Girl in the Big City

Hey all,

Thought I would chime in for a few minutes this Monday and report about my adventures. First of all, to those I haven't talked to (Jeff), I made it to Tallahassee safe and sound. Thankfully, none of the family gets real excitable when I forget to dish out details like when I'm moving, where I'm staying, when to wonder if I've been kidnapped, if I have a place to live, etc. I left Vermont, appropriately enough, in an icestorm at midnight and arrived a couple of days later to the warm rain of Tallahassee.

Work is good so far. It is a good thing to be familiar with your work before you start it. It has been incredibly helpful just to know the programs and language and constituents of Break Away prior to being the Director. That has allowed me to spend more time on learning software and dealing with press so far. We got a good hit last week from the Christian Science Monitor (shout out to you Dad, for helping me love that newspaper early on!). You can view it here:

Christian Science Monitor Loves Break Away

I hope that works as a hot link. I've got to do my homework on this blogging deal. Anyway, MTV and CBS have also called and so I've had to work on my professionalism. We are getting a fair amount of attention because of the sheer numbers of alternative breaks headed to do disaster relief.

Other than that, I went to NYC last week and it was awesome. No kidding. Break Away was awareded one of 10 nonprofit spots at a swanky 1 day marketing seminar put on by

Seth Godin

and mostly attended by the big corporate boys (AOL, Yahoo, Nestle, March of Dimes). We were fortunate to be there because it was probably one of the best professional development experiences I've had. I left the seminar with my mind just full of possibilities and feeling great about the work of this organization for the last 15 years - 10 of which I have been involved. A relaxing Friday ended up with meeting my dear high school friend, Danny Kourianos, and his wife for dinner. The fun was so great that we met up again on Saturday and had an amazing day of good food, Central Park time, going to the Met, and going to an Improv show where Danny has been studying. So much fun, and good to be a part of the New York energy for awhile. Got back last night.

This is getting too epic. I'm out for now. Thanks again Jeff for getting this up and running. It's a great idea. We've already been more in touch this year than the last 10.

I work with robots. Your comments please...

No, though it may be tempting to, I'm not refering to some of the people that I work with as robots. I work with two models or should I say machines: InTouch's Dr. Robot(pictured above with me and patient) and Intuitive's Da Vinci(pictured below in an operating setting).
Pretty cool, huh? "Cutting edge" technology(sorry, that was too good to not put in that pun) in health care. The latest and best- to ensure that patients are getting the best treatments that are avalible. The Da Vanci is the product of technology developed by the military. The idea was that a surgeon/doctor could operate on a wounded person very quickly after being injured thus saving precious time during the 'golden hour'- and saving the person's life. As the picture shows, the surgeon still has to do the surgery, but can now do so at a distance. He can do this at a distance of feet or with oceans between him and his patient. The first transoceanic surgery was done with this technology about ten years ago between the US and France. The Da Vinci machines are now being sold to many hospitals near and far. At Johns Hopkins Hospital, we use them for surgical removal of the prostate- this is a treatment for prostate cancer. There are other surgical uses for this machine but it is mostly being sold as a tool for prostate cancer. My interaction with the Da Vinci robot is assisting the surgeon. As you can see in the top picture, there is an assistant with the 'patient'. This is where I am in when working with the robot. This person also uses tools to help remove the cancer from the patient.
In general the patient and his family are happy and excited about having their surgery with a robot. Why shouldn't he? He has cancer, and he is getting the latest treatment for it with the latest tools. By a similar measure, the patients that I see with Dr. Robot are equally enthusiatic about their machine. It is similar to the Da Vinci in that your doctor still does the work, although from a different location. He /She can do this because the robot is connected to a computer that the doctor has with a wireless internet connection. This connection allows one of the developers of the robot to access it in Baltimore from his home in South America. The robot, as configured now rounds(visits) patients, going from room to room, and allows the doctor to 'see', 'hear' and 'speak' to patients and staff. Future versions of this robot may have an 'arm' with which the doctor commanding it, can perform an ultra sound or other basic test. No one has spoken of using it for things like taking blood .
This past summer, the Washington Post came to Johns Hopkins Hospital to see the rounding robot in action. Dr Kavoussi and I saw a few of his patients with the reporters with us. You can read their article be clicking this link
The title of the published article is "Robot Doctors Replacing Real Doctors". The article has been picked up by dozens of other media. The tone appears to be of fear; that the doctors will be replaced by cold and inhumane decision making machines. (There are many movies and books that have picked up on this theme, 2001: A Space Odessey, Short Circuit, The Teminator series, The Matrix series.) They are also concerned about what may say about the current and future state of medicine.
Interesting. I once read part of a book that advanced the idea that doctors were becoming increasingly detached and distant from their patients the more that they use technology. The author said that this started with the invention and ricing popularity of the stethoscope. This seems more like a topic that includes the use of technology for communication in general- look at us now, trying to use a blog to keep in touch.
Back to the robots. Dr Kavoussi did a study- that is published, about how patients felt about the robot and if there was any difference in the care that the patient recieved when compared to a control group. He found that the patients liked the robot and had no more post operative complications than others who didn't see the robot(the control group). With the surgical robot, the pateints have a smaller blood loss- in general than an open prostatectomy. But there was no other difference- they left the hospital on the same day as patients that didn't get a surgical robot, same medications, same postoperative results. Right now, in general the robots are expensive to own, maintain and operate. But that is the case with all new technology and the price will go down with time and the use of this technology will broaden. Regardless, as one of the surgeons that I work with at the hospital said about using the robots, "The surgeon is still the one doing the surgery, not the robot." Which is a way of saying, a tool is only as good as the person and application it is used for. I wouldn't trust that a 8 year old weilding a nail gun to build me a good house.
What do you think? Would you allow this technology to be used on you or the care of your family? Do you think that you are getting better care if you are seen by a doctor that is using a robot?

Welcome Ruby!

Hooray! Ruby, welcome to the family and the blog! Certainly you are the most lively topic that we've blogged about in the two week life of this blog. Nanci, I'm happy to hear that Becki's peanutbutter M&Ms went to such good and constructive use. I have looked for, and found, some very nice -and postable- pictures of Ruby(The blog won't allow me to post a photo with a comment- hence the new post). Whadaya think Clint? Is this something that even that ultrasound tech can appreciate? Now if she can't get excited about this gem, what can she get excited about?

I found on a brief search of the web that Ruby:
-Is a programming language for writing code on for the web
-At 2,475 carats (495 g), the Rajaratna Ruby is the world's largest ruby
-All natural rubies have imperfections in them. On the other hand, artificial rubies may have no imperfections, our family accepts both
-According to Rebbenu Bachya(a Jewish scholar), the word "Odem" in the verse Exodus 28:17 means "Ruby" and was the stone on the Ephod representing the tribe of Reuben
-Geek note: synthetic ruby crystal was used to create the first laser

Ruby we are proud to have such an accomplished young lady added to da family! I'll make a prediction, based upon nothing but emotion, she'll be born in July- rubies are the birthstone for July. The Guymon/Piacitelli Ruby will weigh much more than the Rajaratna Ruby and will always be of infinite worth. And she'll be born on a Tuesday, better known as....

big news

Well get ready to welcome "ruby". It is official that this lump growing inside of me isn't due (at least completely) to my eating the peanut butter m&ms that I got beck for her birthday and didn't get sent before I lost all self control, but it does contain a girl child. We would post the pictures, but they are a little graphic. Clint was disappointed in the radiology tech. lady who did the ultrasound. He expected her to be as excited about the whole thing as we are, oh well. The boys are excited. We purchased a "girl" outfit today while we were out to make it feel official. We love all of you, and hope that you are healthy and well, without a peanut butter m&m stomach. Nanci

We're here, you're there

We just set the internet up in our home. We're excited to be able to post to this blog where we can keep in touch. It's about 55 or so outside right now, here in Maricopa. Ha-Ha to Jeff and the Utah folk. You'll be laughing in the summer.

Nanci's relieved she hasn't seen any rattlesnakes or scorpions. I'm relieved we haven't been attacked by birds or the neighbors.
We love this family.

This blog thing is pretty cool. Thanks Jeff for setting this up.

The Week so far...

I had the day off on Monday. MLK Day. When I was a 'wee lad', it was President's Day that we had off. A day off of school to celebrate the birthday's of George and Abe and the rest of the President too. My most admirable Presidents List (in no particular order) Abe Lincoln, George Washington, Teddy Roosevelt, Thomas Jefferson, Jack Kennedy. I could go on, but I'll stop there. I've read/listened too a few books about these men. Good stuff Lincoln- by Donald was a good biography of the man. Washington- 1776 McCulllough not about Washington in particular, but still gives you an understanding of what makes him the legend that he is. Roosevelt- Mornings on Horseback by McCullough again(I'm biased to this author ok?) Kennedy- Profiles in Courage by Kennedy good stuff.
Anyway, on my day off I went to D.C. with a couple of friends. We went to the Smithsonian Natural History Museum(NHM). If you ever come out to see the Smithsonian Museums plan for a day to see each museum- this will allow you time to see everything. If you want to contemplate upon what you see, well, add more time your plan. They are open every day but Christmas from 10am til 5pm.
A friend of mine that works in the Museum of Indrustry here in Baltimore, told me once that a museum can only show a very small percentage of their holdings. To put on display, they try to select the items that will stimulate thought and discussion. At the NHM, they have recently revamped the mammals exhibit to make it more interactive. The displays include videos to watch, displays that are kid friendly- about 2 feet off the floor and other stuff that an adult has to get down on hands and knees and crawl to see. In the insect section they have many displays that are at kid height (see photo). Other that that I saw the history of the earth in geological terms from the formation of rocks(the oldest rocks come from Greenland) and oceans to the formation of the earliest protiens and bacteria(shown in fossil history). The Hope Diamond seemed to be quite popular with the ladies of our group too.
After we had spent almost the entire day inside, we steped out to see the Lincoln Memorial where Dr King gave his famous speech from. If you have a chance read/watch the speech http://www.americanrhetoric.com/speeches/Ihaveadream.htm
I think that the world and nation has made progress toward the realization of his dream. Aparthied over turned in South America without a civil war happened in my life time- a demonstration of the dream. However we aren't there yet, there is more to be done.
Thanks Mom and Dad for having us interact with the minorites in our small Utah town(I felt like a minority because of my last name in the small town setting-what a joke!). I know that this wasn't easy, but being in college towns made it easier. College students from Asia, sub Sahara Africa, South America, exchange students, attending church services for other churches helped. My first trip to DC where we were the only white people in the Wendy's resturant helped me to understand what a minority might feel like in Utah. I now go to my local store, post office, etc and don't notice the way others look but what they do, say etc and interact with others. Part of 'Dream'.
Along these lines to, one of my patients this past week was a man with Italian ancestors. I've actually met quite a few Italian Americans at my work, but this man's family came from the same part of Italy as we did. It gave me the chance to call Dan, my uncle and nearest repository of the family tree, and catch up on the geneology. He sent me a tree that included a possible common ancestor with my patient. How do you like that. It is a small world. My new friend is now looking at his family tree and finding out from his family more about his orgins. Oh, and he is recovering well from his surgery too...

Start Here.... The Family Table

Hi, my name is Jeff Piacitelli(email me- photo by Ezrie Pace). I'm the 3rd, of 5 children, born to James E. and Helen E. Piacitelli. Like many families that are moving about the country, we are looking for a way to stay in each others lives by keeping up with the events that happen to each of us as our family continues to grow.

While growing up, my parents did an excellent job of using meal times as the time for our family to meet. Daily, we'd all meet at the family table and eat breakfast and dinner together. Initally Mom would cook these meals and, later on, she'd have us- the kids, help with preparation and clean up. Dad would help out too, on a regular basis he would do the dishes on Sunday after dinner. Later, when Mom when back to working out side the home, Dad prepared breakfast too(His efforts in the morning kitchen bring back memories and inspire urban legends). Around the table at meal was an excellent time for us to interact with one another and find out some of what was happening in the lives of our family members. These meals were important to our family. I remember getting into trouble more than once for not showing up or showing up late to these meals when I was a kid. As our family grew and the pick-nick table and benchs were eventually replaced with a table and chairs. We invited other family members and friends(adopted family) over, to our family table, to join in our conversations. Likewise members of our family were invited to share the at a table with other members of our family and friends. Lots of memories- not just of the food either. Memories: Such as the announcement of Mom being pregnant with Nanci, Brad Pace proposing marriage to Becki, Nanci- in an effort to control her laughing, walking around the table, Jill getting a perm, Matt getting a hair cut from Dad and Jeff being told to leave to flush 'The Grouch' down the toilet.
Over time the family filling chairs at the table became fewer. Matt going to the Academy, Becki and I going on missions began the loss of the daily gatherings. I miss the converstions at the family table. We've grown with communications technology, using it to try and maintain. Letters yelding to phone calls, and calls to email and cell phones. Now a new wrinkle the net and blogs. I'm frustrated when I speak to Mom about getting a computer, a cell phone, an email address. But, I can relate to her resistance to the relentless advancement of communications technology. On a regular basis there are new products introduced to try and help minimize the distance between people. These all cost: money and time to learn to use and operate. Sometimes the type of technology we use excludes others in our communications becasue of formats, compatabily problems and some people don't have a computer or internet access. With this in mind I do believe that Blogs offer many advantages over the short commings of some older technology. Access is simple, via any computer w/internet connection. No just a computer either, but a 'Blackberry', 'Palm', cell phone and more stuff can, with the proper hardware and software, access and contribitue to this forum/Blog. Add comments or pictures and piggy back on the stuff that somebody else puts on the Blog. (Someone may be wondering 'What is a Blog?' Click on this link for the answer http://en.wikipedia.org/wiki/Blog) In my opinion(IMO), this virtual family table is a format that can help us to keep in each other lives- if we use it, and will make those occasions when we gather round the real family table better. Idealy it will become like the old family table where life was communicated- the good and the bad, a place to be together.

So here it is: You are invited to come, to read, to post, to participate in the Piacitelli Family Blog. There is no age restriction to interact. No blood requirement; our common ancestor may need to be no closer that Adam or Eve.

A caution however. Because this format will be open and accessable to those outside our circle of family and friends, BEWARE OF WHAT YOU POST. Please protect your self and loved ones by considering carefully any personal information such as age, address, phone numbers, Social Security number, account numbers, personal schedules, etc. This caution is not just limited to this Blog but to all of your activities on a computer. (For more information on Identity Theft see 'Computer Crimes and Scams' at Clark Howard's page for a launching point http://clarkhoward.com/