Why do writers need editors?

editing-apps-800x600Before you say, “Duh!” please remember that some people have lots of self-confidence. Others can crawl off into a mental state and ignore the world around them, which can be considered a skill in the writing biz, but conformity is comforting to readers. Other writers seem to think that the rules don’t apply to them, like ee cummings. A few insist on ignoring the red and green squiggles that the word processor uses to offer help in eliminating common mistakes. Writers suffer from any of those problems, or have other idiosyncrasies that make editing necessary. Yes, I considered dealing with editors to be something of a pain, because I am self confident and not afraid to break a few rules.

However, I have learned quite a lot from writing teachers and editors. Friends and family will offer a few tips, but if those friends really like you, brutal honesty is off the table. Sometimes the distance combined with authority that goes along with having an editor is transformative. My first novel was a hot mess when it finally got a full length reading at the micro press that ultimately put it through line editing. My second novel was better, but still needed a lot of work in the editorial phase, beginning at conceptual, then line by line, and finally, proofreading. At that time, WCP did not pay proofreaders, instead relying upon volunteers, which was a bad business decision. My work suffered from that lack, as a few errors made it into the printed work, and sales were less than optimal.

Publishers seldom take on a fiction manuscript that isn’t complete, which leaves out the project development phase. Once the novel is finished, most writers will attempt to put it into the hands of either an agent or a publisher. Problems with style or continuity may crop up at this stage, but if the work is compelling, those can be addressed. What most people consider editing is copy or line editing, which is a line by line examination of grammar, spelling, mechanics, and style. Any “big changes” in the manuscript probably occur at this stage. The back and forth over details can be annoying or even funny, but most problems in the work are solved at this phase. Once, an editor challenged me on a detail where I described a man wearing a glen plaid suit. I thought it descriptive, but she thought it was a weird description that no reader would understand. Ultimately, the description remained, but that is the kind of thing that comes up in line edits.

Before printing comes proofreading, when any style or content changes have been addressed—so what’s left is a last look at spelling, capital letters, and adjustments to make the page layout work. I remember the copy editor at Whiskey Creek Press had to substantially change one sentence to avoid a page with a single word on it, and I was okay with her changes.

A good editor makes printed work better—by questioning, suggesting changes, and insisting on being absolutely correct. Real editing makes the author’s work shine, without the distractions of mistakes or inconsistencies. Nowadays, many people think that word processors have made editors obsolete. Unfortunately, that is simply wrong, and writing is suffering mightily. Errors abound, and the solution is a great editor who reads and corrects. Technology is advancing, but it cannot replace editorial expertise.

The book of the year?

The price we pay book cover
Lots of books are published each year, and I can only read a few of them. But, when a really important general interest book comes along, I often put it on the top of my “to be read” pile. In September, Dr. Marty Makary, a surgeon associated with Johns Hopkins, released a book entitled The Price We Pay: What Book American Healthcare—And How to Fix ItSince most people in America eventually get sick or have an accident, and only a few of us are fifty rich, this is the ultimate general interest book.

In Part I, entitled “Gold Rush” Makary doesn’t have to travel far—he visits “health fairs” at local churches, where salespeople disguised as medical professionals do screening tests and scare participants, mostly those on Medicare, into unnecessary and rather expensive procedures, such as placing stents into leg veins. In the second chapter, he discusses the lack of transparency in hospital pricing, as well as the astronomical rise in common procedures. For instance, a medical center in New Jersey offers joint replacement surgery for $135,400.00, which rose a mere 76.8% in a single year. BTW, Medicare only pays 13K for that procedure. For his third chapter, Makary travels to Carlsbad, NM, where the medical center seems to have overcharged and then sued almost everyone in town. Back in Virginia, Makary visits the courthouse to learn more about similar shenanigans at Mary Washington Hospital in Fredericksburg. Sadly, this hospital is supposed to be a “not for profit” hospital, and thus receives favored tax status, too. Also in this section, Makary provides an analysis of the proliferation of for profit helicopter ambulance services, which charge somewhere between $40K and $60K for a ride that I could make in an hour in my Toyota.

In the second portion of the book, Makary delves into some medical practices that can be improved by focusing on individual physicians. One OB doctor in Florida had a reasonable rate of C-sections, until figuring in Fridays, when the rate rose 80%. Why? The good doctor didn’t want to be bothered on the weekend, so moms who were in labor on Friday got the surgery. This section of the book also discusses the opioid crisis, and Makary admits that he had to learn to write fewer prescriptions for pain pills, after learning about the misuse of all those pills.

Part III of the book is about “Redesigning Healthcare” and it does offer several solutions to problems, but one chapter in this section explains how drug prices are affected by middle men (pharmacy benefits managers) who don’t supply anything other than a big bill for their services. Here’s an example: A pharmacy is paid $34.94 for 90 40mg doses of Zocor, but the employer is charged $442.85–and the PBM gets over $400 on that one transaction. Another chapter discusses problems in health insurance, which less and less helpful except in catastrophic circumstances, and there is even a chapter on “wellness” and how those well meaning programs are far too costly, especially as they often mean an invasion of privacy, or worse, over-treatment for minor issues.

Makary doesn’t make the mistake of only discussing problems without discussing solutions. Several positive programs are mentioned throughout the text, including websites such as ImprovingWisely.com, and the last chapter is a bit of a call to arms. In short, legislators and employers need to be educated on these matters, and healthcare consumers should do everything possible to demand transparent pricing for upcoming procedures.

The Price We Pay is a very important book. This should be the topic of your next book club, a gift for your friends and/or family, or even a holiday gift for your doctor or your legislator. Please buy this book, read it, and pass it on. Knowledge is power, and as this text has lots of information for Americans, this may well be the most important book you will read this year.

How much for a flu shot?

Mostly, I write about books, or maybe films. No doubt, I will do that again soon, but recently I have been experiencing various forms of health care, and my latest such visit was for the annual flu shot, so I’ll write a bit about that. For some years, I opted out of having this injection, but after hubby lost a week of work and felt terrible for even longer, I went back to getting the shot. After all, the couple of times I had influenza it was no fun at all.

Current United States policy (via the Affordable Care Act) requires that insurance cover the flu shot as a preventative measure, without any co-pay from the patient. So, my doctor’s office has made a business decision to “stick it” to the insurance company—pun intended. See the attached screen shot of the EOB for this procedure:

Flu Shot

Now, thinking that $248 is a bit steep for this, I just looked at GoodRx (a nifty site if you have never used it) and it tells me that the estimated cost for the shot is $32 at Walmart.

GoodRx

Now, going to my doctor’s office was convenient and fast, but I’ve had flu shots at the grocery store or at a mini clinic, and neither of those were inconvenient. Bottom line, the doctor’s office knows that they can charge whatever for preventive procedures, and my insurance has to pay for it, so they are taking advantage of this. Kudos to Walmart for making this injection available for regular folks. If you don’t have insurance, or if you want to keep it real, just go to the GoodRx site and put in your zip code. The site automatically offers several locations and price points. BTW, the average when I looked was $32.

As for Piedmont Athens Primary Care, they’ve made me think, yet again, that when insurance premiums go up again, and they will, their approach to business is one reason for those hefty increases.

 

Overdignosed— a brief review and commentary

OverdiagLike many people in the USA, I am concerned about the state of our health care. Don’t get me wrong, I’m grateful to live in a country that has lots of great medical facilities and practitioners. But, I’ve watched people go through some pretty difficult situations, too, so I read Over-diagnosed: Making People Sick in the Pursuit of Healthcare in hopes that I’d learn more about what sometimes goes wrong with our healthcare system. This book offers some first hand insights from three physician authors, and I learned a great deal from it.

Many of the chapters have a “case study” to frame the discussion. One of the most memorable is the story of an older gentleman with a borderline diagnosis of diabetes. In the interest of keeping those blood sugar numbers in the optimal range, the principal author (Dr. H. Gilbert Welch) prescribed medication. Unfortunately, the gentleman’s blood sugar dropped, causing him to lose control of his car, resulting in an accident that broke his neck. The gentleman survived, but he had to wear a halo brace for many weeks while his neck healed. When it was all over, the doctor and patient agreed that the best practice in his case would be to forgo the diabetes medication. This anecdote is a great way to illustrate how over diagnosis can make people sick!

Each chapter explains how modern testing, coupled with ever changing standards for “normal,” have resulted in more and more people being diagnosed with something. The approach is cautionary, explaining that many times a diagnosis might be correct, but if the condition is unlikely to cause the patient any reduction in quality of life, or end the patient’s life early, then it is far better to not treat the disease. However, once diagnosed, both the patient and most physicians will be reluctant to “watchfully wait.” Indeed, the principal author states in the introduction that he does not have routine checkups, even though he works in healthcare and could easily do so. Instead, he waits for something to go wrong. As the old saying goes, “If it ain’t broke, don’t fix it.”

The mammogram is probably the first test that my doctor wants me to have done, but our author states that for most women, they do more harm (due to radiation) than good. Aggressive cancers can develop in the one to two year interval between tests, but slow growing cancers can result in over-reaction by doctors and patients. Also, many women go through the “false positive” situation, which might mean more testing, including a breast biopsy. I’ve known several women who had that done, only to find out that the mammogram was incorrect (or incorrectly interpreted.)

Another interesting story is a conversation between the author and a pharmaceutical rep. The latter was touting the benefits of a drug for women with bone density issues. After a friendly discussion, the drug company rep admitted that the greatest risk for these women is mostly hip fractures, which can lead to all sorts of problems, including premature death. The author states that helping women prevent falls, though physical therapy and other practical measures, would be much more useful. And the testing phase of the drug was eventually discontinued due to subjects developing bone cancer.

The author is firm in his stance that patients are often over-tested and over-diagnosed. He believes that many doctors do this out of an interest in finding answers for their patients, and not merely in making more money. He is also firm that the threat of a law suit can be a driver for hyper testing and the end result of over-diagnosis. I’m all for people having the right to seek redress in the case of gross malpractice, but doctors who have been the defendant in a case, win or lose, will often err on the side of caution and order tests that probably aren’t needed and will refer cases that are only marginal. The costs of this mind set are not negligible, as tests can costs hundreds or even thousands, and that doesn’t include the costs of treating a condition that might not need any treatment. Nor does it address the mental stress of having a chronic “condition.”

Common sense is sorely lacking these days. Certainly many aspects of modern America are getting totally weird, so I guess it is not unusual that medicine is affected. I am grateful to Dr. Welch and his fellow authors for this very cogent discussion of the problem of over diagnosis. I am seriously contemplating what to say at my next doctor visit, when I will face that computerized list of items that modern medicine says I need, but just might result in me joining the long list of those who are “over-diagnosed.”

Flag draped caskets

Recently, hubby and I attended the funeral of a contractor who worked for us several times over a couple of decades, a craftsman who was also so personable that we viewed him as a family friend. In addition to being a darned good carpenter, he always visited a bit with us. Mike collected license plates from cars, and he asked for an old plate off my car. (I drive a Honda Odyssey, so my personalized plate says “HOMERS”, thus I drive around in Homer’s Odyssey. A lot of people don’t understand the tag, but Mike was one those who got the joke and thought it funny.) So, after he finished doing a re-roof and soffit repair, I gave him one my old plate, which he put into “a place of honor” in his shop. Since I love to read, he would bring me his old Time magazines. When he gave me a stack, he usually apologized for taking so long, and recommended the articles he had enjoyed the most. I am going to miss those visits.

The first person who eulogized him was his daughter. Although we knew him well, she was able to relay some interesting tidbits of his life, so we were able to know him even better in death than we had in his life. The minister who delivered the message also knew him well, and told some stories of Mike’s service to the church as well as the community.

I didn’t know that Mike had served in the National Guard until the funeral, but his casket was draped with a flag, honoring his service.


When I listened to the funeral of President George H.W. Bush, I was very much reminded of the accomplishments of the forty-first president. His presidency only lasted four years, but he was a hero during our nation’s greatest war, a congressman, an ambassador, and he was commander in chief during the first Gulf War, a crucial time in our country’s history. The remarks by former Canadian Prime Minister Brian Mulroney were particularly enlightening, as they blended the public accomplishments with the private persona of the former president. The remarks by his son, former President George W. Bush, a eulogy that was primarily about Bush as a father, also helped the nation know this man a bit better.

Most Americans know that Bush (41) was a warrior, and the military aspect of his funeral was a affirmation that some of the greatest Americans served the country well, and that flag draped coffin is a sign of honor which signals that another of our nation’s heroes has gone on to a greater reward.

Our friend Mike left his fingerprints all over the community, as he worked for many people in our area. President Bush left his fingerprints on the nation, because he was involved in government service at the highest levels. Regardless of the scope, to serve well is to live well.

Anxious for Nothing— brief review and commentary

A friend told me how much she is enjoying her study of Max Lucado’s book, Anxious for Nothing, so I bought an eBook version. Quite frankly, her comments were so positive that I did not want to wait to pick up the physical book. I’ve read several of Lucado’s Christian living texts, and they have all been easy to read and helpful, and this book fits that mold.

The title says quite a lot. Modern people have too much information coming at them, much of it negative, so being anxious is almost a modern plague. This plays out in all sorts of ways: addiction, suicide, failed relationships, etc. Lucado discusses the whys, and then gives some very good solutions to our problem thinking. One of my favorite passages says this: “There is a reason the windshield is bigger than the rearview mirror. Your future matters more than your past.”From my own experience, over thinking the past— the coulda, woulda, shoulda— is very damaging. When I counsel students, who almost always want me to allow them to “make up work” or “try again” I tell them to do better going forward. I even use the windshield analogy. But I like Lucado’s take on it.

Okay, his writing lacks sophistication; but not substance. Anxious for Nothing can be a quick read, but there is sufficient food for thought for study, too.

Count the flags!

FlagWe had an interesting discussion about celebrating America’s Independence Day, and the  ways to celebrate are as diverse as the country itself. Most of the towns around here offer some sort of fireworks, usually preceded by live music, and people bring lawn chairs and visit for a while. When our kids were kids, we usually visited the one in the town where we lived. Currently, we live out in the country, so we don’t usually bother.

Hubby wants to watch a movie, preferably Independence Day Resurgence. We loved the original ID4 movie, but somehow we missed seeing the sequel. Despite its mediocre reviews, I imagine that we’ll be looking for that one in a couple of days.

In my work as an adjunct instructor, I work with students from lots of differing situations, but some of the most interesting are immigrants to our country. Many of them are just so appreciative for the opportunities that Americans have. I remember one gentleman, originally from Romania, who came over a couple of decades back, beginning with nothing but some work ethic. At first he made his living doing odd jobs. He worked his way into owning his own construction business, and he and his wife raised their family through hard work and savvy real estate deals. At our college, he was working on his HVAC (that’s heating and air-conditioning) certification, as he wanted to open an HVAC business so he could scale back doing difficult construction work as he aged. Being a very smart business man, he said that in the south making money on repairing air conditioning was a sure thing! One day at the end of our class, he spend probably half an hour, telling all of us about what a wonderful country we were living in, because he could never do all that he was doing in the economically and socially constricted country of his birth. It was quite refreshing. Sometimes, caught up in the polarized morass of modern media, Americans forget just how wonderful our country is, and how it differs from others.

When I mentioned that it can be difficult teaching young children about our country, one  mother of youngsters mentioned that when they are driving in the car, her kids count flags. Regardless of the destination, they look for the red, white, and blue symbol of our great country. That, too, is a great way to begin celebrating the good ol’ US of A.

Happy American Independence Day, y’all.

Hollar— and great customer service

hollar-pic.jpeg
Mostly, I intend to write about writing, but real life does get in the way of that, and this post is about the fabulous customer service I got from an online “dollar store” known as Hollar.com. When I ordered from them for the first time, I got several items to try, and a puzzle to share with my family, who are (just like mom) big fans of Star Wars. Let me be perfectly honest— the price for the 100 piece puzzle was $1. But, when the group effort was finished, one piece was missing. Hubby laughed at me and had some disparaging remarks about my being cheap enough to order a $1 puzzle. He is right about me being cheap, however.

Slightly annoyed, I whipped out my iPad, took a picture of the 99 piece puzzle, posted it as a comment on the Hollar Facebook page. Within a few minutes, I had a couple of responses from concerned folks at Hollar. They asked for the order number, and when I replied via FB messenger with it, they assured me that I would get a new puzzle. I was expecting (maybe) a credit on my next order, but they said the item was in stock and would soon be on its way. Kudos, right?

A few days later, I got the box, which was bigger than expected and heavier, too. Curious, I opened the box and there was another boxed Star Wars puzzle. Below it, heavily cushioned, was a very nicely framed Star Wars puzzle, with a missing piece, along with a personal note explaining that they, too, didn’t like missing pieces. Hubby, who had brought the box from the post office couldn’t stop laughing, and I was so pleased with the item that I immediately hung it.

Nowadays, people love to say that almost all companies have “customer no service” rather than treating people right. Obviously, Hollar.com has a different philosophy, as well as a great sense of humor. Needless to say, I will be visiting the site again, because such great customer service deserves a second chance.

Go check out Hollar.com. Really!

“Current Events Day”

coachWhen my kids were kids, I often assisted with homework, but I made a tactical error and told them I’d actually do any thing we determined to be “busy work.” (At the time, I still believed in the integrity of most educators.) My daughter had a couple of coach/ social studies teachers in high school who would set aside one day a week for “current events” which basically meant the students were to bring in a news story and read it to the class. There were absolutely no criteria assigned, nor was there any grade. Since the teacher was just using this instead of doing any work himself, this qualified as a mom task, and I decided to use the weirdest items I could find.

As it is has been a while since my kids were in school, I no longer read so much weird news, but sometimes a headline just grabs my attention. So, I just read a news story which would have made the cut for current events day at JHS. What do y’all think of this one? Call 911!

Star Wars: The Force Awakens

Since Star Wars The Force Awakens has broken lots of records for attendance, there are no doubt too many audience reviews for mine to matter. There are several elements that make this a film worth watching, and fans are mostly happy with it, at least in part due to the items (in my own order of excellence) enumerated here:

#1 The Score! John Williams’ score was instrumental in turning the original Star Wars from a mere comic book B movie into a box office bonanza. For the other films his compositions have kept the audience entertained, and Williams’ music is just as important here ever. For those not into classical music, the technique he uses is called leitmotif, wherein each character or plot device has it’s own musical theme, all interwoven into the whole. This is an operatic technique that helps the audience be even more emotionally involved the happenings on screen. It’s very cool, and it works beautifully in Episode VII.

#2 The respectful treatment of the aging stars of the original series. Although there is considerable exposition prior to the appearance of the famous trio, each character is given his (or her) moment on screen. The audience has a chance to see what’s happened during the passage of time, and the situation of each is organic in regards to their characters and situation way back when the Jedi returned in Episode VI.

#3 The new characters are interesting. Writing is hard work, and creating characters that readers (and/or viewers) care about can be difficult. In Poe Dameron, Rey, and Finn, the writers have given us a new generation of action characters. Hey, there’s even a cool new droid, BB-8. Compared to the characters in Episodes I, II, and III, these new guys are…oh, let’s be real. There is no comparison with those films. The new kids seem to be worthy successors, however. The actors do an excellent job of bringing them to life, too.

#4 Real “special effects” rather than CGI. Don’t get me wrong, computer generated effects have their place. But when Yoda ceased to be a puppet and became a glowing figure out of a computer game, his personality shifted from cute and quirky to something less interesting. This Star Wars has the look and feel of the original, but with more money. No doubt the prop masters were kept very busy during filming, but there is a difference when the actor is doing lots of stuff against a green screen vs. real props and sets.

#5 Good vs. Evil is central to the story line. For audiences to care, the good guys have to be mostly good, but have enough flaws for us to identify with them. The bad guys should be so bad that even Oprah wouldn’t try to understand them, instead she’d just shoot ’em.

The links are present for those who want to know more about certain aspects of the film, but that’s my take on the new Star Wars movie, which I recently saw with hubby and our young adult son.