<The greatest plans of mice and men oft go astray>. A beautiful morning found us in Robinson, IL, a quick 200 miles from home. A quick refill of the tank and we sped for a mile before my bike quit. Just lost power and slowed as I rolled to a driveway of a cement plant. Starter would not crank, nothing...now they say, all you need is spark, fuel and oxygen to fly down the highway, but the devil is <always> in the details. So, luggage off, seat off, fuel tank up, lots of side covers off...(You have to strip these metric bikes to the bone to service them). Did I mention it is now 90 degrees? I called the guys in service at Riva Motorsports in Pompano Beach, FL (where my Dad shops). Thanks, Carlo. They were great in talking me through a few debug steps but ultimately couldn't help. I found the fuse box and lo and behold the 15 A ignition circuit fuse had blown! Being the saavy traveller I happen to have some spares, two in fact. I replace the fuse and it immediately blows. I try one more and lo, the bike starts. I re-assemble but go nowhere as that last fuse shorts out. Now at this point I should have started a search for the short that is causing the problem...but I opt for the AMA (the other one) Roadside assistance.
Two hours later, we load the bike on a flatbed and head off for Thompson's Motor Sports in Terra Haute, IN. First a shout out to Poor Boy's towing: Thanks Steve and Grayson. Second, let me just say that the reception I got at thompson's was great. The service guys told me they realized I was on a trip and would do their best to get us back on the road. And boy, did they!
We wandered the Honey Creek Mall for two hours. Our return to Thompson's showed Xray ready to roll again. The cause (as explained in great detail by the mechanic): a short just under the fuse box!! I was inches from having been able to fix this myself.
Be that as it may, thanks to the great folk at Thompson's we were back on the road by 4 PM. A four hour jaunt up on the backroads to 94 finally brought us home. A temperature of 57 degrees as night fell added insult to injury caused by the horrible road conditions in Chicago.
An ignomious end, but an end none-the-less. The light was on, the hearth was on and the steaks were ready as we walked in the door. A warm embrace from the wife, the kids and the dog sealed the deal. There is no place like home.
The 4th ride is now in the bag. We'll have to see where the fundraising leads.
Dsc
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Wednesday, June 10, 2009
Tuesday, June 9, 2009
Day 3, Mile 1735, Robinson, IL
The home stretch. We are approximately 250 miles out after a lovely evening ride through the heartland of Illinois. We rode up IL 1 along the border of the state. We have avoided most of the heavy weather with the severe thunder storms now below us and moving east.
An easy if not hot and humid ride to the Windy City and back to the real world.
Dsc
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An easy if not hot and humid ride to the Windy City and back to the real world.
Dsc
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Monday, June 8, 2009
Day 2, Mile 15xx, Take the last to Clarksville
We can be there by 4:30; don't be slow...oh no, no, no...
Well, the rain gear only stayed on for about 15 minutes. Then the heat and humidity were killing us so off they came. The rain was the tail of a front passing north of us so we are in the clear heading north.
Our train will leave Clarksville then head to Evansville, IN. From there, its a straight shot up the IL/IN border home.
Dsc
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Well, the rain gear only stayed on for about 15 minutes. Then the heat and humidity were killing us so off they came. The rain was the tail of a front passing north of us so we are in the clear heading north.
Our train will leave Clarksville then head to Evansville, IN. From there, its a straight shot up the IL/IN border home.
Dsc
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Day 2, Mile 1378; the road to Nashville
Bustin' out the rain gear...there's got be a country song there somewhere.
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Sunday, June 7, 2009
Day 1, Mile 1316; The nameless road to the secret city
We rode through Gatlinburg which turns into a real tourist town with restaurants, souvenir shops, attractions, etc. It was packed on this hot, gorgeous day. Cars and motorcycles clog the main drag.
We continue on TN 321 but then turn back into the Smokey Mtn National Forest. Rather than continue south down 411 (toward the Dragon), we turn right toward Townsend. What do we find? You guessed YABRR! But this river has a difference: tubers and swimmers! Absolutely enticing. Great pictures.
We continue from Townsend to Maryville and then on US 140 to Oak Ridge, the secret city; home of the Oak Ridge National Laboratory and the Y-12 Security Complex.
Tomorrow, we turn North.
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We continue on TN 321 but then turn back into the Smokey Mtn National Forest. Rather than continue south down 411 (toward the Dragon), we turn right toward Townsend. What do we find? You guessed YABRR! But this river has a difference: tubers and swimmers! Absolutely enticing. Great pictures.
We continue from Townsend to Maryville and then on US 140 to Oak Ridge, the secret city; home of the Oak Ridge National Laboratory and the Y-12 Security Complex.
Tomorrow, we turn North.
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Day 1, Mile ??, Gatlinburg, TN
We came over 74 West to 26 to Asheville, then picked up 40 over the Smokies. 40 is the park is a great slab; 70 mph through twisting forest.
We then found a small gem, the Foothills Parkway that connects 40 to Maryville, TN. Beautiful. We are continuing 321 S to Maryville re-entering the park.
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We then found a small gem, the Foothills Parkway that connects 40 to Maryville, TN. Beautiful. We are continuing 321 S to Maryville re-entering the park.
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Day 1, Mile 1035, Charlotte
The ride home begins. Our first stop is Knoxville, TN. That means, we are <forced> to ride west through the smoky mountains again. Some of the best greenward twisties foisted upon us. It is a dirty job but someone besides Mike Rowe must do it.
Westward, Ho!
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Westward, Ho!
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Tuesday, June 2, 2009
Day 2, Mile 879.5, Brevard NC
A great start to a great day. I decided to head south on 441 to get to 64 E as the latter is marked as a scenic route. THAT is quite an understatement. 64 E is YASRR (yet another spectacular river road). When the road begins with a warning sign, <narrow road and sharp turns next 40 miles; trucks consider alternate> you know life is going to be good. 64 serpentines itself next to the Cullsuja (Tuskagee?) River and then other branches of the savannah river basin. Between the rapids and the waterfalls along the way there is an abondance of spots just beggin' for a visit and a photo (I only gave in half the time). At the end of the first part of 64 just before Highlands is a rest area built into a waterfall. You can even drive dehind the water! Spectacular.
Highlands is a lovely tourist/nature town set as a gateway to wilderness.
From Highlands to Brevard is more of the same; beatuiful twisties, with residential communities springing up left and right. I hope all the folks here are bikers as this is some of the finest bikin' land.
Now on to Charlotte. Gotta meet up with the Old Man.
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Highlands is a lovely tourist/nature town set as a gateway to wilderness.
From Highlands to Brevard is more of the same; beatuiful twisties, with residential communities springing up left and right. I hope all the folks here are bikers as this is some of the finest bikin' land.
Now on to Charlotte. Gotta meet up with the Old Man.
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Monday, June 1, 2009
Day 2, Mile 810, Dillsboro, NC
What can I say about the Dragon that has not yet been said? It is justifiably the #1 motorcycle road in the US.
US 129 meanders down from Maryville, preparing you gently and progressively for the curves ahead.
The lake formed downstream from the Fontana dam is a saphire gem that extends infinitely in both directions. It concentrates and amplifies the blue of the sky beyond belief.
I enjoyed the Dragon. I would say that it is not so much a question of difficulty as it is a question of concentration. On each curve, you try to remember everything you have learned and then execute. You have to do that 318 times.
I found that a reasonable speed of 35 +/- worked well. I stayed mostly in second, occaisionally third gear. Of course there were a bunch of sport bike riders who zipped by on a number of dangerous occaisions. I can understand why there have been deaths here.
Then you arrive at Deal's Gap: the motorcycle equivalent of the cantina scene from Star Wars. Bikers of every flavor and then some either coming down from the rush or gearing up to go. I get the impression that some of the racers (why would they wear track suits with knee plates if they weren't racers) go back and forth a few times in a day. Yet a lot of casual tourists, yours truly included.
The way out on the NC side takes 28 S through more of the same: twisty passages of green (with a quick stop at the Fontana dam for some grey/brown concrete). Smoky Moutain National Park goes on forever but I finally found a road and more importantly a hotel in the outside world.
All in all a great experience.
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US 129 meanders down from Maryville, preparing you gently and progressively for the curves ahead.
The lake formed downstream from the Fontana dam is a saphire gem that extends infinitely in both directions. It concentrates and amplifies the blue of the sky beyond belief.
I enjoyed the Dragon. I would say that it is not so much a question of difficulty as it is a question of concentration. On each curve, you try to remember everything you have learned and then execute. You have to do that 318 times.
I found that a reasonable speed of 35 +/- worked well. I stayed mostly in second, occaisionally third gear. Of course there were a bunch of sport bike riders who zipped by on a number of dangerous occaisions. I can understand why there have been deaths here.
Then you arrive at Deal's Gap: the motorcycle equivalent of the cantina scene from Star Wars. Bikers of every flavor and then some either coming down from the rush or gearing up to go. I get the impression that some of the racers (why would they wear track suits with knee plates if they weren't racers) go back and forth a few times in a day. Yet a lot of casual tourists, yours truly included.
The way out on the NC side takes 28 S through more of the same: twisty passages of green (with a quick stop at the Fontana dam for some grey/brown concrete). Smoky Moutain National Park goes on forever but I finally found a road and more importantly a hotel in the outside world.
All in all a great experience.
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Day 2, Mile 513, Morning from Manchester
Headed out east from Manchester and picked up 66 heading south. 66 is magnificient; a meandering, tunnel through the Daniel Boone National Forest. It was pretty cool as I started out, enough to merit an extra layer. The sun, heading east as I was, was brilliant, reflecting off every drop of dew it could find. At one point I rode through a cloud of fog just in the process of burning off. I caught a photo of a lingering path of said fog peeking out from the treetops where it was caught like cotton on a carpet.
The curves on 66 were just the warmup I would need for the Dragon. In fact, it was a bit reveresed; instead of riding a ridge, I was often carving through (limestone?) canyons.
As a reminder that this is coal country I passed two functioning coal mines as well as a handful of (ungated!) rail crossings.
I stopped for a coffe at a tiny little general store at the edge of the woods. A perfect start to the day.
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The curves on 66 were just the warmup I would need for the Dragon. In fact, it was a bit reveresed; instead of riding a ridge, I was often carving through (limestone?) canyons.
As a reminder that this is coal country I passed two functioning coal mines as well as a handful of (ungated!) rail crossings.
I stopped for a coffe at a tiny little general store at the edge of the woods. A perfect start to the day.
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Day 2, mile 600, Mid-day
I rolled south from DBoone trying to get back to civilization and Maryville, TN;the mouth of the Dragon.
I noticed that 66 dumped into 25. And 25 leads to the Cumberland Gap! I took a quick (very nice on/off access) detoru into the park. For nothing but to drive up to the outlook point. Lo and behold another baby dragon; a well tended national park rode that switched its way up the Cumberland hills. The view from the outlook is spectacular. You look out on three states; KY, TN and VA.
From there you dip through a tunnel to the other side. And then a quick ride over to Maryville, right?
Easier said then done.
The damn Garmin GPS failed me in my hour of need. It has got some power problems. It doesn't recognize the cradle and doesn't charge from it. I had charged it the night before and was turning it on and off to spare the battery. Unfortunately, now it won't come on. This will be the third time back to Garmin for service! Not recommended!
To top it off, my BB with Google maps had low battery. To its credit, it surviced the day! So I am about 40 miles out from Knoxville trying to figure out how to get to Maryville. Turns out you can't there from here; or just about. There's a lot of construction around Kville, right where I needed to go. So to make a long story short, I spent an hour or so in an involuntary tour of Kville wending a maze of twisty passages trying to get OUT. Did I mention it was 90 degrees! Yikes.
In the end, the brotherhood of the bike came to the rescue. A fellow rider at a gas station pointed me in the right direction to face the Dragon. (He even pointed out the speed trap they set).
Next...the Dragon....
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I noticed that 66 dumped into 25. And 25 leads to the Cumberland Gap! I took a quick (very nice on/off access) detoru into the park. For nothing but to drive up to the outlook point. Lo and behold another baby dragon; a well tended national park rode that switched its way up the Cumberland hills. The view from the outlook is spectacular. You look out on three states; KY, TN and VA.
From there you dip through a tunnel to the other side. And then a quick ride over to Maryville, right?
Easier said then done.
The damn Garmin GPS failed me in my hour of need. It has got some power problems. It doesn't recognize the cradle and doesn't charge from it. I had charged it the night before and was turning it on and off to spare the battery. Unfortunately, now it won't come on. This will be the third time back to Garmin for service! Not recommended!
To top it off, my BB with Google maps had low battery. To its credit, it surviced the day! So I am about 40 miles out from Knoxville trying to figure out how to get to Maryville. Turns out you can't there from here; or just about. There's a lot of construction around Kville, right where I needed to go. So to make a long story short, I spent an hour or so in an involuntary tour of Kville wending a maze of twisty passages trying to get OUT. Did I mention it was 90 degrees! Yikes.
In the end, the brotherhood of the bike came to the rescue. A fellow rider at a gas station pointed me in the right direction to face the Dragon. (He even pointed out the speed trap they set).
Next...the Dragon....
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Sunday, May 31, 2009
Day 1, Mile 513; Manchester, KY
Well, what can I say? Another fantastic voyage through rural America. I stand (can't sit after 513 miles) in awe of this great land.
I decided to slab it from Chicago through Indiana; to get to the good stuff.... The only downside to biking in Chicago is that you have to ride an hour and a half to get to something nice and rural. So, I did the obligatory 90/94 dance to northwest IN, then picked up 65 S to IN'apolis. As I mentioned, <classic> farmland slab (in need of repair).
I continued 65 S to Louisville. I could smell the fear and sweat from the ABR exam and slight chill ran down my spine despite the temp in the high 70's. At Louisville, I picked up the 64 E slab to Lexington. As nice a ride as slab can be. I passed, though did not visit, the Kentucky Bourbon Trail; something to be sampled, I'm sure, perhaps with RDC driving. I also passed the National Retirement Home for Retired Thoroughbred Horses. Had to stop and take a picture to show the REL. As I was stopped by the side of the highway, a very nice fellow rider (in military fatigues) stopped just to make sure I was OK. What a great gesture!
But that was just the start. Just east of Lexington, I picked up the Kentucky Mountainway (402) instead of slabbin' 75 S. In retrospect, the wisest decision I've made in quite some time... For this route, itself in great condition and equally adequatelly hilly and twisty, led me through Natural Bridge Resort State Park (I didn't see the bridge) to KY 11. KY 11 is, as my friend AP, also a rider, says, is a <little slice of heaven>. In addition to passing through small hamlets with names like, <travellers rest>, I had the opportunity to visit Morrocco (IN), Paris (KY?) and Egypt (KY) all in one day. Without even knowing exactly where I was going 11 led me to 30 led me to 421 all three winding their way to and through the Daniel Boone National Forest. A thousand shades of green surrounded me as I leaned into each and every curve. The road curves in all 6 degrees of freedom (if you count the bank of the road); truly a challenge. I could not have thought of a better training course for the Dragon that awaits me.
When my buttocks just couldn't take any more, I GPS'd the nearest hotel and followed the forest to Manchester.
Another note, I must have passed at least 500 bikers today; all out enjoying the beautiful day and the graceful curves of Kentucky.
To think, I get to do this again, tomorrow?!
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I decided to slab it from Chicago through Indiana; to get to the good stuff.... The only downside to biking in Chicago is that you have to ride an hour and a half to get to something nice and rural. So, I did the obligatory 90/94 dance to northwest IN, then picked up 65 S to IN'apolis. As I mentioned, <classic> farmland slab (in need of repair).
I continued 65 S to Louisville. I could smell the fear and sweat from the ABR exam and slight chill ran down my spine despite the temp in the high 70's. At Louisville, I picked up the 64 E slab to Lexington. As nice a ride as slab can be. I passed, though did not visit, the Kentucky Bourbon Trail; something to be sampled, I'm sure, perhaps with RDC driving. I also passed the National Retirement Home for Retired Thoroughbred Horses. Had to stop and take a picture to show the REL. As I was stopped by the side of the highway, a very nice fellow rider (in military fatigues) stopped just to make sure I was OK. What a great gesture!
But that was just the start. Just east of Lexington, I picked up the Kentucky Mountainway (402) instead of slabbin' 75 S. In retrospect, the wisest decision I've made in quite some time... For this route, itself in great condition and equally adequatelly hilly and twisty, led me through Natural Bridge Resort State Park (I didn't see the bridge) to KY 11. KY 11 is, as my friend AP, also a rider, says, is a <little slice of heaven>. In addition to passing through small hamlets with names like, <travellers rest>, I had the opportunity to visit Morrocco (IN), Paris (KY?) and Egypt (KY) all in one day. Without even knowing exactly where I was going 11 led me to 30 led me to 421 all three winding their way to and through the Daniel Boone National Forest. A thousand shades of green surrounded me as I leaned into each and every curve. The road curves in all 6 degrees of freedom (if you count the bank of the road); truly a challenge. I could not have thought of a better training course for the Dragon that awaits me.
When my buttocks just couldn't take any more, I GPS'd the nearest hotel and followed the forest to Manchester.
Another note, I must have passed at least 500 bikers today; all out enjoying the beautiful day and the graceful curves of Kentucky.
To think, I get to do this again, tomorrow?!
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Day 1, Mile 297 Near Louisville
The ride continues well. This part of Indiana starts to look like what I imagine Kentucky to be. Now scattered in amongst the corn and soybean farm there is the occaisional horse farm. Several with horses grazing at their leisure. The number of horse trailers on the road is increasing; as is the number of bikers! It is a glorious day for riding and everyone is taking advantage. Gas up and onward.
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Day 1, Mile 173 Indiana part 1
A quick jaunt through Chicago to northwest Indiana. 65 south to Indianapolis. A perfect day for riding: great weather, light traffic. Though the roads show numerous opportunity for <shovel ready> stimulus work.
The farmland is a patchwork of greens and brown. The air (beyond Gary) is clean and fresh.
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The farmland is a patchwork of greens and brown. The air (beyond Gary) is clean and fresh.
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Day 1, Mile 0: Home on the Range
It is a beautiful morning, the sun shining brightly in a clear blue sky. A welcome change after a long winter, and a rather cold and rainy spring. It is the perfect weather for an early start. The trajectory begins with a jaunt through Chicago to the Skyway. Down 65 to Indianapolis. More later...
4th Annual Ride-2-SIIM BEGINS!!
Well, it's that time of the year. Time to saddle up XRAY and take her through the Tail of the Dragon to the Society of Imaging Informatics in Medicine meeting, this year in Charlotte, NC!
"We do these things, not because they are easy but because they are
Friday, May 15, 2009
Tuesday, May 12, 2009
The Unfortunate Health Care Industry Letter
(Disclaimer: Though a physician, I am not and have never been a member of the AMA. This essay highlights one good reason why not. Of course, the Groucho Marx-ism also applies.)
There is a tremendous amount of hubbub surrounding a recent letter from the leadership of the American Medical Association, the American Hospital Association, the Advanced Medical Technology Association, the Service Employees International Union and America’s Health Insurance Plans to President Obama. In this letter,
There is a tremendous amount of hubbub surrounding a recent letter from the leadership of the American Medical Association, the American Hospital Association, the Advanced Medical Technology Association, the Service Employees International Union and America’s Health Insurance Plans to President Obama. In this letter,
"they are pledging to cut the growth rate of national health care spending by 1.5 percentage points each year — an amount that’s equal to over $2 trillion."
No one in their right mind does not recognize that the health care pie needs to be shrunk and that thereafter, growth of the pie needs to be constrained. Mr. Krugman, in a recent op-ed piece, is, to my mind, rightfully, skeptical. The crux, as he states so succintly, is,
"Remember that what the rest of us call health care costs, they call income."
There is no doubt that we, physicians, need to recognize that we need to shift the income, efficiency and accuracy curves toward the latter away from the former. If, as a medical student or physician that bothers you, then you should probably consider a career in widgets or plastics. The same can be said for health care institutions represented by the AHA.
The AMA and the AHA have, however, made a huge mistake in allying themselves with the rest of the industry. Of the six signatories of the letter, which one most clearly doesn't belong? The AMA represents (unfortunately) doctors. The AHA represents hospitals. One could argue that SEIU represents, at least, a class of patients. No question, these three need to be at the table.
But what about PHRMA and AMTA? As Mr. Krugman notes,
The AMA and the AHA have, however, made a huge mistake in allying themselves with the rest of the industry. Of the six signatories of the letter, which one most clearly doesn't belong? The AMA represents (unfortunately) doctors. The AHA represents hospitals. One could argue that SEIU represents, at least, a class of patients. No question, these three need to be at the table.
But what about PHRMA and AMTA? As Mr. Krugman notes,
"After all, several of the organizations that sent that letter have in the past been major villains when it comes to health care policy."
... and
"There’s also the Pharmaceutical Research and Manufacturers of America (PhRMA), the lobbying group that helped push through the Medicare Modernization Act of 2003 — a bill that both prevented Medicare from bargaining over drug prices and locked in huge overpayments to private insurers."
Yet, Phrma and AMTA, their drugs and devices, are critical components of healthcare. Their problem lies in capitalism. To misquote Churchill (“It has been said that democracy is the worst form of government except all the others that have been tried.”), "capitalism is the worst form of economic model for healthcare except for all the others that have been tried". In capitalism, "Greed is good", devices and drugs don't get inspected and tested as much as they should and not everyone can drive a Cadillac.
No, the real outlier, is AHIP, America's Health Insurance Plans. The health insurer's make no meaningful contribution to the delivery of health care. In fact, they are a barrier to the social contract between the provider and the patient. An expensive impediment at that. Once there is recognition that universal health care is a fundamental human right then we no longer need health insurers to profit from risk stratification; we are all in this together.
We need to grow beyond the fear-mongering myth that a single payor plan would mean "government control" of health care. As the recent financial industry meltdown showed, we just need responsible "government regulation" of a single payor system.
The AMA and the AHA were wrong to join in a letter with AHIP. They legitimized AHIP as part of the solution rather than exclude them as a source of the problem.
No, the real outlier, is AHIP, America's Health Insurance Plans. The health insurer's make no meaningful contribution to the delivery of health care. In fact, they are a barrier to the social contract between the provider and the patient. An expensive impediment at that. Once there is recognition that universal health care is a fundamental human right then we no longer need health insurers to profit from risk stratification; we are all in this together.
We need to grow beyond the fear-mongering myth that a single payor plan would mean "government control" of health care. As the recent financial industry meltdown showed, we just need responsible "government regulation" of a single payor system.
The AMA and the AHA were wrong to join in a letter with AHIP. They legitimized AHIP as part of the solution rather than exclude them as a source of the problem.
Friday, January 23, 2009
Another argument in support of a single payer health care system
There is a great piece in the New York Times, today, by Uwe Reinhardt, supports, nicely, the argument for a single payer health care system. In his piece, Dr. Reinhardt summarizes the "“Chaos Behind a Veil of Secrecy” (I love that line) of how hospitals determine pricing of medical acts. The details are, at the same time, fascinating and nauseating, like any good, blood-soaked medical mystery.
Also note that a single payer system does not mean that the government controls your health care options (any more so than it does now). Nor does it mean that health care providers won't need to compete and evolve under market forces. In fact market forces could be more easily directed at quality, efficiency and outcomes. A single payer would provide a level, open-to-scrutiny-and-regulation playing field upon which society could make its decisions about the allocation of health care resources to clinical care, research, education and community service.
"Over all, then, annually establishing the prices that a given insurer will pay a particular hospital and the prices charged the uninsured is an enormously cumbersome and highly labor-intensive process not used by any other health system in the industrialized world. It adds a significant component to the high administrative cost that is unique to the American health system."In is interesting to note, once we come to a national consensus in favor of universal coverage, how quickly the culture and practices that developed to stratify the haves from the have-nots become ridiculous. With everyone in the same risk pool and a single payer, there is no need for a health insurance industry. Buggy whip manufacturers, all of them. A whole host of healthcare dollars sucked from the system for no healthcare related benefit could be returned to or eliminated from the pie.
Also note that a single payer system does not mean that the government controls your health care options (any more so than it does now). Nor does it mean that health care providers won't need to compete and evolve under market forces. In fact market forces could be more easily directed at quality, efficiency and outcomes. A single payer would provide a level, open-to-scrutiny-and-regulation playing field upon which society could make its decisions about the allocation of health care resources to clinical care, research, education and community service.
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