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This was filmed around the same time the single was in the charts, and transmitted in January The song was omitted from later video releases of the story, but finally reintroduced on the DVD release in The beginning of the song from Live in Boston by Fleetwood Mac can be heard in the second season of the television show Fargo. From Wikipedia, the free encyclopedia. Cover of the French release: Retrieved 2 May Archived from the original on Retrieved from " https: Archived copy as title Articles with hAudio microformats.

Views Read Edit View history. This page was last edited on 26 November , at By using this site, you agree to the Terms of Use and Privacy Policy. Devan agreed but told me once again, gently, that the odds were that Mom wasn't coming back. And she was right. After another week had passed, my brother came home from Asia, and my wife and children joined me in State College for a meeting with Dr.

Charles Maxin, who was Devan's senior colleague. He seemed like a figment of Norman Rockwell's imagination--calm and reassuring and flagrantly decent. Like Devan, he didn't mince words.

Joe Hill (writer)

Mom wasn't responding; we were only prolonging the inevitable. He told us her death would not be painful. I looked around at my family and asked if anyone had any objections to pulling the plug on Mom. Should we add it on? He probably would want to be resuscitated. If we tried to resuscitate him, we'd probably break the rest of his ribs.

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I approved a do-not-resuscitate order for Dad. It was becoming clear to me that in the gentlest possible way, these Geisinger doctors did not mess around. The Geisinger medical center seems almost like a mirage.

It is a giant, state-of-the-art medical facility plopped down amid farmland in the town of Danville, Pa. The hospital is the mother ship of an extensive network of medical practitioners tending to 2. It was founded in by a widow named Abigail Geisinger and first directed by Harold Foss, a surgeon who had been an assistant to the famed Mayo brothers. Like the Mayo Clinic, it employed a team approach, with doctors, paid as employees rather than as independent operators, cooperating on patient care.

Aaron, a health expert at the Brookings Institution. It's a lot more efficient than finding and organizing the carpenters, the electricians and the painters by yourself. There are good contractors and bad ones. The accountable-care-organization model--which is the emerging term of art for places like Mayo and Geisinger--was emulated in all its worst aspects when health-maintenance organizations HMOs emerged as a cost-cutting tool in the s and then became unpopular when they became synonymous with hellish bureaucratic medical rationing.

But during the years that HMOs were going in and out of fashion, a quiet revolution was beginning--the computerization of medical records. And Geisinger became a pioneer in analyzing those records to find out which sorts of treatment worked and which didn't. Over time, as the data accumulated, it has become clear that quality health care can be provided in a way that makes patients happy, with a minimum of draconian bureaucracy and for less money. Glenn Steele, Geisinger's president.

Geisinger has found, for example, that by adding case managers--nurses who work by phone and in person from doctors' offices--to chronic elderly-care cases like my parents before they entered the nursing home , they can give more individual attention and produce better results. The case managers call or visit the patients regularly to make sure they've taken their medication, weighed themselves on Bluetooth scales that send the results to the Geisinger computers , are eating the right things and are aware of upcoming appointments.

They are also there to listen to complaints, which, as those of us who've been through parent care know, are not infrequent. Over those years, Geisinger has quantified almost every aspect of health care. A bundle of nine routine procedures has been identified to treat diabetics, for example.

The bonuses that Geisinger doctors receive depend on how closely they adhere to proven procedures, as monitored by the Geisinger computers. Bonuses also depend, in part, on how the patients rate their care, and doctors--who are not always the most sociable human beings--are asked to go through a bedside-manner orientation program called Patients , which schools them in basic procedures like shaking hands with members of the patient's family, looking them in the eye and introducing themselves. This sort of training is especially important in a system in which doctors sometimes must try to deny care requested by patients or their families that is deemed unnecessary.

John Bulger, Geisinger's assistant chief quality officer. But the time spent on the discreet application of candor saves money and develops a deeper level of patient trust and satisfaction. In my parents' case, Geisinger had worked with the nursing staff at the Fairways. I was consulted about every adjustment in medication and told about every time Dad tried to do a walkabout and inevitably fell down.

By the third week, the staff and I were co-conspirators, laughing about Dad's stubbornness and trying out new strategies to make him more content.

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The situation was, of course, horrific--Mom and Dad were both fading away--but I no longer felt so guilty and frustrated. I was part of a team making their passage as comfortable as possible. After the struggles I'd been through with Dad, it's hard for me to describe what a relief this was. In a Darwinian business system, you have to wonder why it doesn't spread. But the model is becoming more popular, encouraged by the Centers for Medicare and Medicaid Services CMS , which has run hundreds of pilot projects over the past six years.

Much of the savings projected for the Affordable Care Act--Obamacare--would come from a broader application of his model. But that's going to be a big fight and difficult to win: The culture of fee-for-service medicine, which features each doctor as the captain of his or her own ship, is incredibly powerful. The shortcomings of fee-for-service medicine are well known, especially when it comes to Medicare. At the age of 80, my mother insisted on having a heart-valve operation to fix a murmur she'd had since birth.

The current system is rife with such unnecessary expenditures--"We're having a national epidemic of wrong patient operations," Fisher says--and it seems clear that a model like Geisinger's, in which doctors aren't rewarded for performing extraneous tests and operations, would be the best way to reduce the costs of Medicare. It also seems clear that asking people like my parents to make market decisions about their health care--the sort of system that Congressman Paul Ryan and other Republicans support--would be an act of cruelty and an unnecessary one at that.

In the end, changing the way health care is provided rather than the way it is sold may be the most efficient way to generate savings. Doctors are trained to do whatever they can to save a patient, even an elderly one, and that is an excellent thing. But that Hippocratic impulse has been subtly undermined by the rewards of fee-for-service medicine and by the threat of malpractice suits, which militate in favor of ordering the extra MRI or blood test or dialysis even for a patient who probably has only weeks to live.

And so it was that when my father was rushed to the Mount Nittany Medical Center suffering from acute kidney failure in late January, the immediate impulse of the doctors in the emergency room was to try to revive him by rehydrating him. Charles Dalton, told me.

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Dalton is a terrific fee-for-service doctor who had impressed me with his Geisinger-like candor in the past. You just go to sleep. Your dad's kidneys are pretty much shot. You may revive him, but he'll be back here in a month, six weeks. My next decision seemed obvious, but it was much tougher than removing Mom's feeding tube. He had always haunted my dreams, and now I had visions of the Mighty Malcolm rising from his hospital bed, screaming at me for trying to kill him.

But that Malcolm had disappeared after Mom passed away in November, a few weeks after the meeting with Maxin. At the end, I had fed her several teaspoons of chocolate ice cream and said, "I love you, Mom.

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The next morning, I told Dad that for the first time in 86 years, there was no Miriam. His will to live vanished. He pretty much stopped eating. I tried to revive his interest in food by having the nursing home serve him more of the things he loved to eat--salads, pancakes, a glass of sweet white wine with dinner.

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That's amazing," he said of the wine. You're a good son," he said for the first time in my life. Archived from the original on January 12, Retrieved August 18, Uncollected, Unpublished", Abingdon, Maryland: Cemetery Dance Publications, , p.

Transmission #20: Memories Fade

Archived from the original on December 1, Retrieved February 4, Archived from the original on February 5, Archived from the original on January 9, Retrieved January 9, Works of Joe Hill. Welcome to Christmasland — Bibliography Short fiction Unpublished and uncollected Awards and nominations. Heroes for Hope American Vampire World Fantasy Award — Long Fiction.

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