Archive for September, 2009

Kaiser Permanente Farmers’ Market Guru Wins Home Front Award

posted on September 23, 2009

Preston Maring, MD

Preston Maring, MD

By Ginny McPartland

Preston Maring, MD, the Oakland Kaiser Permanente physician who has nurtured our farmers’ markets nationwide, is being honored by the National Park Service (NPS) with the 2009 World War II Home Front award.

The award will be presented to Maring during Richmond’s annual Home Front Festival 2:25 p.m., Saturday, Oct. 3, in the Craneway Pavilion on the Richmond waterfront. Admission to the festival is free. The theme of this year’s all day event is “We Grow When We Come Together,” highlighting victory and community gardens.

Dr. Maring is receiving the award for his role in “keeping the legacy of World War II victory gardens alive by establishing farmers’ markets at Kaiser Permanente and by promoting the role of fresh produce in preventive medicine,” said Carla Koop of the NPS.

Last year’s recipient of the Home Front award was Faith Petric, renowned folk singer and Home Front New Jersey shipyard worker who has championed union, civil rights and anti-nuclear movements since the 1930s.

Dr. Maring started the Friday Fresh farmers’ market at the Oakland Medical Center in 2003. Since then, he has helped to grow 35 more local produce markets at Kaiser Permanente facilities across America. Kaiser Permanente has also supported other farmers’ markets in communities near our medical centers and clinics.

Dr. Maring, an OB-GYN physician with 38 years experience, authored the introduction to EatingWell in Season, the Farmers’ Market Cookbook, published in 2009 by EatingWell magazine. He has been acclaimed nationally, interviewed by many writers and appeared on “Good Morning America Health” in April.

Here are some examples of his yummy, accessible recipes: Moroccan Tomato Soup, the Quarterpounder Revisited, healthy Mash Potatoes, Radicchio with Chicken, Pine Nuts, Raisins, and Orange/Balsamic Vinaigrette salad, and Strawberry, Yogurt and Granola Parfait. For more recipes, go to: recipe.kaiser-permanente.org

Preventing Disease through Healthy Eating

Kaiser Permanente first took on the role of encouraging healthy eating as preventive medicine in the Kaiser Shipyards during the war. Dr. Sidney R. Garfield, founder of the medical care program, and his fellow physicians urged shipyards workers to grow their own fresh fruits and vegetables in the face of shortages.

The shipyard newsletters often carried articles instructing workers to eat a balanced diet, including vitamin-rich produce, to stave off illness and build the stamina to work at a pace and intensity to meet seemingly impossible goals and deadlines.

Kaiser Permanente is a sponsor of the Home Front Festival and will have an exhibit in the Craneway Pavilion at the Oct. 3 event. The display will chronicle the birth of Kaiser Permanente’s preventive care program in the West Coast Shipyards.

Garfield Biographer to Speak at Festival

Also, Heritage Resources Director Tom Debley will speak during the festival on the Red Oak Victory ship docked at historic Shipyard No. 3, which is part of the Rosie the Riveter/WWII Home Front National Historical Park. Debley will discuss the life and achievements of Sidney R. Garfield, MD, who launched the nation’s largest Home Front medical care program at the Kaiser Shipyards.

Debley is the author of Dr. Sidney R. Garfield: The Visionary Who Turned Sick Care into Health Care, published this year. His talk will begin at noon. Free shuttles will be available to take festival participants from the pavilion at the end of Harbour Way South to the Red Oak Victory, located west of the Craneway in the historic Shipyard No. 3 (Port of Richmond).

For more information about the Home Front festival: homefrontfestival.com

Tags: , , , , , , , , ,

CAREER SATISFACTION AS A PERMANENTE PHYSICIAN

posted on September 17, 2009

The following vignette comes from the desk of Samuel Sapin, MD, who writes on physician freedom and the bonds of mutual trust and affection that he found in nearly a half-century of practice in Permanente medicine.

sam-sapin-mdRecent reports indicate that doctors are retiring early.  Having wearied of administrative burdens and insurance company requirements, they are not experiencing the professional satisfaction they had hoped for when they chose to practice medicine.

On August 1, 1955, 54 years ago, I joined the Southern California Permanente Medical Group, leaving a potentially lucrative pediatric practice on Park Avenue in Manhattan mainly because I disliked the business aspect of practice and the inability of my uninsured patients to receive necessary care.  With Permanente, I first practiced general pediatrics in Los Angeles for four years, and then pediatric cardiology from 1959 until I retired in 2000.

Becoming a Permanente physician was one of the most important decisions of my life.  It gave me the opportunity to treat my patients in a manner consistent with my professional knowledge and training regardless of medical care costs, and the opportunity to build warm and trusting relationships that have endured these many years.  This was brought home to me this summer after I received phone calls from three former patients.

The first call was from an 18-year-old girl who had been my patient from birth and found to have a severe cardiac abnormality, a single ventricle.  With love from her devoted parents and family, and after early surgery and implantation of a pacemaker subsequently, she has been living the life of a healthy teenager.  She called this summer to tell me, proudly, that she had just been accepted into the freshman class at UCLA. I felt honored that she wanted to share her good news with me.

The second call was from a 45-year-old woman, also my patient from birth.  In her teens, although asymptomatic, my physical examination revealed evidence of an abnormal, prolapsed mitral valve.  She then left Los Angeles to attend college and changed her health insurance plan.  She subsequently had a career and a child of her own, and would occasionally call me as she got older to update me on her condition.  On this latest call, she was now becoming fatigued and her cardiologist advised surgical correction of her valve, now leaking. I supported his decision.  The valve was then repaired surgically and did not have to be to be replaced.  Her husband and family helped care for her child, and I was kept informed about her progress during and after surgery. All went well.

The third call was also from a former patient, Denise Dalto, now 57 years old.  She is a remarkable woman with a devoted husband, Bob Dalto, two loving elder parents, two children, and two grandchildren.  I first saw her when she was five years old (52 years ago) and made a diagnosis, confirmed by cardiac catheterizations, of coarctation (narrowing) of her aorta with associated abnormalities of her aortic valve and blood vessels going to her head and arms.  Surgery to correct the coarctation was performed at age 14, but repair of the blood vessels was deemed too difficult to repair safely in those years.  Since then she has led a very active life, including hiking, traveling and teaching.  For 34 years, she successfully taught school children in public schools from diverse racial and ethnic backgrounds, who had been unable to reach their academic potential and required teachers with special abilities.

Denise informed me on this call that recent imaging studies showed that one of the abnormal blood vessels in her neck was enlarging and in danger of rupture.  After much deliberation by denise-dalto-with-school-childrensurgeons at the Kaiser Foundation Hospital in Los Angeles, surgery though somewhat risky, was advised.  It would involve four different surgical and radiological specialties, and three operations within one month, a daunting prospect for even a brave patient.  She phoned to ask my opinion about the proposed surgery.  After investigation, I reassured her about the skills of the physicians involved, and she underwent the three procedures.  All were carefully planned and all went well.  A remarkable recovery followed, with a return to her normal, very active lifestyle. Before her surgery, she retired from her teaching position.  One of her colleagues took the photo here of Denise, her pupils gathered around her to say good-bye and wish her well.

These phone calls within a space of weeks, from three former patients, made me realize more than ever, how fortunate I was to have joined the Permanente medical group.  The Kaiser Permanente physician, over a lifetime of practice, has a wonderful opportunity to develop these personal bonds, which in retirement, gives one a great sense of professional fulfillment and the feeling of a life well spent.

– Sam Sapin, MD, SCPMG pediatric cardiologist (retired) and Clinical Professor of Pediatrics, Division of Cardiology,  David Geffen School of Medicine, UCLA

Ms. Dalto gave her consent for the release of her story.

Tags: , , , ,

Richmond Shipyard Workers Suffered Their Own Casualties of War

posted on September 4, 2009

In 1942, eighteen year-old Lucille “Penny” Price joined the shipyard workforce with little idea what lay ahead for her. Read on to hear a poignant account of what those days were like and the daunting challenges Penny faced.

Building warships was a dangerous enterprise. Workers in the Richmond shipyards during World War II learned the hard way how easy it was to be injured when working at a furious speed to fulfill orders for sorely needed war vessels.

Richmond shipyard workers 1943

Richmond shipyard workers 1943

The odd mix of people who converged at the Kaiser shipyards added to the complexity and worry associated with the safety of workers of all levels of skill and socialization. The majority of them had little or no experience building ships.

There were black and white men and women from the agrarian southern states and other parts of the country. There were native San Francisco Bay Area women and men. There were men who had medical conditions that totally disqualified them from serving in uniform (Class 4F). There were handicapped workers.

Risky Business
Injuries minor and major were common. In fact, working in a shipyard was one of the most dangerous jobs in the wartime industries, more risky than the manufacture of tanks, aircraft, and explosives. The shipyards of America reported an average of 33 disabling injuries per million hours worked in 1943. (This compared favorably to the iron and steel foundries whose average accident rate was 40 injuries per million hours worked.) About 700 shipyard workers were killed during 1943 and 1944 in accidents in the nation’s shipyards.*

Some injuries were purely accidental, some were from carelessness, and others were simply vicious.

“It Wasn’t All Beer and Skittles…”
An eighteen-year-old Oakland girl, Lucille “Penny” Price, joined the shipyard workforce in October 1942. She made good money as an electrician and considered the wartime work a great opportunity. She sums up the experience in this casual understatement: “It wasn’t all beer and skittles.”**

Price, an electrician in Yard 3, was almost scared away from the shipyards when she witnessed a fatal accident on her first night of work. A guide was taking a group of new employees, including Price, on an orientation tour when they heard “beep, beep, beep,” the sound of a crane in motion. “The guide was telling us that when you hear that sound you get the heck out of the way and stay away,” Price recalled. But some other workers didn’t heed the warning sound, and as the crane lifted a heavy sheet of steel aboard a ship, one of the cables broke and the load slipped and killed several of them.

“I tell you I was ready to run, and so were the other people in our group of electricians,” she said.

Price was quickly reassigned to the relative safety of the electrical shop to give her time to get over the shock. She stuck it out and by Christmas was wiring C-4 transporters and LSTs (landing ship, tanks) and continued to work in the yards until early 1945. During her tenure there, she would experience many injuries herself.

Threatened by Male Counterparts
Now 84 years old and living in Windsor, Calif., Price recalls the time a “chauvinist” kicked a ladder out from underneath her and caused her to fall over a stack of pipes. The man who made her fall was fined and fired, never to work again in the shipyards. Penny was taken to the shipyard Field Hospital where she was treated for two cracked ribs.

Price also recalls that men also liked to sneak up on her while she was working from a plank stretched across the open deck with six floors below. “They’d make the board vibrate and that scared the hell out of me.”

Male shipyard workers’ poor treatment of their female counterparts was not uncommon. “When women managed to enter jobs that seemed still to be the prerogatives of men, they were sometimes mistreated; “harassed” is the word we would use nowadays,” said Columbia University professor http://www.columbia.edu/cu/history/fac-bios/Kessler-Harris/faculty.html Alice Kessler-Harris in an interview on PBS.

“Men often played tricks on women by sending them for tools that did not exist. Men also sexually harassed women by whistling and cat-calling to them as they worked. Most of the resistance and hostility towards women workers disappeared as the novelty of women workers wore off, the labor shortage got worse, and women proved themselves, according to Susan M. Hartmann, http://history.osu.edu/people/person.cfm?ID=695 author of The Home Front and Beyond: American Women in the 1940s.

Victim of Double Pneumonia—Before the Days of Penicillin
Penny Price was also a victim of double pneumonia that developed after she was caught in a dark corner on the same level as a dozen hostile workmen during an air raid warning drill. Price had been doing some wiring by herself above the shaft alley when the “whoop, whoop” of the siren came and the lights went out. She huddled in a space near a boiler for two hours, shaking with fear as the burly workers made comments like: “Wait ‘til I get my hands on that little chick over there.”

Lucille "Penny" Price 1943

Lucille "Penny" Price 1943

When the drill was over, her leaderman, Charlie Ryder, swooped her up from the spooky pit. She couldn’t stop shivering, so her coworkers gave her coffee to warm her up. “To this day, I can’t stand the smell of coffee with cream in a paper cup.” She “upchucked” the coffee that night at home and returned to work the next day thinking she was fine. But the shaking returned, and she was taken to the field hospital where they took a chest X-ray and diagnosed double pneumonia.

This was in March 1943 before penicillin was available to civilians. At the Oakland hospital where our doctors were perfecting the treatment of pneumonia, she was given a “horrendous” clear liquid (probably horse or rabbit serum) every few hours. That liquid along with oxygen therapy cured her of the mysterious pneumonia.

Penny Price today

Penny Price today

During the war, Permanente physician Morris Collen experimented with the treatment of pneumonia as he managed a large number of shipyard cases. By the end of the war, Collen had published his findings and earned a national reputation as a pneumonia guru. His prestige was such that he was able to get some of the first civilian penicillin in 1944 to save the lives of the 7-year-old daughter of a shipyard worker in Vancouver, Wash., and a young man in a Richmond yard.

Hospital Visits—Much Too Frequent
Throughout her time at the shipyards, Penny Price was injured numerous times and was a frequent visitor to the First Aid Station and the Field Hospital. “I was in and out of the Field Hospital like a yoyo,” she said. She frequently cut herself using a linoleum knife to cut electrical cable. She vividly recalls the inside-out eyelid treatment administered when she got bits of steel mesh from the cable in her eyes. She also recalls that when working around fiberglass she sometimes got particles down her neck that irritated like a thousand flea bites.

Her most serious injury was caused by an accidental explosion that knocked her down from the ship’s superstructure onto the deck below where workers were using acetylene torches to shrink the deck. As a result of the fall, she suffered burns and an injury to her knee when it struck a bolt on the deck. She was burned so badly that she had to return for treatment for nine months before her leg was healed. “I still have scars on my leg to this day,” she said. She returned to work after a short hospital stay wearing a splint on her knee wound.

Price remembers an inspector coming around to urge the workers to follow the Maritime Commission safety rules to avoid injuries. “He’d show us a glass eye and say ‘do you want one of these?’” We’d shudder, and he would say: ‘then, wear your goggles!”

Safety Program Launched in 1943
In 1943, the U.S. Maritime Commission launched a safety program that ultimately reduced the injuries per million hours worked in the shipyards to 23.2 in 1944. “The work of the (commission) was of value in two ways – by allaying fears that working in a shipyard was more dangerous to life and limb than working somewhere else, and by making this true through insistence on a high standard of protection and precaution,” wrote Frederic Lane in his 1951 book Ships for Victory.

*Of the 655 reported private shipyard fatalities in the nation during 1943 and 1944, vehicles or loads striking workers was the second most common type of accident (25 percent) after falls (39 percent). Half of the “strike by” accidents involved cranes.

**’Beer and skittles’ is shorthand for a life of indulgence spent in the pub. Skittles, also known as Ninepins, which was the pre-cursor to ten-pin bowling, has been a popular English pub game since the 17th century. This definition is according to the Phrase Finder, a United Kingdom Web site: www.phrases.org.uk/meanings/230200.html.

— Ginny McPartland

You can watch a lecture about Dr. Sidney R. Garfield’s long quest for health care reform by Tom Debley to the Commonwealth Club of California.

Tags: , , , , , , , , , , ,