Malcom stands tall

John Malcom doubtless didn’t enjoy having to respond to a scathing Auditor General’s report on his last week as CEO of the Cape Breton District Health Authority. Doing so, however, gave him one last chance to demonstrate the exemplary leadership he displayed in 15 years as head of the authority.

Jacques Lapointe released a harsh report on operational shortcomings at the district and provincial levels that contributed to two outbreaks of C. difficile bacteria—infections that caused five deaths.

“As CEO, the biggest mistake is my mistake,” Malcom told reporters Wednesday, in response to the report. “I under-resourced the infection control department. So I accept that responsibility as mine.”

Of course the time to admit a mistake is when you realize you have made one, but in practice, such admissions are rare. When issued, they tend to ring down the curtain on criticism, when a less forthright response can lead to endless curtain calls. I would be surprised if my friend Greg Boone, the CBDHA’s gifted director of communications, had not encouraged Malcom’s response, but it was the CEO himself who had the stand before the cameras and manfully chow down humble pie.

It’s an open secret among provincial officials and politicians that humble pie is rarely found on Lapointe’s bill of fare. This is an auditor general who enjoys his frequent sashays through the media spotlight. Since the Infection Prevention and Control Nova Scotia and the Public Health Agency of Canada had already carried out and reported on investigations of the Cape Breton outbreak, Lapointe could be accused of piling on, or even shooting fish in a barrel, by instigating a third pass through this well-hoed soil.

As usual, certain details of Lapointe’s report seem overstated, most obviously his complaint that Cape Breton health care workers don’t always wash their hands between patients. This is no doubt true, but it simply restates an intractable problem known to persist at hospitals around the world. For further proof, check the hilarious efforts Cedars-Sinai Medical Center in Los Angeles undertook to get its doctors to wash their hands, as recounted by Freakonomics authors Stephen Dubner and Steven Levitt in the New York Times.

I’m going to miss John Malcom. So is Cape Breton.


The shuffle: two afterthoughts

A couple of day-after comments about Darrell Dexter’s cabinet shuffle seem worth passing on:

First, a longtime New Democrat writes that, “Having to take Maureen out of Health to backfill Finance indicates a lack of bench strength.”


Second, a friend notes that, as a former paramedic, incoming Health Minister Dave Wilson should put paid to Nursing Union president Janet Hazelton’s campaign to featherbed the new Collaborative Emergency Centres.

Hazelton has complained the staffing model of one nurse and one advanced care paramedic, with telephone backup from an emergency room specialist physician, is insufficient to meet, ahem, professional standards. Nothing less than two union nurses will do, she insists.

The two governing bodies that regulate the nursing professions in Nova Scotia disagree. The College of Registered Nurses and the College of Licensed Practical Nurses have collaborated on a set of professional standards for the new centres that makes no such demand.

Promising to end rural emergency room closures was an flagrant fib at the heart of the NDP’s election platform. The CECs represent a sensible and creative solution to the problem—and MacDonald’s crowning achievement as minister. Wilson probably won’t be impressed with Hazelton’s thinly veiled slight to his former profession, and he must not allow union staffing rules to sabotage the CECs.

The shuffle: big losses; missed opportunities

Wednesday’s smoothly orchestrated cabinet shuffle could not hide the central fact of the event: It is a big loss for the Dexter Government.

Graham Steele has been the strongest member of Darrell Dexter’s cabinet, turning in a sterling job at Finance while displaying a rare knack for speaking plainly, persuasively, and with conviction.

Bill Estabrooks’s departure likewise represents a big loss. He was the cabinet minister with the commonest touch, a popular, unpretentious man who did solid work putting systems in place for rational decision-making about road work. The province’s roadbuilding oligopoly was apoplectic over Estabrooks’s decision to set up a civil service paving plant, but taxpayers have already benefitted from sharper bidding in parts of the province where one contractor had buffaloed the competition.

Estabrooks was frank about the toll Parkinsons has taken on him; perhaps a more restful pace will slow its cruel progress. Steele was more coy about his reasons for leaving, insisting he has no job lined up but wants to chart a new, as yet undefined career course. The man most often touted as Dexter’s successor pointedly did not rule out an eventual return to elected office at the provincial or federal level.

As the only other minister approaching Steele’s stature, Maureen MacDonald is the logical choice to succeed him, but that leaves the important Health portfolio in the hands of rookie Dave Wilson, about whom I don’t know enough to venture a forecast.

Considering the number of under-performers who fill out the cabinet table, Wednesday’s shuffle was surprisingly minimalist. Several strong MLAs continue to languish on the back benches — Gary Burrill (Colchester-Musquodoboit Valley) and Clarrie MacKinnon (Pictou East) are two obvious examples — while Denise Peterson-Rafuse heads the list of ministers who have shown they are not up to the job.

Competence is only one of many factors that go into crafting a cabinet, and Darrell Dexter knows his caucus far better than I. But his continued willingness to countenance incompetence in a 12-member executive council is the most disquieting feature of his government.

Lost and found text

Early in 1229, Johannes Myronas, a monk working in Jerusalem, wrote a prayer book. He constructed the book on parchment he recycled from several documents, including a manuscript by the Greek mathematician Archimedes of Syracuse (287–212 BC).

Myronas erased Archimedes’ words, separated the pages of his manuscript, cut the pages in half, turned them sideways, shuffled them, and transcribed his own prayers onto them. In the years since, the prayer book was drizzled with wax and repaired with various types of glue. Some its pages were covered again with forged paintings.

In this way, a unique work by one of humankind’s seminal mathematicians was lost for eight centuries. In the TED talk below, curator William Noel of the Walters Art Museum recounts the extraordinary steps by which a group of scientists recovered the text. It’s a great yarn, but the real lesson is not about science, but about how data increases in value when it is shared.

[Video link]

Well, that’s one view of newspapers

What exactly is this message, displayed on the London Underground? Is it a come-on from a tonier paper–The Times, perhaps? A pitch to get off dead-tree communications altogether, and follow The Guardian online?

No, as the fine print makes clear, it’s a plea from the Mayor of London and Transport for London to avoid subway clutter by disposing of your reading matter in an appropriate recycling receptacle:

Newspapers left on the Tube can jam doors and cause delays to your journey. Take your newspaper with you or put it in the bin to to be recycled.


More excellent medical news — coffee drinkers’ division

The good news about the healthful effects of a certain delicious, refreshing, invigorating hot beverage just keeps piling up. (Previous instalments here and here.)

Researchers with the US National Institute of Health examined the association between coffee drinking and mortality among 400,000 men and women in a Diet and Health Study they conducted in association with the American Association of Retired People. Participants with pre-existing cancer, heart disease, and stroke were excluded.

During 5,148,760 person-years of follow-up between 1995 and 2008, a total of 33,731 men and 18,784 women died. In age-adjusted models, the risk of death was increased among coffee drinkers. However, coffee drinkers were also more likely to smoke, and, after adjustment for tobacco-smoking status and other potential confounders, there was a significant inverse association between coffee consumption and mortality… Inverse associations were observed for deaths due to heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections, but not for deaths due to cancer. Results were similar in subgroups, including persons who had never smoked and persons who reported very good to excellent health at baseline.

In this large prospective study, coffee consumption was inversely associated with total and cause-specific mortality. Whether this was a causal or associational finding cannot be determined from our data. (Funded by the Intramural Research Program of the National Institutes of Health, National Cancer Institute, Division of Cancer Epidemiology and Genetics.) Supported by the Intramural Research Program of the National Institutes of Health, National Cancer Institute, Division of Cancer Epidemiology and Genetics.

[Emphasis: Contrarian’s.]

[UPDATE] – Contrarian reader Mark Austin comments:

This is not peer-reviewed, but my research tells me that both heavy coffee drinkers and abstainers have a 100% risk of mortality.

Does he have a guitar instructor, too?

Dave Carroll has a publicist.

I’m going to say that again. Son of Maxwell Dave Carroll, the Nova Scotia folksinger who needed only $150 and some creative friends to turn a beef with a US airline into a mortifying (to the airline) viral video that drew nearly 12 million pageviews, now has his own publicist.

Eliza Levy is a pleasant sounding young “assistant to the publicity team” at Media Connect, a division of Finn Partners of New York. She’s handling PR for Carroll’s newly published book, United Breaks Guitars: The Power of One Voice in the Age of Social Media, and his related website.

Contrarian heard from her, likely because we featured UBG, as she calls it, the day after Carroll posted it on YouTube, when it had only a few hundred hits. You can buy the book here or, no doubt, at your nearby bookstore.

Dredge it, and they will come. And we will throw them out.

Headline: CBRM to seek control of Laurentian Energy’s greenfield site
Headline: CBRM warns harbour site suitor

Let me see if I have this straight:

The Cape Breton Regional Municipality, which is $102.9 million in debt, and which constantly complains that it can’t afford to provide basic services, is going to borrow $6 million to buy 400 acres of harbour-front land, or a lesser amount to buy a controlling interest in the company that is selling the land, all to block — yes, block! — a proposed industrial development, so it can “save” the land for a fantasy container pier that will never, ever happen.

CBRM can afford to do this because it is overflowing in industrial development, and because a glorious fantasy in the bush is worth a real industry in the hand, especially in an election year.

CBRM can borrow beyond its already unsafe debt-service ratios, because it will be rolling in cash as soon as it gets the evil oppressors in Halifax to start forking over its rightful level of handouts, or rather, equalization payments. (The current level is more than what Halifax sends to all other municipalities in the province, combined.)

Dredge it, and they will come. And we will put the run on them. This is what passes for economic development strategy in the fervid brains of CBRM’s mayor and council.

There may be legitimate reasons to question this proposed development. But pretending Sydney is going to get a container pier isn’t one of them. That fraud has gone on long enough.

Don’t you wish your kids went to this high school?

Mike Penney, a teacher at Abby Kelley Foster Charter Public School in Worcester, Massachusetts, invited his students to record their thoughts on the ups and downs of the school year, while secretly sneaking fellow teachers into the the video frame for some stealth disco. Then he set the footage to Whitney Houston’s “I Wanna Dance With Somebody.”


H/T SP vis Gawker