loss, experience, or despair. How might anyone who did not live it do so? I am fortunate nonetheless. Many will never meet such a survivor. And with each passing day, the population of survivors is diminished. In my lifetime, it is nearly certain that population will become zero. 

That is why they asked me to remember. It is left to those who study history to remember. Even as the eyewitnesses age and pass, someone must preserve the Socialist history, and remember the atrocities that it committed. 

I rounded out my 2024 foray with a stop in Amsterdam. I toured the hiding place of the most famous of holocaust victims, Anne Frank. I looked, wondered, and contemplated. I saw little with which to identify when I read her diary decades ago. It has taken me years of life and miles of travel to appreciate the plight of her family. 

Her persecution in Germany, flight to the Netherlands, isolation, fear, and feelings are well documented. Her life and death, however, are more real to me having toured these sites. She was betrayed, captured, and transported from Amsterdam. She stopped briefly in Auschwitz and moved on to yet another of the vast camp system. She died a child in a system that cared nothing for her humanity, dignity, or promise. 

I reflected on the message from Auschwitz. It asked no reparation of me. It asked for no sacrifice. It asked simply for remembrance. It is cared for, curated, and preserved. It is a testament to the works of evil and the peril of forgotten humanity. It asks little, simply to be remembered. Not for its sake, but for the sake of the millions who were slaughtered throughout the Socialist camp system. 

Perhaps, in some manner, this short piece does that. 

Psychedelic Mushrooms

We are facing a mental health challenge in this country, and any element of a person's life can be brought to work (intentionally or not). Two recent news stories reminded me of the challenges we might encounter in the workplace and the potential impacts.

About one, most will remember last October (2023) when an off-duty pilot made the news. He was riding in the cockpit of the aircraft, but as a passenger. That is apparently a reasonably common situation. There has also been a practice of allowing pilots to bypass airport security. This was explained years ago with "if a pilot wants to crash a plane, the pilot can crash a plane." Some logic may be gleaned there.

But, the 2023 incident involved a pilot allegedly doing (or attempting) just that. At 30,000 feet, this gentleman allegedly "raised his arms and pulled two large red levers that could have shut down both engines." Now, the fact is that engines could possibly be restarted in such a situation. Nonetheless, loss of power is a serious situation. One website lists it as the #2 most serious in-flight urgencies, above fire, hijacking, and more.

The situation made the national news, and the pilot is back in the news recently with an admission: "I made a big mistake." The pilot was experiencing issues regarding the death of a friend. Everyone has had such tragedy invade their existence. This pilot, though, decided it would be a sound idea to take "psychedelic mushrooms." He apparently had an expectation for the potential of hallucination and other effects in the ensuing hours. However, he inexplicably experienced those for "days."

He is charged now with putting "83 other lives in danger," with his impulse to stop the engines. Luckily, the pilots on the flight had little challenge in removing his hands from the controls and he was shown the cockpit door. Sitting in the cabin, after being excluded from the cockpit, he then allegedly reached out similarly to the lever "operating the cabin door," but a flight attendant (They are there primarily for your safety, see BLS) stopped him from opening the door. He then asked to be handcuffed. 

This pilot has founded a non-profit called "don't take illegal drugs." I'm kidding. It is called "Clear Skies Ahead," with a focus on "awareness of pilot mental health, and to emphasize the importance of not being afraid to seek help." A physician quoted in the article asks "Who would you rather fly with: a pilot who is depressed, or a pilot who is depressed on medication?" There is no option for "pilot under the influence of illegal hallucinogens." While the "attempted murder charges" associated with the incident were dismissed, he still faces multiple other charges.

In the second news story, the Miami Herald reported on a vehicle accident in Miami. A "self-proclaimed social media model" has been charged with DUI manslaughter and various other charges. She allegedly told responding officers afterward that she was "from the future," and apparently was somewhat disoriented.

The police say she "reportedly blew the red light at Eighth Street, then put her foot on the gas at '100 percent acceleration,' driving nearly 80 mph on a street with a posted speed limit of 30 mph." They allege she was "under the influence of "pink cocaine," which is also called "2C" or "tusi." Officials allege that "toxicology report revealed a variety of drugs in the defendant’s system."

It might be said that she should not have been driving. The article notes that her license to drive was suspended at the time (first clue as to when not to drive). But, in the decision process, the decision to drive may occur long after the decision (usually a decision, see below) to ingest illegal drugs, or the more (perhaps) mundane alcohol. 

In the broad analysis of what went wrong in these two incidents, there could be a variety of opinions expressed. Some may see the underlying similarity of congruity as the illegal drugs. In our society, there is a consensus that some people are involuntarily drugged by those around them. An article, More than a Myth, on the American Psychological Association site, concludes that involuntary drug use does occur. Thus, the presence of some chemical compounds in our society poses risks that are beyond our personal best judgment.

Nonetheless, the personal judgment remains a potential challenge. People may choose to put chemicals in their bodies. They may make decisions that are not in anyone's best interest. Those decisions may implicate the health, safety, and welfare of that person or a variety of people around them.

In the Miami instance, someone died at the accident scene and another died at the hospital. People died. The chemicals did not kill them, but the judgment of the person who ingested them was potentially impaired by those chemicals. There are reminders here, and there is reason to remain wary. What is impacting people around us, the drivers of other vehicles or the operator of equipment?

How do we remain alert to potential challenges or threats? Can we hope to spot those who are challenged with some impairment? In June, a social elite was arrested after missing a stop sign, swerving, and failing a field sobriety test. He was assessed by police officers who had training and experience in such observations and evaluations. Outward signs, above, were visually observed as were perceptions of his "glassy eyes." But are laypersons in a position to make such observations?

What do we say, to whom, and when? Is the potential for the presence of such issues in the workplace different from the mental acuity issues that will be addressed on September 18, 2024, on The Point? Does it matter what is causing the mental status concern, or is the main point recognizing and dealing with such status concerns?

Join us Wednesday for The Point: https://workcompcollege.com/the-point-webinar-slip-slidin-away-identifying-and-managing-the-loss-of-mental-acuity-in-the-workplace-and-beyond/

Slip Slidin' Away

The Point is back on Wednesday, September 18, 2024, at 13:00, Eastern. We will strive to identify clues and signs of people with cognitive or emotional challenges. We live in an age of significant life expectancy, and in a variety of jobs, many are working beyond traditional "retirement" ages. In addition, some perceive general increases in mental health issues across generational lines.

Does it matter why people are working longer? Certainly, the economy may play a role in people delaying retirement or returning to the workplace. Some believe various prices have risen about 50% in the last four, pandemic recovery, years. Workers may be concerned about retirement in this setting. 

But, some may simply be resisting retirement and their perceptions of it. They may simply want to feel needed, to contribute, or to remain active. Activity is good for the soul, body, and brain. 

Regardless, we are told that senior participation in the workplace remains significant, and growing. This may implicate workplace safety. And there may also be other concerns including physical injury, absences, and more. But, the theme of this post is mental acuity.

I recently attended a meeting in Florida. I ran into a fellow I have known for over a decade. He was genial and seemed to recognize me. But he seemed confused to see me. His confusion was manifest in several statements. One example is when I encountered him while entering the meeting room, he asked what I was doing there. He then said I must be entering the wrong room. He asked if I was not at that venue for “the Tennessee conference?”

We were far from Tennessee (Florida). There was no Tennessee conference at that location that week or day. In fact, I remain unpersuaded that particular venue had any other events that day. I later related the interaction and experience to others, but they expressed no similar interactions with this person's cognition.

Was his Tennessee reference a disconnected attempt at humor?

Was the speaker confused by some context (I struggle to recall when I last saw him prior, perhaps it was in Tennessee?)

Was there some broader cognitive disassociation at work?

How was I to tell what drove the odd and confused conversation?

In the widest context, how can workers and managers look out for mental health challenges in the workplace? What are the signs of budding issues? When do we mind our business and when do we seek help (for ourselves or others)?

Let’s face it, I have called people by the wrong name. I have found myself in a room and struggled to recall why I went there. I have walked away from my car and forgotten my cell phone, keys, and other items. Who hasn’t? Are those warnings or are they merely part of a busy world?

The fact is, we are all prone to mistakes, missteps, and misremembering. Life is persistent in its challenges.

This recent interaction reminded me of another incident. Years ago, I ran into another fellow at a distant conference. I said “hello, “ and he noted it was good to “meet in person finally.” The problem is that we had met in person previously (reasonably recently). I apparently had failed to leave any lasting impression. Who hasn’t failed to remember someone or something?

The point is, that such interactions may not be so rare. Perhaps the potential or probability of challenges with memory and beyond should be one of our foci? 

But relations with and among employees are constrained. There is privacy to respect. There is the safety of a possibly challenged worker, and others, to consider. There is minding your own business. There is the counter responsibility of both community and conscious.

Are there bright lines? When might you wonder or worry about a worker? When would you speak frankly to a coworker? When would you approach management? How would you decide?

Join us for The Point to hear from a manager, a physician, a business owner, and me. Let’s hear your questions, and share thoughts on how we can be better at the challenges we may face with doubt, concern, and consequences.

The Point Webinar – Slip Slidin’ Away: Identifying and Managing the Loss of Mental Acuity in the Workplace and Beyond.

https://lnkd.in/erUdc4an

https://workcompcollege.com/the-point-webinar-slip-slidin-away-identifying-and-managing-the-loss-of-mental-acuity-in-the-

Dopey Vernacular

I had the opportunity recently, at the Workers' Compensation Institute, to converse about a variety of issues with those who regulate Worker’s Compensation in America. The conversation eventually turned to dope, and there was great interest and entertainment found in the topic. 

Dope somehow persistently invades such conversations. There is some degree of academic interest. Some decry the challenges of measuring impairment. See Pot, Impairment, and Car Crashes (July 2017). Some lament the banking challenges of drug dealers. See What will the next 30 Years Teach Us (January 2016); Justice Thomas and Pot (August 2021). Some just elatedly expound on their love of pot and all things pot. The mere mention of weed excites them. The conversation turning to dope enthuses them.

The troubling aspect is that a great many educated, experienced, and otherwise grounded individuals continue to flippantly, persistently, and ignorantly proclaim that weed is “legal.” They banter regarding the manner in which the world has changed since dope "became legal." I find myself persistently reminding the masses that ganja is illegal in every U.S. State. You cannot blame them for their misstatements, there are stores on every corner hawking weed. It sure looks legal to the casual observer. 

There is persistent focus in these conversations on the changes in the employment process. Many find comfort or solace in their perceptions that various employers have stopped testing for cannabis in the pre-hire process. Their insinuation is that dope is acceptable, and weed is simply a ubiquitous part of the workplace.

Intoxicants and depressants are dangerous in the workplace. They are dangerous to those operating equipment, and even those in the presence of equipment. I encourage you to tread carefully when explaining to the police officer that you have not been drinking and driving but merely smoking “legal" dope. I wish you the very best.

In the health perspective, there is some chance weed is actually dangerous. See Smoking Never Killed Anyone (August 2024). So, it could kill you.  It could get you arrested.  But wait, there’s more!

In the post-injury context, many statutes provide an intoxication defense to workers' compensation. And while many would focus on the technicality of the word “intoxication,“ various statutes provide termination of benefits for the presence of drugs, legal or not. Many injured workers find themselves with no benefits as a result of their Drug use. This includes cannabis.

Employers that condone or ignore drug use and impairment may find themselves facing allegations of negligence. If someone is injured by an impaired forklift driver, truck driver, or machine operator, it is possible that impairment could lead to allegations of negligent hiring or supervision. It is possible that the employee's use of bourbon, marijuana, or oxycodone will result in a conclusion that the employer was negligent. An employer might exclaim "we didn't know," but questions might persist. 

In the instance of a coworker being injured, a company might still be shielded by the immunity of worker’s compensation. The employee distinction may be critical. An employee injured by an intoxicated coworker may be prevented from seeking a negligence recovery against either the employer or coworker. Thus, for workplace injuries, there is perhaps solace in "don't ask, don't tell" regarding workplace drug use.

However, what if the injured individual is instead struck on a street corner, at a customer's facility, or similar? Might a drug-using worker and her/his employer be liable for damages to such a plaintiff? In the event of such an injury, must the employee be “intoxicated“ for a jury to conclude the employee or her/his employer is liable for negligence? I would suggest not necessarily so. It’s quite possible that a substance-using employee could create employer liability.

These issues seem alien in many dopey conversations I witness. There is seemingly ignorance of implications, or perhaps merely ambivalence.

The disappointment is not in the debate. The world is certainly changing, as one of the recent participants pointed out. Attitudes toward persistent, or constant intoxication, addiction, and illicit drug use do seem to be shifting. Society has become seemingly welcoming to a population of the Spicoli walking dead(heads). There is a seeming increase in societal acceptance of personal choice or addiction taking precedence over the safety, well-being, and protection of society at large.

But what is as disappointing is the lack of comprehension. It is unlikely the result of negligence or happenstance ignorance. It is more likely, the result of willful ignorance, and which these leaders choose to ignore the legalities and implications of weed use.

After the recent panel presentation, and my reminder regarding illegality, I had multiple audience members and panelists approach me with their gratitude regarding my reminders that dope remains illegal. They express incredulity and astonishment at the misapprehension of this technicality.

This technicality is resulting in damage to American workers. They get a "recommendation" for ganja from a physician. They purchase marijuana at a local storefront. They end up taking a drug test, related to a work injury or not and then are fired for flunking it. See Decriminalizing Marijuana (May 2021). They are damaged by their beliefs that they "had a prescription" (they did not) and that pot "is legal" (it is not). 

The damage to these people is real. They are hurt by the disinformation and misinformation too common in the press. Every time someone says pot "is legal," they reinforce falsity. Workers rely on that falsity. Workers are damaged by that falsity. Teachers and others have been fired for their use of weed. Injured workers have had their benefits denied because of their use of weed. Marijuana is illegal. No matter how many times the press publishes "legal," and misleads these workers, pot will presently be illegal. 

Is the press to blame for people's misfortune? Perhaps not. But, the press could be more responsible in their word choice. Are administrators and regulators to blame for worker's woes from the use of dope? No more so than the press. But, it is troubling to see these state leaders blithely and mistakenly repeating the "legal" myth in any context. Hearing them do so repeatedly, publicly, and erroneously is nonetheless disconcerting. 

Could workers rely to their detriment on these misstatements? Who will pay the price of a positive drug test? It will not likely be the regulator or reporter. The probability is that it will be the worker. Choose your words wisely, someone may be listening. 

Teflon Flu

In the realm of Worker’s Compensation, one of the most difficult topics to address is occupational disease. We are surrounded by a significant measure of potential irritants, pollutants, viruses, and more. Perhaps the most challenging element of these is their existence in a variety of locations in our daily lives. 

In the early days of my legal practice, I was embroiled in a massive volume of asbestos claims. That introduced me to occupational disease when the compensability standard was perceived by some as far simpler than today. From that exposure, I became amazed at how  things so small and undetectable can be so pernicious and damaging.

In that age, I took hundreds of depositions regarding asbestos exposure, and medical science, which surrounded the diagnosis of various disease processes. There were several potential diagnoses that might be associated with asbestos exposure. A recurrent theme was the potential for compounding effects of multiple exposures, the “repetitive exposure” analysis. 

As a side note, if you are over 40, and have lived your life in America, There is some probability that you have inhaled a measure of asbestos at some point. To be fair, it’s perhaps as likely we have each taken in some quantity of "forever chemicals," "nano particles,"  and even erosion from someone’s yoga pants. Not mine, I don't wear yoga pants (you are welcome). You can Google all this, I’m not making it up. 

We might encounter such irritants and pollutants naturally. They might be in what we purchase and consume. They might fall from a passing vehicle and take up residence in our vicinity or body, as asbestos allegedly did in a Montana town over the course of decades of shipping. 

As small as items are, they are nonetheless, particulates, physical, And tangible. They are part of our world. We might be exposed to them in the workplace, in our kitchen, on a bus, or otherwise. That is one of the toughest challenges of occupational exposure, demonstrating where the exposure occurred. With some substances, occupational presence may be more profound or probable, but can workplace exposure be proven to the exclusion of other exposure? The compensability of such exposure allegations may come down to who has the burden of proof.

The news recently focused on a small population of people who have found themselves ill. Medical experts have apparently concluded that this illness is not a result of a particle or particulate, but a fume.  That is not revolutionary. Over many years, I have seen various examples of valid medical diagnoses linking causation to fume exposure. Typically, in the industrial setting, that has been associated with various chemicals, processes, and production. 

Perhaps there is some tendency to anticipate and appreciate such risks. Certainly, I have heard lectures by various occupational safety experts, who expound on the importance of PPE (personal protective equipment) in the workplace. Admittedly, that focus and such devices may be more prevalent in some occupations than others. Despite many efforts at workplace safety, there are some who nonetheless perceive a significant population of ongoing risks. 

Nonetheless, I was intrigued by the report of a recent study regarding the perceived increase in the prevalence of “Teflon flu.“ There is an increasing volume of diagnoses related to non-stick implements, which have become overheated, leading to fumes. An immediate question upon reading the article is whether more people are recently suffering from Teflon flu, or whether increasing knowledge and recognition is leading to a more prevalent label or diagnosis for an existing malady. That is worthy of consideration. 

The outcome is similar, and the fundamental conclusion remains: there is a potential for symptomatology and injury being expressed by some in the scientific community. Though the numbers are still moderate (267 cases in 2023), there may be reason for concern. 

The analysis seems to be one of cost/benefit. There is a product that is prominent in our lives (206.1 million non-stick retail units sold in 2020). There is a fair chance to find this material in almost any home. And yet, there are few among us who maintain PPE in our homes in preparation for something as seemingly mundane as an overheated frying pan.  The potential for exposure at home therefore seems significant, and PPE seems lacking.  But where might such material exist in the workplace? If we don’t know, PPE might be ignored there also.

 

Thus, there are risks we face daily that may be similar in our personal lives and occupations. Another good example is motor vehicle accidents, which could be occupational or not depending not on the action (driving), but the purpose of the particular trip. There may similarly be occupations in which the presence of such Teflon coatings may not be patent or obvious, and yet might yield occupational exposure in various circumstances. 

There is therefore no patent answer as to occupational exposure to something like these fumes. The questions will remain. Where was the exposure at work? Was the activity leading to exposure the work? Is the risk of such exposure one to which the worker is not exposed in non-occupational settings? Would it matter if the person claiming exposure neither owned nor used such implements in the home?

The result of this analysis is that there are many potential questions and challenges associated with such exposure allegations. There will be burdens to prove, science to examine, and questions to answer. 

Informed Consent

There are a multitude of issues surrounding medical care. Anyone who has undergone a medical procedure is somewhat attuned to the idea of "informed consent." An article published by the National Institute of Health (NIH), titled Informed Consent, defines this as:

"Informed consent is the process in which a health care provider educates a patient about the risks, benefits, and alternatives of a given procedure or intervention."

In the years I spent litigating workers' compensation and medical malpractice cases, this was a frequent subject. Patients ultimately make decisions about their care. The point is that they need to have sufficient information about that care and its risks in order to make valid choices.

Unfortunately, there are untoward outcomes from medical care. But there are miracles as well. In our modern world, we see news stories of miracles that are fantastic: vaccines, robot surgery, targeted medications. See Cleveland Clinic overview for details in recent years.

Unfortunately, there are also tragic instances in the news. A plastic surgeon here in Paradise was arrested after a surgery patient died in the midst of a procedure. There was another example recently in Nashville. These are extreme examples, but there are various potential complications of surgery. VeryWell Health provides a list that is similar to others on the internet:

• "Postoperative Pain, Swelling, and Bruising"
• "Anesthesia Reactions"
• "Intraoperative Injuries"
• "Bleeding Problems During Surgery"
• "Blood Clots Caused by Surgery"
• "Nerve Damage From Surgery"
• "Postoperative Infections"
• "Postoperative Pneumonia"
• "Delayed Healing After Surgery"
• "Scarring After Surgery"
• "Poor Results After Surgery"
• "Death Due to Surgery"

Suffice it to say that there are many potentials worthy of consideration. Over the course of many years, I have seen various patients or their families complain of each of these listed. 

Despite the risks "Globally, a staggering 310 million major surgeries are performed each year; around 40 to 50 million in USA and 20 million in Europe," according to an article published by the NIH. That is a great many operations, and in each, the patient was purportedly thoroughly informed and educated in order to facilitate an "informed consent."

I have seen informed consent in various settings. Some doctors deliver information verbally with a member of her/his staff witnessing/documenting. Some provide written materials listing and explaining the various potential outcomes and risks. Others have videos that describe and even demonstrate surgical procedures as well as the potential risks and challenges. The point, through whatever means, is that patients must realize what they are to undergo and what the potential risks may be.

This is sound practice. It makes sense that patients understand risk and make informed decisions. In doing so, patients use an economic analysis that is called a "cost-benefit analysis." Too often, that is seen as a purely economic tool. Those who make this mistake perceive "cost" as a purely financial element. The fact is, that "cost" can be any detriment.

So, if I will be unable to walk for some period following surgery, then that is a "cost" (I like to walk, and I do so daily, thousands of steps). If I won't be allowed to eat certain foods or will require so many hours of physical therapy after surgery, those are "costs." If the surgery may cause me pain for some period, that is a "cost." The idea here is clear. The downsides have to be measured against the upsides and then an informed decision can be made.

Thus, as Hamlet alluded to Horatio so long ago, however,

"There are more things in Heaven and Earth, Horatio, than are dreamt of in your philosophy.”

Hamlet, Billy Shakespeare, 1599. 

It is prudent to consider the known costs and benefits. Will the procedure provide the relief or restoration that is sought? Will any of the untoward outcomes listed above by VeryWell Health occur? If the surgery is to correct the fact that one of my eyebrows is higher than the other, or that one of my ear lobes is lower than the other, and there is a probability of a complication like death, my cost-benefit analysis has to consider that. Am I willing to risk death to even my ear lobes?

We all would like to be prettier. Let's face it, Madison Avenue and Hollywood have done a pretty solid number on most of us. There is a consensus that we all could use a little work, whether it is body rebuilding or just a little Bondo and paint. We are persistently being told we could look better (I have a mirror, you didn't need to tell me), and our society celebrates you pretty people while not supporting folks who look like me so much. 

Over time, it is possible that we might be affected by all this. We might come to see our body as needing work. In a recent story by the British Broadcasting Corporation (BBC) there was description of

"body dysmorphia, a mental health condition where a person sees a flaw in their appearance no matter how others see them. The impact of the condition can be devastating."

Thus, there are people like me who really could use a makeover and there are people who perceive flaws in themselves that either don't exist or are overemphasized. And, for some reason, there is a tendency to turn to surgery (see above re plastic surgery tragedies). The BBC article describes a young lady who wanted to be taller. Not "NBA" taller. She sought to go from 5'2" to 5'5", a three-inch increase.

The outcome? She had complaints of incredible pain following the surgery. She required additional surgeries to correct the placement of metal implants. She suffered through having legs of different lengths, which she says altered her posture and caused curvature of her spine. The outcome?

"Eight years on from the initial surgery Elaine says she is still recovering from her mental and physical scars."

The costs, perhaps, outweighed the benefits there. The potential benefit was to spend 50 thousand pounds ($64,000) and be three inches taller. The risks? Well, they are listed above. 

This is an extreme example of some of those coming true. There are many people every day who undergo surgical procedures. Some have far fewer complications or complaints, and some have none at all. For some the benefits prevail, for others the risks. 

It is highly personal; that your aunt Gertrude had no complications with her ear lobe lowering does not mean you will not. Just because your cousin George got an infection after his appendectomy does not mean that you will. The risks and benefits are possibilities, not certainties. As they used to say, "your mileage may vary."

So, if I need my appendix removed, it needs to go. People can die from a ruptured appendix. There is a health risk to foregoing that surgery. Having surgery, I risk death (see above) and not having surgery, I risk death. The analysis is challenging. However, if I don't have my ear lobe lowered, the risk is people may stare. Is that risk sufficient for me to take the risk of surgery (see above)? It is a cost-benefit analysis that is personal and complex, but above all should be informed. 

In the course of litigation following the leg-lengthening surgery noted by the BBC, there are two perspectives. There is the disappointed and disfigured patient who claims damages. There is the surgeon who voices, essentially, "She knew the risks."

The point is that both the benefit and the costs/risks are potentials that bear consideration and weighing in making that "informed consent" to undergo the care. 

How much information? The answer is "enough," and that will depend on the risks, the benefits, and the overall circumstances. The patient, ultimately, should be diligent and thorough in the decision because it is the patient who faces risks.