Brian Wakamo: Even for rich ballplayers, the drawbacks of contract work
From OtherWords.org
Major League Baseball has a problem on its hands: Teams are making record revenues thanks to massive regional cable deals. But more than ever, those teams aren’t signing players. They’re becoming cheapskates.
Take, for example, Craig Kimbrel and Dallas Keuchel.
Kimbrel is one of the greatest relief pitchers of all time — he’s the youngest player to reach 300 saves in MLB history — and as of today, he remains unsigned. Keuchel won the Cy Young award given to the best pitcher in the league in 2015, and won a World Series with the Houston Astros. But he too remains unsigned.
Even players like Bryce Harper and Manny Machado, the marquee free agents of this past year, got slightly shafted out of deals that would’ve truly paid them what they’re worth.
MLB teams waited and put off signing them to drive their price down — which might seem absurd, seeing as those two ultimately signed deals paying them $300 million or more. But their value to their teams is so high that they could’ve been paid more.
The MLB also has a problem with its young talent.
Teams wait to bring players up to the majors because of a “service time” rule. That rule says that if a league player is on a major league roster for 172 days out of the 187-day MLB regular season, he’s “earned” a year of service time. But that’s being manipulated to keep young players on cheaper contracts for longer periods of time.
Basically, teams won’t call up talented and valuable youngsters to the majors until enough days have passed that they can’t earn a year of service time. Therefore, that young player is forced to stay on a team for an extra year on a smaller contract. Past MVP Kris Bryant is an outspoken victim of this manipulation.
Vlad Guerrero Jr., the extremely talented son of famed slugger and bad ball hitter Vladimir Guerrero, is another, while Harper had a similar situation occur when he was still on the Washington Nationals.
What all of this does is deprive the fans of seeing their teams at their best.
Harper and Machado being signed late means they enjoyed less time acclimating to their new teams. Keuchel and Kimbrel remaining unsigned means that teams are actively worse because they don’t have those players. Postponing someone like Guerrero Jr. from playing prevents fans from seeing him make extraordinary plays, and from making an impact for their teams.
It also hurts the players themselves. They’re not getting the full benefits of their work because of the billionaires who own these teams seemingly colluding to prevent paying these players and to keep them tied down for longer.
Why should we care about the paychecks of millionaire athletes? Because they’re a highly public example of what many much lower-wage workers experience in their own lives.
In the broader economy, the rise of contract employment has allowed employers to avoid paying benefits and suppress wages. Other employers will manipulate part-time vs. full-time classifications for the exact same reason.
These baseball teams are acting like modern-day corporations, in other words.
But professional baseball players have a resource many other workers no longer enjoy: a powerful union. That union should step up to protect their players — and to show workers at all levels that they can do the same.
What can the fans do? Let your team know they need to splash the cash and build their best teams. And don’t forget: If corporations treat millionaire assets this way, imagine how they’ll treat you.
Brian Wakamo is a research assistant on the Global Economy Project at the Institute for Policy Studies.
Liberating art
“The Doctrine of Liberty’’ (oil on canvas), by Carl Mehrbach, in his show of 3D abstractions at Bromfield Gallery, Boston, through June.
Beware 'Fairy Circle'
Thomas Hook, the Southbury, Conn.-based photographer and naturalist who took this picture, explains: “This circle of mushrooms appeared on my lawn last evening and it’s the first I’ve seen in many years. It medieval times it was known as a ‘Fairy Circle,’ not to be stepped into for fear you would disappear into some supernatural realm or be faced with an early death were you to step in and then step out. In Germany it was called a ‘Witches’ Circle,’ wherein dancing occurred on Walpurgis Night. Whatever your belief system, it was exciting for me to find, as good as finding a Scarlet Tanager!
Quirky list of Mass 'bests'
An online news service called Your RV Lifestyle presents what it calls the best things to do in Massachusetts. It says the best is Boston’s Freedom Trail, seen above at Faneuil Hall. The list has some amusing factual errors.
— Photo by Mama Geek
Smaller and richer
The Berkshires from North Adams, Mass., once an important industrial city and source of several steam pollution.
— Photo by JBCurio
From Robert Whitcomb’s “Digital Diary,’’ in GoLocal24.com
Justin Fox, writing in Bloomberg, had a good piece on how some cities can shrink in population but yet get richer by reinventing themselves. Pittsburgh, which moved from steel and other manufacturing, to high tech, higher education and health care, is probably the best example.
Mr. Fox also cites among other cities Pittsfield, Mass., once heavily dependent on manufacturing, especially General Electric’s, but that has now positioned itself as a tourist, arts and college center in the middle of the Berkshires. Then there’s Barnstable County, Mass. (aka Cape Cod), another scenic area, which has become a favored retirement center for affluent older people. (That doesn’t seem a perfect recipe for long-term economic growth, if Cape Codders really want that growth.)
So once distressed cities can reinvent themselves. Still, it seems to me that truly long-term prosperity, with a strong middle class, is more likely with a highly diversified mix of services and manufacturing.
To Mr. Fox’s article, please hit this link.
https://www.crainscleveland.com/government/opinion-can-city-shrink-and-thrive-its-complicated
At PCFR, Taiwan diplomat to look at East Asian scene
Dragon boat in the annual Taiwan Dragon Boat Festival on the Blackstone River.
Taiwan Diplomat to Discuss East Asian Trade and Security Issues
The last dinner of the current season of the Providence Committee on Foreign Relations (founded in 1928) is scheduled for Tuesday, June 4, here at The Hope Club. The new season will open in September.
Please consult its Web site -- thepcfr.org -- and/or send queries to pcfremail@gmail.com for more information about the PCFR, including on how to join.
On June 4, Douglas Hsu, a senior diplomat who currently oversees Taiwan’s interests in New England as director general of the Taipei Economic and Cultural Office in Boston, will speak about current political and economic conditions in that nation (one of Rhode Island’s largest export markets), China’s military and other threats to Taiwan and the East Asian scene in general.
(Taiwan sponsors the annual Dragon Boat races on the Blackstone River and indeed just gave six of them to the City of Pawtucket!)
Mr. Hsu, who previously served two stints in Washington, may have some perspectives on the China-U.S. trade war. His work in Washington included being Taiwan’s liaison with Congress. (Meanwhile, a reminder that the official name of Taiwan is the Republic of China.)
Mr. Hsu has served in multiple positions in Taiwan’s Department of North American Affairs in the Ministry of Foreign Affairs, beginning as a desk officer in 1998. He was the department’s Deputy Director-General from 2016 to 2018, when he assigned to Boston.
The director general (effectively the consul general for New England) earned a B.A. and M.A. in International Relations from National Cheng-Chi University and has participated in the Diplomats Training Program at Oxford University (1998) and the Senior Executive Fellows Program at Harvard University (2009).
Art offsets the indignities of age
Phillip Evergood, “Dowager in a Wheelchair” (1952), by Phillip Evergood, in a traveling show from the Smithsonian American Art Museum titled “Modern American Realism: Highlights from the Sara Roby Foundation Collection’,’ through Oct., 14, at the Nantucket Historical Association.
The exhibition includes over 40 works of art by notable artists Will Barnet, Isabel Bishop, Edward Hopper and Wolf Kahn, among others.
nha.org/modern-american-realism
Chris Powell: Connecticut's self-destructive income tax and migration problems
On State Street, in the famous sanctuary city of New Haven.
Last week brought more evidence that Connecticut is paying successful and self-sufficient people to leave and paying poor and dependent people to stay or settle in the state.
The evidence came from Bloomberg News, which analyzed Internal Revenue Service and Census Bureau data about population movement among states in 2015 and 2016. The news service found that population movement was most costly to Connecticut, New York, and New Jersey, with Connecticut losing 1.6 percent of its population's annual adjusted gross income. The study found that the average income of people departing Connecticut was $122,000, the average income of people arriving was $97,000, and five people left the state for every four people arriving.
Many arrivals in Connecticut are illegal immigrants settling in the state's "sanctuary cities." They depress the income averages and tend to require government services. Poverty may be a virtue in religion but it is only a handicap in governance, and yet legislation pending in the General Assembly would establish "sanctuary" for illegals in all the state's 169 towns by prohibiting almost any cooperation with federal immigration authorities.
There is much dispute over whether raising Connecticut's taxes on the wealthiest, risking more income migration, would cost more tax revenue than it gained. But the data examined by Bloomberg News show that Connecticut already has plenty to worry about with the flight of its middle and upper-middle classes.
Florida may be the leading destination for people departing Connecticut and other highly taxed and declining states, in large part because Florida has avoided a state income tax. The study found that while Connecticut was losing 1.6 percent of its population's adjusted gross income, Florida was increasing its population's income by 3 percent. The average income of a Connecticut resident moving to Florida appears to be a whopping $253,000, but in recent years many people of all self-sufficient income levels have left Connecticut for the Sunshine State.
Of course Florida isn't heaven. Its mild winters are matched by oppressive summers. Away from the shore, Florida's geography is bland prairie. Florida real estate near the shore is more expensive than most real estate in Connecticut. The bears that increasingly annoy Connecticut's rural and suburban residents are cuddly pets compared to Florida's alligators, Burmese pythons, and year-round insects. Florida's hurricanes do far more damage than Connecticut's snowstorms.
Indeed, Connecticut has many natural advantages -- lovely, varied, but gentle geography, a temperate climate with three pleasant seasons, proximity to New York and Boston, and suburban convenience. But its cities continue to decline and the income-migration data is an indictment of the gross failure of state government policy to improve Connecticut's demographics, to do much more than sustain the government and welfare classes at the expense of the private sector. The more taxes are raised to perpetuate this policy failure, the more the most taxable people depart -- and taxes are about to be raised again.
Progressive taxation is good only insofar as it helps to deliver good government. It is not an end in itself but a means to that end. When it fails to deliver, the people it taxes most may wise up.
The income migration data argues against raising Connecticut's income tax rates as many Democratic state legislators want to do. But it also argues for challenging the premises of much state policy. If state government was improving rather than impoverishing Connecticut, people who pay more taxes might be inclined to stay anyway.
Chris Powell is a columnist for the Journal Inquirer in Manchester, Conn.
High-end coastal crops
The Whaleback Shell Midden, in Damariscott, Maine, contains the shells from oysters harvested for food dating from 2,200 to 1,000 years ago
“Of all New England dishes, clam chowder probably evokes the strongest feelings. In 1939, for instance, a bill was introduced into the state legislature in Maine suggesting that to make a clam chowder with tomatoes be deemed illegal. Almost passed too.
-- From Inside New England (2010), by Yankee magazine’s Judson D. Hale
From Robert Whitcomb’s “Digital Diary,’’ in GoLocal24.com
The Maine Coast is becoming an international center of aquaculture, especially of oysters and other shellfish and edible seaweed, even as the warming of New England waters drives the lobster catch further north and east. The number of these salt water farms has increased rapidly in the Pine Tree State, with the epicenter in the Damariscotta area. It’s worth a trip up there by present and potential aquaculturalists from southeastern New England, although their crop mix might be a bit different from Maine’s because of our warmer water and different coastal geology.
For more information, please hit this link.
“Of all New England dishes, clam chowder probably evokes the strongest feelings. In 1939, for instance, a bill was introduced into the state legislature in Maine suggesting that to make a clam chowder with tomatoes be deemed illegal. Almost passed too.
-- From Inside New England (2010), by Yankee magazine’s Judson D. Hale
Todd McLeish: Amphibians and reptiles under stress in New England
A northern leopard frog, a species that has been disappearing
From ecoRI News (ecori.org)
When Scott Buchanan was hired as a wildlife biologist at the Rhode Island Department of Environmental Management last year, he became the first full-time herpetologist on the state payroll. It’s a sign, he said, that reptiles and amphibians are in need of management and conservation in the state.
“To be in herpetology is to be on the front lines of the global biodiversity crisis,” he said. “We’re at risk of losing, globally, roughly half of the reptile and amphibian species on Earth in the next 100 years. Turtles and frogs are in a neck-and-neck competition for the unfortunate title of being the most endangered wildlife taxa.”
While Rhode Island’s reptiles and amphibians haven’t experienced the level of habitat loss and disease that occurs in Southeast Asia or the tropics, Buchanan said “the crisis is very real in New England. The mission is very urgent, and we need to do everything we can here in Rhode Island.”
About 40 species of turtles, snakes, frogs, toads, and salamanders call the Ocean State home. All face issues of habitat loss, road mortality, and disease, but turtles are also faced with high demand from collectors for the pet trade.
While monitoring a rare population of wood turtles this spring, herpetologist Lou Perrotti, director of conservation at the Roger Williams Park Zoo, observed a small specimen he estimated to be 5 or 6 years old.
“I love to see the little ones,” he said, “but I worry that someone would put this one in their pocket and take it home.”
It’s such a concern that Buchanan is co-chair of a collaborative group of biologists, law enforcement officials, and legal experts from up and down the East Coast working to combat the illegal trade in native turtles. The objective, he said, is to raise the profile of the issue and encourage the law-enforcement community to be aware that a black market in native turtles exists in the region.
The illegal trade in wildlife is valued at about $19 billion annually, according to the World Wildlife Fund’s TRAFFIC program, a network of organization that monitors the trade.
“It’s something I worry a lot about,” said Buchanan, who conducted research on spotted turtles for his doctorate at the University of Rhode Island. “If you know where they are, turtles are pretty easy to pick up, take home, keep alive, and get them into the black market. All of our native species are vulnerable, though some are more prized than others.”
A Pennsylvania man was arrested last year for smuggling 3,500 rare diamondback terrapins from marshes in New Jersey and selling them online. Although no cases have been adjudicated in Rhode Island, Buchanan said there is evidence of the illegal turtle trade in the state.
Buchanan is also involved in region-wide efforts to study spotted turtles and box turtles, two species that are considered to be of significant conservation concern. He is conducting surveys of both species in Rhode Island this spring to gather as much data as possible about their distribution, abundance, demography, and population genetics.
In collaboration with Roger Williams Park Zoo and Brown University, he is also investigating the presence of disease in local populations of reptiles and amphibians.
“We need to improve our understanding of where the diseases are and what species are harboring them to get a sense of their susceptibility,” Buchanan said. “There’s chytrid [a common amphibian disease in the tropics] in our environment, though our frogs don’t seem to be susceptible, but there hasn’t been a lot of testing. And there’s a similar disease for salamanders that has had bad outbreaks in Europe, and we’re worried about it coming overseas.”
Two species of amphibian — the eastern spadefoot toad and northern leopard frog — are on the verge of disappearing from Rhode Island. Both have only one known population. The toad is only found at one site in Richmond, though efforts are under way to create habitat to establish additional populations.
The northern leopard frog is found only on the border of Bristol and Warren, and Buchanan said there is little that can be done to help it recover.
“The northern leopard frog might be the best example of a species that’s about to disappear from the state,” he said, noting that the species faces multiple threats from habitat loss, pollution, and invasive species. “It could happen this year, next year, or in five years, but all indications are it’s going to happen soon. And there’s not a tool in my toolbox at the moment that I can use to confront the situation.”
Rhode Island resident and author Todd McLeish runs a wildlife blog.
Ben Lilliston: Trump's trade fights expose fragility of the farm sector
From ecoRI News (ecori.org)
Over the last year, President Trump has taken farmers on a roller coaster ride that’s finally gone off the rails.
Escalating trade fights have kicked farmers, already mired in a five-year slump, in the gut. Now, the administration is working up a new trade aid package, while simultaneously opposing aid for farmers recovering from recent Midwest flooding.
What’s going on? If there’s a plan, it’s hard to see from here.
Just in the last few weeks, Trump tweeted a dramatic escalation in new tariffs on China, which immediately announced an escalation of tariffs on U.S. goods, including agriculture products.
A week later, without notice or explanation, Trump ended steel tariffs (based on dubious national security concerns) on close trading partners Mexico and Canada. Yet the same day, Trump signed an executive order threatening new auto tariffs on Japan and the European Union.
If the auto tariffs move forward, Japan and the E.U. will almost certainly retaliate with tariffs on, you guessed it, agricultural products.
In a hasty attempt to put a Band-Aid on these self-inflicted wounds, the Trump administration is proposing another round of trade aid for farmers. The new round comes after promising that a $12 billion trade aid package last year would be a one-time thing, because a China trade deal was just around the corner.
But, surprise surprise, it wasn’t. So the administration backtracked and recently unveiled another $16 billion aid package for farmers hurt by its policies.
The first aid package doesn’t appear to have focused on the mid- and small-sized farm operations that needed it most. The Financial Times found that half of the trade aid money went to just 10 percent of farmers, who used loopholes to elude payment caps.
Moreover, nearly 10,000 people and businesses based in cities — rather than the countryside, where you expect to find farms — accessed the aid. And it was multinational agribusiness firms like Tyson Foods, Cargill, and the Brazilian-owned JBS that benefited when the USDA made large purchases of pork, chicken, and beef.
Trump’s trade disruptions come amid much larger challenges in the agriculture economy. Rising farm bankruptcies, the loss of thousands of mid- and small-size dairies, farm lenders getting tighter with loans, and plummeting land values are all part of the current crisis.
And when it rains, it pours. A series of extreme, climate-related weather events — severe Midwest floods this year, wildfires and hurricanes last year — also hit farmers. Yet the Trump administration has opposed allowing farmers to access disaster aid from these events.
The drivers of our slumping farm economy are longstanding and structural.
We’re flooding the market — too much corn, soy, wheat, and milk. Meanwhile the government has approved a steady series of agribusiness mergers, leading to less competition and fewer choices for farmers.
Federal Farm Bill programs support this system, which precariously relies on expanding trade. If we don’t grow exports, the system collapses — at least for family farmers. It works just fine for the global agribusiness firms that operate in multiple countries and benefit from below-cost corn and soy.
Trump’s dizzying trade disruptions are inflicting real short-term damage, but they’re also exposing the frailty of an agriculture economy built for big business. Instead, we should be looking for ways to reduce overproduction, lift prices to fair levels that keep farmers on the land, and invest public money in climate resilient strategies on the farm.
A different farm economy is possible, but we must come to terms with past mistakes that created this roller coaster.
Ben Lilliston is a senior policy analyst for the Minnesota-based Institute for Agriculture and Trade Policy.
Living vertically
Lower Warner Meetinghouse, in Warner, N.H.
Where I Live
is vertical:
garden, pond, uphill
pasture. run-in shed.
Through pines, Pumpkin Ridge.
Two switchbacks down
church spire, spit of town.
From “Where I Live,’’ by Maxine Kumin (1925-2014). She lived in Warner, N.H., where she and her husband raised horses. She received the Pulitzer Prize for her book Up Country: Poems of New England.
Chrysanthe Demetry/Elizabeth Long Lingo/Jeanine Skorinko: WPI helps lead way to more faculty diversity
Boynton Hall, the main administration building at Worcester Polytechnic Institution.
From The New England Journal of Higher Education, a service of The New England Board of Higher Education nebhe.org)
WORCESTER
The goals of higher education—engaging the hearts and minds of our next generation, advancing novel and pragmatic solutions to the most pressing local and global problems—call for great passion and skill. That’s not the whole formula, though. Diversity performs its own powerful role.
College faculties that represent a diversity of expertise, ideas and perspectives help create the kind of environment where learning, innovation and excellence thrive.
While much good work is being done to recruit female and minority faculty members and retain them through their first promotion to tenure, their advancement to the highest faculty ranks and to institutional leadership positions has remained elusive due to various systemic barriers.
Nationally, women account for only about 30% of college presidents and about 30% of the highest-rank full professors, a dynamic that has ripple effects on decisions made throughout institutions of higher education. The picture is even bleaker for female minority members in these upper echelons.
Further, while more women and minorities are being recruited, they are more likely to be hired for non-tenure-track (NTT) positions that typically have less advancement opportunity. These NTT faculty, the teaching workhorses, are often not supported with professional development opportunities or pathways to promotion.
So, how do universities diversify the ranks of those holding their field’s highest positions?
In 2014, our institution, Worcester Polytechnic Institute, undertook an overhaul of our associate-to-full professor promotion system after participating in a nationwide faculty satisfaction survey that many institutions conduct. Findings revealed high levels of satisfaction with the tenure process—but deep dissatisfaction among associate professors, women and NTT faculty about their promotion systems. Three years of hard work and messy internal politics later, our faculty governance body approved an associate-to-full promotion policy that draws on the work of the late educator Ernest L. Boyer and others to define and welcome multiple forms of scholarship.
Such policies are not new; decades ago, dozens of institutions put in place similar ones. However, what is becoming clear is that adopting new criteria and policies is only a first step. How schools implement the new policies is vital to success.
With the support of a three-year ADVANCE Adaptation grant from the National Science Foundation, we are tackling this challenge at our institution head-on, and we plan to share our findings with others in higher ed. We found three key areas that warrant specific focus:
Advancement for non-tenure-track faculty
Nationwide, a disproportionately large number of women and minorities hold non-tenure-track positions. At many universities, these faculty do not have a promotion pathway. While at WPI, non-tenure-track professors do have a path to promotion, both the criteria and process are perceived as unclear, and the criteria do not seem to recognize scholarly contributions. Moving forward, it is important for WPI and other institutions to provide clear promotion pathways and criteria to recognize the important and valuable work non-tenure-track faculty conduct.
A wider view of what’s valuable
Traditionally, promotion criteria are often interpreted too narrowly—emphasizing traditional peer-reviewed and externally-funded research, for example, rather than the broad array of interdisciplinary, teaching and community-engaged contributions that often distinguish scholarship portfolios and undergird universities’ missions. Broadening promotion criteria can help remediate the systemic biases that exist in traditional scholarship metrics—as women and minorities receive less funding, are cited less frequently and have more issues in the publication process. However, a wide range of faculty and academic leadership need to work together to ensure that new policies are interpreted and applied as intended and to make expectations and standards transparent. Moreover, it is also essential to engage colleagues in efforts to increase awareness of explicit and implicit biases about who’s a leader, who does what type of work and what high-quality scholarship looks like.
Tailored focus on mid-career faculty
A common misconception is that once faculty members reach tenure, they are well-positioned to take the next leap to full professor. Continued professional development and mentoring would benefit all mid-career faculty. Typical “fix-the-faculty” ideas that focus on enabling individuals (especially women) to say “no” to service and engagement requests, spend more time on their research and succeed in the traditional system fall short. Instead, a model for mentoring and professional development that prioritizes the creativity and passions of each individual in order to use their strengths in ways that advance themselves and the institution is needed. At WPI, we are introducing personally tailored professional development plans designed to become the centerpiece for conversations with mentors. We are also helping to activate department heads as catalysts for mid-career faculty innovation rather than as managers and arbiters of performance.
Throughout any examination of its promotion processes, a university must make choices that align with and bolster its core strengths and purpose. It is vital that the most distinctive elements of an institution are woven into the promotion pathways from associate-to-full for non-tenure-track and tenured faculty. It is just as vital to ensure that all faculty, regardless of their backgrounds, have the opportunity for advancement.
By aiming for systemic change rather than tinkering at the edges, reformed promotion policies can value and recognize more diverse faculty at all ranks. A flourishing diverse faculty body dedicated to the shared goal of excellence promises an innovative and stronger educational and scholarly environment for all.
Chrysanthe Demetry is an associate professor of mechanical engineering and director of WPI’s Morgan Teaching and Learning Center. Elizabeth Long Lingo is an assistant professor at WPI’s Foisie Business School. Jeanine Skorinko is a professor of psychological science and director of WPI’s Psychological Science Undergraduate Program.
'The Dignity of Trees'
Work by Renee Monteiro-Bernard, in the group show “The Dignity of Trees,’’ at the Dedee Shattuck Gallery, Westport, Mass., June 8-30.
Wider Cape highway bridges would bring more traffic
If only more people could take the train to Cape Cod, via the Cape Cod Canal Railroad Bridge, above, on such services as the CapeFLYER, seen below at Buzzards Bay.
From Robert Whitcomb’s “Digital Diary,’’ in GoLocal24.com
There are big plans afoot to replace the Bourne and Sagamore bridges, over the Cape Cod Canal, with wider ones, with the hope of easing the flow of traffic, especially, of course, in the summer, and making the crossings safer. There would be an additional third lane in each direction on each bridge. In fact, after a while the wider bridges would be as jammed as the current thrillingly narrow ones, which were built in the 1930s. More roads and lanes draw more cars.
If only there were daily, year-round train service to get more Cape-bound people off the road.
There is CapeFLYER’s Boston to Cape Cod passenger train service, over the canal’s railroad bridge, offered Friday evenings, Saturdays and Sundays from Memorial Day weekend to Labor Day. It goes from Boston’s South Station to Hyannis via Braintree, Brockton, Middleborough/Lakeville, Wareham Village, Buzzards Bay and Bourne, with scheduled travel time from Boston to Hyannis (the Cape’s Los Angeles) of 2 hours and 20 minutes. But much more train service is needed to reduce the traffic on and approaching the highway bridges.
Melissa Bailey: Bringing home dying children
Boston Children’s Hospital
From Kaiser Health News
Anne Brescia sat beside her only child, Anthony, as he lay unconscious in a hospital bed at age 16. Just a few months before, he was competing in a swim meet; now cancer was destroying his brain. Brescia couldn’t save her son. But she was determined to bring him home.
Anthony Gabriel Brescia-Connell was not conscious for his voyage from Boston Children’s Hospital to his home in Medford, Mass., where he died on March 3, 2011, surrounded by his family and beloved stuffed animals. He may not have heard the parting blessings before a doctor turned off his portable ventilator and let him die naturally.
But having the choice to take Anthony home, away from the beeping hospital monitors, “meant the world to me,” his mother said.
Anthony’s journey was made possible through swift and unconventional efforts by the hospital staff, including a critical-care transport team accustomed to rushing kids to the hospital to save their lives, not taking them home to die.
The experience galvanized Harriett Nelson, a nurse on that team who helped arrange the trip. It inspired her to conduct pioneering research on and advocate for “pediatric palliative transport” — a rare but growing practice that aims to give families choice, control and comfort at the end of life.
Palliative transport lets families move critically ill children from the hospital intensive care unit to their home or hospice, with the expectation they will die within minutes to days after removing life support.
It means “having parents go through the hardest thing they’ll ever know — in the way they want to do it,” Nelson said. Boston Children’s has sent 19 children to home or hospice through palliative transport since 2007, she said.
These final journeys — also offered by Mayo Clinic, Children’s Hospital of Philadelphia and Kentucky Children’s Hospital — can involve elaborate planning, delicate transfers and even long helicopter rides. In some cases, families took a child far from home for a last-ditch effort to save their lives.
At Mayo Clinic, in Rochester, Minn., palliative transport has helped culturally diverse families carry out end-of-life wishes for their dying children. In one case, a newborn girl rode 400 miles by ambulance to return to her Amish community, where she was extubated and died in her parents’ arms, in the company of her 11 siblings. In another, an 8-month-old Native American girl traveled 600 miles by air and ground ambulance to her rural tribal reservation, where she could participate in end-of-life rituals that could not be done in the hospital.
These trips, which can cost thousands of dollars, are typically offered free to families, paid for by hospitals or charities. Most children are taken home, where they transition to receiving care from hospice staff. Some go instead to hospice facilities.
Dr. Megan Thorvilson, a pediatrician and palliative care specialist at Mayo Clinic, said palliative transport aims to address a gap between families’ preference and reality. Most parents of terminally ill children would prefer that their child die at home, but most of these children die in the hospital, most commonly in the intensive care unit. Most pediatric ICU deaths happen in a controlled way, following the removal of life support, she noted. That means there may be time to move the child to an alternative location to honor a family’s wishes.
Transporting children on life support is risky. At a palliative care conference, a nurse from Children’s Hospital of Philadelphia described the difficulties staff faced in trying to fly a 10-year-old girl home to Michigan. After she was rolled on her side several times to be transferred between vehicles, the child died before the plane could take off.
And dying at home is not what every family wants.
“We do sometimes overly romanticize the death at home,” Thorvilson acknowledged. Some parents would much rather have a child die in the hospital, with familiar nurses at the bedside for medical and emotional support. Some would rather keep this traumatic experience away from where they live.
Brescia, however, said she couldn’t bear to return home without her son.
Brescia, a biologist who used to run an electron microscopy lab, wasn’t sure if she and her husband, Brian Connell, would ever have kids. Fertility treatments didn’t work. But on June 23, 1994, seven days before Brescia turned 44, she gave birth to a baby boy.
“Anthony is the love of my life,” said Brescia, who is now 68. “The OB-GYN put him on my chest and I really thought that my heart was going to burst.”
The mother-son bond was especially close: Brescia home-schooled her son for most of his life. Anthony grew to be 6 feet tall, full of curiosity. He loved identifying mushrooms, studied Arabic and oceanography, and aspired to go to MIT. He was an avid swimmer, competing on a team in Belmont, Mass.
One day in late 2010, while racing the backstroke, he became disoriented in the pool and was disqualified.
A neurologist prescribed rest. But over the next two weeks, Anthony grew only more tired and began to lose his balance. On Dec. 20, he was taken to Boston Children’s Hospital and diagnosed with a brain tumor.
The disease “came out of nowhere,” Brescia recalled. “He went from looking incredibly healthy and swimming like a healthy kid” to living at the hospital. At his bedside, she told him she’d bring him home to celebrate Christmas and eat stuffed shells.
His condition deteriorated very quickly. The tumor could not be surgically removed. Anthony pushed through radiation and chemotherapy with the hope of going home, but the treatments failed. By late February 2011, the tumor began pressing on his brain stem, and fluid was building up in his brain.
Anthony was unconscious, relying on a ventilator to breathe. Brescia connected with the hospital’s palliative care team.
“I want to bring him home tomorrow,” Brescia told the staff.
“I was scared to death he was going to have another incident,” she recalled. “I didn’t want them to do any more invasive procedures to reduce the pressure on his brain.”
Staff from the ICU, palliative care and transport teams scrambled to honor her request. The critical care transport team arranged for the use of its ambulance, a mobile ICU the size of a small bus.
The night before the trip, Brescia said goodbye in the privacy of Anthony’s hospital room.
“I don’t want to lose you,” she told him, holding his hands. “I’m going to let go. I want you to go where you need to be.”
On March 3, 2011, Brescia and her husband boarded the bus along with Anthony, a chaplain, two doctors, Nelson and a nurse from the ICU. They rode 10 miles to the family’s home, where Anthony was laid on a hospital bed in his living room, surrounded by his stuffed animals, on his favorite flannel sheets.
A pastor held a service for Anthony, and close family gathered to say goodbye. Then Brescia signaled for a doctor to disconnect the ventilator.
Anthony seemed to be at peace, Brescia said. After he died, she climbed into the bed with her son and held onto him for a while.
The death was still traumatic. But “it was really a gift to bring him home,” she said. “It was a significant act of compassion and kindness and love on the part of the Children’s staff.”
After Brescia’s experience, Nelson was inspired to offer the choice to more families. First, she interviewed Brescia and other parents about whether palliative transport had had a positive impact. All nine parents said it had. One family described holding a celebration when they brought their newborn baby home, even though he was about to die. They took family photos and used the nursery they had set up, establishing a brief sense of normalcy for four days before he died.
In her 14 years on Boston Children’s critical transport team, Nelson has found that parents benefit from palliative transport for various reasons: At home, they’re away from the noise of the hospital. They have control over who can visit. They feel more comfortable. And they don’t feel rushed after their child dies.
Nelson created a protocol that allows the hospital to offer palliative transport in a more routine way. Now, when children come to any of the hospital’s four ICUs, Nelson said, “we have the power to say, ‘You have a choice when it comes to the end of life.'”
The practice appears to be spreading.
After Dr. Lindsay Ragsdale, director of the palliative care team at Kentucky Children’s Hospita,l in Lexington, presented her protocol for palliative transport at a conference last year, staff from 20 hospitals asked her to share her checklist, she said.
Mayo’s Thorvilson, who has worked closely on a half-dozen palliative transports, said it’s possible these last-minute trips from ICU to home could be avoided by earlier referrals to hospice, which might get kids home sooner. But when children with complex illnesses get sick, she said, “sometimes it’s hard to know whether this is just another bump in the road, or whether this is the natural end of the child’s life.”
“There’s something really unique about a child dying,” she said. “Everyone’s heart breaks, and we want to be able to do all that we can to be able to support the family in the midst of the tragedy.”
Eight years after Anthony’s death, his bedroom remains unchanged. (KAYANA SZYMCZAK FOR KHN)
Eight years after Anthony’s death, his bedroom remains untouched, his socks still folded in his top drawer, swimming trophies on the cabinet, slippers under his chair. Pictures of him adorn every room in the house — on the fridge, the kitchen table, the living room stereo.
Looking through photos one recent morning of her son fishing and blowing out birthday candles, Brescia struggled to hold back tears.
“I couldn’t cure him,” she said. “I failed to protect him from a tumor — that’s how you feel. They did all they could. It wasn’t enough. Bringing him home was the best I could do.”
Melissa Bailey: mbailey@kff.org, @mmbaily
The Republic of Vermont
Mt. Mansfield
"I would like to give you my idea of a republic. My idea of a republic is a little State in the north of your great country — the smallest of the New England States — Vermont."
— What German Chancellor Otto von Bismarck is said to have said to visiting Americans in 1878.
Approach with care
“Splash,’’ by Joy Garnett, in the show “Dead Ringer,’’ at the Bristol Art (R.I.) Museum, June 7-July 14.
Frank Carini: N.E. coastal-property values don't reflect threat of rising waters
Coastal flooding in Marblehead, Mass., on Oct. 29, 2012 during Superstorm Sandy.
From ecoRI News (ecori.org)
Along the nearly 13,000 miles of coastline of the contiguous United States, hundreds of thousands of buildings lie in the path of rising waters. Long before these properties and accompanying infrastructure are underwater, though, millions living in coastal communities will face more frequent flooding, as the tides inch higher and reach further inland.
Property values in most coastal real-estate markets, including in southern New England, however, don’t reflect this risk. These properties are routinely more expensive, even though their future is likely to be wet.
Accelerating sea-level rise, primarily driven by human activity, is projected to worsen tidal flooding in the United States, putting as many as 311,000 coastal homes in the lower 48 states, with a collective market value of nearly $118 billion, at risk of chronic flooding within the length of a typical mortgage, according to the Union of Concerned Scientists (UCS). Those 300,000-plus homes generate some $1.5 billion annually in property-tax revenue.
Another 14,000 or so coastal commercial properties assessed at a value of nearly $18.5 billion also are at risk during the next 30 years.
Although the Industrial Revolution began more than two and a half centuries ago, some 60 percent of industrial carbon dioxide emissions have been released since 1980, according to the Cambridge, Mass.-based nonprofit. Emissions from the extraction, manufacturing, and burning of products produced by 90 corporate cement manufacturers and fossil-fuel goliaths, such as Chevron, ExxonMobil, and Shell, contributed to nearly half of the global rise in surface temperature and about 30 percent of the rise in global sea level between 1880 and 2010.
By the end of this century, thanks in large part to decades of unrelenting climate emissions, 2.4 million homes and 107,000 commercial properties currently worth more than a combined $1 trillion could be underwater, according to UCS projections.
Many of the at-risk waterfront communities in Connecticut, Massachusetts, and Rhode Island, most notably underserved and marginalized communities — the South Providence and Washington Park neighborhoods in Providence, for example — are underprepared to deal with the many challenges climate change presents.
Currently, according to a 2018 UCS report, 940 properties in Connecticut, 2,405 in Massachusetts, and 278 in Rhode Island are at risk. By 2030, under the organization’s high scenario, those numbers jump to 2,540, 3,303, and 419. The high scenario is where climate change is trending.
The UCS analysis combined property data from the online real-estate company Zillow with peer-reviewed methodology developed by the nonprofit for assessing areas at risk of frequent flooding. Using three sea-level-rise scenarios developed by the National Oceanic and Atmospheric Administration and localized for this analysis, UCS determined how many residential and commercial properties along the entire lower 48 coastline are at risk of becoming chronically inundated from high tides — flooding on average 26 times annually or more, or the equivalent of once every other week — in the coming decades even in the absence of major storms.
Shana Udvardy, a climate resilience analyst with the UCS who co-authored last year’s report, recently spoke with ecoRI News about sea-level rise and the growing risks of chronic inundation.
“We put this together because a lot of potential homebuyers don’t necessarily know that their home is at risk of tidal flooding,” she said. “Or that things like home insurance doesn’t cover flooding, so you need flood insurance.”
The core results in the 2018 report are from the high sea-level-rise scenario — an appropriately conservative projection to use when estimating risk to homes, according to Udvardy. This scenario projects an average of 1.9 feet of sea-level rise for Massachusetts in 2045 and 6.9 feet in 2100. The analysis also projects how many properties might avoid such flooding if sea-level rise is constrained through the achievement of the long-term temperature goals of the Paris Agreement and if ice loss is limited.
The results for Massachusetts, in particular, are sobering. The analysis found that without additional measures to adapt to rising seas that:
By 2045, about 7,000 of today’s residential properties, currently home to roughly 14,000 people, are at risk of chronic inundation. The total number of at-risk residential properties jumps to nearly 90,000 — home to about 178,000 people — by 2100. While Massachusetts has a network of shoreline stabilization structures along its coast, few of these are designed to keep out higher tides.
By 2045, more than $4 billion worth of residential property — based on today’s values — is at risk of chronic flooding. The homes that would face this flooding at the end of the century are currently worth roughly $63 billion — an amount that would rank the state fifth nationally in 2100 for value of residential properties at risk.
The Massachusetts homes at risk in 2045 currently contribute about $37 million in annual property-tax revenue. The homes at risk by 2100 currently contribute roughly $413 million collectively in annual property-tax revenue.
By 2045, five Massachusetts communities are projected to have 600 or more at-risk homes: Revere, Marshfield, Quincy, Hull, and Salisbury. In Salisbury and Hull, these homes represent more than 10 percent of the local property-tax base.
Homes valued below the state median are disproportionately at risk of chronic inundation in the next 30 years. Revere, Saugus, and Winthrop — all working-class suburbs of Boston — have large clusters of at-risk homes.
Massachusetts ranks fourth in the nation for the most commercial properties at risk by the end of the century. By 2045, nearly 500 of today’s commercial properties in Massachusetts, currently assessed at more than $1 billion, would experience chronic inundation. In 2100, this number jumps to roughly 8,000 properties — assessed at about $35 billion today.
Coastal flooding, as seen here in March 2014 on Main Street in Warren, R.I., is being caused by more frequent and intense rains and storms. (ecoRI News)
Market crash
Once market risk perceptions catch up with reality, the potential drop in coastal property values could have reverberations throughout the economy, according to the UCS, and could potentially trigger regional housing market crises.
Homeowners whose properties become chronically inundated may find themselves with mortgages that exceed the value of their homes, or face steeply rising flood insurance premiums. Lenders carrying large numbers of these risky mortgages could lose money or even become insolvent, with smaller banks concentrated in areas with high-flood risk being especially exposed. Coastal real-estate investors and developers may similarly experience financial losses in some coastal areas.
Udvardy noted that there are many federal, state, and local policies that, while originally well intentioned, mask risk and create incentives that reinforce the status quo or expose more people and property to risk. The market’s bias toward short-term decision-making and profits can also perpetuate risky development and investment choices. These flawed policies and incentives include incomplete or outdated flood-risk information, subsidized insurance, lax zoning and building codes, and incentives for business-as-usual development and rebuilding.
Identifying and improving the best policies and market drivers of risky coastal development is necessary to better protect communities, Udvardy said. She noted the importance of “climate-safe infrastructure.”
To use the UCS’s interactive mapping tool, click here. The map allows you to learn more about the impact of chronic inundation on properties, people, home values, and the tax base in specific states, communities, or ZIP codes. When you zoom in, the maps become more detailed. You can also click on a specific state or community for more details about it.
Udvardy encouraged municipal and state officials to use the report and UCS website as a climate-change tool.
“The need for action is now,” she said.
Frank Carini is ecoRI News's editor. Joanna Detz, an ecoRI journalist, contributed to this report.
Philip K. Howard: A plan to fix America's crumbling infrastructure?
The Crook Point {Railroad} Bridge over the Seekonk River, in Rhode Island.
Fixing America’s decrepit infrastructure enjoys rare bipartisan support. But the recent announcement of a $2 trillion plan by President Trump, Speaker Nancy Pelosi (D-Calif.) and Minority Leader Chuck Schumer (D-N.Y.) was quickly doused by reality. White House Chief of Staff Mick Mulvaney said the proposal would go nowhere without permitting reform. Leaders in Congress, including some Democrats, said they would not support any significant increase in gasoline taxes to fund it.
No one seriously doubts the need to modernize America’s infrastructure. The main stumbling block is broad distrust of Washington’s ability to deliver any large public works initiative. Getting past this impasse offers a unique opportunity to reboot the rules, cutting effective costs by over 50 percent. Here are three reforms that should be enacted as the foundation of any infrastructure bill:
Permitting reform: In 2009, Congress authorized $800 billion to stimulate the economy, promising to rebuild infrastructure. In the final tally, a grand total of 3.6 percent was spent on transportation infrastructure. Projects never got out of the gate, because, as President Obama put it, “There’s no such thing as shovel-ready projects.”
The red tape is also cripplingly expensive. The 2015 Common Good report, “Two Years, Not Ten Years,” found that a six-year delay in permitting more than doubles the effective cost of projects, and lengthy environmental reviews are generally harmful to the environment because they prolong polluting bottlenecks.
The reform needed is not to weaken environmental rules but to create clear lines of authority to make the decisions needed to adhere to deadlines. For example, a project with minimal environmental impact — such as raising the roadway of the Bayonne Bridge using existing foundations — does not need a 10,000-page analysis (plus another 10,000 pages of appendices). Common Good has a three-page legislative proposal that gives designated officials the job of deciding the proper scope of environmental review and resolving disagreements among different agencies.
Discipline in prioritizing and procuring projects: Cynics don’t have to look far to see the likelihood of wasting public funds on pork such as “the bridge to nowhere.” Just as most of the 2009 stimulus was distributed to states in block grants, so too it is likely that much of any large infrastructure initiative will end up being distributed for political purposes.
Nor should the price tag of infrastructure be inflated to meet unrelated social goals. The goal is modern roads, locks and electrical grids — not, as Pelosi and Schumer stated, an “imperative to involve women, veteran and minority-owned businesses.”
Congress should create an independent National Infrastructure Board, using the model of base-closing commissions, to set priorities for use of public infrastructure funds. That’s how Australia does it — it receives applications from states and then announces who gets federal funds.
A National Infrastructure Board could avoid pork barrel projects and avoid use of critical infrastructure as pawns in unrelated political disputes. The Trump administration early on highlighted the new Gateway rail tunnel into Manhattan as a critical need of the Northeast. This $30 billion project is vital not only for commuters and rail travelers, but also for vehicular traffic. Gridlock would extend for 25 miles if one of the two existing rail tunnels shuts down long term. Now that project is being held up because President Trump is using it as a political chip in a running dispute with Senators Schumer and Cory Booker (D-N.J.).
The National Infrastructure Board also could oversee contracting policies, to avoid waste of inflexible procurement practices and local featherbedding.
Funding infrastructure: User fees will only repay a small portion of the cost of most public infrastructure. Republicans are correct that Washington is filled with wasteful programs that can be cut. Democrats (supported by the Chamber of Commerce and Business Roundtable) are correct that gas taxes, last set in 1993, have not kept up with inflation. The obvious political compromise is for Congress to use both sources and create a funding plan that is half cuts and half new taxes. A 25-cent hike in gas taxes would raise about $40 billion each year. The 2010 Simpson-Bowles debt reduction plan offers a road map for cutting obsolete subsidies, such as New Deal farm subsidies.
Modernizing America’s infrastructure would be a boon to the economy — enhancing competitiveness and creating over a million jobs that cannot go offshore. It would result in a greener footprint. The case for funding is compelling if accompanied by streamlined permitting and a National Infrastructure Board to avoid waste. Abandoning the legacy bureaucracies that stifle infrastructure projects might be the most important change of all — rebooting the rules could demonstrate what’s needed to fix broken government.
Philip K. Howard is chairman of Common Good and author of the new book Try Common Sense. This piece first ran in The Hill.
Follow him on Twitter@PhilipKHoward.