GOING HOME

PAMELA DICKENS GILCHRIST WAS AN ANGEL ON EARTH. From the first time we met in the early 1990s, we had an intimate connection. I honored her repeatedly when I was in her presence; it was quite easy to do with such a gentle soul.

I was the best man at her wedding, when she married my dear friend Charles Gilchrist. She had this silly giggle of a laugh that was so endearing. And so I tried — incessantly so — to make her laugh, just to unleash the glee.

It was glorious when I succeeded, which was often.

Though she would never concur, she was just a gorgeous gal — and one of the most gracious people to have ever crossed my path.

Pamela was blessed; she was a seer, and spectacularly gifted. She used the insights to help others — almost to the point of harming herself. That’s how big her heart was. As you can tell, I adored her. . .she was was the best friend a person could have.

She and Charles lived happily on a farm in Medina, OH., about 45 minutes outside Cleveland. It was her dream home, and it took all of the happy couple’s savings to buy this century-old farmhouse with six acres of land.

But it was worth it. They both beamed at the prospect of two creative souls owning a piece of the American Dream, far away from the bustle of the big city where they’d spent most of their lives. They had a barn full of cats, a dog and plenty of space — it was all they needed or wanted.

I often say that Pam was the kindest being I’d ever met — and that inludes the dozens of priests, ministers, and spriritual leaders I’d encountered over the decades.

We were so close that we spoke nearly every day. Yet, out of all of the conversations I had with her — over the many years I knew her, we only had one minor argument.

The discontent lasted all of an hour before it was resolved.

Five years after my divorce, when I was in serious conflict about living near New York City as a single father of two, it was Pam whom I phoned. There were, of course, more financial opportunities open to me in New York — and there was no lack of interest. But there were the kids, who lived primarily with me. At what price to them, I worried.

“Come home, Kevin,” Pam simply said. “You should come home. This is the right thing to do.” Less than a week later I rented a U-Haul truck and drove back to Cleveland with kids in tow.

That was how much I trusted my “Pammy,” as I called her. She was part Mom, part girlfriend, part healer, and part inspirational leader. Since her husband Charles and I were best friends, she adopted me, and nourished me like the single Dad I was, facing a world of challenges ahead.

Even though I had a special place in her heart, I knew I was not alone, for there were many whom she loved in such innocent and spectacular ways.

Not long after returning to Cleveland, we discovered that Pam had breast cancer. There had been months of bumbling by her doctors, as they missed huge tumors on her lower back repeatedly, even though she had undergone MRIs and x-rays monthly. But her doctors continued to misread her x-rays and misdiagnose her, so within months, the disease had advanced enough to be serious and life threatening. Forced with what she literally considered to be no choice, she chose the chemo.

For months, she struggled so, torn by the fact that she knew the chemo was killing her, but unable to afford anything else. This tore at Charles also, because as any man will attest, there is nothing more emasculating than being unable to create a financial miracle to save the day; to whisk her off to Mexico or Europe or wherever was necessary; to utilize any extravagant alternative treatments available to save the life of a loved one.

It was ten years ago this month, in April of 1999, when Pammy finally gave in — gave up, and checked out. I can honestly say that not a week goes by without me thinking of her. I see her in my dreams — and my daydreams. She speaks to me, I think, just to let me know that I still have responsibilities to carry forth.

When Pam died, I was seriously concerned about Charles. He’d finally found the love of his life only to lose her — and ultimately, the farm. Because even though Pamela had health insurance, her final bill was over $200,000 more than the insurance would cover. The bank seized the farm, which was to be Pam’s last vestige, after the flood of medical bills completely swallowed my dear friend, leaving him broken and sad.

For Pam’s two sons it was a wake up call about death, dying, and the reality of healthcare in America. What neither of them understood at the time was that there would be more painful lessons to come later in life.

PAMELA ADORED HER SONS, Jim and Mark Dickens — and her giggle laugh was out in full force whenever they were around, which was often. We were all kind of a big happy family for a while, and
Mark and his brother Jimmy would even babysit my two boys when they were very young so I could go to business meetings.

When I’d return, I usually found them wrestling and laughing and generally being little boys again themselves. I’ll never forget those scenes of hilarity and the pure, joyful havoc they wrought.

When their Mom died, there was such a void — for so long. We kept in touch, though not enough, I’m afraid.

THE LAST TIME I SAW MARK was around Christmastime 2007. There were hundreds who came together for a ‘silent auction” benefitting Mark, who as a 20-something had contracted cancer. There he was, with no health insurance — barely able to keep his head above water in the economic and ethical abortion we call healthcare in America.

He was gaunt after months of chemo and radiation. He was deeply in debt and conflicted. He was trying to survive cancer, the disease that had claimed his mom, but the medical bills were further stressing him out.

As I privately pressed a wad of money into his hands I whispered, “Mark, not one dime goes to those medical bills. NOT ONE DIME. Use this for food or heat or whatever you need most, but not one dime to those people.”

Mark looked at me and smiled. He knew it was a conversation I had had with his Mother many times when she became ill. It reminded him of her, and he got a very faraway look in his eyes.

Today, we buried Mark, who died a few days ago. I was regaled with stories of his kindness, his magnetism, his selflessness — and it reminded me of Pam.

It made me smile to know that mother and child are reuniting, somewhere in the ether. And to know that somewhere, there is joy and laughter.

So today, Breathe. Take in every minute. Take not for granted even a moment of Life. Honor your time here. Express your love. Now.

Don’t wait.



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Photo of Mark Dickens and Pamela Dickens Gilchrist courtesy of Charles L. Gilchrist

THE PROMISED LAND

THEY FOUGHT THE ENEMY through the jungles of Vietnam, ducking gunfire, spending sleepless nights and avoiding death, only to be caught in the tripwires and booby traps set by society here at home. I see the faces of America’s war heroes living on the streets of every major city I travel to. They were soldiers who were proud to serve...proud to fight for a way of life here in the Promised Land.

And now they sleep on the streets for all to see, from Los Angeles to our nation’s capitol.

That this fate has been dealt to them is ironic — because these men and women — like so many before them who served in a foreign land — dreamed of the day they would come home to America. Home — home of the plenty, home of the brave — and now, home of the homeless.

“The way I live now is like I lived back in the jungle,” one vet told me. “Thirty years later look at me. . .this is where I live at,” he said while motioning to his plastic-encased barracks. I sat with James for nearly an hour as the wind ripped through his 6X10 shack. He was an articulate man, but clearly troubled. I saw a few books stacked neatly in the corner; one by Albert Camus, the French author and playwright, and another by James Baldwin.

Can you imagine that, if but for a moment? A homeless man, a soldier who’d dug a new foxhole, reading books by a Nobel prizewinner — and another by a man who was a powerful voice in literary circles for decades?

How could it be, I asked James, that patriots have been relegated to this subterranean existence — especially in a nation which claims to revere its’ warriors?

He looked at me and smiled. “Son,” he said with sad eyes and a half-smile, “have you ever killed a man? Do you know what that can do to you in your darkest hours?”

When I produced THE PROMISED LAND in 1991, America had just won the first Gulf War a year earlier. There was talk from President George H.W. Bush that we had finally “kicked the Vietnam syndrome, once and for all.”

Back then, I thought it apropos to raise the question of what it meant to be a soldier in war, and whether these men and women on the streets — drunk with dark images and in need of help — were casualties of a society disconnected from the realities of the horror they encountered in war.

It is a question I have never been able to escape. . .and it is a question we should be asking ourselves today as the killing and dying continues in Iraq and Afghanistan.

Cleveland State professor John P. Wilson was the first to call Vietnam vets “Forgotten Warriors,” and to bring attention to the deeply held trauma they felt upon returning from that war. Wilson and his own “band of brothers,’ including former Army Captain Shad Meshad and others, helped define what we now know as PTSD, or Post Traumatic Stress Disorder. It was the modern version of “shellshock,” a term known to just about any WWII veteran.

The question is, will we really “support our troops” when they come home? The answer is anything but certain, considering our recent history.

I remember thinking how nearly every car in America sported those silly magnetic yellow ribbons proclaiming “We Support Our Troops,” but when push-comes-to-shove, chances are that we will abandon our soldiers again — even if they are not homeless.

TODAY, with about 130,000 Americans serving in Iraq and Afghanistan, the soldiers we claim to support are living a hellish existence: again, they are ducking gunfire, spending sleepless nights and doing their best to avoid death in faraway lands.

They are fighting in divided nations, and their world is a tempest-in-a-teapot.

Will we remember that we owe them a far greater debt than to merely pat them on the back? Will we repay their service —as the Pentagon budget becomes more bloated with weaponry and big corporate payoffs — with counseling and healthcare services and job support? Or will we fail them again — as we have done so many times in the past?

Will we drug them with anti-psychotics and consider it “Mission Accomplished,” or will we really embrace them, show patience and compassion and loyalty after their selflessness?

These men and women have sacrificed the best years of their lives in service to our nation. They will be stained by the sights, sounds and smell of war — and trapped by the hyper aberrations of combat.

It is up to us — to our leaders — to choose whether they return with the full support of our people, or whether they become — like so many before them — unknown soldiers left to die without dignity — in the Promised Land.

OVER 271 MILLION POUNDS OF DRUGS CONTAMINATE PUBLIC WATERWAYS

When I was filming GENERATION RX, I met a British psychiatrist and we talked about the revelation that Prozac had been discovered in the River Thames . . .and had entered the water supply consumed by millions of Brits.

"Are people in London really THAT depressed?" I asked him, somewhat sheepishly.

"No, no. . .no," was his response while laughing.

As it turns out, however, our conversation was no laughing matter.

Over the past few years, events have proven that concern over drugs in public rivers and streams are not limited to the UK. In America, the AP has uncovered that at least 271 millions of pounds of unused pharmaceuticals are being released by the drug companies in our public waterways. This is frightening, to say the least. Millions more are flushed down the toilet and down the drain, and make no mistake: we are pumping powerful contaminants and intoxicants like lithium into America's drinking water every single day. It's not only bad news for the fish, but for tens of millions of us.

If one refuses to take this threat seriously, they need only look to India, where a growing environmental and public health disaster is looming. When researchers analyzed vials of treated wastewater from a plant where about 90 Indian drug factories dump their residues, they were stunned to discover that a powerful antibiotic was "being spewed into one stream each day." Enough antibiotics were being released "to treat every person in a city of 90,000."

And it’s not just ciprofloxacin. The water — supposedly cleaned by a wastewater filtration plant — was "a floating soup of 21 different active pharmaceutical ingredients, used in generics for treatment of hypertension, heart disease, chronic liver ailments, depression, gonorrhea, ulcers and other ailments."

Researchers in India said, "It is the highest levels of pharmaceuticals ever detected in the environment," but then again, they haven't yet come to America, where the AP has confirmed that this nightmare is coming to a stream, lake, and landfill near you.

From the AP Investigation: "One thing is clear: The massive amount of pharmaceuticals being flushed by the health services industry is aggravating an emerging problem documented by a series of AP investigative stories - the commonplace presence of minute concentrations of pharmaceuticals in the nation's drinking water supplies, affecting at least 46 million Americans."

The AP series follows one by the New York Times last Spring, the BBC last year, the UK's Guardian newspaper and probably countless others. Millions of tons of narcotics, antipsychotics, antidepressants, stimulant drugs and more are being ingested by children, the elderly, and well, ALL of us who do not use some kind of sophisticated water purification system.

Now, that the AP has confirmed that codeine, lithium (used in bipolar drugs), blood thinners, chemotherapy agents like fluorouracil, epilepsy drugs and sedatives are being released into the environment by the ton, Americans had better take notice — and take action to protect themselves. Anyone who does not have a powerful water filtration system is playing Russian roulette every time they drink water from the tap.

IT'S WORTH REPEATING: the ongoing investigation by the Associated Press proves what a nightmare we have wrought by our obsession with pharmaceuticals.

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Tons of released drugs taint US water

By JEFF DONN, MARTHA MENDOZA and JUSTIN PRITCHARD, Associated Press Writers
Mon Apr 20, 2009

U.S. manufacturers, including major drugmakers, have legally released at least 271 million pounds of pharmaceuticals into waterways that often provide drinking water — contamination the federal government has consistently overlooked, according to an Associated Press investigation.

Hundreds of active pharmaceutical ingredients are used in a variety of manufacturing, including drugmaking: For example, lithium is used to make ceramics and treat bipolar disorder; nitroglycerin is a heart drug and also used in explosives; copper shows up in everything from pipes to contraceptives.

Federal and industry officials say they don't know the extent to which pharmaceuticals are released by U.S. manufacturers because no one tracks them — as drugs. But a close analysis of 20 years of federal records found that, in fact, the government unintentionally keeps data on a few, allowing a glimpse of the pharmaceuticals coming from factories.

As part of its ongoing PharmaWater investigation about trace concentrations of pharmaceuticals in drinking water, AP identified 22 compounds that show up on two lists: the EPA monitors them as industrial chemicals that are released into rivers, lakes and other bodies of water under federal pollution laws, while the Food and Drug Administration classifies them as active pharmaceutical ingredients.

The data don't show precisely how much of the 271 million pounds comes from drugmakers versus other manufacturers; also, the figure is a massive undercount because of the limited federal government tracking.

To date, drugmakers have dismissed the suggestion that their manufacturing contributes significantly to what's being found in water. Federal drug and water regulators agree.

But some researchers say the lack of required testing amounts to a 'don't ask, don't tell' policy about whether drugmakers are contributing to water pollution.

"It doesn't pass the straight-face test to say pharmaceutical manufacturers are not emitting any of the compounds they're creating," said Kyla Bennett, who spent 10 years as an EPA enforcement officer before becoming an ecologist and environmental attorney.

Pilot studies in the U.S. and abroad are now confirming those doubts.

Last year, the AP reported that trace amounts of a wide range of pharmaceuticals — including antibiotics, anti-convulsants, mood stabilizers and sex hormones — have been found in American drinking water supplies. Including recent findings in Dallas, Cleveland and Maryland's Prince George's and Montgomery counties, pharmaceuticals have been detected in the drinking water of at least 51 million Americans.

Most cities and water providers still do not test. Some scientists say that wherever researchers look, they will find pharma-tainted water.

Consumers are considered the biggest contributors to the contamination. We consume drugs, then excrete what our bodies don't absorb. Other times, we flush unused drugs down toilets. The AP also found that an estimated 250 million pounds of pharmaceuticals and contaminated packaging are thrown away each year by hospitals and long-term care facilities.
Researchers have found that even extremely diluted concentrations of drugs harm fish, frogs and other aquatic species. Also, researchers report that human cells fail to grow normally in the laboratory when exposed to trace concentrations of certain drugs. Some scientists say they are increasingly concerned that the consumption of combinations of many drugs, even in small amounts, could harm humans over decades.

Utilities say the water is safe. Scientists, doctors and the EPA say there are no confirmed human risks associated with consuming minute concentrations of drugs. But those experts also agree that dangers cannot be ruled out, especially given the emerging research.
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Two common industrial chemicals that are also pharmaceuticals — the antiseptics phenol and hydrogen peroxide — account for 92 percent of the 271 million pounds identified as coming from drugmakers and other manufacturers. Both can be toxic and both are considered to be ubiquitous in the environment.

However, the list of 22 includes other troubling releases of chemicals that can be used to make drugs and other products: 8 million pounds of the skin bleaching cream hydroquinone, 3 million pounds of nicotine compounds that can be used in quit-smoking patches, 10,000 pounds of the antibiotic tetracycline hydrochloride. Others include treatments for head lice and worms.

Residues are often released into the environment when manufacturing equipment is cleaned.

A small fraction of pharmaceuticals also leach out of landfills where they are dumped. Pharmaceuticals released onto land include the chemo agent fluorouracil, the epilepsy medicine phenytoin and the sedative pentobarbital sodium. The overall amount may be considerable, given the volume of what has been buried — 572 million pounds of the 22 monitored drugs since 1988.

In one case, government data shows that in Columbus, Ohio, pharmaceutical maker Boehringer Ingelheim Roxane Inc. discharged an estimated 2,285 pounds of lithium carbonate — which is considered slightly toxic to aquatic invertebrates and freshwater fish — to a local wastewater treatment plant between 1995 and 2006. Company spokeswoman Marybeth C. McGuire said the pharmaceutical plant, which uses lithium to make drugs for bipolar disorder, has violated no laws or regulations. McGuire said all the lithium discharged, an annual average of 190 pounds, was lost when residues stuck to mixing equipment were washed down the drain.
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Pharmaceutical company officials point out that active ingredients represent profits, so there's a huge incentive not to let any escape. They also say extremely strict manufacturing regulations — albeit aimed at other chemicals — help prevent leakage, and that whatever traces may get away are handled by onsite wastewater treatment.

"Manufacturers have to be in compliance with all relevant environmental laws," said Alan Goldhammer, a scientist and vice president at the industry trade group Pharmaceutical Research and Manufacturers of America.

Goldhammer conceded some drug residues could be released in wastewater, but stressed "it would not cause any environmental issues because it was not a toxic substance at the level that it was being released at."

Several big drugmakers were asked this simple question: Have you tested wastewater from your plants to find out whether any active pharmaceuticals are escaping, and if so what have you found?
No drugmaker answered directly.

"Based on research that we have reviewed from the past 20 years, pharmaceutical manufacturing facilities are not a significant source of pharmaceuticals that contribute to environmental risk," GlaxoSmithKline said in a statement.

AstraZeneca spokeswoman Kate Klemas said the company's manufacturing processes "are designed to avoid, or otherwise minimize the loss of product to the environment" and thus "ensure that any residual losses of pharmaceuticals to the environment that do occur are at levels that would be unlikely to pose a threat to human health or the environment."
One major manufacturer, Pfizer Inc., acknowledged that it tested some of its wastewater — but outside the United States.
The company's director of hazard communication and environmental toxicology, Frank Mastrocco, said Pfizer has sampled effluent from some of its foreign drug factories. Without disclosing details, he said the results left Pfizer "confident that the current controls and processes in place at these facilities are adequately protective of human health and the environment."
It's not just the industry that isn't testing.

FDA spokesman Christopher Kelly noted that his agency is not responsible for what comes out on the waste end of drug factories. At the EPA, acting assistant administrator for water Mike Shapiro — whose agency's Web site says pharmaceutical releases from manufacturing are "well defined and controlled" — did not mention factories as a source of pharmaceutical pollution when asked by the AP how drugs get into drinking water.

"Pharmaceuticals get into water in many ways," he said in a written statement. "It's commonly believed the majority come from human and animal excretion. A portion also comes from flushing unused drugs down the toilet or drain; a practice EPA generally discourages."

His position echoes that of a line of federal drug and water regulators as well as drugmakers, who concluded in the 1990s — before highly sensitive tests now used had been developed — that manufacturing is not a meaningful source of pharmaceuticals in the environment.

Pharmaceutical makers typically are excused from having to submit an environmental review for new products, and the FDA has never rejected a drug application based on potential environmental impact. Also at play are pressures not to delay potentially lifesaving drugs. What's more, because the EPA hasn't concluded at what level, if any, pharmaceuticals are bad for the environment or harmful to people, drugmakers almost never have to report the release of pharmaceuticals they produce.
"The government could get a national snapshot of the water if they chose to," said Jennifer Sass, a senior scientist for the Natural Resources Defense Council, "and it seems logical that we would want to find out what's coming out of these plants."
Ajit Ghorpade, an environmental engineer who worked for several major pharmaceutical companies before his current job helping run a wastewater treatment plant, said drugmakers have no impetus to take measurements that the government doesn't require.

"Obviously nobody wants to spend the time or their dime to prove this," he said. "It's like asking me why I don't drive a hybrid car? Why should I? It's not required."
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After contacting the nation's leading drugmakers and filing public records requests, the AP found two federal agencies that have tested.

Both the EPA and the U.S. Geological Survey have studies under way comparing sewage at treatment plants that receive wastewater from drugmaking factories against sewage at treatment plants that do not.

Preliminary USGS results, slated for publication later this year, show that treated wastewater from sewage plants serving drug factories had significantly more medicine residues. Data from the EPA study show a disproportionate concentration in wastewater of an antibiotic that a major Michigan factory was producing at the time the samples were taken.

Meanwhile, other researchers recorded concentrations of codeine in the southern reaches of the Delaware River that were at least 10 times higher than the rest of the river.

The scientists from the Delaware River Basin Commission won't have to look far when they try to track down potential sources later this year. One mile from the sampling site, just off shore of Pennsville, N.J., there's a pipe that spits out treated wastewater from a municipal plant. The plant accepts sewage from a pharmaceutical factory owned by Siegfried Ltd. The factory makes codeine.

"We have implemented programs to not only reduce the volume of waste materials generated but to minimize the amount of pharmaceutical ingredients in the water," said Siegfried spokeswoman Rita van Eck.

Another codeine plant, run by Johnson & Johnson subsidiary Noramco Inc., is about seven miles away. A Noramco spokesman acknowledged that the Wilmington, Del., factory had voluntarily tested its wastewater and found codeine in trace concentrations thousands of times greater than what was found in the Delaware River. "The amounts of codeine we measured in the wastewater, prior to releasing it to the City of Wilmington, are not considered to be hazardous to the environment," said a company spokesman.

In another instance, equipment-cleaning water sent down the drain of an Upsher-Smith Laboratories, Inc. factory in Denver consistently contains traces of warfarin, a blood thinner, according to results obtained under a public records act request. Officials at the company and the Denver Metro Wastewater Reclamation District said they believe the concentrations are safe.
Warfarin, which also is a common rat poison and pesticide, is so effective at inhibiting growth of aquatic plants and animals it's actually deliberately introduced to clean plants and tiny aquatic animals from ballast water of ships.

"With regard to wastewater management we are subject to a variety of federal, state and local regulation and oversight," said Joel Green, Upsher-Smith's vice president and general counsel. "And we work hard to maintain systems to promote compliance."

Baylor University professor Bryan Brooks, who has published more than a dozen studies related to pharmaceuticals in the environment, said assurances that drugmakers run clean shops are not enough.

"I have no reason to believe them or not believe them," he said. "We don't have peer-reviewed studies to support or not support their claims."
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Associated Press Writer Don Mitchell in Denver contributed to this report.

Film Review of Generation RX: "An Important Message to Society"

The above is an insightful film review by Ronen Levi Yitzchak Segal of New York City. I think the words speak volumes, and represent the views of millions of others.

Shalom, brother. Thank you for caring!

A NOTE ABOUT RECIPROCITY

WHENEVER I WRITE ABOUT THE POOR, the responses always come in abundance. ONE PAYCHECK AWAY FROM HUMANITY was another example of this and my email was jammed with dozens of letters. A number of you have been kind enough to broadcast your feelings here. More than one of you were offended, as if I were issuing a personal and direct challenge; some were inspired to act; some heaped praise, and so on.

It is a sign that I should continue to write about the poor and homeless, especially as our nation struggles. That I shall do.

Below is a post from Gemma Benton, whose blog I began following at the beginning of 2009. She is committed to "Setting a thought in motion that will sustain seven generations, and prompting an indigenous conversation." I hope to pursue these issues with her over the coming weeks and months, but in the meantime, I don't think she'll mind if I share the entirety of what she wrote here.

You can find her wonderful blog, "Way Beyond Green: going beyond the conventional into deep sustainability" at http://waybeyondgreen.org/


ANOTHER NOTE ABOUT RECIPROCITY

If you read this blog through Google reader, you’ll want to “refresh” my post about reciprocity. I changed a bit. Soon after I changing it, I came across Kevin Miller’s post about his interaction with some ‘down on their luck’ folks in Cleveland.

You’ll enjoy his story. Here’s my take.. Kevin’s generosity was true in deed and heart and is a great example we can all learn from. Thank you Kevin!

Yet standing away from the forefront, in a single gesture I was struck by the black man who had nothing..homeless and freezing… yet found a generous moment in his soul as well. He could have done the ’street rap’, ranting about how “Its about time someone helped..I’m entitled to…a warm bed, a roof over my head…”

Yet that’s not what happened, he turned his attention to express his appreciation and return a kindness. Wow! Now that’s worth talking about. I wish I could buy this guy dinner and a cool hat to go with his new jacket and thank him for giving us the gift of meaningful conversation.

There has been a lot of talk going around about what folks think they have a “right to” or are entitled to. Some times we get so sideways with our “right to” that we lose our way and become ‘besides our selves‘.

True generosity and kindness is about giving with humility. This way of getting ‘besides our selves’ and getting humble again, it’s what the old people used to call “becoming a human being”.

If out of the crisis, we emerge true human beings… well that would be the healing miracle that the Elders have been calling for and it could be the sign for great healing of the planet; better said, the healing of our selves.




The above photo is 57-year-old Robert Slaughter, a homeless man who lives in a wooded area in Rockville. It was taken by Michael Williamson/The Washington Post