Thursday, June 17, 2004

To a recovering cancer patient

Dear Friend:

I want to tell you the story of a decision I made soon after I had sixteen hours of surgery on a brain tumor in 1990.

My recovery from this 'medical intervention' was long. It involved three days in the intensive-care unit, followed by another week on the hospital ward. The worst that I recall about the medical interventions on the ward was the being stuck three or four times a day for 'blood work'. It seemed like the gratuitous blood letting would never end!

Once I got home the real recovery took more than a year and I remember that my life seemed to revolve around visits to one or another doctor's office. It took a long time to really feel that I had my life again and that I wasn't a perpetual 'patient'. I guess that is where the word 'patient' comes from -- the waiting.

Overall, I was very aware that my body and mind had to some extent been traumatized by the experience of intense medical intervention --- interventions that I don't regret, because they no doubt saved my life.

The decision I made, which I am very happy about, was to take action to reclaim my sense of myself in my body, and to strengthen my body. Basically, I decided to increase my physical training by running 50% more than had been my prior routine and taking myself to the gym once a week to work out on the weight machines, a first for me. It was hard at first, but I had a sense I really needed to do this so that I could feel strong again and not dwell on the feelings of being a victim of physical assault. I kept at it.

I am happy to report that it has worked. I am now thirteen years into the training program and I definitely feel stronger and more grounded in my body than I ever have -- even though I am thirteen years older and 'getting on', as they say. Not only did I physically survive the medical trauma, but I have psychologically survived and thrived, in part, I believe, because I have the daily support of my body.

Wishing you well,

Yours,

Charles

Tuesday, June 15, 2004

Memorial post to my friend Susan Eaton

In the last days of 2003 we lost Susan Eaton, labor organizer, progressive academic, leading feminist voice, and dear friend to acute leukemia at age 46. At her memorial service on January 10, 2004 John J. Sweeney, the President of the AFL-CIO said this about Susan:
I'm not sure I've ever met anyone with a greater level of passion for working people...Susan championed [the] cause [of working women] from our historic strike of African American nursing home workers in Beaumont, Texas to struggles of Latina building janitors in Los Angeles and Atlanta. Susan was a leader of a new breed of organizers who essentially led a revolution of our union [SEIU]. Our entire movement owes Susan a special debt of gratitude for the role she played in awakening all of us... to the potential of women as labor leaders.


In Susan's honor I put together this verse adapted from the lyrics of John Gorka and from a recitation of an old song in Cambridge Friends Meeting for Worship, April 11, 2004:
You ask the world and the world says no,
It's an old world refrain, and she said go!
Cool neglect, hot anger.
She chose to act from love.

Now sisters and brothers, together,
Remember the hour is getting late,
And we are but passing through,
We are passing through.

____________________________________

Swanee Hunt wrote a memorial commentary about Susan that appeared in a number of newspapers:

A union organizer's legacy
By Swanee Hunt
Scripps Howard News Service
21 January 2004

"Yes, it is bread we fight for, but we fight for roses too." -- Line from "Bread and Roses," a union organizing song.

There has been lots of talk about unions on the campaign trail, as Dick Gephardt hoped strong labor backing would carry him in Iowa and beyond. It didn't -- music to the ears of the businessmen I grew up with in Texas, who didn't distinguish between union organizers and communist agitators and considered the whole pack a menace to America.

Meanwhile, away from the hoorahs on the hustings, I joined some 800 friends, colleagues and family to sing "Bread and Roses" in memory of a union organizer -- Susan Eaton. As we heard about her 46 years of life, there was enough of Susan's spirit in the sanctuary to transform us all.

The two-hour service was astounding. For all I knew, Susan was just a kind and unassuming teacher with a doctorate from MIT who started lecturing at the Kennedy School of Government a few years ago. I don't think any of us at Harvard understood how Susan's academic rigor was matched by her equally earnest background as a union champion.

Her father told how her passion for the oppressed began when she was a teenager at summer camp and worked with children of migrant workers. Her letters home questioned the justice of a society that allows some to live predictably successful lives, while others struggle with every ounce of energy they can muster just to survive.

Susan broke a lot of china as a new breed of organizer for the Service Employees International Union, the folks who carry out the garbage and empty bedpans. Seems she was an odd fit in the union world, given her pursuit of higher education, "The only one who described others in the movement as 'perspicacious,' " a fellow organizer mused.

The sweet colleague I passed in the hall wasn't always easy to get along with, to hear the stories of the 30 on the program. Joe Buckley, 10 years her senior, teamed up with her for a confrontation with management at a Baptist hospital in Beaumont, Texas. He described Susan as a "young red-hot," ready to march in with 85 demands on behalf of low-paid workers. As she and he debated their strategy on the Holiday Inn elevator before the negotiation, she pressed the stop button. They continued their confrontation between floors. "No telling how many businessmen missed the breakfast buffet because of us."

Later that day, in the heat of the negotiations, Susan leaned across the table to the opposing lawyer: "How about I come over right now and rip (words not fit to print)?" Susan's organizing impulses never flagged. When she was diagnosed with acute leukemia, a friend came over, offering to clean. Instead, she was appointed communications manager. She set up an e-mail network to help us all know how we could give blood, what the latest medical report was or where we could send a card. Soon there were 450 people on the e-mail list.

Just before Christmas, I went by with some food. Susan looked beautiful without hair, I assured her. She was as kind as always, and as her husband walked me out, he said the doctors thought her chances for survival were about even. Six days later she died.

Days after, I found an e-mail from her, thanking me for my support. She had written it as her body was succumbing to a ferocious infection. I sat at my computer in wonder at the discipline, values and empathy of a person who chooses to spend some of her last hours writing thank you notes.

Such a way of living and loving spun a network that eventually supported Susan herself. The nurse caring for her as she died was a woman with whom she'd organized hospital workers in Texas. That coincidence was a gift _ and a reminder that Susan's influence extended to far reaches even a Harvard researcher can't track.

I've been to many funerals but never experienced such an outpouring of spiritual energy at the end of a life. Letters, conversations, e-mails are streaming among those who were there. As different as we are, we seem to share a sense of obligation: not to let Susan's death be in vain and to recommit our lives on behalf of others. I don't think any of us will forget that time together singing, for Susan, one last union song:

"Drops of water turn a mill. Singly none. Singly none."

(Swanee Hunt lectures at Harvard's Kennedy School of Government. She is the former U.S. ambassador to Austria.)
_________________________________

In 2000 Susan authored a paper called Beyond 'Unloving Care': Linking Human Resource Management and Patient Care Quality in Nursing Homes, published in the International Journal of Human Resource Management, June 2000, Volume 11, No.3. pp. 591-616.

Abstract:
This study examines the link between human resource management,(HRM), work organization, and patient care quality in U.S. long-term care settings, proposing a key role for both management philosophy and improved front line staffing arrangements in delivering consistently higher quality care, defined to include both physical and psychological outcomes. Using the “high performance” model from industrial relations as a lens, the paper identifies three distinct systems of HR and nursing home management: traditional low-service quality, high service quality medical rehabilitative, and ‘new paradigm regenerative.’ The original research includes case studies conducted in 20 facilities in California and Pennsylvania, USA.

Two critical themes dominate the research literature on the U.S. nursing home industry: 1) many patients receive poor quality care; and 2) most front line employees have low quality jobs and work environments. Often these have been viewed as separate problems studied by academics and practitioners from different disciplines. In this paper, I use data collected from 20 nursing homes to investigate whether these phenomena are linked in a systematic way. I conclude that they are, and argue that alternative ways of organizing front-line work exist that improve on both outcomes. I outline a new model of innovative patient care, in which management philosophy and action is crucial, and argue that this warrants further empirical investigation and testing.

The goals of the paper are: (1) to propose a typology of management systems associated with distinct types of direct care; (2) to theorize the mechanisms through which front-line work organization and human resources management (HRM) practices are translated into quality care for residents: and (3) to document the crucial importance of management values and choices, relative to structural variables more typically cited as sources of good or poor quality (e.g. economic status of the firm, direct costs, market served, resident mix, etc.) I conclude that a “bundled” approach of HR practices, combined with innovative management philosophy, is likely to yield the best outcomes (MacDuffie 1995), but that strong institutional forces are arrayed against this combination.

The paper first offers background on the US nursing home industry and the methodology of the study. The second section presents findings from original research; the study identifies two nursing home “models of work and care,” corresponding with “low-wage, low-skill, low-cost” and “high quality” models in industry. These are associated with particular human resource practices for front-line workers. A third model, with qualitatively different outcomes, appears to be least common, and to feature distinctive human resource management (HRM) practices.

The final section of the paper proposes a model for predicting varying outcomes, identifies barriers to diffusion of best practices, and suggests future research.

Susan's other scholarly publications

Academic Journals
Eaton, Susan C. "If You Can Use Them: Flexibility Policies, Organizational Commitment, and Perceived Performance." Industrial Relations Journal 42.2 (April 2003): 145-167.

Eaton, Susan C. "Frontline Caregivers in Nursing Facilities: Can Policy Help in Recruitment and Retention Crisis?" Public Policy and Aging Report 13.2 (2003): 8-11.

Book Chapters
Bohnet, Iris, and Susan Eaton. "Does Performance Pay Perform? Conditions for Success in the Public Sector." For the People: Can We Fix Public Service?. Ed. John D. Donahue and Joseph S. Nye, Jr. Brookings Institution, 2003, 238-254.

Research Papers
Wilson, Randall, Susan C. Eaton, and Amara Kamanu. "Extended Career Ladder Initiative (ECCLI) Round 2: Evaluation Report." KSG Faculty Working Papers Series RWP03-006, January 2003.

Eaton, Susan C., Amara Kamanu, and Randall Wilson. "Extended Care Career Ladder Initiative (ECCLI) Round 2: Evaluation Report." Working Paper, August 2002.

Eaton, Susan C. “Keeping Caring Caregivers: The Role of Relationships.” Gerontological Society of America Conference Paper, November 2002.

Eaton, Susan C. "Keeping Caring Caregivers: Investigating Frontline Staff Turnover in Nursing Facilities.” Boston University School of Public Health Colloquium Conference Paper, February 2002.

Eaton, Susan C. “The Emergence of a Social ‘Non-Contract’: Evidence from the Biotechnology Sector." American Sociological Association Conference Paper, August 2002.

Eaton, Susan C., Thomas A. Kochan, and Robert A. McKersie. "Labor-Management Partnerships in the United States: The Case of Kaiser-Permanente." Conference on Modernising Employment in the 21st Century Conference Paper, June 2002.

McKersie, Robert A., Susan C. Eaton, and Thomas A. Kochan. "Interest-Based Negotiations at Kaiser-Permanente." MIT Institute on Work and Employment Relations Working Paper, December 2002.

Eaton, Susan C. "If You Can Use Them: Flexibility Policies, Organizational Commitment, and Perceived Productivity." KSG Faculty Research Working Papers Series RWP01-009, March 2001.

Eaton, Susan C., Claudia Green, Randy Wilson, and Theresa Osypuk. "Extended Care Career Ladder Initiative (ECCLI): Baseline Evaluation Report of a Massachusetts Nursing Home Initiative." KSG Faculty Research Working Papers Series RWP01-035, July 2001.

Eaton, Susan C. "What a Difference Management Makes! Nursing Staff Turnover Variation within a Single Labor Market." Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes: Report to Congress, September 2001.
_________________________________

One of Susan's favorite poems:

“To Be of Use” by Marge Percy

The people I love the best
jump into work head first
without dallying in the shallows
and swim off with sure strokes almost out of sight.
They seem to become natives of that element...

I love people who harness themselves,
an ox to a heavy cart,
who pull like water buffalo, with massive patience,
who strain in the mud and the muck to move things forward,
who do what has to be done, again and again.

I want to be with people who submerge
in the task, who go into the fields to harvest
and work in a row and pass the bags along...
The work of the world is common as mud...
But the thing worth doing well done
has a shape that satisfies, clean and evident.

Greek amphorae for wine or oil,
Hopi vases that held corn, are put in museums
but you know they were made to be used.
The pitcher cries for water to carry
and a person for work that is real.

_____________________________

Susan Eaton is deeply missed!






Iraq Free State, Inc.

by Charles Knight

The neocons are a tenacious bunch. Last week I got together with an old college roommate who grew up to become a neocon insider in Washington. On the way to meet him I practiced my nuanced "I told you so" lines in anticipation that he would be anxious and vulnerable about the great project unfolding and apparently collapsing in Iraq. Instead he was positively glowing and enthusiastic about the future.

He told me he had just returned from a high-level weekend retreat at a location near Washington that he could not disclose. In the course of a single day they had gone from "very troubling" assessments of the prospects for the new Interim Government to detailing an "entirely new program for freedom" in Iraq. Somewhat dubious, I asked him what this could be. Earnestly he proceeded to outline the new plan.

First he reminded me that the Bush administration believes that "government is a bad way (sic) to do anything worthwhile" and that the policy in Iraq has been to privatize as many functions as possible.

The big new idea coming out of the weekend retreat was to privatize the whole affair. The Iraqis don't seem to be too keen on the democratic way we want to show them, so why not just dispense with the Iraqi government idea all together.

When, as expected, the new Iraqi government body collapses in failure later this year the U.S. will declare the new Iraq corporation modeled after the Congo Free State owned privately for thirty years by King Leopold II of Belgium in the late 19th Century. Secretary Rumsfeld, working closely with the Vice President's office, will put together a consortium of multinational corporations to invest in, run, and make profitable the Iraq Free State, Inc. "We've been criticized for unilateralism," he said, "but this will involve multinational corporations. You can't fault that."

"Look," my friend continued, "everyone knows that Iraq was cobbled together by the Brits and isn't a nation state in any true sense. Our corporate model will avoid all the problems of getting Kurds, Sunnis, and Shiites to work together in a national government. We'll just appoint a board of directors, reserving a couple spots for prominent native Iraqis. Leave the day to day stuff to the CEO who could come over from any of the major corporations doing business in Iraq already."

"Between you and me," he went on, "the only important parts of the Iraqi economy are the natural resources and some agriculture along the river banks. The rest of the place, well forget it! Oh, I almost forgot, the Iraq Free State, Inc. will make some real good money from leasing bases to the U.S. military. With any luck in a few years the company can go public and the principals should be a position to become truly rich."

"But Iraq has population of 25 million," I protested, "and the business you have described would at best only employ a few hundred thousand."

"Yes that is a problem," he admitted, "and it took several hours at the retreat to come up with an answer. Many Iraqis actually prefer Arab tribal life to the modern market economy we have in mind, so we are thinking of declaring large parts of the desert 'Arab Reserves' where Iraqis who don't work for the company can pursue their traditional nomadic customs. In ten years or so these areas might even become a tourist attraction providing investors another profit center -- imagine camel rides and resorts with luxury air-conditioned tents surrounding large 'blue oasis' pools."

"Besides, a corporate structure makes it much easier to deal with recalcitrant characters and dead-enders. You just give them a pink slip and tell them to get off the property."

"Have you briefed the president on this yet," I asked.

"Yes, I'm pretty sure he'll buy in. He said he really liked the sound of the 'free state thing'; that it went really well with his big freedom theme."

"Oh, one other thing," he said as we parted, "The Israelis are really excited about the idea. How does 'Palestine Free State' sound?"

----------------------

Charles Knight is the co-director of the Project on Defense Alternatives at the Commonwealth Institute -- http://www.comw.org/pda/