Compromising On the Road to My Horizon

/ Marcia Brom Smith / 6 Comments

“There’s been a load of compromising on the road to my horizon,
but I’m gonna be where the lights are shining on me.”
– “Rhinestone Cowboy” by Larry Weiss, popularized by Glen Campbell

This song is on my iPod, thanks to Eric. During a recent workout, I got to thinking about what Glen meant by “compromising” and what sort of compromises I might have made on the road to where the sky has met the earth in my life.

The  word “compromise” has many different meanings. To compromise is to reach an agreement, find a middle way between two extremes, or expose or make liable to danger, suspicion or disrepute. I think Glen had the following definition in mind: a concession to something derogatory or objectionable;  a compromise of principles.

We have all made compromises in our life. It is a part of growing up to make concessions, to choose the least objectionable path, to focus on the positive and ignore the negative.  If you’re lucky and the road is smooth, you won’t have to give up too much of yourself to get where you want to be – whether it’s Broadway or the corner office.

So what concessions have I made in my life, prejudicial or otherwise?

Love: I have rarely compromised in the area of love, which I would define as dating, or even marrying, someone for reasons other than a sincere desire to be with that person. A classic example of compromise would be choosing a husband based on his perceived ability to keep you in the style to which you have become accustomed rather than feelings of romantic love. I never felt the need to let economics play a role in choosing who to date.

Education: Not from my perspective. I went to one of the best undergraduate schools in Minnesota and the only law school in the community where I lived at the time. From my perspective, it would have been a compromise of my values to insist on going to a top tier law school at the expense of spending time with my family.

Work: Often. In private practice, I did not have a proper work-life balance and sacrificed time with my family to keep the partners and clients happy.  Chasing billable hours can also feel like trading your soul for money, but I learned how to provide value for dollar and always ensured the bill reflected the value provided.  As an in-house attorney, I very rarely feel the need to compromise.

Family: It depends. I have no regrets about choosing to have a child or choosing to have only one child. This is an intimate decision that is best worked out between the parents. I had to compromise though on where we lived when raising our family, which influenced how much time I could spend with my parents and siblings. Go hug your mother now.

Fun: Almost never. I have the pictures to prove it. I tend to lose all perspective on what is the right way to behave when there is wine and dancing. It’s just how we Brom girls roll.

Politics: Not intentionally. I have always tried to pick the candidate who can do the best job, and not the one who will further my own interest.  My Dad was a Democrat. We watched the 1968 election returns hoping Herbert Humphrey would make us Minnesotans proud. My mother was a Republican. She probably voted for Nixon in 1968, but I didn’t figure that out until I was in my 20’s.  In the past, I liked some of what I heard in both parties and have voted for both Democrats and Republican for President.   These days I am a registered Democrat and support Democratic candidates.

What compromises have you made on the road to your horizon?

Mirό: The Dutch Interiors Exhibition

/ Marcia Brom Smith / 4 Comments

One of the best exhibits I have ever seen was at the Metropolitan Museum of Art: Mirό: The Dutch Interiors Exhibition.  Joan Mirό was a Spanish surrealist painter known for his collages and whimsical style. The exhibition linked a May 1928 visit by Mirό to the Rijksmuseum in Amsterdam to four of his early works. While in Amsterdam, he viewed works by Dutch Golden Age painters such as Hendrick Martensz Sorgh and Jan Steen, whose works we also viewed at the Met.  The exhibition put  Mirό’s works in context by showing the post cards that his paintings were based on, his preliminary sketches, the two original works that provided the basis for the paintings, and side-by-side comparisons that illustrate how Mirό reinterpreted these works.

The exhibition was curated by the Rijksmuseum which provides the following background:

In May 1928, Miró travelled from Paris to the Netherlands and included the Rijksmuseum in his itinerary. He also took two home two postcards, which were colour reproductions of paintings from the Rijksmuseum collection: The lute player by Hendrick Martensz Sorgh (1661) and Children teaching a cat to dance better known as The dancing lesson by Jan Havicksz Steen (c. 1660-1679). Both paintings feature a musician, surrounded by one or more listeners, a cat and a dog. In the Dutch interiors, the scenes undergo a complete metamorphosis, as Miró captures these figures in his own surreal fantasy world.

In summer 1928, during a visit to his studio on the family farm Montroig in Catalonia, Miró drew inspiration from these two picture postcards, creating the three paintings later entitled Dutch interiors. Rather than working spontaneously as he usually did, he prepared an extensive series of sketches and drawings. The paintings are currently part of the collections of the Museum of Modern Art (New York), the Peggy Guggenheim Collection (Venice) and the Metropolitan Museum of Art (New York). The postcards, sketches and drawings were donated by Miró to the Museum of Modern Art and the Fundació Joan Miró (Barcelona) in the seventies. This study material offers a unique insight into how Miró transformed the original 17th-century works.

By working in this way, Miró subscribed to a long tradition of ‘creative copying’, whereby artists reinterpreted the masterworks of predecessors, using them as a source of inspiration for new artworks.

It is interesting to see how Mirό transformed Sorgh’s The Lute Player into Dutch Interior (I) and Steen’s The Dancing Lesson into Dutch Interior (II).  The bored woman in Sorgh’s painting has been minimized, probably because she was not dynamic enough.  He also chose to emphasize the earthy elements in the paintings. For example, the dog in Dutch Interior (II) has visible genitalia and an anus, and appears to be going to the bathroom, something that dogs often do at inappropriate times.  The dog in the original Steen painting looks too friendly and eager to please to do such a bad thing.

Although there were only four Mirό paintings on display in this exhibition, I learned more about these paintings and the artist who created them than I learned from other exhibitions showing numerous works of a particular artist.

Views from an Empty Nest

/ Marcia Brom Smith / 4 Comments

Eric and I were in Napa Valley a few years ago. It is a great place for adults to do things that adults like to do, particularly those who are empty-nesters or who left their children at home. We took a wine tour, played golf, ate nice dinners, visited with new friends and relaxed and enjoyed the beautiful sights.

We also walked every day.  During our walks, we discovered the Veterans Home of California near our hotel. It is a scenic, campus-like home for qualified veterans, complete with a 1,200 seat theater (home of the Napa Valley Symphony), 9-hole golf course, RV park, baseball stadium, bowling lanes, and swimming pool. The campus is nestled in the scenic hills of Napa Valley with great views and within walking distance of the village of Yountville, even for those using a motorized scooter.  It’s great that the California Department of Veterans Affairs is able to make such nice accommodations available to those who have served our country.  There is probably a long waiting list to get into the facility.  If it were a private facility, it would be in great demand.

Eric and I are veterans so we meet some of the basic eligibility criteria. But I do not strive to become a resident of the facility. I am hoping to avoid nursing home care.

In the  documentary by Doug Block, The Kids Grow Up,  he chronicles his daughter’s senior year of high school and how he and his wife dealt with their only daughter’s imminent departure for college.  This is a stressful time for parents and child.  The parents are saying goodbye to their daughter and coming to terms with their own mortality.  In the movie, while in a therapeutic walking pool at a Florida recreation center, Mr. Block is quoted as telling his wife: “This is our future together. Get used to it.”

I can relate.  When you become an empty-nester, your focus shifts from raising a child to . . . .  what? What are you going to do with your extra time? Will you work more, find a new hobby, start blogging, watch more TV, have more sex (Eric votes yes)? What do you want to do with the rest of your life?  Even if you still have kids at home, you may want to start thinking about this now. It goes by fast.

I Love You (Wo)Man!

/ Marcia Brom Smith / 3 Comments

“Like, I love to take a girl out to dinner, but I’m not gonna go golf 18 holes with her.”
– I Love You Man Screenplay

Golf season is here again, yeah! Eric used to love playing golf with me, it was the others on the course he disliked. We had a great time.  He liked riding around in a golf cart and hitting things with his girlfriend at his side. I like playing with someone who doesn’t judge me if I take a mulligan or two. He also helped me to diagnose my swing mishaps.

We  learned to play golf together. I decided it was an essential function of my job as a partner in a law firm, and took lessons so I wouldn’t embarrass myself. I was surprised at how much I liked it. I shouldn’t have been.  If your Dad is a serious golfer, your Mom is an occasional golfer, and five of your siblings are golfers, chances are that you won’t suck at it. We are built with long arms, plus I am taller than average, which means I have some leverage.

I Love You Man is a great movie. Paul Rudd’s Peter is perfectly written and perfectly cast. Sweet but not too sappy. Jason Segel gets to play against his Lily-whipped character on TV’s How I Met Your Mother. Sydney is the guy’s guy. His garage is a mancave stocked with guitars and plenty of lotion and kleenex. Sydney teaches Peter the rules of guydom, including the one noted above. Guys play golf with other guys. They don’t play golf with their girlfriends.

Maybe so, but then they are missing something. We may not be able to hit the ball as far as the guys, but we have as much fun as they do. Plus we look better doing it. Real men play golf with women, not other guys.

Lost It!

/ Marcia Brom Smith / Leave a comment

Scientists apparently disagree on whether counting calories helps or does not help you lose weight. This Healthline article by Alina Petre is a good summary of the evidence for and against calorie counting. Ms. Petre concludes counting calories helps because, duh, you can’t lose weight unless you burn more calories then you consume.

Ms. Petre also does a good job explaining why some studies appear to show it doesn’t work. She thinks it’s because these studies fail to account for how poorly people estimate what they eat and how much they exercise. Also, studies showing that people on low-carb diets lose weight even though they don’t consume less calories are misleading because low-carb diets are higher in protein and fat, which have different impacts on the body than carbs, and can result in water weight loss rather than fat loss.

For what its worth, calorie counting works for me. I have lost at least 10 pounds since I began counting calories and recording my exercise activity on the Lose It! app on September 1, 2017. The weight loss happened gradually and I did not feel like I had to deprive myself of the foods (wine!) I love and enjoy. I was also able to eat out with loved ones without carrying around my own salad dressing. Often, if I consume more calories than my calorie budget for the day allows, I will either exercise more or cut back on my calorie intake the next day. I feel more in control of my weight than I have in years.

When I wanted to lose weight in the past, I would pick a restrictive diet and follow it for one or two weeks. I was miserable most of the time. Watching what I ate was counter-productive because it made me think about food more. It also made me feel worse about myself.  “Mostly Miserable Marcia” was a good description of my mood during those weeks. Needless to say, these restrictive diets did not result in long-term weight loss.

In the past few years, I relied on my step counter to control my weight. I thought as long as I got my steps in, I could eat and drink (most of) what I wanted. This approach stopped working, probably because my metabolism slowed down as I got older. A new approach was needed, so I did some research on calorie counting apps and chose Lose It!. The app is easy to use and has great search and scanning features. I probably spend 15 minutes per day entering my food and exercises into the app. Using LoseIt! facilitates contemporaneous record-keeping which (as long you don’t intentionally cheat) improves compliance.

My happy experience with the app has encouraged others to use it, including my husband, my daughter, my sister-in-law, a co-worker, and her son and mother. We have long (entertaining to us, but probably boring to others) conversations about what we ate, how many calories we recorded for what we ate, our exercise activity for the day and how many calories we have left to consume. Eric and I have also developed our own comedy routine about who ate more of the shared dessert and has to record more calories. Eric definitely ate 75% of the Hula Pie at Duke’s Beach House in Maui. Even though we blew our calorie budget that day, it was worth it!

                                                         Try the Hula Pie at Duke’s!

My Birthday Should Be a Holiday

/ Marcia Brom Smith / 1 Comment

March 8th is a special day in the Smith family household. We celebrate two out of three birthdays on this day, mine and Katelin’s. Eric often jokes about how this makes things easier, as he only has to remember one date. In truth, trying to make the two most important people in your life feel equally special on the same day is a daunting task, particularly when one of them is a small child and the other is her mother.  He never disappointed either one of us.

Birthday with Kakey

Although Katelin has learned to appreciate our shared day, when she was a child, she did not give it much thought.  More often than not during her childhood,  we would have two completely separate birthday celebrations.  She was busy planning her own birthday party: who should she invite, where should it be, what would the theme be. You know you are doing something right as a parent if your child is allowed to be self-centered.

Now that she has learned to adult, she thinks it is great and has embraced the specialness of sharing her birthday with her mother.  We send each other birthday “gifs” and have at least one joint celebration. This year Eric booked us a Signature Escape at the Langham Hotel’s Chuan Spa: 5 Wu Xing Elements In-One.  It sounds heavenly and just what two busy women need to relax and unwind.

Our friends, family and acquaintances will usually exclaim “How neat” or “What a blessing” when they are told (or remember) that we share the same birthday.  So how rare is it? Ken Thompson, a researcher at Millsaps College in Jackson, Mississippi calculated the odds of a baby being born on the same day as the baby’s mother and father (this actually happened in 2016):

“There are lots of variables at play,” he said. “To make it as simple as possible, let’s say that the distribution of birthdays throughout the year is uniform, that people are equally likely to be born on any given day of the year. This isn’t necessarily a true assumption, but it makes the interpretation much easier. I don’t know what the true distribution would be — babies are not likely to be conceived uniformly throughout the year — and let’s ignore leap years, which brings another level of complexity.”

“Given these ideal situations, the probability that a person is born on any given day of the year is 1/365, regardless of the day. The probability of being born on Dec. 18 is 1/365 for the mother, the father, and the son.”

“The probability of three independent events would be the product of the three probabilities. Thus, the probability of mom born on Dec. 18 and the probability of dad born on Dec. 18 and the probability of their son being born on Dec. 18 is (1/365)(1/365)(1/365), which is 0.000000021.”

The odds Katelin would be born on my birthday are 1/365, since I have already been born, and my birthday is known to be March 8.  These odds are a lot better than claiming the Power Ball jackpot (1/292 million) or being struck by lightening some day this year (1/700,000), but it’s still a pretty special occurence.

March 8 is also International Women’s Day  How perfect is that? Women from all over the world celebrating their womanhood and empowerment on our special day.  International Women’s Day has been celebrated for over 100 years. It began as a women’s suffrage and workers’ rights movement, and is even credited with starting the Russian revolution. Although originally celebrated primarily in Socialist and Communist countries, the event has continued to grow and is now recognized in over 100 countries.  Afghanistan, Angola, Armenia, Azerbaijan, Belarus, Burkina Faso, Cambodia, China, Cuba, Georgia, Guinea-Bissau, Eritrea, Kazakhstan, Kyrgyzstan, Laos, Madagascar, Moldova, Mongolia, Nepal, Russia, Tajikistan, Turkmenistan, Uganda, Ukraine, Uzbekistan, Vietnam, and Zambia have declared March 8 an official non-working holiday.

The United States does not officially recognize March 8 as International Women’s Day, not even as a working holiday. Maxine Waters introduced a resolution in 1994, but the resolution did not get an up or down vote. It is time we fixed this oversight.

This year women were protesting all over the world on March 8, and more people were talking about it because of the #MeToo movement.  Those of us who thought the battle was won, are waking up to the realization that women have a long way to go to achieve equality and be fully empowered.  #MeToo has changed the nature of the conversation, but even more importantly, it has increased our awareness of where the lines are currently being drawn and where they should be drawn. Real and permanent progress will come when women have more than a token seat at the table, and have the power to ensure our perspective is heard and the issues we care about are addressed.

I believe my daughter’s generation will make this happen and in the future, our special day will be celebrated as International Women’s Day in the United States.  Why not make it a non-working holiday like those other countries.  We need a holiday in March!

Confronting Disruption in Healthcare

/ Marcia Brom Smith / Leave a comment

The message is clear. Tech companies and others are determined to disrupt healthcare.  Payers think it is too expensive. Patients think it is too complex.  Meanwhile, physicians are getting paid less to do more and hospitals are providing care to more complex patients with fewer resources.  No one is happy with the inefficient healthcare system as it exists today.

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Disruption brings opportunities, as well as challenges. Your healthcare organization  can meet the disruption head on if it pays attention to the following trends:

  • Importance of data analytics. Thriving healthcare organizations invest in the capability to use data analytics to manage the effectiveness and cost of health care. Mercy Health Network (MHN) developed a comprehensive data warehouse that aggregates data from over 150 sources, with plans to expand to over 500 sources.  These sources include electronic medical record clinical data, billing records, scheduling data, hospital demographic data, public exchanges, and payer claims data feeds.  MHN uses this data to anticipate patient needs and proactively engage patients in self-management.  This type of data can also be used for predictive analytics to determine needed interventions while the patient is in the hospital, such as determining which patients are at risk for falls or re-admissions and developing a care plan to address these risks.
  • Patient-Centered Marketplace. MHN is focused on putting its members at the center of its business strategy. Consumers are making more of the decisions on what  healthcare services to consume and which providers to use. Consumers are demanding more cost and quality transparency from providers.  Is your brand associated with high quality in the minds of your patients? Do you deliver an exceptional patient experience? Are you being transparent about how much the patient will pay for her care, or is she going to be surprised (and shocked) when she gets the bill? Are you aligned with your hospital-based providers so you can estimate what their charges will be?
  • Need for Cost Reduction. Purchasers of health care, including the government, employers and consumers, are increasingly cost sensitive. To be seen as the provider of choice in your market, your healthcare organization must deliver value to the community: better care and better health at a lower cost. Traditionally, cost-cutting efforts are focused on areas such as supply chain, revenue cycle, clinical documentation improvement, and labor productivity.  What is needed, however, are transformational changes to the cost paradigm in health care. Are patients receiving care in the lowest cost setting? Are nurse practitioners being used effectively? What controls are in place to ensure patients are receiving medically necessary tests and therapies? Are you using data to coordinate your patients’ care to ensure they receive needed interventions.

As General Counsel of MHN, I clearly see an important role for the legal team in these efforts. My priority as Mercy Health Network’s General Counsel is to ensure the Legal Department has the right culture and is appropriately staffed to meet the needs of our organizational clients.

To be effective, Legal staff must be responsive and understand their role in managing risk. If Legal is a “black hole”, the clients will find ways to work around them, which increases the risks to the organization and leads to litigation and non-compliance.  Legal staff also need to understand their role in providing proactive, strategic guidance. They need to be “yes” lawyers, without becoming rubber stamps, carefully gauging and advising on the risk of a particular strategy.

Employing outside counsel can be an effective way to add needed competencies.  I have used alternative fee arrangements to manage these expenses.  These arrangements include fixed-fee retainer agreements for ongoing needs and not-to-exceed fees on discrete engagements.  Active engagement and management is also key.  Outside counsel are most effective when they have an in-house lawyer advising them on who to interview and how to get needed information. This approach also eases the concerns of fellow employees who are not accustomed to being interviewed by attorneys or being questioned about what they did and why.