Hollywood's Paradigm

According to Wikipedia, the description for the movie "Florence Foster Jenkins" starring Hollywood elitist Meryl Streep reads: In the 1940s, New York socialite Florence Foster Jenkins (Meryl Streep) dreams of becoming a great opera singer. Unfortunately, her ambition far exceeds her talent. The voice Florence hears in her head is beautiful...

The end of the movie narrative reads: As she is dying in bed, Bayfield (Hugh Grant) by her side, Florence remembers a fancy angel costume worn for the concert as an angel and imagines herself singing beautiful opera. She imagines that she, McMoon and Bayfield all take a triumphant bow to a standing ovation. She points out proudly that even though people can say she could not sing, no one can say she did not sing. Peacefully, she dies.

Is it just me, or does this strike anyone as a paradigm for Meryl Streep's (if not most of Hollywood's actors) real-life acting career? All these years, she thinks she's a great actress, but her ambition far exceeds her talent, and those around her feel revulsion and pity for her and just keep telling her how great she is, even though they really can't stand to watch or listen to her. And on her death bed, she'll point out that even though people will say that she could not act, not one can say that she did not act.

Boycott the 2017 Academy Awards

Boycott the Academy Awards

Do NOT watch Sunday Feb 26th, 2017

Let Liberal Left Hollywood know we don't care what they think

They are not important!  We are Sick of their behavior!

PLEASE SHARE to all Groups.... your wall...and INVITE

all the Deplorables / Trumpsters you know!!!

LET'S BE HEARD!!! 

It's about time the left hears the right now

...and we do it with class, not violence!

Hollywood: The Land of Bonehead Actors and Lousy Screenwriters

My husband was watching the movie "The Martian" and I happened to catch a little of the dialog, which was, "In the face of overwhelming odds, I'm left with only one option: I'm gonna have to science the shit out of this."  I wouldn't be surprised if NASA scientists and the ghost of Carl Sagan weren't collectively cringing after hearing this horrible drivel.  Do they think this is clever writing, or are they just too damn lazy to write something good?  Why don't they just have the actors say, "Yada yada yada, rocket propulsion, blah blah blah, Mars, something, something, science..."  I've said it before:  I think Hollywood should just give up all pretense and film one of their over-paid, self-important "actors" to sit on a toilet for 2 hours.  It couldn't be any worse than this movie or most of the other garbage they keep churning out in order to separate us peasants from our hard-earned money.

Hollywood is the Land of Unicorn Farts

I'm sure you've seen the buzz about Meryl Streep and her 2017 Golden Globe speech in which she rakes Donald Trump over the coals but won't speak his name (she also berates MMA and football, but we won't go into that because it may tend to make her look like a deranged screwball).  I still remember Streep's ridiculous demand a while back that everyone buy a Prius to help save the environment, but because she's just another pig-ignorant celebrity regurgitating bullshit, she obviously isn't aware that (1) 67% of electricity in the U.S. comes from coal, natural gas, and petroleum, so how does driving an electric or hybrid car really help the environment, and (2) how on earth is everyone in the U.S. going to buy a Prius when one in two working Americans make less than $30,000 a year and a Prius costs almost $25,000?  Is Ms. Streep offering to buy everyone their own Prius, or at least subsidize those who can’t afford a brand new car?

I'd take celebrities and other Liberals a little more seriously if they would stand up for what is truly right rather than the "offense du jour" by the Republicans or Conservatives.  Where was the outrage when NDAA was signed into order? Where was the outrage when Operation Fast & Furious was exposed? The NSA spying scandal? Benghazi? The Iran nuclear deal and ransom?  The IRS targeting of Conservative groups?

Please don’t misunderstand – I did not vote for Trump, but I am sick and tired of Liberals acting like everything they do and say is A-OK but everything Conservatives do and say is barbaric and wrong.

Update:  A quote from an article in the Huffington Post titled, "Meryl Streep's Golden Globes Speech Belied An Inconvenient Truth About Hollywood:"

"Hollywood is willing to touch on the issue of disability without actually inviting any members of the community to partake in the conversation, according to New York Times best-selling author and disability activist Kody Keplinger.

“I couldn’t help rolling my eyes,” Keplinger told The Huffington Post. She’s a co-founder of Disability in KidLit, an online resource regarding the depiction of disability in children’s and young adult literature. “The applause in the room felt almost self-congratulatory.”"

This pretty much sums it up. It seems Hollywood is only willing to touch on the issue of disability, women's rights, global warming/climate change, endangered species, etc., when they can get mileage out of it. Afterward, they all go back to their mansions and figure out how they're going to spend all their money, and forget all about the peasants until the next time they need someone to exploit.

Horrible Bosses

For anyone who's had a really horrible boss, I'm sure you can all relate to the petty mind games, the undermining of your expertise or opinions, the taking credit for work that you've done, the overall deliberate sabotage of your reputation and value as an employee.  Below is a list of just some of the really shitty bosses I've had in my life, starting with the most recent:

Clinic Director
This guy is the Clinic Director of a Physical Therapy clinic, and though he has a few letters after his name, he couldn't manage his way out of a wet paper bag.  He's an insecure, antagonistic jackass control-freak who loves to play mind games with people because he thinks he's so much smarter than anyone else.  I should've known what a know-it-all douche he was going to be after I'd told him I'd worked at a couple of gold mines and I shared some interesting tidbits about gold and other minerals, to which he questioned my facts and arrogantly informed me that HE had minored in Geology.  Well, dickhead, the information I had was given to me by actual Geologists working for actual gold mines, not some educated idiot who only minored in Geology.  After months of scheduling problems that this asshole created himself, he tried to blame the scheduling problems on the staff.  I quit after he sent an email publicly flogging the staff for doing exactly what he told us to do.

Vice President & CIO
The CIO was so technically-retarded that he kept telling us that our jobs could be done "with just 5 clicks" of the mouse.

A very married Vice President (one of many) was sending filthy text messages (sexting) to any and every woman willing to have sex with him.  I especially liked the text he sent to a female technical recruiter in which he said he wanted to have her fuck him while wearing a Santa hat.  Merry Christmas!

Supervisor and Manager
Probably the worst two bosses I've ever had were a supervisor and manager who had the maturity of a couple of ten-year-olds.  They sat in their office giggling all day (when they weren't out of the office screwing off, which was often), and bragged about smoking crack and doing other drugs (I used to call them Beavis and Butthead).  The supervisor was the worst: pounding the back of my chair with his fists, kicking expensive electronic equipment because he was having a tantrum, threatening to fire people because he claimed we weren't doing what he wanted (but would never say what we weren't doing whenever we asked).  He got demoted (big surprise) and he told me it was my fault.  Yes, it was my fault that you're an asshole.  Where the fuck do they find these people?

Customer Service?

This is a reprint of an email exchange with a local endodontist I recently consulted:

May 22, 2014 10:47 PM

Endodontist:  "I am writing you privately in response to your Yelp review of your experience in my office.  I think private correspondence is a much better way to resolve concerns versus an open public forum where limited information is available and uninvolved parties can form conclusions that do not take into account all the variables associated with the circumstances.

Here is a reprint of your online review (date 5/18/14):

The first experience was about a year ago when I was having problems with a tooth that had previously had a root canal and crown, and that experience was fine other than being bugged incessantly to take a survey for the business.  I had to return this year for problems with the same tooth and after they took an x-ray, I didn't hear back from them for almost 3 weeks, and only after I called my dentist for a referral to another endodontist.  There is no excuse to leave a customer waiting for almost 3 weeks for a return phone call.

I understand you are frustrated with the delayed response regarding your follow-up exam.  I am at fault for not contacting you in a timely manner, and for that I apologize.

I also understand that you have requested to be seen by another endodontist for your specialty needs.  That is your choice and you should go where you feel most comfortable.

I take every patient complaint very personally because the care I provide represents my own personal dedication to your health and the gratitude I have for the trust you and your general dentist have placed in me.  I would like to review with you some of the details of your patient relationship with our office so you can perhaps understand from my perspective what I am about as a provider and the service level that my office strives for.

Our first encounter was in regards to tooth #2 back on November 3rd, 2011.  You called us in the morning and were seen 2 hours later.  Pretty good service to you, while you were in pain.   Your pain had been significant but just improving due to antibiotics.  Here are the notes I took from that visit:

Pt referred because of pain URQ, present for the past 5 days, currently 5/10.  Hx of previous RCT #2 by an unspecified endodontist, PFM crown.  Patient has been taking antibiotics for the past 2 days and just starting to experience relief.

Clinical/Radiographic exam: #2 periapical pathosis is present.  Aggressively enlarged canals, amalgam core extending well into the orifi.  #2 +++ to perc, WNL to palp.  #3 WNL to perc and palp.  Pt is missing tooth #30.  #2 is D and B inclined.

Pt is concerned about long term prognosis and questions whether #2 can be predictably preserved.

Pre-treatment prognosis is guarded.  Canals have been enlarged to the point where root walls are thin.  Removal of the core will have high probability of loss of the crown.   Area might be challenging for implant placement (pt informed).  She did not want to re-invest in #2 unless prognosis justifies it. 

Patient's symptoms are improving, likely because of the antibiotics.  She will elect extraction and seek implant consultation, including for space of #30.

Consultation only today.

It was unfortunate that #2 was to be lost.  I like to save teeth if at all possible, but this tooth was really beat up.  Preserving teeth improves our quality of life in many ways.  My role in this situation was to come in as the “last responder” and decide, along with your desires, if there was a chance that it might respond favorably.  In the case of your tooth #2, I felt the execution of the previous therapy (of which I had no part in whatsoever) did not leave us much to work with.  So extraction was recommended. 

Our second encounter was on 4/17/13 for pain with tooth #19 (lower left side).  My office received the call at 7:57 am that you were hurting, and you were seated at 8:25am that same day.  Again, pretty good service to you, while you were in pain.  Receiving attention no more than 30 minutes after first contact isn’t bad, in my opinion.

Your problem was another tooth again with previous root canal (not done by me, but rather another endodontist, maybe even the same one that treated #2?).  It had been treated on multiple occasions by 2 different providers.   We had a lengthy discussion of the prognosis of the tooth in its current condition, and the recommended treatment of choice was extraction (due to a suspected fracture or possible perforation).  Seeing that you were already missing multiple teeth, you wanted to try to save it if at all possible.  I agreed to try, but also emphasized that the treatment provided to salvage your tooth #19 would be the very last effort, and that there is a very good chance it will not respond and could still be lost.  You understood and agreed.  Here are the notes from that day and the treatment:

Hx of RCT #19 approx 9-10 yrs ago (first by general dentist, completed by endodontist?).  3 weeks ago became tender to biting and sometimes cold, wakes patient up at night.

Eval:  #19 + to perc, + to palp.  No swelling or soft tissue abnormalities.  Mid-root radiolucency that does not involve the apex of #19.  Short endodontic fill.  Normal probings.  Robust coronal canal enlargement and amalgam deep into the canal orifi.  Pt recently lost tooth #2 under the same circumstances and does not want to lose #19 if at all possible.

CBCT analysis:  Radiolucency is adjacent to the ML root primarily, suspicious of root fracture.  The periradicular bone loss does not advance to the cervical osseous crest.  Normal appearace of PDL/lamina dura D root.

Prognosis is questionable.  Informed patient that the history of aggressive endodontic treatment along with the mid root bone loss increases the risk that a root fracture is present.  She understood and elected to proceed with the full understanding that #19 very well may not respond to any therapy we can provide.  No disease is present with the D root, and retreating that area provides more risk than potential benefit.

Accessed through crown, removed amal core, located MB, ML.  Removed GP from 2 canals.  Bypassed apical ledge for patency.  No internal cracks seen.  CaOH for one  month.  Pt returned with improved symptoms, reports a few episodes of dull ache there, but ok for the past week.  Obturated.  Removed coronal GP from ML root and was able to visualize a possible (still hard to tell)  crack in the canal wall, but still hard to tell.  Placed amal core.

Post-operative prognosis is Guarded.  Pt understands.  Reduced fee (no charge for CBCT or restoration).  Pt will return in 6 months to re-evaluate, or sooner if symptoms arise.  Next step is extraction if necessary.

Again, I was asked to come in and salvage an already bad situation.  The previous aggressive treatment had a direct negative influence on the survival of your tooth.  What I mean by “aggressive” is that when root canal therapy is performed, it can be done in either an invasive or minimally invasive way.   Invasive therapy involves the widening of the canal space in order to improve visualization and the procedural steps of cleansing.  Invasive/aggressive therapy is the norm and often the only way to deliver the therapy when a microscope is not used.  The provider must enlarge the areas because of the limits of illumination and lack of adequate magnification.  The result of enlargement of the canals is thinning of the root walls.  Thinning of the root walls leads to weaking of the root structure, which increases the chance of eventual fracture.  If the walls are really enlarged, a perforation can occur.  A perforation is when the enlargement finally breaks through the wall and leaves an opening in the area where the exterior tissues (i.e. ligament and supporting bone) should be adhering to the root structure.  Without the zone of adherence intact, the tooth is doomed and will eventually be lost.  How are these risks of treatment reduced?  With the use of the dental microscope.  Skillful use of the microscope improves visualization and illumination, and thus facilitates minimally invasive treatment.   Minimally invasive treatment preserves tooth structure and decreases the risks of fractures and perforations.  I prefer this approach to the alternative (even though it is much more time consuming to provide) because it avoids problems just like the ones you have experienced on both of these teeth.  Unfortunately, minimally invasive treatment is impossible when another provider has already drilled/treated your tooth.   In other words, aggressive treatment is not reversible.

I suspected a fracture or perforation in your case.  Unfortunately, it is challenging to detect cracks and/or perforations in teeth.  Our traditional xrays don’t show us enough.  If we assume the tooth is fractured, extract it, and only find that it is not fractured after all, you lost your tooth for nothing.   Rather than risk loss of your tooth without justification, I elected another step in the process, which was to look at it with the aid of CBCT, which a small-scale CT scanner for teeth.  I am fortunate to have this new technology in my office.  On 4/17 we did an analysis of your tooth using CBCT.  You were not charged for this, as I saw it as a beneficial step in trying to understand your problem.  I really wanted to do what was best for you.    Please understand that the national average for this service is $200-$300.  Your fee was zero.  Pretty good service for you, in my opinion.

With every tooth that is lost, the remaining ones become more important.  You were already missing #2 and #30 and #19 looked very questionable.  Nevertheless, the goal was to save your tooth if at all possible. Truthfully, if I could eliminate any aspect of the services I provide, it would be to salvage the work of others of which I had no previous involvement, and whose treatment philosophy differs from my own.  I simply cannot reverse the negative effects of previous aggressive treatment. It leaves the tooth structurally compromised.  I believe this to be the case with both of the teeth your teeth that I evaluated.  Unfortunately, someone has to do it and I am the most qualified.   I should add that I also believe that respecting your desires (via fully informed consent) is at the heart of a patient-provider relationship.  If there is a chance the treatment could be successful, you deserve to know this and have the chance to decide what is in your best interest.  I thought we had a chance.

So your tooth was treated over multiple visits in order to try to achieve the best outcome with what we had to work with.  A multiple visit approach allows some feedback on the progress of healing.  The presence of progressing pain, the onset or nonresolution of swelling, etc, would all be negative prognosticators of healing.  Even though dental insurance provides no additional reimbursement for a multiple visit approach vs a single visit approach, I feel very strongly that it is better for patients to be treated this way.  From a purely business model (which I am sure you understand being an office manager in a health-related field), each visit significantly reduces the financial gain of our services.  You are not charged for the additional visits.   Regardless of the negative incentive to spend time on cases, I am in favor of this approach because it is in your best interest and a very good service for you.   At the second visit your symptoms were improved (but not perfect).  We needed to complete your treatment, so the retreatment was finished.  Your crown still needed repair.  Still feeling unsure of the chance of success, I repaired the crown with a permanent filling at no charge, also a very good service.  I also feel very strongly that minimizing your financial risk on cases with uncertain prognosis is simply the right thing to do.   We set an appointment for a 6 month follow-up appointment before you left the office.

The purpose of the follow-up appointment is to further evaluate the healing.  This is another complimentary service that we provide, solely because it is in your best interest.  This is a great service for you.  When the date was approaching for your visit (11/14/2013), as a courtesy we contacted you for a reminder.  You declined to take advantage of this beneficial step, instead opting to wait and have (my dentist) look at it at your next routine examination.  Our notes from that phone conversation:

11/13/13 - Patient doesn't want to come for a recall on her tooth.  She said she is just going to have her general dentist look at it when she goes to her regular appt in January.  She said it is feeling great…LAR

Our next encounter was via a phone call (a voice message you had left on our answering machine) on 3/27/14.  Our notes:

Pt called today had seen her dentist. He would like us to check #19 again. He feels it's not healing .Pt left a message on the answering machine; I called her back and asked her to call us back. Will call back again if she doesn’t call us.

On 3/31/14 an appointment was made for 4/10/14 for evaluation.  I remember that was a particularly busy day due to unscheduled emergencies that required immediate care.  That happens from time to time.  Severe pain and/or swelling cases can shake the day up a little so I occasionally have to balance these with an already full day.  The endodontist office is a lot like a “dental ER” where I must triage and see patients when they must be seen versus waiting.  This can make it quite inconvenient for other patients, my staff, me, and even my family- especially when conditions arise where I need to stay 4-5 hours after closing time just to take care of situations.  Such was the case that day.  It’s not unlike your first visit with use where you called and were seen the same day.  Or the second visit when you were seen immediately after you called.  We take care of people in pain, it’s what we do.

On April 10th, I sat with you in the waiting area and discussed your case. It was a fairly pleasant conversation.  We reviewed the conditions that were present prior to your treatment of tooth #19, including the prognosis, the decision to treat as a last resort, the agreement that in the event that any problems persisted extraction would be necessary.   I then had to tend to another patient and you were taken back to the evaluation room, an xray was taken, and you left the office.  No charge, of course.  Free follow-up evaluation is a pretty good service to you.

I regret that I failed to follow through with the report of the xray.  I thought that our discussion served that purpose that any additional efforts would be unnecessary and extraction was the next step.  In hindsight, it would have been much better to have communicated more directly.  I ran out of time that day and never got around to contacting you again. 

Regarding the “incessant bugging” regarding feedback for our services, I again apologize.  My records show that an email message was sent on 5/17/2003 (now we're back in 2003, this was apparently a typo).  This email contains information including what to expect after treatment is complete, our phone number should you have any questions/concerns, and asks for a favor of leaving positive feedback on our facebook page if you feel you were dealt with in a fair manner. 

My records also show another email was sent on 6/12/2013 from a new service (Panda) which we began using right around that time.   Again, asking for feedback if you were willing. 

If there were other emails sent, I do not have a record of them.  For the 5 appointments that you were seen in our office, you received 3 courtesy appointment reminders, one post-operative follow-up, and 2 asking for feedback only.  This doesn’t seem to “incessant” to me.  You were seen for 2 teeth.  Seems fair.  (I never said anything about being "bugged" by appointment reminders, only the surveys.)

When your retreatment was completed on tooth #19, you were provided an information sheet that included my personal cell phone number so you could contact me at any time with any concern.  I provide this to all my patients so I can personally resolve problems that may arise.  A simple phone call, with a friendly reminder that we had neglected to contact you, would have jogged our memory and resolved your concerns.  Instead, a scathing review on an online site was used.   Ouch.  Now the world at large gets to judge my office based on your feedback. 

I don’t look at you as a “customer,” but rather a patient.  If you were another face in the crowd customer I never would have offered anything without a charge attached to it.  I would have never booked a return visit to follow-up.  I wouldn’t have offered treatment options.  I would have given you antibiotics over and over again.  I wouldn’t have even taken then time to write this letter (a weak attempt to help you understand the value in treatment above what you might get somewhere else).  I don’t have “customers”.    Or I could actually be asked to be a “first” responder and not have my reputation dependent on the irreversible damage to teeth by other providers.  Now there’s a thought. 

I will continue to try my best to provide the best care I can.  I will invest in the best technology (even when I don’t charge for its use), and I will spend an over-appropriate time for what in-network insurance discounts pay.  I will make room for patients in pain at the expense of personal and family time, just like I did for you.  I will be honest and up-front regarding the prognosis of the procedures.   I will give you options even if that involves referral to another provider for services that I don’t provide.  And, as I have for the past 4 nights, I will leave the office at 10pm even though the office “closes” at 5.   I will probably (without even realizing it) leave without having returned a phone call or written a formal report.  Everybody is human and if that is what deserves a public flogging, I’m going to have to live with that.  The 3 patients that were added on to the end of the day that were in crippling pain today sure were relieved they could be seen instead of waiting until after the holiday.  Oh, and I didn’t have any part in causing their pain either.  I hope they don’t vilify me later.

Doofus

Yours in better dentistry.

Jonathan Richards, DDS, MS

Eastlake Endodontics

801-645-4590 (mobile)"

Wow.  If the reader is still awake, please note that all I said was that he didn't call me for nearly 3 weeks and only after I called my dentist for a referral to another endodontist.  He responded more quickly and took more time to research and rebut my online review than he did to follow through with what he promised, which was to phone me back to tell me what my options were with my tooth.

May 23, 2014 7:20 PM

I responded:  "While I appreciate your efforts in finally responding to the situation, the bottom line is that you told me you would call me after reviewing my x-ray but didn't for nearly 3 weeks.  This is a failed promise, so I asked (my dentist) for the name of another endodontist who took less than 5 minutes to tell me that the most viable option was to extract the tooth, and then gave me the name of an oral surgeon.  In short, you missed your chance at providing promised customer service, and if it was going to take nearly 3 weeks to review my x-ray and call me back to tell me that my most viable option was to have the tooth extracted, you should have set that expectation by giving me that information.  Good luck in your future business."

May 23, 2014 7:56 PM

He immediately responded:  "I was a phone call away. An easy resolution.

We both knew that we were dealing with a pre-existing problem and heroics to save yourtooth (sic).   To add into the review that I was solely responsible for your failed treatment was misleading. (Hopefully he's better at dentistry than reading since I never said anything about him being solely responsible for failed treatment.)

This is analogous to publicly shaming a caring ER physician for a failed effort in reviving a half-dead patient.   We do our best. 

To actually go out of your way to trash my online reputation I feel is hardly fair."  (If your reputation is trashed by one online review, what does that say about your reputation?)

May 26, 2014 3:54 PM

I responded:  "I find it interesting that it took less time to respond to my online review of your lack of timely response than it did to call me as promised and let me know that my only option was to have the tooth extracted (and thus either schedule the extraction or refer me to an oral surgeon), which contradicts your "I'm so busy" excuse.  Blaming me for not contacting you because you had not contacted me as promised is ludicrous.  Claiming that I accused you of being solely responsible for failed treatment is blatantly false.

If you're so worried about your online reputation, then maybe you should practice better customer service by (a) following through with your customers as promised, and (b) by not responding to negative reviews of your failed customer service with a 3,000+ word email making excuses and attacking/harassing your customers because you didn't follow through as promised, which also contradicts your "I'm so busy" excuse.  I have since removed my Yelp review because I do not want you to feel that you are at liberty or have my permission to contact me in any way, shape or form in the future."

His entire reaction to my survey was classless, unprofessional and a complete overreaction.  Instead of just apologizing and taking responsibility, he made ridiculous excuses and even blamed me because I didn't phone him!  If nothing else, this is a perfect example of how NOT to treat a customer.