December 27, 2006
Helpful Hints from joeeze: Why microwave meals need to "rest" after nuking
Robert L. Wolke, the Washington Post's estimable food writer, addressed this topic in today's "Food 101" column, noting that it's one of the questions that repeatedly comes up.
Here's the Q & A.
Q. Why do almost all microwaveable frozen meals instruct you to leave the meal in the microwave for two minutes or so after the cooking period? What happens during those two minutes?
A. Microwaves deposit all their energy within a half-inch or so of the food's surface. It takes time for that heat to work its way inside and heat the interior to the same temperature as the surface. Surprisingly, microwaves don't melt ice crystals very well, so any remaining ones need to be melted by contact with already heated food.
Okay, that's all well and good, thought I, but why do you have to leave the meal in the microwave instead of letting it finish outside on the counter?
Then the penny dropped: it's much hotter inside the box than outside, so that final internal heating is going to be far more efficient inside the machine.
I mean — that's hot.
Hanging Wine Rack
Pretty clever, and especially useful if your fridge's vertical inter-shelf space makes on-end storage difficult or impossible.
From the website:
- Holdups™ Refrigerator Wine Bottle Holder
Horizontally cradles bottle of wine above food and off shelf making vertical height a non-factor when it comes to refrigerator storage.
Saves space and secures bottle to prevent spills.
Unique design hangs from bottom of wire shelf.
Two for $9.98.
BehindTheMedspeak: Why your doctor might be forced to betray medical confidentiality
joe, you're getting a little too hysterical for our taste: this sounds like something out of the New York Post or Mother Jones.
Well, wait a sec.
Take a few moments to read Theo Francis's superb front-page story from yesterday's Wall Street Journal about loopholes in medical record confidentiality laws that allow insurance companies to drive proverbial Mack trucks through them, opening your records to far more eyes than you'd think.
Long story short: If your psychotherapy records are a part of your overall medical file or record, they lose the added layer of confidentiality granted to psychiatrists' and psychologists' files.
As Francis wrote, "When psychotherapy notes are mixed in with general medical records, the federal rules afford them no special protection."
Here's the article.
- Spread of Records Stirs Patient Fears Of Privacy Erosion
Ms. Galvin's Insurer Studies Psychotherapist's Notes; A Dispute Over the Rules
Complaint Tally Hits 23,896
After her fiancé died suddenly, Patricia Galvin left New York for San Francisco in 1996 and took a job as a tax lawyer for a large law firm. A few years later, she began confiding to a psychologist at Stanford Hospital & Clinics about her relationships with family, friends and co-workers.
Then, in 2001, she was rear-ended at a red light. When she later sought disability benefits for chronic back pain, her insurer turned her down, citing information contained in her psychologist's notes. The notes, her insurer maintained, showed she wasn't too injured to work.
Ms. Galvin, 51 years old, was appalled. It wasn't just that she believed her insurer misinterpreted the notes. Her therapist, she says, had assured her the records from her sessions would remain confidential.
As the health-care industry embraces electronic record-keeping, millions of pages of old documents are being scanned into computers across the country. The goal is to make patient records more complete and readily available for diagnosis, treatment and claims-payment purposes. But the move has kindled patient concern about who might gain access to sensitive medical files — data that now can be transmitted with the click of a computer mouse.
The U.S. Department of Health and Human Services implemented standards in 2003 for guarding patient privacy, supplementing a patchwork of state laws. The federal standards, which grew out of the 1996 Health Insurance Portability and Accountability Act, single out psychotherapy notes for extra protection.
Critics claim that loopholes in the rules have left patient privacy under threat. Ms. Galvin, for example, discovered that when psychotherapy notes are mixed in with general medical records, the federal rules afford them no special protection. That is precisely what happened with her records at Stanford, she says.
"I feel like now I have no privacy," Ms. Galvin says. "My most private thoughts, my personal tragedies, secrets about other people, are mere data of a transaction, like a grocery receipt." Ms. Galvin has sued Stanford Hospital and her insurer in California state court for, among other things, violating state medical-privacy laws.
In a written statement, a spokesman for the hospital said: "We believe we acted legally and appropriately." He declined to comment further due to continuing litigation.
Confidentiality has been integral to the practice of medicine since the Hippocratic oath was drafted some 2,400 years ago. Today, the American Medical Association's ethical guidelines call on doctors to "safeguard patient confidences and privacy within the constraints of the law."
Patients tend to be especially sensitive about medical information they believe could stigmatize them in the workplace or among acquaintances, such as records about AIDS, substance abuse and abortion. "What's sensitive to one person may not be to another," says Deborah Peel, an Austin, Texas, psychiatrist and head of Patient Privacy Rights, a medical-privacy advocacy group. "How many women want somebody to know whether they are or are not on birth control?"
Mental-health records are generally viewed as worthy of the most stringent safeguards. In recent years, courts and state legislatures have afforded psychotherapy records special protections. All 50 states recognize some form of psychotherapist-patient privilege to limit disclosures in legal proceedings, and a similar federal privilege was established in a landmark 1996 Supreme Court ruling.
Because Ms. Galvin learned of the disclosure and filed a lawsuit, unusual in such cases, her experience offers a look at how increasingly complex confidentiality issues are affecting patients and their insurance coverage.
Ms. Galvin, a former litigator for the Securities and Exchange Commission and for the U.S. Attorney's office in Manhattan, says she decided to leave her native New York for a fresh start on the West Coast after her fiancé committed suicide. She took a job with Heller Ehrman LLP. Eventually, the partner she reported to left the firm, and she clashed repeatedly with a supervisor, she says. In a later lawsuit in California state court against the firm related to her employment, she called the supervisor's conduct abusive. The supervisor has since died. (Terms of the lawsuit's resolution bar both Ms. Galvin and the firm from commenting on the allegations.)
In 2000, she sought help for sleeping problems at a sleep-disorder center at Stanford Hospital. She began psychotherapy sessions with clinical psychologist Rachel Manber, director of the center. The sessions, she says, delved into her problems at work, as well as deeply personal matters such as her fiancé's death. "I would never have engaged in psychotherapy with her if she did not promise me those notes were under lock and key," Ms. Galvin says.
On a rainy morning in February 2001, Ms. Galvin was rear-ended at a red light in Palo Alto and suffered four herniated discs. She returned to work, but over time her back problems worsened, she says. Her doctor eventually diagnosed an unusual connective-tissue disorder that made healing difficult, she says. Two years after the accident, she applied for long-term disability leave. "My body just started breaking down," she says.
Her employer's carrier, UnumProvident Corp., asked her to sign a broad release covering her medical records. Without it, the insurer said, it would deny her claim. Ms. Galvin signed, she says, only after receiving assurances from Dr. Manber that the therapy records wouldn't be turned over without additional authorization. Ms. Galvin says she figured the newly adopted federal privacy rules that grew out of the Health Insurance Portability and Accountability Act, or HIPAA, would give her another layer of protection.
HIPAA's principal goal was to ensure that people could change jobs without losing insurance coverage for pre-existing medical conditions. When employers and insurers complained about the added cost, the federal government pledged to make it easier for medical providers, insurers and others to swap medical information electronically, potentially saving as much as $30 billion over a decade.
To assuage concerns of privacy advocates, Congress authorized the Department of Health and Human Services to draft privacy regulations. The final rules allow health insurers and medical providers — including doctors, pharmacies and hospitals — to disclose medical information for "treatment, payment and health-care operations," among other situations, without specific patient permission. But they aren't supposed to send any more records than necessary for nontreatment purposes.
Dawn Ross, a 37-year-old Los Angeles hairstylist, says she was startled to discover how much a bill collector knew about her. Federal rules permit the release of medical records in connection with "payment." Soon after Ms. Ross returned home from an uninsured hospital stay, the hospital's collection agency began dunning her for $8,600. When she disputed the bill, she learned that the agency had detailed records about her miscarriage and the treatment she received for it.
The rules also do not require patient permission for the release of records for "health-care operations," a broadly defined category that includes some marketing, data warehouses and fund-raisers. John Metz, chairman of JustHealth, a consumer health-care advocacy group in California, says he has encountered patients who were diagnosed with borderline diabetes — then inundated with marketing materials for diabetes services and supplies from their medical providers.
The federal rules allow patients to ask doctors, other medical providers and insurers not to share records with certain people, groups or companies. But medical professionals and insurers can ignore such requests.
Kaiser Permanente, the big Oakland, Calif.-based managed-care organization, informs its 6.2 million members in California in a privacy notice that "you may request that we limit our uses and disclosures of your" personal health information, but that "it is our policy to not agree to requests for restrictions." Scott Morgan, Kaiser's national privacy and security compliance officer, says that because patient records often reside in many locations, it would be too difficult logistically to accommodate special privacy requests. Furthermore, some requests would have to be reviewed by lawyers, driving up costs.
Complaints of privacy violations have been piling up at the Department of Health and Human Services. Between April 2003 and Nov. 30, the agency fielded 23,896 complaints related to medical-privacy rules, but it has not yet taken any enforcement actions against hospitals, doctors, insurers or anyone else for rule violations. A spokesman for the agency says it has closed three-quarters of the complaints, typically because it found no violation or after it provided informal guidance to the parties involved.
"We're three years into the enforcement of the rule, and they haven't brought their first enforcement initiative," says Peter Swire, a law professor at Ohio State University who helped write the regulations. "It sends the signal that the health system can ignore this issue."
The agency's spokesman maintains that it is "very serious about compliance and enforcement, and we take complaints very seriously."
Mr. Swire says the drafters of the regulations intended to give special protection to psychotherapy notes by requiring patient consent before they are released. But the rule drafters didn't want to get bogged down coming up with a precise definition for such notes, he recalls. Because the drafters understood that such notes were typically kept separate from other medical records, they made that a criterion for the extra protection.
In mid-2003, three months after Ms. Galvin signed UnumProvident's release for her medical records, the Chattanooga, Tenn.-based insurer denied her long-term disability coverage. In a letter explaining its decision, UnumProvident cited notes taken by Ms. Galvin's psychologist about her "working on a case" and about a job interview in New York. "[Y]ou continued to actively seek a new position and actively interviewing for positions, including traveling to New York," the letter said. "There is also some indication that you were working on a case... after you left work." The medical information in her file, the letter said, did not support her claim.
Ms. Galvin disputed UnumProvident's decision. She said that the notes about the job interview referred to the psychologist's suggestion during one session that she find another job, and that the reference to "working on a case" referred to her pursuit of a claim against the driver who rear-ended her. She says she showed UnumProvident telephone and bank records and they prove she wasn't in New York when the insurer said she was. UnumProvident stuck to its decision.
Jim Sabourin, a spokesman for UnumProvident, says the contents of Dr. Manber's notes were one reason it denied her claim. He says the company obtained the records appropriately, using the authorization form signed by Ms. Galvin for the release of her general medical records. If she thought there were errors in her record, he says, she should have asked Stanford to correct them. Mr. Sabourin says the insurer has extended the time for Ms. Galvin to appeal its denial.
Ms. Galvin says she complained to her therapist, Dr. Manber, and to others at Stanford Hospital that she hadn't given permission for her psychotherapy records to be released — and that Stanford should have made sure her insurer obtained permission. In 2004, she sued Dr. Manber, the hospital and her insurer, accusing them of violating their professional obligations, malpractice and invasion of privacy, among other things.
In a written statement, Lee Wills, Stanford Hospital's chief marketing and communications officer, denied that any records had been sent improperly. He declined to comment further. A Unum spokesman said: "We believe that for our part, the proper procedures were followed, and that Ms. Galvin's lawsuit is without merit."
A year after she sued, says Ms. Galvin, she learned from a lawyer representing Stanford that the hospital had scanned at least some of Dr. Manber's notes about her into its computer records system, effectively making them part of her basic medical record. Stanford then had sent this file to her insurer and to the lawyer for the driver who hit her car. Later, UnumProvident sent Ms. Galvin's records to a lawyer for an auto club that insured Ms. Galvin against uninsured motorists. Unum says it did nothing improper.
In court papers, Stanford said that "psychotherapy notes that are kept together with the patient's other medical records are not defined as 'psychotherapy notes' under HIPAA." The hospital is not required to keep them separate, the court papers said, and it would be "impracticable" to do so. In a separate filing, Dr. Manber asserted that the notes "do not constitute psychotherapy notes" as defined by the federal rules and that it was appropriate for her to send them to Stanford's medical-records department. Dr. Manber declined to comment, as did a lawyer representing her and Stanford.
The U.S. Department of Health and Human Services last summer rejected an administrative complaint by Ms. Galvin against Stanford, saying the hospital hadn't broken any rules because it "did not separate Ms. Galvin's Sleep Center Records from her general medical records."
Ms. Galvin says she has acted as her own lawyer because she has had trouble finding a California attorney with privacy experience, although one has recently begun to assist her. She says she has asked Stanford to separate her therapist's notes from other medical records the hospital can disseminate without her permission. Stanford told her it wouldn't do that, she says. A spokesman for Stanford declined to comment.
She continues to worry, she says, that "any time anybody asks for my medical records, my psychotherapy notes are going to be turned over." In therapy, she adds, "all kinds of things come up — they want you to go into detail about your feelings about your mother and your father and your sister and your brother and your dead fiancé and how all of that affects you."
Here's a link to an article sidebar examining a typical privacy notice of the sort you might be asked to sign.
Knowing the above, you have to be somewhat leery of making your HMO physician/gatekeeper your mental health professional, even if mandated by your insurance company because it refuses to allow a referral to a (much more expensive) specialist.
Flower Power Car Magnets
I'll take one in electrical banana.
But I digress.
From the website:
- Flower Power Car Magnets
Flower power magnets are a fun, easy way to add instant CARma.
Strong magnets attach securely but remove easily without leaving any marks.
$14.98 (car not included).
KadmusArts – 'Where culture begins'
Bill Reichblum, the president of KadmusArts, emailed me yesterday afternoon to invite me to have a look.
That was the best offer I'd had all day up to that point (2:16:57 p.m. ET, if you must know) so I took him up on it.
He wrote, "On KadmusArts, users can add Festival News, Artist News, Podcasts, respond to our weekly Blog on Culture, and post festival reports and reactions, job opportunities, announce new projects and find those seeking collaborators on our Forum."
Tell you one thing: my blog sure can't do all that — or any of it.
The only thing we have in common is we're both free.
What is it?
Answer at this time tomorrow.
Hint: It's a finalist for the 2006 bookofjoe "Strangest Item of the Year" Award.
'Spirit in the Sky' —
Tom McNichol, for a story that appeared in the December 24, 2006 New York Times, traveled to Santa Rosa, California, to pay a call on Norman Greenbaum (above, at home), the epitome of one-hit wonders whose classic 1969 rock anthem, "Spirit in the Sky," will be heard on board the first starships launched from our solar system.
Long story short: By 1980 Greenbaum (below, in the 70s)
was broke and working as a cook in a series of Northern California restaurants, having quit the music business when his career fizzled following his monster hit.
Then producers of the 1987 film "Maid to Order" decided to include "Spirit in the Sky" on the movie's soundtrack, and from there demand spiked up and Greenbaum's life got progressively better.
Here's McNichol's article, demonstrating yet one more time just how random and haphazard is the series of linked events that sometimes leads to wonderful things.
- A ‘Spirit’ From the ’60s That Won’t Die
The last time Norman Greenbaum had a hit record, Richard Nixon was in his first term as president. It was back in 1969 when Mr. Greenbaum released his most popular song, a guitar-drenched rock anthem called “Spirit in the Sky.” The tune climbed to No. 3 on the Billboard pop chart that year and went on to sell more than two million copies. It was Mr. Greenbaum’s first Top 40 hit, and as it turned out, his last.
But in an industry full of one-hit wonders, Norman Greenbaum is that rarest of creatures — a performer who has finally managed to make a living off the one hit. That’s because Mr. Greenbaum’s song, an arresting mixture of old-time gospel and a killer fuzz guitar riff, has in recent years become the quintessential soundtrack for movies and TV commercials.
At last count, “Spirit in the Sky” has been featured in 32 movies (including “The Longest Yard,” “Ocean’s 11,” “Superstar,” “Apollo 13” and “Wayne’s World 2”) and more than a dozen national television ads (for companies like Nike, HBO, American Express and Toyota). “Spirit in the Sky” has also appeared on at least 50 compilation CDs and in more than a dozen television shows, and has spawned innumerable cover versions, two of which were major international hits in their own right (for Doctor & the Medics in 1986 and Gareth Gates and the Kumars in 2003).
“Spirit in the Sky” has become the song that won’t die, a wailing rite of passage for two generations of rock fans, and more to the point, Mr. Greenbaum’s 401(k) plan. Even though Mr. Greenbaum long ago signed away the publishing rights to his song, as the song’s performer, he still receives a cut of the revenue. Each time “Spirit in the Sky” lands in a major movie or ad, he cashes a check for $10,000 or more.
“Well, it’s not like it’s made me rich, as you can see,” said Mr. Greenbaum, 64, gesturing at his modest two-bedroom apartment in Santa Rosa, Calif., about an hour north of San Francisco. “But because of ‘Spirit in the Sky,’ I don’t have to work. So in that sense, it’s a comfortable living.”
These days, Mr. Greenbaum, his flowing silver mane pulled back into a ponytail, is content to be the official curator of his most famous work. From his cluttered apartment adorned by the requisite gold record on the wall, Mr. Greenbaum runs a Web site called spiritinthesky.com where he posts photos and stories about himself; hawks “Spirit in the Sky” T-shirts, hats, coasters, mouse pads and CDs; and acts as an electronic sounding board for thousands of devotees.
“I get e-mails from 9- and 10-year-old kids who say it’s their favorite song,” Mr. Greenbaum said. “I’ve gotten letters from funeral directors telling me that it’s their second-most-requested song to play at memorial services, next to ‘Danny Boy.’ ”
Oddly, the tune that’s turned out to be Mr. Greenbaum’s salvation is in part a shout out to Jesus, written and performed by a nice Jewish boy from Massachusetts. As one verse of “Spirit in the Sky” proclaims:
Never been a sinner, I never sinned
I got a friend in Jesus
So you know that when I die
He’s gonna set me up with
The spirit in the sky
Mr. Greenbaum claimed that he has received thousands of e-mail messages and letters about that verse. “A lot of them say, ‘We’re all sinners, we were born sinners, how dare you,’ ” he said. “O.K., so what do I know? ‘Sanford and Son’ was written by Jews and what did they know about being black?”
Mr. Greenbaum had a traditional Jewish upbringing. “My parents weren’t Hasidic, but they were almost Orthodox,” Mr. Greenbaum said. Growing up in Malden, Mass., he attended Hebrew school and was bar mitzvahed.
His early musical influences were somewhat incongruous: folk, delta blues and jug band music. He played guitar and sang in coffeehouses while attending Boston University, and then moved to Los Angeles in 1965 to form Dr. West’s Medicine Show and Junk Band, sort of a psychedelic jug band. Band members wore face paint and played instruments like the washboard, whiskey jug, kazoo and automobile fender while bathed in colored lights. The group once opened for Sonny and Cher and scored a modest novelty hit in 1966, “The Eggplant That Ate Chicago.”
Dr. West broke up shortly after its lone hit, leaving Mr. Greenbaum on his own. “I thought maybe I’d stop the goofiness and go electric,” he recalled. Mr. Greenbaum signed a deal with Erik Jacobsen, a successful producer who had a string of hits with the Lovin’ Spoonful, and began work on his first solo album.
One night, while Mr. Greenbaum was watching TV, he happened upon country gospel king Porter Wagoner singing a stirring song about forgiveness and redemption. Mr. Wagoner’s performance sent Mr. Greenbaum scrambling for a notepad.
“I thought, ‘Yeah, I could do that,’ knowing nothing about gospel music,” Mr. Greenbaum remembered. “So I sat down and wrote my own gospel song. It came easy. I wrote the words in 15 minutes.”
The song’s first verse set the tone for what would be Mr. Greenbaum’s message for the ages:
When I die and they lay me to rest
Gonna go to the place that’s the best
When I lay me down to die
Goin’ up to the spirit in the sky.
While Mr. Greenbaum wrote the words to “Spirit in the Sky” quickly, the music proved more difficult. Mr. Greenbaum tried a jug band version, a folk rendition and even a delta-blues inspired incarnation, but couldn’t get the sound he wanted.
The song began to come together in the studio. To give the tune an authentic gospel feel, the production team brought in the Stovall Sisters, an Oakland-based gospel trio, to sing backing vocals. Mr. Greenbaum ditched his acoustic guitar for a more aggressive-sounding Fender Telecaster that had a raspy fuzz box custom-built into the body of the instrument.
The resulting sound was an oddly compelling combination of gospel and hard rock: a clap-along church spiritual featuring a preacher who slides to one knee at the edge of the stage and plays a scorching solo on his Telecaster. (Jack Black, call your agent.)
“There was resistance to releasing ‘Spirit in the Sky’ as a single,” Mr. Greenbaum said. “First of all, it was too long. It’s about four minutes. Plus it was so weird. Here’s a Jew singing about Jesus with this fuzz box going ‘brrrrrr.’ That fuzz tone, you can’t get it out of your head. Even to this day, I’ll be walking around and I can hear it somewhere.”
In late 1969, Reprise Records finally released “Spirit in the Sky” as a single after two other singles from Mr. Greenbaum’s first solo album tanked. “Spirit in the Sky” became an instant smash worldwide. The song stayed on the Top 40 charts for 14 weeks and was at the time the best-selling single ever for Reprise, a label that included stars like Frank Sinatra and the Kinks.
What happened next to Mr. Greenbaum’s career will be familiar to anyone who has ever watched a special on VH1. Mr. Greenbaum’s follow-up singles fizzled, his record company dropped him from the label, his marriage fell apart and the phone stopped ringing. By 1980, Mr. Greenbaum had quit music and was working as a cook in a series of Northern California restaurants.
“I thought, ‘Well, that’s it,’ ” Mr. Greenbaum said. “I was broke, what else could I do? You can’t write another ‘Spirit in the Sky,’ so I’ll do this. I worked my way up from cooking hamburgers to being a sous chef to being a kitchen manager writing menus and cutting meat. I was O.K. with it.”
Mr. Greenbaum’s redemption came with a call from Hollywood. The producers of the 1987 film “Maid to Order,” starring Ally Sheedy, decided to include “Spirit in the Sky” on the movie’s soundtrack, which soon led to several other movie and advertising deals, sparking a demand that has remained remarkably steady ever since. Last summer, Nike used “Spirit in the Sky” as the centerpiece of a special 90-second TV commercial.
“There are two things we look for in a song,” said Ryan O’Rourke, art director for Wieden & Kennedy, the ad agency based in Portland, Ore., that created the Nike spot. “One is what is the song’s vibe, what’s the feeling it conveys? And second, does the song’s structure fit the structure of the commercial? ‘Spirit in the Sky’ had two really good things going for it. Almost instinctively when you hear that guitar riff, it communicates to you, ‘Get ready, something fun is coming.’ ”
Mr. Greenbaum agreed that the reason for the song’s popularity is simple.
“It still sounds good,” he said, after listening — yet again — to the paean that both made and ended his career. “It sounds perfect.”
Okay, in case you're in the mood for more "Spirit in the Sky," here are:
• The song's Wikipedia entry
• Once again, spiritinthesky.com, Greenbaum's website, where you're greeted by the song's opening — w00t!
To celebrate Greenbaum's great hit, bookofjoe World Headquarters™ will cancel all announcements for the remainder of the day to instead repeatedly blast the song over our loudspeakers at max volume.
Don't bother knocking 'cause this blog is rocking.
National Geographic Sounds Clock
Can your clock do that?
Didn't think so.
From the website:
- National Geographic Sounds Clock
National Geographic clock comes to life with authentic animal sounds.
Growling, grunting, chirping or squeaking noises announce the top of the hour, with full-color photos of exotic animals.
Light sensor deactivates sounds when the room is dark, or use on/off switch.
Requires 3 AAA batteries (not included).
Educational animal cards included.