California Seismic Safety Standards 101

In light of a recent report on the status of seismic safety for California hospitals, as well as some discussion about the expense involved, the following is a summary of the structural performance categories (SPC) established by California’s Office of Statewide Health Planning and Development (OHSPD) for state-wide hospitals:

  • SPC-0 The hospital evaluated this building but did not provide any rating in its report to OSHPD.
  • SPC-1 These buildings pose a significant risk of collapse and a danger to the public after a strong earthquake. These buildings must be retrofitted, replaced or removed from acute care service by January 1, 2013 (or 2015 in some cases) for many hospital buildings.
  • SPC-2 These are buildings in compliance with the pre-1973 California Building Standards Code or other applicable standards, but are not in compliance with the structural provisions of the Alquist Hospital Facilities Seismic Safety Act. These buildings do not significantly jeopardize life, but may not be repairable or functional following strong ground motion. These buildings must be brought into compliance with the Alquist Act by January 1, 2030 or be removed from acute care service.
  • SPC-3 These buildings are in compliance with the structural provisions of the Alquist Hospital Facilities Seismic Safety Act. In a strong earthquake, they may experience structural damage that does not significantly jeopardize life, but may not be repairable or functional following strong ground motion. Buildings in this category will have been constructed or reconstructed under a building permit obtained through OSHPD. They can be used to 2030 and beyond.
  • SPC-4 These are buildings in compliance with the structural provisions of the Alquist Hospital Facilities Seismic Safety Act that may experience structural damage which could inhibit the building’s availability following a strong earthquake. Buildings in this category will have been constructed or reconstructed under a building permit obtained through OSHPD. They may be used to 2030 and beyond.
  • SPC-5 These buildings are in compliance with the structural provisions of the Alquist Hospital Facilities Seismic Safety Act, and are reasonably capable of providing services to the public following strong ground motion. Buildings in this category will have been constructed or reconstructed under a building permit obtained through OSHPD. They may be used without restriction to 2030 and beyond.

The following is a summary of non-structural performance categories (NPC): These ratings cover a building’s non-structural systems including communications, emergency power supplies, bulk medical gas, fire alarms and emergency lighting.

  • NPC-0 The hospital evaluated the building’s non-structural components but did not report any rating.
  • NPC-1 In these buildings, the basic systems essential to life safety and patient care are inadequately anchored to resist earthquake forces. Hospitals were required to brace the communications, emergency power, bulk medical gas and fire alarm systems in these buildings.
  • NPC-2 In these buildings, essential systems vital to the safe evacuation of the building are adequately braced. The building is expected to suffer significant nonstructural damage in a strong earthquake. Hospitals must meet this deadline by January 1, 2013 (or under new legislation (SB 499) apply for an extension through January 1, 2030).
  • NPC-3 In these buildings, nonstructural systems are adequately braced in critical areas of the hospital. If the building structure is not badly damaged, the hospital should be able to provide basic emergency medical care following the earthquake.
  • NPC-4 In these buildings, the contents are braced in accordance with current code. If the building structure is not badly damaged, the hospital building should be able to function, although interruption of the municipal water supply or sewer system may impede operations.
  • NPC-5 These buildings meet all the above criteria and have water and waste-water holding tanks—sufficient for 72 hours of emergency operations—integrated into the plumbing systems. They also contain an on-site emergency system and are able to provide radiological service and an onsite fuel supply for 72 hours of acute care operation.

Additional information can be found on OSHPD’s Website under seismic retrofit program.

The Power of Play

All work and no play makes Jack. . . sick.  At least according to Dr. E. Christine Moll, a leisure expert, professional counselor, and professor of counseling and human services at Canisius College in Buffalo, New York.

Leisure time or “play” is as important as exercise, Dr. Moll explains: ”It airs out our brain. It renews our spirit. It gives us clarity of thought. It’s a benefit to our blood pressure. It gives us life satisfaction. For all the dimensions of our lives: our physical, mental, spiritual and cognitive health, leisure time should be a necessity not a luxury.”

Moll defines leisure as just about anything that brings personal enjoyment, providing individuals an opportunity to recharge. “Work is the single activity we do most in our lifetimes. We work more than we sleep or eat. Our health and medicine are so much more improved than they were a century ago but we’re going to wipe ourselves out because we’re just working, working, working.”

David L. Farrugia, PhD, chair of the Counseling and Human Services Department at Canisius and also a professional counselor, notes that many patients see him after they visit an internal medicine doctor. Often, according to Dr. Farrugia, stress is to blame. ”Physiologically, the body is able to adapt and function at high levels of stress but eventually it begins to take its toll on a person’s mental and physical health.”

Known as General Adaptive Syndrome (GAS), a term first coined in the 1930s, this refers to the consequence of the failure of an organism – human or animal – to respond appropriately to emotional or physical threats, whether actual or imagined. Hans Selye, MD, pioneered research in this field and is known as the “father of the stress field.”

According to a study done by Summer M. Reiner under the supervision of Moll: “Findings show that people who nurture leisure activities throughout their lives have a much healthier outlook physically, mentally, emotionally, socially and in their sense of selves. Extra-curricular activities for school-aged children contribute a lot towards their development.”

The results of Reiner’s research was published in Counseling Today Magazine.

A Lost Art of Execution1

If you lived in England circa fourteenth century, and you also happened to be guilty of “high treason” (significant disloyalty to your own government through particular actions such as waging war against said government, and sometimes spying), there was a good chance your punishment would be severe. For those found guilty of such acts, the penalty was “to be hanged, drawn, and quartered.”

While recordings of this punishment date back as early as the reign of King Henry III (1216 to 1272) and his successor Edward I (1272 to 1307), to be hanged, drawn, and quartered was an official penalty in England as of 1351.

The process was quite simple: Individuals convicted of the requisite crimes were fastened to a wooden hurdle (a portable part of a fence, usually made from branches and in more modern times metal) and then dragged by horse to the specific location where the execution was set to occur.Then, the subject was hanged in traditional fashion — but only to the point of near death, not actual death – followed by punishments of emasculation (removal of the genitals), disembowelment (the removal of some key internal organs), beheading (an act which needs no explanation), and then finally quartering. By tying the individual’s four limbs to a different horse and then sending each horse in a separate direction, the act of quartering was complete. … Read more →

Lost Hospital Series — Northwest Georgia Regional Hospital, Rome, Georgia2

Construction began in March 1943 for a hospital to treat the sick, wounded, and disabled World War II veterans.

Completed later that same year, the hospital was named Battey State Hospital after Dr. Robert Battey of Rome, Georgia, a famous pioneer in the area of surgical treatment for ovarian cancer. It opened on September 1, 1943 in Rome, Georgia.

By June 1946, the facility was transferred to the State of Georgia and served as a tuberculosis hospital.  During its peak, Battey General Hospital accommodated 2,000 tuberculosis patients.

Construction began in April 1971 for a new facility to replace Battey State Hospital and its 1940s-era design.  In 1973, Battey State Hospital was renamed Northwest Georgia Regional Hospital.  Construction continued throughout the 1970s to replace all of the obsolete structures with the red brick buildings that now stand.Read more →

An Epidemic of “Gray Homicides”1

Health care has absorbed the blows of budget cuts across the nation. While some states have fared better than others, most are mindful of the impact these decisions may have on our health.  Few are aware that the impact has also been felt, sort of, by the recently deceased.

Medical examiner and coroner offices, many underfunded, have just stopped performing autopsies in some categories of deaths.  Some states no longer perform autopsies after a suicide, while others refrain from post mortem intervention after a car accident.  Many have stopped the practice on individuals over the age of 40 (with certain exceptions in the event of an obvious violent death), and Oklahoma has lowered the age limit to 40.

This has led to an investigation by NPR, PBS Frontline and ProPublica as they found concerns among law enforcement and health care professionals over a disturbing trend.  Far too many assume the elderly die only of natural causes.  Is there an epidemic of “gray homicides” spreading across the nation?  See the entire article on

Studying the Science of Sex

Every 9 seconds, someone in the world purchases Viagra. Available in over 120 countries, it confirms yet again that sex sells. Although medication used primarily to treat erectile dysfunction, Viagra is viewed by some as an aphrodisiac, even if medical science proves otherwise.

History is filled with food, drink, and behavior that enhances or even increases the likelihood of intercourse, although there are limited studies in support. A recent article in the journal Food Research International explores the effects of ginseng and saffron. Massimo Marcone, a professor in Guelph’s Department of Food Science, and master’s student John Melnyk, led the research.

“Aphrodisiacs have been used for thousands of years all around the world, but the science behind the claims has never been well understood or clearly reported,” Marcone said. “Ours is the most thorough scientific review to date. Nothing has been done on this level of detail before now.”

Marcone contends that natural products are superior to synthetic drugs because they do not have any direct impact on the libido. The researchers examined hundreds of studies on commonly used consumable aphrodisiacs to investigate claims of sexual enhancement — psychological and physiological.

The study concluded that panax ginseng, saffron and yohimbine, a natural chemical from yohimbe trees in West Africa, improved human sexual function. Chocolate, on the other hand, was not linked to sexual arousal or satisfaction (although there is some discussion whether the chemical phenylethylamine, often in chocolate, is an aphrodisiac). “It may be that some people feel an effect from certain ingredients in chocolate, mainly phenylethylamine, which can affect serotonin and endorphin levels in the brain,” Marcone said. Alcohol was found to increase sexual arousal (and perhaps reduce inhibitions) but to impede sexual performance.

Don’t Lie to Your Doctor

According to a General Electric study exploring the communication channels between patients and providers, about 28% of Americans say they sometimes lie or omit facts when speaking with their doctor.  Doctors think the number is higher.

According to Dr. Nieca Goldberg, director of the Women’s Heart Program at New York University: ”There are a variety of reasons why patients withhold information. Sometimes they are ashamed. Sometimes they can’t afford the medications. Sometimes they feel like they might upset the doctor.”

Dr. Alfred Bove, past president of the American College of Cardiology, offers another explanation: ”I think a lot of patients won’t tell you details or symptoms because they are not aware of what the important details to share are. So they deny or ignore it and the next thing they just drop over.”

February is American Heart Month, and the Centers for Disease Control and Prevention has released some estimates on the number of Americans at risk for heart disease. According to the CDC, 68 million Americans are taking medications to lower high blood pressure and hopefully prevent coronary artery disease and heart attacks.

While keeping secrets from your doctor is ill advised, withholding information from your cardiologist can be fatal. A recent article at noted five secrets you should not keep from your heart doctor.

  • If you are taking vitamins or supplements: Cardiologists warn that certain dietary supplements can have a dangerous reaction with medications for heart disease. The Journal of the American College of Cardiology lists more than two dozen herbal products cardiovascular disease patients should avoid.
  • If you have undergone tests from other doctors: According to Dr. Richard Stein, a national spokesperson for the American Heart Association. ”Your goal walking out is to get the best health care — not to make the doctor feel good. If you’ve had a blood test, EKG, echocardiogram or angiogram, Stein says to keep your own patient file and bring it with you to your appointment. It’s not fair to expect a doctor to understand the seriousness of your condition if they don’t have all of the information.” To help you maximize your next visit to the cardiologist, CardioSmart has a useful checklist to help patients prepare.
  • If you have skipped your medications: Dr. Goldberg adds: “Patients often lie about taking blood pressure or cholesterol medication. ”You don’t want to accidentally be given a prescription for a higher dose, when you’re not even taking the lower dose.”
  • If you are going through hard times:  Dr. Bove offers: ”When you’re under stress you have extra adrenaline that can stimulate the heart to skip beats and have palpitations.”  Patients who have endured serious life trauma such as death, job termination, or divorce may have elevated blood pressure.
  • If you haven’t really stuck to your diet:  Dr. Goldberg concludes: “Everyone wants to put their best foot forward, so it’s easy to come in and say you’ve started an exercise program when it really didn’t happen. But just saying you exercised doesn’t improve your cardiovascular health.”

Lost Hospital — Karlstad Memorial Hospital, Karlstad, Minnesota

Around 1883, Carl August Carlson moved from Sweden into an area of the United States west of Twin Lakes and established a homestead. In 1904, the Soo Line Rail Road built its track through the Carlson farm, purchasing a town site from him. The area was named Karlstad, honoring both Mr. Carlson and the city of Karlstad in Sweden.

Karlstad Memorial Hospital opened in 1951, providing medical care to the small town in Minnesota. In the 1990s, a shortage of money and doctors forced the town’s only hospital to close. The closure of the Karlstad Memorial Hospital cost the community about 20 jobs, but residents who needed emergency care were forced to travel to hospitals in Thief River Falls and Roseau, 35 and 40 miles away, respectively.

Karlstad had a closing ceremony in 1995 when it finally shut its doors. Residents circled the building while holding lighted black candles. “It was a black day in Karlstad,” said Lori Bothum, local resident and managing editor of the North Star News.

Aside from the loss of jobs, shortly after the hospital closed the Town & Country restaurant also shut its doors. With a bakery, banquet room, bar and fine dining, the restaurant added to the quality of life in the small town. That the restaurant closed just after the hospital, according to local residents, was not a coincidence: “It lost a lot of business without that traffic from the hospital,” Bothum said. Two gas stations and a grocery store also closed after the hospital.

“We knew it was going to be bad,” said George Wikstrom, former Karlstad mayor for 28 years. “Whenever a service or business is lost, the community is hurt.”  According to Marlene Pearson, one of the hospital board members who voted unanimously for the closing: “We had no money to continue to function. So many things in small towns seem to be so out of anyone’s control.”

Wikstrom also exlained:  “The doctor situation was part of it, but it was of more a financial issue. Financially, it was not carrying the load. The city had been subsidizing it for quite some time. It was not easy, but it had to be done.” The city subsidy amounted to $70,000 to $100,000 a year, according to the former Wikstrom.  “And the rules then were that we couldn’t increase our levies.”

Bothum noted: “Most of the older residents were unhappy, and a lot of that was because they had worked so hard to get it going (in 1951). They got contributions from people who really didn’t have the money to contribute.” Older residents that made a $25 contribution were rewarded with a certificate to display proudly in homes and businesses.

After it closed, the hospital was used for cold storage, home to medical equipment, city records and Tri-County School property. “It hurts to see the hospital just sitting there, falling apart,” Bothum said. “But I suppose it’s too expensive to fix up or tear down.”

Visit to see other “lost hospital” stories.

Texans Lie…About Health

Texans lie.  At least according to the True Results Health Honesty Survey.

According to the results, more than half of Texans admit to lying to family or doctors about diet and exercise. 46% are not honest with family members and 32% lied to their doctors. From this group, about 70% lied only a few times each year.  57% lied to avoid embarrassment, and 33% just did not want to explain the truth.

According to Jessica Diaz, nutritionist and exercise physiologist for True Results stated: “Lying about your health and fitness, if even only a few times per year, can signify a fundamental issue in your ability to achieve your health goals, Numerous studies have shown, the key to achieving any health or fitness goal is support from those around you and that cannot happen if you’re not honest with yourself or others.”

The survey also showed that more women lie than men about their diet and exercise habits (50% and 43%) as well as to their doctors (34% and 28%).

Apparently, underweight people lie just as much as overweight individuals.

The complete report can be viewed HERE.

PBS’s ‘This Emotional Life’: Reducing Stress This Winter

“In order to learn the most important lessons of life, one must each day surmount a fear.” — Ralph Waldo Emerson, American lecturer, essayist, and poet

The flu — suddenly it’s everywhere. We read about it in the paper and see it on the news. We listen in fear to reports on how it invades our hospitals and schools, contaminating drinking fountains, public bathrooms and restaurants. Each winter this invisible little bug returns with seemingly greater authority to disrupt our daily lives and spread paranoia throughout the community.

The fear and anxiety that accompanies seasonal influenza can also infect hospitals, chipping away at the mission for which they stand by causing patients to question a health care facility’s very ability to treat the infirm in times like these. As hospitals in Britain are forced to cancel operations and leave beds empty in preparation for anticipated flu cases, one can only hope that this patient surge in the United States does not escalate to needless panic over possible pandemic.

With today’s antibiotic-resistant germs and mutating strains, our grandparents’ “sniffles” have been replaced in the eyes of the general public by potentially fatal pandemics, bringing with them a mixture of fact and myth that baffles many of us still wondering how best to protect ourselves and our families during these winter months. Like it or not, influenza is here — including the H1N1 strain of the common cold better known as “Swine Flu” — but everyone must remain calm. To survive another flu season, information and common sense must prevail. Indeed, the very origin of the word “pandemic” from the Greek “pan” (meaning “all”) and “demos” (meaning “people” or “population”) would imply that the best way to avoid one is simply to prevent it from spreading.

In the grand scheme there is as yet no reason to let the fear of flu wreak havoc on the emotional well-being of you and your loved ones. The simple fact is that whether fighting a super-bug or a runny nose, the approach is the same: Prevention is a key element in reducing the chances of finding yourself bedridden throughout the winter. Flu season marks a distinct period where we are all duty bound to take extra precautions to keep from getting waylaid by this year’s scourge and spreading it to our families, friends, coworkers and neighbors. By arming yourself with the facts about the flu and taking a few simple steps, you can reduce emotional stress and maintain peace of mind while keeping your family in peak physical condition this winter.

Wash Your Hands, Please

It sounds so simple, and yet it works. Repeating their age-old mantra, public health officials continue to remind us that routine hand-washing is still one of the most powerful defenses against the spread of influenza in its many forms. According to the Food and Drug Administration, proper hand-washing can prevent up to half of all food borne illnesses. Children who wash their hands at least four times per day experience 24 percent fewer days with colds and flu, and 51 percent fewer days sick from stomach ailments.

No matter how potent the germ, it cannot take hold if it is removed before infection can occur. And yet, most of us wash our hands in a cursory manner at best, which limits effectiveness. To properly protect yourself, use warm water, wet your hands and cover them with soap. Rub your hands vigorously together for at least 30 seconds, making sure to scrub all skin surfaces thoroughly. When you are finished, be sure to rinse the soap completely from your hands. Should no soap and water be available, hand sanitizers can be an effective substitute until you can reach a well-stocked sink.

Be it in the hospital or at home, it is doubly important to follow this procedure before visiting elderly loved ones, those with compromised immune systems due to illness, pregnant women, or babies. Children should likewise be taught the necessity of regular hand hygiene, both as a means to keep themselves healthy and as a lesson in consideration for others. However, be mindful not to frighten them or make them overly conscious of disease. Using a musical timer or singing a 30-second song can turn the time at the sink into a fun and constructive, non-threatening exercise.

Don’t Fear The Needle

Even in this modern age, many of us are wary of vaccines and what they may or may not contain, and year after year many of us rely upon our excuses until it is too late. But the quick and easy act of getting a shot is an effective way to provide peace of mind and greatly improve your chances of standing tall instead of staying in bed with the chills.

Beginning in 2010, the CDC now proposes “universal annual vaccination,” recommending that everyone over the age of six months receive a flu shot. While the CDC recommends that everyone get an influenza vaccine each flu season, particular emphasis is placed on the following groups to get vaccinated, either because they are at high risk of having serious flu-related complications or because they live with or care for people at high risk for developing flu-related complications:

  • Pregnant women
  • Children younger than five, but especially children younger than two years old
  • People 50 years of age and older
  • People of any age with certain chronic medical conditions
  • People who live in nursing homes and other long-term care facilities
  • People who live with or care for those at high risk for complications from flu
  • Health care workers
  • Household contacts of persons at high risk for complications from the flu
  • Household contacts and out of home caregivers of children less than six months of age (these children are too young to be vaccinated)
  • However, there are some people who should refrain from getting a flu vaccine without first consulting a physician. These include:
  • People who have a severe allergy to chicken eggs
  • People who have had a severe reaction to an influenza vaccination
  • People who developed Guillain-Barré syndrome (GBS) within six weeks of getting an influenza vaccine
  • Children less than six months of age (influenza vaccine is not approved for this age group)
  • People who have a moderate-to-severe illness with a fever (these patients should wait until they recover to get vaccinated)

This flu season, focus on prevention and its many possible steps to reduce anxiety while improving your mental health. By fighting the fear of influenza first, hopefully you can avoid the traditional somatic symptoms altogether. As today’s germs seek new ways to outmaneuver advances in modern medicine and today’s newscasts spread fear through statistics without context, it is important to maintain perspective around the word “pandemic.” Statistically speaking, the flu claims very few lives each year, especially for those who are in otherwise good health. With a daily routine of preventive measures and a simple shot, the vast majority of Americans should have little to fear from the upcoming flu season.

This Emotional Life is a two-year campaign to foster awareness, connections and solutions around emotional wellness. Join our community at