Lower Keys Medical Nightmare

The debate over the Lower Keys Medical Center on north Stock Island is heating up and could provide an interesting bit of public wrangling to take us into Fantasy Fest. Here's the deal as reported and as much discussed by local residents....

Lower Keys Medical Center as the hospital is officially known has apparently annoyed one person of influence too many and simmering resentment against the hospital has exploded into a  public call for a boycott and numerous stories of hidden billing, malicious collections and medical shortcomings. A local advocate of impeccable credentials Reverend Stephen Braddock took on the hospital by demanding an itemized bill, as required by law and the hospital not only refused but sent out the bill collectors with legal threats.   Braddock was delighted and said he was happy to take the hospital on in court at which point the bullies backed down and settled. 

Funnily enough the hospital flew out a well known local community leader for treatment in Miami and when the wife asked he be flown by the Sheriff's helicopter which doesn't charge county residents the hospital told her it wasn't available. When the private carrier sent her a bill for $60,000 she checked with her friend the Sheriff who told her that his helicopter had been absolutely available she went ballistic and a group of community leaders called for a boycott of Lower Keys. The hospital run by a shady medical group out of Tennessee rewarded their patsy running the place by firing her:

Nicki Will, CEO of Lower Keys Medical Center in Key West, Fla., has resigned, effective immediately.

Ms. Will is leaving her position after 13 years as as CEO. LKMC did not provide a reason for her departure.

During Ms. Will's tenure, LKMC achieved numerous accomplishments, including facility improvements and recruitment of new physicians to the community, hospital officials said.

"It has been my honor to serve as CEO of Lower Keys Medical Center and work with the incredibly talented and passionate teams who provide care to our community," Ms. Will said in a prepared statement. "The hospital is a vital, valuable asset to the Lower Keys community and I am confident that the board, medical staff and dedicated employees will continue to move the hospital forward for the benefit of our island community."  Becker's Hospital Review

Yeah, whatever, good riddance. I know these allegations of appalling billing practices are real because one day last month a bill collector appeared at my door. Wrong address as it happened, but my neighbor told me he wanted to discharge a $1500 bill $50 a month and the hospital sued him, which is illegal and was thrown out of court. Go figure.

At this point the people I have talked to about the hospital fiasco want Community Health Systems of Tennessee out and would like to see not-for-profit Baptist Health come in and give the community the impeccable service for which they are renowned in South Florida. I wouldn't mind if Lifenet the pirates of the air took a hike too but I guess it's one step at a time. It sure is time for Monroe County to take control of this situation. 

Interestingly enough there may be a simple legal way to dump these nasty inhumane business people from these islands and that is an issue of  the lease that the hospital is currently operating under. Lower Keys used to be a county facility  paid for by a tax district which decided almost two decades ago to give the failing hospital a new lease of life by transferring the facility lease to the for profit people from Up North. Now some legal minds have been studying the entrails and they say the lease might have been executed improperly.  If so the whole fiasco will be in the local politicians' hands to screw up.

Health care is too serious and affects too many people for Lower Keys to continue to be operated as a cash cow for the benefit of stockholders elsewhere with no regard for human decency right here. I hope for happier days as I grow older not younger with all that that entails.

CHS are not good neighbors or decent humane business people apparently:

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Rainy Night

I like summer rain in the Keys. To be in Key West  at dusk on a rainy evening adds to the pleasure.

The thing is summer rain is warm compared to winter rain Up North and a temperature drop to 75 degrees is actually welcome around here. 

The swish of tires on wet roads is evocative of cold winter nights to me, so hearing it as I walk in shirt sleeves creates pleasurable  confusion in my mind.

Drivers tend to lose the ability to drive in these relatively mild conditions but rain can also keep people home so I welcome it doubly when I'm working as it helps to keep 911 calls to a minimum.  

I saw this work truck, loaded with boxes and I saw the bumper sticker about loving Stock Island and I thought "that figures." But I had those thoughts with a pang as Stock Island may not be a working class refuge for much longer...

I am always able to find things to photograph in this remarkable town. Recording it's descent into sterile gentility gives me less pleasure, even on a rainy night.

There's not much to say about the beauty that still lines these streets, and all the stuff I have to say about the changes sweeping Key West are predictable and at some point...

 ...they become repetitive. 

Fleming street, looking to Duval Street above, and to White Street below. Taken from the library area.

We went to see the One NIght Stand short plays at the Studios of Key West in their new space at the old Freemason's Hall on Eaton at Simonton. We quite enjoyed them did my wife and I (Rusty stayed home, hence no dog pictures.). The drama consists of twenty four hours to write a play, rehearse it and find costumes and props for it. One performance and it's all over. I shan't soon forget the weird tattoo parlor play run by a weird Teutonic boss lady declaiming about TAT-OW art. Ten minutes of weirdness. Four plays in all, one odder than the next. LINK  

 Rain during the day has less impact than the wet dusk of the night before. Highway One becomes a pain, more so than usual, as people crawl in terror at the sight of raindrops.

 Heavy dark skies give the Keys some drama.

 I like rainy season, day or night.

Oranges and Lemons

This essay from December 2008 grew out of a trip my wife and took to explore Central Florida. Often when you get on the road you seem to manage to get blinded into rushing headlong so we decided to stop and explore and check out Florida. This pause on the road taught us the value of stopping at fruit stands when we criss cross the Sunshine State. 

Citra Florida

It has always struck me as very old fashioned to stop at a Florida roadside stand and buy citrus fruit. Why bother to haul Florida grapefruit 1500 miles in the trunk of the car these days? This, when fruit from all round the world is shipped to us in such a continuous stream that we don't even know anymore when the season is for the food we eat. Grapes from Chile, tomatoes from Mexico, asparagus from California...and citrus from Citra, Florida.We left Ocala after breakfast and took off for Jacksonville seventy miles down Highway 301 across the top of the state which is all citrus groves, as it turns out, or at least a lot of it is. Interspersed with pine forests and horse ranches and...roadside stands. We were cruising the four lane when my wife said out of nowhere. "I think I'd like a fresh squeezed orange juice.""We should stop," I said. "No," she said. "We'll stop at the next one we see." But I knew better so we pulled a (legal) U-turn and headed in. In to the stupid old fashioned citrus stand that has beensuperseded by international shipments of fruit.It was a blast actually. We bought two bags of grapefruit for five bucks and for another five we got a bag of tangerines, all piled up and ready to go:I'm pretty sure if you shop a lot you wouldn't be surprised by the interior of the store, cookies, jams,mustards honeys and all the bric-a-brac one should probably expect in a store that sells oranges and lemons...I wasn't about to be seen walking around in one but I took a quick picture to remind myself where I was:And the old fashioned truck might look cute but orange processing has apparently moved along a bit with the times:When I lived in Fort Myers almost twenty years ago (oops!) I used to ride across the state to visit a friend in Palm Beach and a half hour out in the country I would ride towards LaBelle which in those days, and may in these days for all I know, had an orange processing plant by the side of the highway, west of the town. When they were working, it smelled like the sweetest orange sponge cake I had ever eaten as a child, and my nose would twitch under my helmet like a dog as a I passed by. Oranges and bananas, some of my favorite fruit and in Florida they grow together:Take that you ski fanatics hoping for snow and ice this Christmas Day. Put me in an orange grove when the fruit are ripening and I will be happy.We got back in the car clutching a quart (liter) of sweet fresh orange juice snagged for just three bucks and set off again down the highway.That was definitely not my last stop at an orange shop on a Florida highway. But next time I'm going without my wife because I have a feeling an orange flavored chocolate something might taste good while on the seat of a Bonneville. It's worth remembering too, not a hundred years ago, oranges were so rare and expensive they were treasured Christmas gifts. As they should be.


The title for this freshly published essay came to me from ditty we used to chant in my childhood in England. It turns out the nursery rhyme had actually to do with politics of a different era, like most such things seem to tend to.

"Oranges and lemons" say the bells of St. Clement's
"You owe me five farthings" say the bells of St. Martin's
"When will you pay me?" say the bells of Old Bailey
"When I grow rich" say the bells of Shoreditch
"When will that be?" say the bells of Stepney
"I do not know" say the great bells of Bow
"Here comes a candle to light you to bed
Here comes a chopper to chop off your head
Chip chop chip chop - the last man's dead."

The history and origins of the lyrics - sinister!
The words and lyrics have been much loved by generations of British children. The place names relate to some of the many churches of London and the tune that accompanies the lyrics emulates the sound of the  ringing of the specific church bells. The words of the nursery rhyme are chanted by children as they play the game of 'Oranges and lemons' the end of which culminates in a child being caught between the joined arms of two others, emulating the act of chopping off their head! The reason for the last three lines of lyrics are easily explained. The 'Great Bells of Bow' were used to time the executions at Newgate prison, which for many years were done by means of beheading. The unfortunate victim would await execution on 'Death Row' and was informed by the warder, the night before the execution ' here comes the candle to light you to bed' of their imminent fate and to make their peace with God! The executions commenced when the bells started chiming at nine o'clock in the morning. When the bells stopped chiming  then the executions would be finished until the following day!

Everything Will Be OK

"Everything will be OK." I read that sort of sentiment and I wonder why it irks me. But it does anyway. How do they know everything will be okaY/ Because it has been okay so far? That seems a bit thin to me.

Then I walked past the No Trespassing sign stuck on a fence. These signs seem absurd to me as they disfigure the landscape pointing out the obvious. It's someone's front yard so of course there's no trespassing! Better yet in this case they forgot to put a gate on the fence so there is a no trespassing sign but it's not strongly enforced it looks like. I expect everything will be ok.

Then Rusty and I pass by a baseball cap hanging on a fence. Why it's there I couldn't say. It put me in mind of Hemingway days the coming weekend which I had off. Naturally my troublesome tooth developed an abscess and I spent the weekend off in bed or traveling to the doctor's for pills. Great stuff and I missed the festivities downtown. 

Rusty is becoming quite the urban dog. When I got him at the end of February he was all nerves especially in the city. Four years as a stray on Homestead streets made him worried about every little thing. He's got a lot more confident now and he enjoys walking the streets smelling everything and even meeting other dogs.

I am constantly amazed by people who think rescuing a dog means you are taking home a bundle of problems. Dogs are easy to fix and their gratitude is forever. People are the problem, people who mistreat dogs or other people. Dogs are ready to be loved and only want to please. Five months after I got him I declare Rusty mended and able to face the world.

He's more laid back than many pedigree dogs I meet bought from breeders and raised with all due attention. Besides which I am confident he can look after himself as he has proved over the course of years that he knows how to do that.

Happily from here on out he won't be alone anymore. So I guess for him everything is okay.

Casa Marina Heat

I had a hole in my jaw, my right nostril was numb, the hole where my tired old stub of a front tooth used to be wouldn't stop bleeding, so I did what only made sense: I took Rusty for a walk. Seen here starting out from the weather station on White Street.

Later that night at work Nick and Chelsea started a long meandering discussion about people they knew who keep dogs, and don't do a very good  job of it.  I put a stop to that, not wanting to hear about dogs caged all day and never walked and dogs on chains and all sorts of stuff that makes me crazy.

I'm thinking it's pretty hot these days even for Rusty the wonder dog. He walks half an hour and he's had enough in the afternoon but I got a chance to check a shady street in the Casa Marina district.

This gate cracks me up, planted as it is in the middle of a low fence:

It puts me in mind of this:

So much elaborate landscaping. It exhausts me just thinking about the labor required to keep it pristine. Which is probably why you see armies of gardeners tending to these places all summer long while the residents are away in some cooler clime.

And stuff at these latitudes grows robustly and year round:

Not all homes are opulent in Casa Marina and there are a few older homes dotted between mansions.

Always hunting for shade:

We're talking millions here depending on amenity:

A Mediterranean style mansion, peeping through the trees.

These two scooters sit out in the sun mal=king rather good use of a chunk of sidewalk to nowhere.

The Key West ideal; a place to live and a place to park two wheels.

This i Liked. Look closely:

Not very active if the car is covered, you'd think:

City hall is coming along, with the schol supposed to be transformed by the end of the year:

We drove home, me recovering from blood loss feeling not terribly energetic. Rusty retreated to his bed in the darkened bedroom and got a few hours of solid sleep before pottering out for a spot of dinner and  nap on his couch. Summer's heat is getting to him too. I bet he misses Vermont.