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Corneal ulceration affects the eye and its vision. The signs and symptoms include the following:
- Extreme pain and soreness accompanied by redness in the eye
- Blurred vision
- Tearing
- Sensitivity to light
- Appearance of white patch on the cornea
- Squinting
- Inflammation of the eye
- Pus discharge
- Photophobia
We present the case of a 76-year-old male, admitted for sudden visual loss in the left eye, associated with ocular pain, tearing, and photophobia. [ncbi.nlm.nih.gov]
Topical corticosteroids do decrease the pain and photophobia, and speed the increase in visual acuity, significantly. [msdmanuals.com]
- Blurred Vision
Other symptoms included pain, blurred vision and excessive yellowish-white discharge from both eyes. There was a history of multiple sexual partners. [ncbi.nlm.nih.gov]
Symptoms can include the following: Itching Irritation Burning sensation Redness Eye pain Excess tearing Discharge White spots on the cornea Light sensitivity Blurred vision Corneal ulcers are commonly caused by germs, so it is important to wash your [goeyesurgeons.com]
Other symptoms can include pain, redness, blurred vision, excessive tearing, and sensitivity to light. If left untreated, corneal ulcers can lead to serious vision loss, and even loss of an eye. [villageeyecare.net]
Corneal ulcer symptoms Symptoms of corneal ulcers include: redness of the eye severe pain and soreness of the eye the feeling of having something in your eye tearing pus or other discharge blurred vision sensitivity to light swelling of the eyelids a [aao.org]
Symptoms associated with corneal abrasions include tearing, redness, pain, soreness, and blurred vision. [themedicaleyecenter.com]
- Eye Pain
A 22-year-old male, seen in the ED 5 days prior (diagnosis: corneal abrasion), presents for a second visit due to persistent left eye pain and redness. [emdocs.net]
Doctors will treat you right away with: Antibiotic eye drops to fight infection Eye drops to dilate your eye, which helps with the pain You may need to use the antibiotic eye drops every hour or two at first. [msdmanuals.com]
Symptoms of Corneal Ulcers Severe eye pain, feeling that something is lodged in the eye (foreign body sensation) Redness in or discharge from the eyes Heightened sensitivity to light (photophobia); aversion to bright light Excessive tearing Blurred vision [healthcommunities.com]
Symptoms can include the following: Itching Irritation Burning sensation Redness Eye pain Excess tearing Discharge White spots on the cornea Light sensitivity Blurred vision Corneal ulcers are commonly caused by germs, so it is important to wash your [goeyesurgeons.com]
- Blepharitis
Often associated with blepharitis. Mooren Ulcer Autoimmune. [webeye.ophth.uiowa.edu]
He had a two-year history of chronic blepharitis and recurrent episodes of conjunctivitis that were treated with Tobramycin and corticosteroid eye drops over the years. [ncbi.nlm.nih.gov]
[…] from the eye Causes of corneal ulcers: Infection Wearing contact lenses for excessive periods of time Inadequate contact lens sterilization Eye injury Lack of tear production Complications of herpes simplex keratitis, neurotrophic keratitis, chronic blepharitis [northdakotaeyeclinic.com]
- Excessive Tearing
Methods: The patient complained of bilateral red, itchy eyes, decreased vision, photophobia, difficulty opening the eyelids upon awakening, palpebral edema, excessive tearing, along with yellowish mucous discharge. [ncbi.nlm.nih.gov]
Symptoms can include the following: Itching Irritation Burning sensation Redness Eye pain Excess tearing Discharge White spots on the cornea Light sensitivity Blurred vision Corneal ulcers are commonly caused by germs, so it is important to wash your [goeyesurgeons.com]
Other symptoms can include pain, redness, blurred vision, excessive tearing, and sensitivity to light. If left untreated, corneal ulcers can lead to serious vision loss, and even loss of an eye. [villageeyecare.net]
Here are just a few symptoms of a corneal ulcer: Severe eye pain Feeling of something stuck in the eye Red, irritated eyes Blurry vision Eye discharge Burning and itching Sensitivity to light Excessive tear production Eyelid swelling If you are experiencing [arlingtoneyes.com]
Symptoms of Corneal Ulcers Severe eye pain, feeling that something is lodged in the eye (foreign body sensation) Redness in or discharge from the eyes Heightened sensitivity to light (photophobia); aversion to bright light Excessive tearing Blurred vision [healthcommunities.com]
A dye known as flurorescein is used to appropriately study the ulceration in the corneal region. The eyes are examined using a special microscope known as slit lamp. This lamp enables the ophthalmologist to completely and minutely study the cornea and make the diagnosis. Tests to study the tear production also need to be done.
A blood test may be carried out to determine the presence of any inflammatory disorders. In addition to these tests, the following diagnostic procedures are useful to study corneal ulceration.
- Keratometry for studying the curvature of the cornea
- Papillary reflex response
- Refraction tests
- Visual acuity to determine the vision [6]
- Vibrio Vulnificus
To describe a corneal ulcer due to Vibrio vulnificus that resolved rapidly with antibiotic therapy alone. Case report and review of literature. This is the third reported case of corneal ulcer due to V. vulnificus. [ncbi.nlm.nih.gov]
- Streptococcus Bovis
The purpose of this study was to report the first case of Streptococcus bovis causing a perforating corneal ulcer in a healthy adult. Observational case report. [ncbi.nlm.nih.gov]
- Nocardia Asteroides
Nocardia asteroides is a rare cause of keratitis usually associated with trauma. We report a case of corneal ulceration caused by N. asteroides in a patient with leprosy. This is the first case report of nocardial keratitis from Southeast Asia. [ncbi.nlm.nih.gov]
The treatment regime for corneal ulcer is cause dependant. It is necessary to initiate treatment as soon as diagnosis is made in order to avoid further damage to the eyes. If the infection is the source then antibiotic drops are administered. In addition, eye drops containing corticosteroids are also prescribed in order to reduce the pain and inflammation [7].
In certain cases, oral pain relieving medications may also be prescribed. Ophthalmic pain relieving solutions like bromfenac has been most effective and does not interfere with the corneal epithelialization process of healing [8]. Neurotrophic ulcers may benefit from the topical application of nerve growth factors on the cornea [9]. Severe cases of ulceration may call for a corneal transplant.
The use of a tectonic graft in the repair of corneal thinning and perforation has exemplified a good visual rehabilitation post operatively [10]. However, with prompt diagnosis and appropriate treatment regime a transplant can be avoided.
Prognosis of the disease condition is usually good with proper treatment regime. Some individuals completely recover, but can suffer minor changes in the eye vision [5]. However, some individuals in whom the condition has turned severe can cause irreversible damages to eye which cannot be treated.
It is necessary to immediately treat any underlying infection of the eye to prevent the development of corneal ulcers. Failure to do so can cause life threatening complications such as:
- Loss of vision
- Permanent scars on the cornea
- Loss of eye (rare cases)
Corneal ulcers are caused due to infections by bacteria, viruses, parasites and or fungi. The following is the list explaining the various infectious agents which are known to cause corneal ulcers.
- Bacterial infections cause Acanthamoeba keratitis, a type of corneal ulcer which mostly strikes those individuals who wear contact lenses.
- The herpes simplex virus cause is also a potential agent in causation of corneal ulcers.
- Use of eye drops containing steroid can contribute to fungal infections which can lead to corneal ulcers.
- Fungal corneal ulcerations may occur post-operatively in immunocompromised hosts [2].
In addition to these infectious agents, there are also other factors that cause corneal ulcers. These include:
Corneal ulcer is a common problem caused either due to infections or due to other associated disease conditions. It has been stated that this form of eye disorder is one of the leading cause of blindness in the developing countries.
About 11.3 per 10,000 populations are known to suffer from corneal ulcer. Research also led to the finding that, during the period of 1997 to 2007 there was a significant increase in the incidence of viral ulceration.
Individuals with a suppressed immune system fall easy prey to infections and develop corneal ulcerations. Individuals who wear contact lenses and that too for long duration are more prone to develop sores in the cornea.
The condition further aggravates when individuals make use of homemade lens solution. Such a solution is not sterile in nature and can be contaminated from various agents. The use of such non sterile homemade solution can call for development of corneal ulcers.
Any injury to the cornea of the eye by use of physical agents such as make up brush, fingernails, and branches of the tree can result in development of wound which can lead to corneal ulcers.
Prevention is the best way to avoid corneal ulcerations. Adopting the following practices can help keep corneal ulceration at bay.
- Washing hands properly while handling contact lenses is necessary to prevent infection.
- It is advised to avoid wearing lenses overnight.
- Slightest of discomfort in the eyes should be immediately shown to an ophthalmologist in order to prevent any serious damage.
Corneal ulcer in common terms can be described as development of open sores in the corneal region of the eye. This condition is also termed as ulcerative keratitis, marked by development of erosion in the outer layer of the cornea due to infection.
Most commonly affected are the populace of tropics and agrarian. In addition, children with vitamin A deficiency also fall prey to this condition.
Corneal ulcers are generally associated with disease conditions such as Sjogren syndrome, Mooren ulcer, systemic vasculitic disorder and rheumatoid arthritis. Autoimmune diseases like Hashimoto's thyroiditis, psoriasis and Harada disease may also be associated with paracentral corneal melting [1]. Severe dry eyes and other disorders of the eye predispose an individual to develop corneal ulcers.
Patient Information
Corneal ulcers are open sores that develop in the cornea of the eye. It is a common condition and mostly affects those who wear contact lens. Infections are the major causative factor.
Infection due to bacteria, virus, parasites and fungi are the major factors for development of corneal ulcers. In addition, individuals who make use of contact lenses and improperly handle the same also fall prey to this condition. Dry eyes are also more prone to develop corneal ulcers.
Symptoms of corneal ulcers include pain and inflammation of the eyes, watery eyes, redness and itching sensation in the eyes, pus discharge from the eyes and sensitivity to light.
Diagnosis involves examining the eyes by staining the cornea using fluroescein dye. The eyes are then studied using slit lamp microscope. Blood tests are done for evaluating the source of infection. In addition to these, tests to examine the vision and refraction test are also carried out.
Treatment is geared towards the cause of the condition. If infection is the source then antibiotic drops are administered. Other eye drops that contain corticosteroids are also given along with oral medications to relieve pain and inflammation.
- Paroli MP, Pinca M, Speranza S, Marino M, Pivetti-Pezzi P. Paracentral corneal melting in a patient with Vogt-Koyanagi-Harada's syndrome, psoriasis, and Hashimoto's thyroiditis. Ocul Immunol Inflamm. Dec 2003; 11(4):309-13. [
- Kim EC, Kim MS, Kang NY. Fungal corneal ulcer and bacterial orbital cellulitis occur as complications of bacterial endophthalmitis after cataract surgery in an immunocompetent patient. Semin Ophthalmol. 2013; 28(2):75-8 (ISSN: 1744-5205)
- Asai T, Nakagami T, Mochizuki M. Three cases of corneal melting after instillation of a new nonsteroidal anti-inflammatory drug. Cornea. Feb 2006; 25 (2):224-7.
- Schechter BA, Rand WJ, Nagler RS. Corneal melt after amniotic membrane transplant. Cornea. Jan 2005; 24(1):106-7.
- Suzuki A, Matsumoto Y, Uchino Y, Kawakita T, Shimmura S, Tsubota K. Risk factors of severe peripheral corneal ulcers.Nihon Ganka Gakkai Zasshi. 2011; 115(2):116-21 (ISSN: 0029-0203)
- Klamann MK, Maier AK, Gonnermann J, Klein JP, Bertelmann E, Pleyer U. Ocular surface temperature gradient is increased in eyes with bacterial corneal ulcers. Ophthalmic Res. 2013; 49(1):52-6 (ISSN: 1423-0259)
- Bullen CL, Liesegang TJ, McDonald TJ, DeRemee RA. Ocular complications of Wegener's granulomatosis. Ophthalmology. Mar 1983; 90(3):279-90.
- Schechter BA, Trattler W. Efficacy and safety of bromfenac for the treatment of corneal ulcer pain. Adv Ther. 2010; 27(10):756-61 (ISSN: 1865-8652)
- Lambiase A, Rama P, Bonini S, et al. Topical treatment with nerve growth factor for corneal neurotrophic ulcers. N Engl J Med. Apr 23 1998; 338(17):1174-80.
- Vanathi M, Sharma N, Titiyal JS. Tectonic grafts for corneal thinning and perforations. Cornea. Nov 2002; 21(8):792-7.


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subset: commoncrawl


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Common misspellings for turned:
dunreadd, trined, turng, reaturned, tunel, eurned, turnado, turnt, tudent, tarnshed, tennid, tarined, thunde, turnet, tubed, tuanted, thurned, tundr, leaurned, curtined, ruturned, turnikit, tourted, outined, turend, turnoil, retuirned, curnet, rerturned, journed, turfed, termined, turened, turlte, talend, tunned, journied, tourterd, turny, runed, truend, tunrned, journeied, tourqued, turnded, towned, turket, turnon, tened, tturned, paterned, turnner, tournie, tuenti, trund, eturnaty, tound, tournaent, turnd, terned, rturned, trnned, foturnato, tournamet, turnng, toand, reuturned, rreturned, aerned, tousend, theend, turnes, turnne, reurned, tornade, ternd, tunder, thorned, thined, tourned, burdoned, turnup, turnright, tured, guned, turnn, tousand, turnedto, curtened, runned, tkind, tooned, tarnado, lurnd, turnb, tighned, turent, turnned, tained, returnned, returnde, turmned, tutned, tarnised, ytoured, tuened, deened, stuned, urned, truied, turnred, tuerned, burnde, sturned, tornaod, tourguide, tuend, tornedo, tunend, erned, atuned, tornando, tneed, reterned, teend, turne, truned, tunda, tausand, taned, theneed, arned, tornadio, turmed, thurnder, trned, topend, tornoado, turbed, turneds, tighened, turna, dunde, gaurtneed, turnend, tannd, iternet, trurned, turnthe, tearned, tosend, edorned, turnedin, torked, dunndee, tuged, turnied, runnned, gurned, ttend, tune'd, tournout, torned, retuerned, turnede, turnel, turnig, turnerd, ouned, duned, teenhood, yerned, turnaway, titened, tonned, torndao, takend, turnind, iorned, yurned, nternet, nurturned, tunred, tursed, tornodo, tournado, traned, turneed, lurned, starned, burnned, turded, retourned, tneder, torced, tirned, turrned, toend, tornait, burdned, tunde, tende, mutined, atunned, tourtied, retturned, uined, tonedeaf, tornaydo, turnemet, tournry, turkety, turnesd, turnedon, tourneur, turndow n, 6urned, 5urned, tyrned, thrned, tjrned, t8rned, t7rned, tudned, tufned, tu5ned, tu4ned, turjed, turhed, turnwd, turnsd, turndd, turnrd, turn4d, turn3d, turnex, turnec, turnef, turner, turnee, fturned, tfurned, gturned, tgurned, yturned, tyurned, 6turned, t6urned, 5turned, t5urned, tuyrned, tuhrned, tjurned, tujrned, tiurned, tuirned, t8urned, tu8rned, t7urned, tu7rned, tudrned, turdned, tufrned, turfned, tutrned, turtned, tu5rned, tur5ned, tu4rned, tur4ned, turnbed, turnmed, turjned, turnjed, turhned, turnhed, turnwed, turnewd, turnsed, turnedd, turn4ed, turne4d, turn3ed, turne3d, turnexd, turnedx, turnecd, turnedc, turnefd, turnedf, turnedr, utrned, turnde, tuurned, 4urned, turned, durned, uurned, t5rned, tqrned, twrned, ttrned, tu2ned, tuzned, tuvned, tupned, tusned, tur.ed, turoed, turnud, turnmd, turnad, turngd, t urned, tu rned, tur ned, turn ed, turne d.
Usage examples for turned
Wisbech turned to Nasmyth. The Greater Power by Harold Bindloss W. Herbert Dunton
She turned and looked. The Literary Sense by E. Nesbit
The lady turned to me as if Mr. Sawtelle had left us. Ma Pettengill by Harry Leon Wilson
Framl turned to Jack. The Boy Allies with Uncle Sams Cruisers by Ensign Robert L. Drake


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Tag: witches fingers and toes
witches fingers, monster toes, 10.31
These brilliant Martha Stewart finger and toe soft pretzels are so god damn amazing and hands down the best Halloween finger food I've ever made. The witches fingers and monster toes are fairly labor intensive, but so well worth it. I hand painted each fingernail (made of whole almonds) with red food coloring. Sprinkled with […]


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August Ushers 59 New Titles… The Mr. Magazine™ Launch Monitor.
By Samir Husni
From the latest trend in stress relief for adults: coloring books, to the controversial world of marijuana commercial growing and selling; the month of August was filled with titles that continue to reflect the face of our society more than any other medium in the industry. Arts & Crafts were big this time around and […]
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text: 341.SB.131.RX Hublot. This Watch has Fixed Ceramic bezel with Black dial and Silver-tone hands. The watch performs following functions: chronograph, date, hours, minutes and seconds. The watch has Black Rubber strap with a hidden Fold Over Buckle. Sapphire crystal protects only Front side of this watch. Case back is Transparent. Automatic movement. Power reserve 42 hours. This model is water-resistant up to 100m/330ft . The watch comes with 41 mm Stainless Steel case 341.SB.131.RX Hublot Stainless Steel and Ceramic Watch.


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On October 24, 2014 Plaintiff received $885,000 in a settlement with the Defendant's Insurer, Discovery Property & Casualty Insurance Co. Plaintiff was involved in an accident with a bus while walking on Houston and Chrystie Street in the East Village of NYC. Plaintiff claimed he was hit by the bus as the bus made an illegal left turn. Defendant Bus Driver claimed he had a green light which gave him the right to turn and that Plaintiff ran into the side of the bus.
Plaintiff's injuries included a broken knee, broken leg, multiple breaks in the foot, broken ribs, torn shoulder, and herniated discs. Plaintiff underwent multiple surgeries to remedy his condition as well as extensive physical therapy. Additionally, Plaintiff claimed lasting effects from the incident, including difficulty walking, lifting heavy objects and exercising.
Just as the parties began selecting a jury to try the case the parties reached an agreement and settled.


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Ducey oversteps with state agency orders
Gov. Doug Ducey's edict to the Department of Child Safety to treat same-sex married couples the same as heterosexual ones regarding adoptions and foster care was widely applauded by people who approve of the result, even though they generally don't approve of Ducey.
However, Ducey's edict, along with others to other state agencies, raises the question of whether he understands the difference between being governor, which he is, and being chief executive officer of state government, which he is not.
Arizona law defines marriage as between one man and one woman. State law also says that "a husband and wife may jointly adopt children."
Under state law, gays can adopt and be foster parents. They cannot, however, do it as a married couple.
Last fall, a federal judge held that Arizona's marriage definition violated the right of gays, under the federal Constitution, to be married. The state did not appeal, since the Ninth Circuit Court of Appeals had already ruled similarly in other states.
After same-sex marriage became legal in Arizona, DCS started treating same-sex married couples the same as heterosexual ones regarding adoption and foster care. After the U.S. Supreme Court accepted the issue of same-sex marriage, Attorney General Mark Brnovich reportedly advised DCS to revert to the previous policy.
Now, the right legal course can be argued both ways. To the extent same-sex marriages are legal in Arizona, not recognizing them for adoption and foster care undoubtedly violates the federal Constitution's equal protection clause. On the other hand, an argument could be made that state statutes should be followed until a court expressly declares them invalid.
Ducey's edict, however, wasn't rooted in law or the prudent avoidance of litigation. In fact, Ducey has made a big deal of getting the governor's office out of the legal business, leaving that to the attorney general.
Instead, Ducey said that the reinstated policy violated his "priorities," specifically encouraging adoption, and hence he was ordering it rescinded.
In other words, if a state statute is in conflict with Ducey's policy preference, his preference trumps state law.
Ducey has also intervened recently to effectively dictate the actions of administrative agencies in two individual cases.
For reasons that are difficult to fathom, Ducey vetoed a bill that made it clear that the state sales tax doesn't apply to crop-dusting planes and charter aircraft. Despite the veto, he instructed the Department of Revenue not to collect the tax or pursue "any future and ongoing enforcement efforts."
That means that Ducey is ordering DOR not to collect $700,000 in past taxes from a specific company, Papillon Helicopters, even though the Court of Appeals has ruled that it is owed.
In early April, Ducey wrote to the director of the Department of Gaming suggesting that he tell the Tohono O'odham tribe that he would not approve state licenses needed to operate its Glendale casino because the tribe had engaged in fraud while negotiating the compact governing Indian gambling in Arizona.
Unsurprisingly, the director, who according to state statute serves at the pleasure of the governor, thought the governor's suggestion was the cat's meow. And promptly did what the governor wanted.
So, we have the spectacle of a state agency announcing that it will disapprove applications before they are even made. So much for due process.
A lot of state government consists of administrative agencies applying laws and regulations to individuals and individual organizations. There's a huge body of administrative law to make the process fair and transparent. It's not appropriate for a governor to reach into the administrative processes in individual cases and dictate outcomes, irrespective of how high the stakes.
Now, to be fair, Ducey is still a piker compared to Gov. Jan Brewer when it comes to misusing executive authority. Brewer ordered two new state agencies – the Arizona Commerce Authority and DCS – into existence in direct contravention of state statutes. The Legislature eventually cleaned up after her by changing the law to comport with her executive ukases.
Still, the early signs are that Ducey has an unhealthily expansive view of his role and authority as governor.
Reach Robb at firstname.lastname@example.com.


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It isn't surprising that a family dentist such as Dr. Luu of Gentle Care Dentistry of San Gabriel Valley believes that thorough dental care habits are the foundation of good oral health. Taking care of your teeth can help lead you in the right direction when it comes to your dental health.Patients who follow healthy daily regimens, such as brushing and flossing their teeth and gums, can help combat periodontal disease and improve their overall health and well-being.
Many patients are unaware of the negative effects that periodontal disease can have on the entire body.
Brushing and flossing every day is a great step in committing yourself to your oral health care. Dr. Luu recommends that patients of Gentle Care Dentistry of San Gabriel Valley consider a soft bristle toothbrush rather than a medium or hard brush. This is because a harder bristled brush can erode the enamel over time. The staff at Gentle Care Dentistry of San Gabriel Valley always make sure that patients leave with a "goodie" bag after their routine cleaning. This "goodie" bag consists of soft bristle toothbrush, toothpaste, and floss. Dr. Luu wants to ensure that her patients leave her office well equipped to maintain great oral health care at home.
Dr. Luu of Gentle Care Dentistry of San Gabriel Valley is trained and experienced in recognizing the signs and symptoms of gum disease, also known as periodontal disease. She is able to guide patients through the process of diagnosis and treatment and can help them manage the disease so that it doesn't progress to the point of being irreversible. As periodontal disease advances, it can result in the loss of bone structure, teeth, and gum tissue. Treatment can be time-consuming and expensive, which is why patients are better off being more proactive about their oral health than reactive.
At Gentle Care Dentistry of San Gabriel Valley, we are committed to providing dental care and oral health services to the entire family. Call us today to schedule a consultation appointment and get started taking great care of your smile!


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|Every square centimeter packed
Topics: Biology, Civics, Civil Rights, Existentialism
I shopped and bought the supplies you see above for the suggested "hunker down." It's the most I've ever purchased at one time in a grocery store. Missing from the pile of food, meat and cleaning supplies is hand sanitizer and toilet paper. Amazon is out, with delivery projections of off-brand toilet paper mid April, according to a college friend on lock down in California. Though I don't own a dog anymore, I observed dog food was missing from the shelves. The city is on limited hours from 10 am to 3 pm. The suggested crowd assemblies dwindled swiftly from 500 - 300 - 100 to 10 or less. There will likely be no spring commencement. Susan Rice was to be our keynote speaker, and I was going to attend to congratulate newly-minted Doctors of Philosophy.
My classes went online almost immediately through Blackboard. It was kind of cute to see my professors struggling and fully admitting they've never taught an online class before. The fact that they were lecturing was a departure from previous experiences, typically PowerPoint slides uploaded to Canvas (another college app), chapters read and a test proctored. That was my experience with it before. There's a video app: Zoom that I used to view a Ph.D. defense and a seminar on writing. My tiny house seems at comparison to my mobility before, smaller ...
I took a walk today in the neighborhood. Teleworking tends to drive one "stir crazy." I saw a family that lives across the street from me playing with her son in the street. She was accompanied by her brother, his girlfriend, her kids and their mother. The brother and his family had moved into the neighborhood. I said hello, mouthing a few brief remarks. I was friendly ...at a distance.
I continued walking.
A jogger passed by me on my right. A couple walked by on my left: I spoke briefly. I still walked.
A neighbor said "did anyone tell you you look like Charles Barkley?" I smiled: I've heard it before, and said "I wish I had his salary!" We laughed. I said it ...at a distance.
I continued walking.
A read on my phone about a few young spring breakers determined to party in Florida, full of the invulnerability of youth. They're not practicing social distancing, or good sense.
Italy passed a grim marker in the number of infected and deaths. I'm sure we're trying not to copy-exact this aspect of what was the Roman Empire in these modern times where the globe is no longer vast, and the oceans not the barriers they once were.
Columbus Day may not get as much attention as our other holidays, but scientists are still fascinated by what Christopher Columbus' arrival meant for the "New World" and how it shaped where we are today.
"It was a culture clash, obviously," said OMRF President Stephen Prescott, M.D. "But it also launched a clash of infectious diseases."
Columbus and other visitors from Europe lived in agrarian societies and cities, he said. The viruses and bacteria that develop in farming and when large groups of people live together are different from those in a more nomadic society, like the American Indians.
Think about swine flu and bird flu, Prescott said. We're always on the lookout for viruses that pass from humans to animals, mutate DNA, and then return to humans.
"Well, that didn't just start last year. So long as humans have been raising livestock, we've been passing viruses back and forth," he said. "When explorers from Europe reached the Americas, they brought livestock and they brought diseases and the result was devastating."
In Hispaniola, Columbus' first stop in the Americas, the native Taino population (an indigenous Arawak people) had no immunity to new infectious diseases, including smallpox, measles and influenza. There were an estimated 250,000 indigenous people in Hispaniola in 1492. By 1517, only 14,000 remained.
Oklahoma Medical Research Foundation: Columbus brought more than ships to the New World, October 10, 2013
Related link: Coronavirus statistics
Earth system impacts of the European arrival and Great Dying in the Americas after 1492
Alexander Koch, Chris Brierley, Mark M. Maslin, Simon L. Lewis
Quaternary Science Reviews
Volume 207, 1 March 2019, Pages 13-36
The conversation that hasn't been had: we're seeing not just the impact of a zoological virus from bat to human, we're seeing the impact of a globalization protocol that's been in place since 1492. The bats are in China, but bats are on every continent. The trade agreements we've negotiated for cheap labor also meant the ones in charge of the labor pool ignored (or, weren't pressed to follow) OSHA and safety regulations we take for granted. The "chickens [were eventually going to] come home to roost" because human society as far as temporal considerations is episodic. We think of the quarter, the end-of-year, the holiday push and financial goals higher than last years. We think of stock dividends and investor sentiments; use bailout money to buy back stocks and artificially pump up the value of their companies. This selloff on Wall Street has simply been an adjustment from the previous superfluous bullshit. My trip to Texas to see our granddaughter, relatives and friends; my wife's annual girlfriends' trip, our sons trip to Greensboro have all been put on hold indefinitely to flatten the curve.
I walked alone ...home, continuing social distancing.
Related link: Coronavirus statistics


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For the first time since we got her back from her hospital stay, we actually had to give up on the fluids this morning. She kept curling up into a ball, rolling over on her side, growling, scratching, biting and being ornery.
When this happens, we usually just let her go, leave her on her own for a while, pick her up again, and eventually succeed in getting at least 100 if not the full 200 cc's into her.
Not this morning. It just was wasn't going to happen. Not even with the clothes pins. And when Kathy tried removing them, Widgit attacked her properly and bit her. I had a breakdown one morning during the last month. It was time for Kathy to have one, and this morning was it.
Maybe we'll try again later today. Maybe we'll call the vet and try to get her sedatives. For now, we're just going about our day.


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Apple Watch, Google's acquiring Fitbit and Xiaomi's new apple-watch-like, Mi Watch
Up until 2018, I sat on the fence about buying a high-end smartwatch. Such a purchase would have felt like a waste of good money for little return in terms of features. Sure, it would have felt okay to own one. But was it really worth the cost?
A good friend pointed out that it's almost never a bird thing to play by Lackland's Laws. Never to be first, never to be last, and most importantly, thou must not volunteer for anything. Except if it doesn't cost you money and it's informative.
Thusly, I stuck to cheap fitness trackers. You know, just for the feel of what the future could feel like. Not to mention that I like to have something on my wrist. Mostly a watch or something watch-ish. I did better; I have been following the smartwatch industry with keen interest.
The Apple watch and Fitbit have been the kings of the industry. Fitbit was the first to enter industry in 2007 and reigned supreme for 8 years.
By 2015, the market became saturated with cheaper alternatives. Saturated not because the market was already mature, but rather because it was still a niche market.
Outside the world of nerds, fitness enthusiasts, and early adopters, fitness trackers didn't provide a compelling reason for the common folk to consider buying. In all fairness, the industry was young and with time, new incentives would be created and won over.
In the same year, Apple, which up until that point had been busy perfecting its iPhone devices, made a play for the market. As with everything that Apple does (well, not all but most), the first Apple Watch won some love. So much so that in the 2nd quarter of 2015, it captured roughly 75% of the market and continued to dominate over the following years.
Four years later, Apple Watch enjoys a significant lead in the market. Samsung and their copycat kin huawei have tried to take a slice of the market. To date, their combined market has not been able to break above 15%.
As in everything else, magic is needed to win over the hearts of people. As the naysayers continued to sing the song "it's a gimmick, a fancy fashion accessory", Apple gradually injected its magic on their watch. Thus cementing their product lead.
The Apple Watch Series 4 introduction in 2018 drove a heart right into the spiteful hearts of detractors and vindicated the faith of fanboys. A year later, the Apple Watch Series 5 has cemented that love.
Enter 2019, Fitbit has asserted its values by winning over the attention of the algorithm king, google. Maybe Alphabet can use it's AI superiority and wealth of data to help Fitbit regain its position in the industry.
If all goes well, Google could use its muscle to provide android users a watch that is equally as good as what iOS users already have. Perhaps even better than that. In terms of software, there's a lot to look forward to. In terms of hardware, that would be hard to say.
The copycat from china, Xiaomi, has already unveiled an Apple Watch clone for the android ecosystem; Mi Watch. Although Mi Watch physically looks like an Apple Watch, its OS seems to have been inspired by Google's Wear OS.
Perhaps there's something 'innovative' being inspired by what already works well and creating alternatives for neglected markets. Especially when you can do that and sell it for less. This sort of competition lits a fire under the status quo. Industry players are incentivized to create more value for the same price. More often for a lesser price.
How are smartwatches useful today?
Smartwatches are more than mere watches. They're computers on your wrist. They are to the phone what the phone was to laptops and desktops. Perhaps this tweet puts the idea in better context
As iPhone becomes Mac, Apple Watch becomes iPhone, AirPods become Watch. :)Rene Ritchie (@reneritchie) \~ October 31, 2019
But I'm not sure what apps will look like by then. Ambient computing changes the model. https://t.co/fCSJ5FxSb2
The extent to which a smartwatch is useful depends on the particular watch that you're using. Some have more features than others. Some are better at certain things than all their competitors.
For example, there's no shortage of reports of how the Apple Watch has repeatedly saved lives. These stories are all over tweeter and the wider worldwide web. This is a result of its fall detection and heartbeat tracking features. In that regard, the Apple Watch clearly shines.
Yet there are good things to be said about Fitbit a device, for example. Specifically, Fitbit Versa. It can be used with both ios and android which is a good thing for folks who are not in the iOS ecosystem. After all, Fitbit Versa can do most of the things that an Apple watch can. In some cases, it can do better.
There's a tonne of information about what a smartwatch can do. Therefore, rather than spin the details that are already documented, here is a concise list of the possibilities.
- Health tracking e.g irregular heartbeats, sleeping patterns, women health (menstrual cycles)
- Exercise tracking
- Making payments with technologies such as FitbitPay, Apple Pay ...
- Streaming music from streaming services such as Spotify, Apple Music,
- Answering calls, viewing and responding to text messages.
In what ways could smartwatches improve?
Unlike smartphones, smartwatches have tiny screens and tiny batteries. Consequently, it's difficult to show as much detail on a smartwatch than you would on a phone. The small batteries also mean that they drain faster. Thus battery life somewhat sucks.
Predictably, smartwatches will only get thinner with time. They'll also require more components, in the form of sensors and chips to handle more complex tasks. This means the tiny real estate will not magically increase.
However, industry players may develop better chips, better power consumption. On the display side, they'll need to rethink how information is displayed and consumed.
If we're being honest, it's unlikely that smartwatches will replace some of the uses of a phone. However, they can soon start to do most of the things that a phone can. The result would be that you can do more on your watch.
On the other hand, it's possible that smartwatches are only a detour to something else. Maybe AR devices? Maybe implants? Who knows 🤷🏻♂?😂


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By Jason Frye
Rail fans rejoice: Rocky Mountaineer will bring their lauded luxury train journeys to the American Southwest in 2021 and you're all invited. Their new route, Rockies to Red Rocks, marks the Vancouver-based Rocky Mountaineer's first stand-alone train tour in the U.S. with 40 departures over a 10-week preview season. From Aug. 15 to Oct. 23, 2021, guests can hop on board for a two-day trip between Denver, Colorado, and Moab, Utah, with an overnight stop in the hot springs studded resort town of Glenwood Springs, Colorado.
"The work to find a new route has been underway for several years," explains Rocky Mountaineer president and CEO, Steve Sammut. "We needed to find a special location with many of the same features we have in Western Canada — incredible scenery, iconic destinations and the option for an all-daytime, multi-day journey best experienced by rail."
Scenic Delights
Riding in custom-built, glass-domed rail cars, guests will traverse a landscape that's varied and vibrant, from the sky-scraping peaks of the Rocky Mountains to the red rocks of Southwest Utah. Along the way, onboard hosts act as storytellers, providing insights into the pioneering and railway history of the region, notable flora and fauna and Indigenous peoples. Route highlights also include the 440-acre Gross Reservoir and its dramatic spillway sitting at 7,225 feet above sea level; the 6.3-mile-long Moffat Tunnel, which cuts through the Continental Divide at an elevation of 9,239 feet; all 25 miles of red sandstone cliffs in Ruby Canyon, which is accessible only by boat or train; and Arches National Park. Along the way the route parallels the Colorado River.
As with all of Rocky Mountaineer's trips, Rockies to Red Rocks is an all-daylight journey — guests travel by day and stay in a partner hotel (like Hotel Colorado, Hotel Denver, Glenwood Hot Springs Lodge and others) overnight. This means guests won't miss a moment of the scenery or the storytelling by onboard hosts and that they'll have the chance to get familiar with Glenwood Springs, a town filled with hot springs, boutiques and restaurants, before retiring for the evening. This off-train break also gives Rocky Mountaineer staff time to clean, sanitize and refresh the train for the next day.
During the day, a multi-course breakfast and lunch are served on board, with each meal featuring flavors and ingredients from this slice of the Southwest. Working closely with culinary partners in the region, Rocky Mountaineer designed a menu reflective of the cultures and food traditions here and the bar will also be stocked with local libations. This provides guests a taste of Colorado and Utah on the plate, in the glass and as they gaze out the window.
Savor the Journey
This is no express train zipping across the country. Rather, Rocky Mountaineer travels at around 30 mph, giving guests ample time to soak up the scenery and marvel at each passing mile. Glass-domed coaches and oversized windows provide panoramic views from every seat. They also give photographers a crystal-clear look at the landscape and wildlife — bighorn sheep, deer, birds and coyote, mountain lions and bears — just outside.
"We're excited to launch this new route," says Tessa Day, spokesperson for Rocky Mountaineer. "It will be the perfect complement to our existing routes in Western Canada and we truly believe travelers who are looking to explore the U.S. and stay closer to home will find this route is a great option for them."
Rocky Mountaineer had planned to announce Rockies to Red Rocks in early 2020, timed with the company's 30th anniversary. However, COVID pressed pause on travel. As a result, they spent that time focused on perfecting the trip, including establishing new on-board policies to ensure the ongoing health and safety of guests and crew members. Daily health screenings (prior to boarding), train-wide disinfection protocols and high-end air filtration systems are just a few of the methods they're using to ensure the season is a success.
Plan Your Trip
The journey — an 8-hour trip of 185 miles between Denver and Glenwood Springs, and a 5-hour trip of 194 miles from Glenwood Springs to Moab — makes for two full days. However, guests aren't beholden to begin their trip in Denver. You can reverse course and travel east from Moab, ending in Denver. The timing of the Rockies to Red Rocks inaugural season — late summer into the heart of autumn — means leaf-peepers will want to consider color forecasts when they chose their direction of travel and the date of their trip.
Passengers can choose from two levels of service: SilverLeaf or SilverLeaf Plus. SilverLeaf Plus includes exclusive access to the newly-renovated lounge car where signature cocktails and mocktails will be mixed, shaken and stirred up to order, and where a small outdoor viewing area offers unimpeded views. Additionally, dining comes with a perk for SilverLeaf Plus guests: additional courses and an expanded drinks menu.
Rates for the "Rockies to Red Rocks" itinerary vary by departure date and service level. Reservations are available with a refundable $25 deposit. In addition, packages to extend your trip are available with extra days in Denver and Moab, stays in Salt Lake City or Las Vegas, guided motorcoach tours and even rental car and hotel packages that allow you to experience the region at your leisure.
All aboard! Call your local AAA Travel Agent at 800-750-5386 to reserve your seats and explore your trip options.


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Lord Byron by Elbert Hubbard
Story type: Essay
I stood in Venice, on the Bridge of Sighs;
A palace and a prison on each hand:
I saw from out the wave her structures rise
As from the stroke of the enchanter's wand:
A thousand years, their cloudy wings expand
Around me, and a dying Glory smiles
O'er the far times, when many a subject land
Look'd to the winged Lion's marble piles,
Where Venice sate in state, throned on her hundred isles!
—Childe Harold
Man! I wonder what a man really is! Starting from a single cell, this seized upon by another, and out of the Eternal comes a particle of the Divine Energy that makes these cells its home. Growth follows, cell is added to cell, and there develops a man–a man whose body, two-thirds water, can be emptied by a single dagger-thrust and the spirit given back to its Maker.
This being, which we call man, does not last long.
Fifty-seven generations have come and gone since Caesar trod the Roman Forum. The pillars against which he often leaned still stand, the thresholds over which he passed are there, the pavements ring beneath your tread as they once rang beneath his. Three generations and more have come and gone since Napoleon trod the streets of Toulon contemplating suicide.
Babes in arms were carried by fond mothers to see Lincoln, the candidate for President. These babes have grown into men, are grandfathers possibly, with whitened hair, furrowed faces, looking calmly forward to the end, having tasted all that life holds in store for them.
And yet Lincoln lived but yesterday! You can reach back into the past and grasp his hand, and look into his sad and weary eyes.
A man! weighted with the sins of his parents, grandparents, great-grandparents, who fade off into dim spectral shapes in the dark and dreamlike past; no word of choice has he in the selection of his father and mother, no voice in the choosing of environment–brought into life without his consent and thrust out of it against his will–battling, striving, hoping, cursing, waiting, loving, praying; burned by fever, torn by passion, checked by fear, reaching for friendship, longing for sympathy, clutching–nothing.
* * * * *
Doctors and priests attend us at both ends of the route. We can not be born, neither can we die, without consulting the tax-collector, and interviewing those who look after us for a consideration.
The doctor who sought to assist George Gordon Byron into the world dislocated the bones of his left foot in the operation. Forsooth, this baby would not be born as others—he selected a way of his own and paid the penalty. "It is a malformation–take these powders–I'll be back tomorrow," quoth the busy doctor.
The autopsy proved it was not a malformation, but a displacement.
"Doctor, now please tell me just what is the matter with me," once asked an anxious patient.
"Tut, tut!" replied the absent-minded physician; "can't you wait? The post-mortem will reveal all that."
The critics did not wait for Byron's death–it was vivisection. And after his death the dissection was zealously continued. Byron's life lies open to us in many books. Scarcely a month in the entire life of the man is unaccounted for, and if a hiatus of a few weeks is found, the men of imagination fill in and make him a pirate on the Mediterranean coast, or give him a seraglio in some gloomy old Moorish palace in Venice.
In his lifetime Byron was overpraised and overcensured, and since his death the dust has been allowed to gather over his matchless books. Between the two extremes lies the truth; and the true Byron is just now being discovered. Byron in literature will not die. He is the brightest comet that has darted into our ken since Shakespeare's time; and as comets have no orbit, but are vagrants of the heavens, so was he. Tragedy was in his train, and his destiny was disgrace and death.
And yet as we review the life of this man, "the lame brat" of his mother, as this mother called him, and behold the whirlwind of passion that swept him on, the fulsome praise, the shrill outcry of hypocritical prudes and pedants, the torrent of abuse, and the piling up of sins that he never committed (and God knows he committed enough!); and yet behold his craving for tenderness, the reaching out for truth, and hear his earnest and unquenchable prayer to be understood and loved, we blot out the record of his sins with our tears. To know the life of Byron and not be moved to profoundest pity marks one as alien to his kind.
"God is on the side of the most sensitive," said Thoreau. And did there ever tread the earth a man more sensitive than Byron?–such capacity for suffering, such exaltation, such heights, such depths! Music made him tremble and weep, and in the presence of kindness he was powerless. He lived life to its fullest, and paid the penalty with shortened years. He expressed himself without reserve–being emancipated from superstition and precedent. And the man who is not dominated by the fetish of custom is marked for contumely by the many. Custom makes law, and the one who violates custom is "bad." Yet all respectable people are not good; and all good people are not respectable. If you do not know this you are ignorant of life.
So imagine this handsome, headstrong, restless young man, in whose lexicon there was no such word as prudence, with time and money at his command, defying the state, society and religion, and listen to the anathemas that fill the air at mention of his name.
That a world full of such men would not be at all desirable is stern truth; but that one such man lived is a cause for congratulation. His life holds for us both warning and example.
Beneath the strain of the stuff and the onward swirl of his verse we see that this man stood for truth and justice as against hypocrisy and oppression. Folly and freedom are better far than smugness and persecution. Byron stood for the rights of the individual, for the right of free speech and free thought: and he stood for political and physical freedom, long before abolition societies became popular. He sided with the people; his heart went out to the oppressed; and all of his fruitless gropings and stumblings were a reaching out for tenderness and truth, for life and love–for the Ideal.
* * * * *
The father of Byron, the poet, was a captain in the army–a man of small mental ability, whose recklessness won him the sobriquet of "Mad Jack Byron." When twenty-three years of age he eloped to France with the Baroness Conyers, wife of the Marquis of Carmarthen. Happiness, in a foreign country, for a woman who has exchanged one love for another is outside the pale of possibilities. Love is much–but love is not all. Life is too short to break family-ties and adjust one's self to a new language and a new country. The change means death.
Two years and the woman died, leaving a daughter, Augusta by name, afterward Mrs. Augusta Leigh.
Back to England went Mad Jack Byron, broken-hearted, bearing in his arms the baby girl. Kind kinsmen, ready to forgive, cared for the child. Mad Jack didn't remain broken-hearted long–what would you expect from a man? He sought sympathy among several discreet dames, and in two years we find him safely and legally married to Catherine Gordon. Scotch, and heiress to twenty-five thousand pounds. On the occasion of the wedding, Jack informed a friend that the fact of the lady's being Scotch was forgiven in view of the dowry. Most of this fortune went into a rat-hole to help pay the debts of the Mad Jack.
One child was born to this ill-assorted pair–a boy who was destined to write his name large on history's page. But such a pedigree! No wonder the youth once wrote to Augusta, his half-sister, expressing a covetous appreciation of her parentage, even with its bar sinister. In passing, it is well to note the sunshine of this love of brother and sister, which continued during life–confidential, earnest, tender, frank. In their best moods they were both lofty souls, and their mutuality was cemented in a contempt for the man who was their sire. This fine brotherly and sisterly affection comes close to us when we remember that it was our own Harriet Beecher Stowe, with sympathies worn to the quick through much brooding over the wrongs of a race in bondage, who rushed into print with a scandalous accusation concerning this same sweet affection of brother for sister. The charge was brought on no better foundation than some old-woman gossip held over the hyson when it was red, and moved itself aright–all vouchsafed to Mrs. Stowe by the widow of Byron in Eighteen Hundred Fifty-six. If a woman as good at heart as Harriet Beecher Stowe was deceived, why should we blame humanity for biting at a hook that is not baited?
No sane dentist will administer an anesthetic to a woman, without a witness: not that women as a class are dangerous, but because some women can not be trusted to distinguish between their dreams and the facts. Every practising lawyer of insight also knows that a wronged woman's reasons are plentiful as blackberries, and must always be taken with large pinches of the Syracuse product.
Mad Jack followed his regiment here and there, dodging his creditors, and finally in Seventeen Hundred Ninety-one induced his wife to borrow a hundred pounds for him, with which he started to Paris intent on retrieving fortune with pasteboard.
He died on the way, and the money was used to bury him. The lame boy was then three years old, but a few dark memories, no doubt retouched by hearsay, were retained by him of Mad Jack, who in his most sober moments never guessed that he would be known to the ages as the father of the greatest poet of his time.
Mad Jack was neither literary nor psychic.
The widowed mother remained at Aberdeen with her boy, living on the hundred and fifty pounds a year that had been settled on her in a way that she could not squander the principal–all the rest had gone.
The child was shy, sensitive, proud and headstrong.
The mother used to reprove him by throwing things at him, and by chasing him with the tongs. At other times she diverted herself by imitating his limp. And yet again she would smother him with caresses, beseech his pardon for abusing him, and praise the beauty of his matchless eyes.
Children are usually better judges of grown-ups than grown-ups are of children. This boy at five years of age had estimated his mother's character correctly. He knew that she was not his steadfast friend, and that she was unworthy of his confidence and whole heart's love. He grew moody, secretive, wilful. Once, being wrongly accused and punished, he seized a knife from the table and was about to apply it to his throat when he was disarmed. The child longed for tenderness and love, and being denied these, was already taking on that proud and haughty temper which was to serve as a mask to hide the tenderness of his nature.
We are told that seven brothers Byron fought at Edgehill, but when we get down to the time of Mad Jack there was danger of the name being snuffed out entirely. Nature is not anxious to perpetuate the idle and dissipated.
When little George Gordon was ten years old, his mother one day ran to him, seized him in her arms, wept and laughed, then laughed and wept, kissing him violently, addressing him as "My Lord!"
His great-uncle, William, Lord Byron of Rochdale and Newstead Abbey, had died, and the big-eyed, lame boy was the nearest heir–in fact, the only living male who bore the family-name. The next day at school, when the master called the roll and mentioned his name with the prefix "Dominus," the lad did not reply "Adsum"–he only stood up, gazed helplessly at the teacher, and burst into tears.
Even at this time he had given promise of the quality of his nature, by his firm affection for Mary Duff, his cousin. All the intensity of his childish nature was centered in this young woman, several years his senior. To call it a passion would be too much, but this child, denied of love at home, clung to Mary Duff, to whom he went in confession with all his childish tales of woe. When his mother proposed to leave Aberdeen, now that fortune had smiled, the anguish of the boy at thought of leaving his "first love" nearly caused him a fit of sickness.
And all this wealth of love was met with jeers and loud laughter, save by Mary Duff. The vibrating sensitiveness of such a child, with such a mother, must have caused a misery we can only guess.
"Your mother is a fool," said a boy to Byron at college some years later.
"I know it," was the melancholy answer, as the brown eyes filled with tears.
When money came, Mrs. Byron's first move was to take the lad to Nottingham and place him in charge of a surgical quack, who proposed, for a price, to make the lame foot just as good as the other, if not better. To this effect wooden clamps were placed on the foot and screwed down by thumbscrews, causing a torture that would have been unbearable to many.
No benefit was experienced from the treatment, although it was continued by another physician at London soon after. A schoolfellow of Byron's visited him in his room when his foot was encased in a wooden compress. The visitor noted the white face, and the beads of anguish on the boy's forehead, and at last said, "I know you are suffering awfully!"
"You will never hear me say so," was the grim reply.
The emphasis placed on Byron's lameness has been altogether overdone. In fact, as he grew to manhood, it was nothing more than a stiffness that would never have been noticed in a drawing-room. We have this on the testimony of the Countess Guiccioli, Lady Blessington and others. Byron himself made the mistake of referring to it several times in his verse, and doubtless all the torture he had suffered through ill-considered medical counsel, and his mother's taunts, caused the matter to take a place in his sensitive mind quite out of its due proportion. Sir Walter Scott was lame, too, but whoever heard of his discussing it, either by word of mouth or in print?
Of Byron's life at Harrow we have many tales as to his defending his juniors, volunteering to take punishment for them–and of lessons unlearned. He could not be driven nor forced, and pedagogics a hundred years ago, it seemed, was largely a science of coercion. Mary Gray, a nurse and early teacher of Byron's, has told us that kindness was the unfailing touchstone with this boy; no other plan would work. But Harrow knew nothing of Froebel methods, and does not yet.
* * * * *
Byron's first genuine love-affair occurred when he was sixteen. The object of this affection, as all the world knows, was Miss Chaworth, whose estate adjoined Newstead. The lady was two years older than Byron, and being of a lively nature found a pleasant diversion in leading the youth a merry chase. So severe was his attack that he was alternately oppressed by chills of fear and fevers of ecstasy. He lost appetite, and the family began to fear for his sanity. Such a love must find expression some way, and so the daily stealthy notes to the young woman took the form of rhyme. The lovesick youth was revealing considerable facility in this way. It pleased him, and did the buxom young woman no harm.
Beyond the mere prettiness and pinky whiteness of a healthy country lass, Miss Chaworth evidently had no beauties of character, save those conjured forth from the inner consciousness of the poet–a not wholly original condition.
Byron loved the Ideal. And this love-affair with Miss Chaworth is only valuable as showing the evolution of imagination in the poet. The woman hadn't the slightest idea that she was giving wings to a soul–to her the affair was simply funny.
The fact that Byron's great-uncle, from whom he had inherited his title, had killed the grandfather of Miss Chaworth in a duel, lent a romantic tinge to the matter–the boy was doing a sort of penance, and in one of his poems hints at the undoing of the sin of his kinsman by the lifelong devotion that he will bestow. This calling up the past, and incautious revealing of the fact that the ancestor Chaworth could not hold his own with a Byron, but allowed himself to be run through the body by the Byron cold steel, was not pleasing to Miss Chaworth.
"Don't imagine I am such a fool as to love that lame boy," cried Miss Chaworth to her maid one day.
Unluckily, "the lame boy" was in the next room and heard the remark.
He rushed from the house with a something gripping at his heart. Straightway he would go back to Harrow, which he had left in wrath only a few months before.
So he went to Harrow.
When he next returned home, his mother met him with the remark, "I have news for you; get out your handkerchief–Miss Chaworth is married."
In just another year Byron was home again, and was invited to dine with the Chaworths. He accepted the invitation, and when he was introduced to a baby girl, a month old, the child of his old sweetheart, his emotions got the better of him and he had to leave the room. And to ease his woe he indited a poem to the baby.
Miss Chaworth was not happy with her fox-hunting squire. Her mind became clouded, and after some years she passed out, in poverty and alone. And if there ever came to her mind any appreciation of the greatness of the man who had given her name immortality, we do not know it.
The years from Eighteen Hundred Five to Eighteen Hundred Eight Byron spent at Cambridge. The arts in which he perfected himself there were shooting, swimming, fencing, drinking and gambling.
During vacations, and off and on, he lived at Southwell, a village halfway between Mansfield and Newark. Southwell was sleepy, gossipy, dull–and exerted a wholesome restraint on our restless youth. It was simply a question of economy that took Byron and his mother to Southwell. The run-down estate of Newstead was yielding a meager income, but at Southwell one could be shabby and yet respectable.
At Southwell Byron met John Pigot and his sister–cultured people of a refined and quiet sort. Byron took to them at once, and they liked him.
In a country town the person who thinks, instinctively hunts out the other man who thinks–granting the somewhat daring hypothesis that there are two of them. So Byron and the Pigots often met for walks and talks, and on such occasions the poet would read to his friends the scraps of verse he had written. He had gotten into the habit–he wrote whenever his pulse ran up above eighty–he wrote because he could not help it; and he read his productions to his friends for the same reason. Every one who writes longs to read his work to some sympathetic soul. A thought is not ours until we repeat it to another, and this crying need of expression marks every poetic soul. All art is born of feeling, high, intense, holy feeling, and the creative faculty is largely a matter of temperature. We feel, and not to impart our feelings is stagnation–death. People who do not feel deeply never have anything to impart, either to individuals or to the world. They have no message.
The young man, fresh from the dusty, musty lectures of Cambridge, and out of the reach of his boisterous and carousing companions, grasped at the gentle, refined and sympathetic friendship of this brother and sister. The trinity would walk off across the fields and recline on the soft turf under a great spreading tree, reading aloud by turn from some good book. Such meetings always ended by Byron's reading to his friends any chance rhymes he had written since they last met.
John Morley dates the birth of Byron's poetic genius from his meeting with Miss Chaworth, while Taine names Southwell as the pivotal point. Probably both are right.
But this we know, that it was the Pigots who induced Byron to collect his rhymes and have them printed. This was done at the neighboring town of Newark, when Byron was nineteen years old. Possibly you have a few of these thin, poorly printed, crudely bound little books entitled "Juvenilia" around in the garret somewhere, and, if so, it might be well enough to take care of them. Quaritch says they are worth a hundred pounds apiece, although in the poet's lifetime they were dear at sixpence.
Byron sent copies to all the leading literary men whom he knew, including Mackenzie, the man of feeling. Mackenzie replied, praising the work, and so did several others. All writers of note are favored with many such juvenilia, and usually there is a gracious electrotype reply. A doubt exists as to whether Mackenzie ever read Byron's book, but we know that his letter of stock platitude fired Byron to do still better. It is said that no flattery is too fulsome for a pretty woman–she inwardly congratulates the man on his subtle insight in discovering excellences that she hardly knew existed. This may be so and may not, but the logic holds when applied to fledgling authors. When it comes to praise he is quite willing to take your word for it.
Byron's spirits arose to an ecstacy–he would be a poet.
About this time we find Hydra, as Byron pleasantly called his mother, rushing to the village apothecary and warning that worthy not to sell poison to the poet; and a few moments after her leaving, the astonished apothecary was visited by the poet, who begged that no poison should be sold to his mother. Each thought the other was going to turn Lucretia Borgia, or play the last act of Romeo and Juliet, at least.
There were wild bursts of rage on the mother's part, stubborn mockery on the other, followed up once by a poker flung with almost fatal precision at the poet's curly head.
Upon this he took flight to London and Hydra followed, repentant and lacrimose. A truce was patched up; they agreed to disagree, and coldly shaking hands withdrew in opposite directions.
After this, when the poet wrote he addressed his mother as "Dear Madam," and confined himself to business matters. Only rarely was there any flash in his letters, as when he said, "Dear Mother–you know you are a vixen, but save me some champagne." If Byron's mother had been of the stuff of which most mothers are made, we would have found these two safely settled at Newstead, making the best of their battered fortune, with the son in time marrying some neighbor lass, and slipping into the place of a respectable English gentleman, a worthy member of the House of Lords.
But the boy, now grown twenty, had no home, and either was supplied too much money or else too little. He wasted his substance in London, economized in Southwell, sponged on friends, and borrowed of Scrope Davis at Cambridge. When a remittance again came, he explored the greenrooms, took lessons from Professor Johnson, the pugilist (referred to as "my corporeal pastor"), drank whole companies under the table, bought a tame bear and a wolf to guard the entrance of Newstead, and roamed the country as a gipsy, in company with a girl dressed in boy's clothes, thus supplying Richard Le Gallienne an interesting chapter in his "Quest of the Golden Girl."
But all this time his brain was active, and another book of poetry had been printed, entitled "Hours of Idleness." This book was gotten out, at his own expense, by the same country printer as the first.
Surely the verse must have had merit, or why should Lord Brougham, in the great "Edinburgh Review," go after it with a slashing, crashing, damning criticism?
When Byron read the review, a bystander has told us he turned red, then livid green. He straightway ordered and drank two bottles of claret, said nothing, but looked like a man who had sent a challenge.
A challenge! that was exactly what Byron proposed. He would fight Jeffrey first, and then take up in turn every man who had ever contributed to the magazine–he would kill them all. And to that end he called for his pistols and went out to practise firing at ten paces. Wiser counsel prevailed, and he decided to attack the enemy in their own citadel, and with their own weapons. He ordered ink, and began "English Bards and Scotch Reviewers."
It took time to get this enormous siege-gun into position and find the range. Finally, it was loaded with more kinds of missiles, in the way of what Augustine Birrell has called literary stinkpots, than were ever before rammed home in a single charge.
It was an audacious move–to reverse the initiative and go after a whole race of critics, scribblers and reviewers, who had been badgering honest folks, and blow 'em into kingdom come.
But at the last moment Byron's heart failed him, his wrath gave way to caution, and "English Bards and Scotch Reviewers" appeared anonymously.
The edition was soon exhausted–the shot had at least raised a mighty dust.
The author got his nerve back, fathered the book, made corrections; and this edition, too, sold with a rush. Byron returned to Newstead, invited a score of his Cambridge cronies, who came down, entering the mansion between the bear and the wolf, and were received with salvos of pistol-shots. Here they played games over the spacious grounds, wrestled, boxed, swam, and at night feasted and drank deep damnation out of a skull to all Scotch reviewers.
Probably the acme of this depravity was reached when the young gentlemen began shooting the pendants off the chandelier; then the servants hastily decamped and left the rogues to do their own cooking.
This brought them to their senses, sanity came back, and the company disbanded. Then the servants, who had watched the orgies from afar, returned and found a week's pile of dishes unwashed and a horse stabled in the library.
* * * * *
Then Byron had reached the mature age of twenty-one, he was formally admitted to the House of Lords as a Peer of the realm. His titles and pedigree were so closely scanned on this occasion that he grew quite out of conceit with the noble company, and was seriously thinking of launching a dunciad in their direction. His good nature was especially ruffled by Lord Carlisle, his guardian, who refused to stand as his legal sponsor. The chief cause of the old Lord's prejudice against the young one lay in the fact that the young 'un had ridiculed the old 'un's literary pretensions.
They were rivals in letters, with a very beautiful, natural and mutual disdain for each other.
Lord Byron was not welcomed into the House of Lords: he simply pushed in the door because he had a right to. He thirsted for approbation, for distinction, for notoriety. His sensitive soul hung upon newspaper clippings with feverish expectations; and about all the attention he received was in the line of being damned by faint praise, or smothered with silence. Patriotism, as far as England was concerned, was not a part of Byron's composition.
When all Great Britain was execrating Napoleon, picturing him as a devil with horns and hoofs, Byron looked upon him as the world's hero.
In this frame of mind he went forth and borrowed a goodly sum, and started cut to view the world. He was accompanied by his friend Hobhouse, and his valet, Fletcher.
It was a two years' trip, this jolly trio made–down along the coast of France, Spain, through the Straits of Gibraltar, lingering in queer old cities, mousing over historic spots, alternately living like princes or vagabonds. They frolicked, drank, made love to married women, courted maidens, fought, feasted and did all the foolish things that sophomores usually do when they have money and opportunity.
These months of travel supplied Byron enough in way of suggestion to keep him writing many moons. His active imagination seized upon everything picturesque, peculiar, romantic, sentimental or tragic, and stored it up in those wondrous brain-cells, to be used when the time was ripe.
The disciples of Munchausen, who delight in showing Byron's verse to be only biography, have found a rich field in that two years' travel. One man really did a brilliant thing–in three volumes–recounting the conquering march of the poet, whom he depicts as a combination of Don Juan and Rob Roy.
The probabilities are that the real facts, not illumined by fancy, would be a tale with which to conjure sleep. Foreign travel is hard work. It constitutes the final test of friendship, and to make the tour of Europe with a man and not hate him marks one or both of the parties as seraphic in quality. The best of travel is in looking back upon it from the dreamy quiet and rest of home–laughing at the things that once rasped your nerves, and enjoying, through recollection, the scenes you only glanced at wearily.
Two instances of that trip–when Hobhouse threatened to desert the party and was dared to do so, and Byron slapped Fletcher's face and got himself well kicked in return–will suffice to show how Byron had the faculty of seizing trivial incidents, and by lifting them up and separating them from the mass, made them live as Art.
At Athens the trio made a sudden resolve to be respectable, and practise economy. To this end they hired rooms of a worthy widow, who accommodated travelers with a transient home for a moderate stipend. This widow had three daughters: the eldest, Theresa by name, lives in letters as the Maid of Athens, and the glory that came to her was achieved without any special danger to either her heart or the poet's. The young woman, we know, assisted in the household affairs; and probably often dusted the mantel in the poet's room while he sat smoking with one foot on the table, making irrelevant remarks to her about this or that.
Suddenly he wrote a poem, "Maid of Athens, ere we part, give, O give me back my heart." * * *
With the genuine literary thrift that marked all of Byron's career, he preserved a copy of the lines, and some years after recast them, touched them up a bit, included the stuff in a book–and there you are.
The other incident is that of Hobhouse recording in his journal the bare and barren fact that outside the city wall in Persia they once saw two dogs gnawing a human body. Byron saw the sight, but made no mention of it at the time. He waited, the scene sealed up in his brain-cells. Years after he wrote thus:
"And he saw the lean dogs beneath the wall,
Hold o'er the dead their carnival;
Gorging and growling o'er carcass and limb,
They were too busy to bark at him.
From a Tartar's skull they stripped the flesh,
As ye peel the fig when its fruit is fresh;
And their white tusks crunched on the whiter skull,
As it slipped through their jaws when the edge grew dull."
And this only proves that Hobhouse was not a poet and Byron was. The poet is never content to state the mere facts–facts are only valuable as suggestions for poetry.
Travel often excites the spirit to the point of expression. Good travelers carry pads and pencils. Byron reached England with fragments of marbles, skulls, pictures, shells, spears, guns, curios beyond count, and many manuscripts in process.
Upon arriving on the English coast the first news that reached him was that his mother had just died. He hastened to Newstead and reached there in time to attend the funeral, but refrained from following the cortege to the grave because he could not master his emotions. Their quarrels were at last ended.
A diversion to his feelings came soon after, in the way of a blunt letter from Tom Moore demanding if Lord Byron was the author of "English Bards and Scotch Reviewers."
Byron replied very stiffly that he was, but he really had intended no insult to Mr. Moore, with whom he had not the honor of being acquainted. Furthermore, if Mr. Moore felt himself aggrieved, why, the author of "English Bards" was at his service to supply him such satisfaction as he required.
The irate Irishman accepted "the apology," a genial reply followed, and soon the poets met at the house of a friend, and there began that lifelong friendship, with the result that Moore wrote Byron's "Life" and used much needless whitewash.
While abroad Byron had gotten into shape for publication one piece of manuscript. This was "Hints From Horace," and the matter was placed in the hands of Mr. Dallas, his businessman, very soon after his arrival. Dallas read the poem and did not like it.
"Haven't you anything else?" asked Dallas.
"Oh, nothing but a few stanzas of Spenserian stuff," was the answer.
Dallas asked to see it, and there were placed in his hands rough drafts of the first and second cantos of "Childe Harold." This time Dallas was better suited, and to corroborate his judgment the matter was submitted to Murray, the publisher.
Murray thought the matter had more or less merit, and arrangements were at once made for its publication. And so it came out, hammered into shape while in the printer's hands.
"Childe Harold" was an instantaneous, brilliant success–a success beyond the publisher's or author's expectations. The book ran through seven editions in four weeks, and Lord Byron "became famous in a night."
London society became Byron-mad. The poet was feted, courted, petted.
He indulged in much innocent and costly dissipation, and some not so innocent.
Finally all this began to pall upon him. When twenty-six we find him making a bold stand for reform: he would get married and live a staid, sober, respectable life. His finances were reduced–all the money he had made out of his books had been given away, prompted by a foolish whim that no man should take pay for the product of his mind.
Now he would marry and "settle down"; and to marry a woman with an income would be no special disadvantage. To sell one's thoughts was abhorrent to the young man, but to marry for money was quite another thing. Morality depends upon your point of view.
The paradox of things found expression when Byron the impressionable, Byron the irresistible, sat himself down and after chewing the end of his penholder, wrote a letter to Miss Milbanke, with whom he was only slightly acquainted, proposing marriage. The lady very properly declined. To be courted with a fresh-nibbed pen, and paper cut sonnet-size, instead of by a live man, deserves rebuke. Men who propose by mail to a woman in the next town are either insincere, self-deceived, or else are of the sort whose pulse never goes above sixty-five, and therefore should be avoided.
Byron was both insincere and self-deceived. He had grown to distrust the emotions of his heart, and so selected a wife with his head. He chose a woman with income, one who was strong, cool-headed, safe and sensible. Miss Milbanke was the antithesis of his mother.
The lady declined–but that is nothing.
They were married within a year.
In another year the wife left her husband and went back to her mother, carrying in her arms a girl baby, only a few weeks old.
She never returned to her husband.
What the trouble was no one ever knew, although the gossips named a hundred and one reasons–running from drunkenness to homicide. But Byron, the world now knows, was no drunkard–he was at times convivial, but he had no fixed taste for strong drink. He was, however, peevish, impulsive, impetuous and often very unreasonable.
Byron, be it said to his credit, brought no recriminating charges against his wife. He only said their differences were inexplicable and unexplainable.
The simple facts were that they breathed a different atmosphere–their heads were in a different stratum. His normal pulse was eighty; hers, sixty-five.
What do you think of a spiritual companionship where the wife demands, "How much longer are you going to follow this foolish habit of writing verses?"
They did not understand each other. Byron uttered words that no man should voice to a woman, and his outbursts were met with a forced calmness that was exasperating. The lady sat down, yawned wearily, and when there came a lull in the gentleman's verbal pyrotechnics, she would ask him if he had anything more to say.
One day she varied the program by packing up her effects and leaving him.
Of course, it is easy to say that had this woman been wise she would have stood the childish outbursts and endured the peevish tantrums, for the sake of the hours of tenderness and love that were sure to follow. By right treatment he would have been on his knees, begging forgiveness and crying it out with his head in her lap very shortly. But all this implies a woman of unusual power–extraordinary patience. And this woman was simply human. She left, and then in order to justify her action she gave reasons. Our actions are usually right, but our reasons for them seldom are.
Mrs. Byron made no concealment of her troubles. Society had occasion for gossip and the occasion was improved. Stories of Byron's cruelty and inhumanity filled the coffeehouses and drawing-rooms; and the hints at crimes so grave they could not even be mentioned gave the gossips their cue.
The press took it up, and the poet was warned by his friends not to appear at the theater or upon the street for fear of the indignation of the mob. The spoilt child of London was paying the penalty of popularity. The pendulum had swung too far and was now coming back.
Byron, hunted by creditors, hooted by enemies, broken in health, crushed in spirit, left the country–left England, never to return alive.
When Byron trod the deck of the good ship bound for Ostend, and saw a strip of tossing, blue water separating him from England, his spirits rose. He was twenty-eight years old, and the thought that he would yet do something and be somebody was strong in his heart. All the old pride came back.
The idea that he would not sell the product of his brain for hire was abandoned, and soon after arriving in Holland he began to write letters home, making sharp bargains with publishers.
Further than this, his attorneys, on his order, made demand for a share of his wife's estate. And erelong we find Byron, the wasteful, cultivating the good old gentlemanly habit of penuriousness. He was making money, and had he lived to be sixty it is probable he would have evolved into a conservative and written a book on "Getting on in the World, or Success as I Have Found It."
Byron's pilgrimage down through Germany, along the Rhine to Switzerland, was one of rest and recreation. At Berne, Basle, Lausanne and Geneva he found food for literary thought, and many instances in his writings show the reflected scenes he saw. No visitor at Lausanne fails to visit the Castle of Chillon, and all the guides will recite you these sweeping lines, so surcharged with feeling, beginning:
"Lake Leman lies by Chillon's walls;
A thousand feet in depth below,
Its many waters meet and flow."
At Geneva began the most interesting friendship between Byron and that other young man, so like and yet so unlike him.
Only a few years and Byron was to search the shores of the Mediterranean for Shelley's dead body, and finding it, be one of the friends who reduced it to ashes.
Tiring of Geneva and the tourists who pointed him out as a curiosity, we find Byron and his little party making their way across the Simplon, to cross which is an epoch in the life of any man, and then down by the Lago Maggiore to Milan.
"The Last Supper" of Leonardo da Vinci did not impress Byron–the art of painting never did–this was his most marked limitation. From Milan they wandered down through Italy to Verona and Venice.
The third Canto of "Childe Harold," "Manfred," and dozens of shorter poems had been sent to Murray. England read and paid for all that Byron wrote, and accepted it all as autobiography. Possibly Byron's defiant manner lent an excuse for this, but by applying similar rules we could convict Sophocles, Schiller and Shelley of basest crimes, put Shakespeare in the dock for murder, Milton for blasphemy, Scott for forgery, and Goethe for questionable financial deals with the devil. Byron's sins were as scarlet and the number not a few, but the moths that came just to flit about the flame were all of mature age. Byron set no snares for the innocent, and in all of the man's misdoings, he himself it was who suffered most.
The Countess Guiccioli, it seems, was the only woman who comprehended his nature sufficiently to lead him in the direction of peace and poise. With her, for the first time, he began to systematize his life on a basis of sanity. They lived together for five years, and from the time he met her until his death no other love came to separate them.
Throughout his life Byron was a man in revolt; and it was only a variation of the old passion for freedom that led him to Greece and to his grave. The personal bravery of the man was proven more than once in his life, and on the approach of death he was undismayed. When he passed away, April Nineteenth, Eighteen Hundred Twenty-four, Stanhope wrote, "England has lost her brightest genius–Greece her best friend."
His body was returned to England, denied burial in Westminster, and now rests in the old church at Hucknall, near Newstead.


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Report: Stigma a barrier to mental health and substance abuse treatment in Greene County
More than 200 community leaders and representatives from health providers came to the Springfield Art Museum on Friday, April 12, to learn results of the Community Mental Health and Substance Abuse Assessment.
The assessment was a 15-month-long project to assess the needs, challenges and opportunities for improvement surrounding mental health and substance abuse in Greene County.
Katie Towns, assistant director for the Springfield-Greene County Health Department, called the crowd "amazing."
"I love this community, and one of the reasons is when we tackle hard issues, people show up," she said. "This is just evidence of that."
"Mental health and substance abuse can be a very dark and lonely topic," Towns continued. "We want to be honest about our challenges today, but we also want to recognize how much hope and opportunity exist in our area."
The Missouri Foundation for Health awarded the Springfield-Greene County Health Department a $252,500 grant in 2017 for a comprehensive study and action plan for mental health and substance abuse.
The Crescendo Consulting Group was selected as the consultant to bring outside expertise, perspective, and guidance to the project. Leadership and guidance were provided by Greene County's Healthy Living Alliance (HLA).
Robert Hughes, president and CEO of the Missouri Foundation for Health, commended those in attendance for being "in a sense, role models for families and individuals that are confronting substance abuse and confronting mental health issues."
"You are confronting the stigma. You are saying that is not going to be an impediment," he said. "Thank you for letting us be a part of this project."
Clay Goddard, director of the Springfield-Greene County Health Department, said the assessment was about listening "to the needs of our friends, our families, and our neighbors."
"As this process progressed, themes began to emerge in what people were telling us," he said. "We found one common thread through so much of our community — that stigma is powerful and it's prevalent. Stigma touches every one of our findings. But like so many challenges that have emerged in this effort, our community has already began working to turn the tide."
Goddard pointed to the Greene County Mental Health Awareness Training Project at Community Partnership of the Ozarks as an example of that work. He called the mental health first aid training, which is a national program, a "powerful antidote to stigma."
"Thanks to their work, there are 3,000 people in our community trained to recognize warning signs and connect people with services," Goddard said. "And we hope to see many more trained in this important effort."
The full assessment can be found at www.sgfmentalhealth.org.
From the assessment:
Primary data was collected directly from mental health and healthcare service providers or other stakeholders and offered an in-depth understanding of mental health and substance abuse specific to the demand in the community on the local system. Service use data was collected from partners Burrell Behavioral Health, CoxHealth, Jordan Valley Community Health Center, and Mercy Springfield.
Community data came from more than 200 people as part of 18 focus groups, 62 one-on-one interviews from individuals representing more than 50 service organizations, as well as additional feedback and support from broader community presentations.
The information below is from the executive summary of the Community Mental Health and Substance Abuse Assessment.
Key Findings:
As a result of this process, HLA decided upon three domains and one common thread. The domains were developed to categorize findings to create an organized set of information. Stigma was determined to be the common thread.
Stigma is the result of a personal feeling of shame, embarrassment, failure or judgment around mental health or substance abuse. Stigma can be powerful enough to prevent people from seeking support and care. One in three young adults chose not to get treatment because of stigma.
The first domain is awareness and early intervention. This includes community awareness, insight and perceptions regarding mental health and substance abuse.
The second domain is crisis stabilization, a "direct service that assists with deescalating the severity of a person's level of distress and/or need for urgent care associated with a substance use or mental health disorder."
The third domain is access to appropriate care. This includes capacity and the availability of direct service providers, care coordination and other system-level supports that facilitate efficient access to the health care system. This domain is concerned with people getting the right care, at the right tie, in the right place.
Community improvement efforts:
Throughout the assessment, community providers took action to address mental health and substance abuse concerns. Below are a few highlights in the executive summary. More can be found in the full report.
- CoxHealth is providing PDMP Leadership at the local and state levels;
- CoxHealth's number of "psych safe" beds has doubled from four to eight;
- CoxHealth's addiction treatment services have been expanded by establishing a new partnership with Hazelden Betty Ford Clinic;
- Mercy Hospital's behavioral health unit in its emergency department has been created for psychiatric patients;
- Mercy's initiatives to reduce opioid use in pain management programs is underway;
- Mercy's access to mental health services through telemedicine — especially in pediatrics — is increasing;
- Burrell Behavioral Health increased access to mental health care. Specifically, efforts at Burrell have led to increased access to the walk-in clinic and decreased wait time for appointments;
- Burrell's partnership with the Springfield Public Schools system includes offering counseling services in schools;
- Burrell's embedded access in primary care practices and emergency departments is underway. For example, Burrell is currently partnering with CoxHealth and Mercy Hospital to offer mental health access inside the hospitals' emergency departments;
- Jordan Valley Community Health Center's ACES screening is beginning to take place in the clinical care environment;
- Jordan Valley's community health workers are increasingly being used to increase system capacity;
- Jordan Valley's Medication Assistance Therapy Clinic currently operates five days per week.
Opportunities for improvement
As a result of this report, the community is armed with knowledge and information needed to address mental health needs and take ownership of efforts to reduce stigma, increase awareness, and improve access to mental health services.
Here are some opportunities for improvement identified in the assessment:
Reimbursement: Assuring that adequate reimbursement for treatment of mental illness is available for substance abuse and mental health providers alike was identified by all providers and other interviewees through the assessment. The rate of reimbursement is not sustainable for adequately meeting demand for mental illness.
The report notes that addiction treatment services are often reimbursed at rates lower than the cost of care, or not covered by insurance. In addition, the lack of Medicaid expansion impacts uncompensated care in all settings. And there is a need for Medicaid suspension rather than termination upon incarceration in Missouri.
Access to Appropriate Care: Emergency departments are often the place where patients seek care for mental illness, especially in crisis situations. Identifying symptoms and preventing crises can offer diversion to other more appropriate care. Additionally, efforts to prevent and reduce the suicide rate in Greene County should be a priority.
Resources and Tools: Mental health first aid training was identified as a valuable resource and necessary tool to be used to offer early intervention and prevention of crisis. Currently, Community Partnership of the Ozarks is offering training and education to reduce the incidence of mental illness and prevent crises. These efforts and others should be leveraged and should be used to train our community, specifically children,
youth and young adults, some of our most vulnerable.
Provider Shortages: Mental health provider shortages are prevalent in Springfield but also throughout the country. Efforts to seek options for alternative ways to treat patients such as telehealth and community health workers must be explored to expand care.


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Adam Ford, author of Vermouth: The Revival of the Spirit that created America's Cocktail Culture discusses how the category shook off its dusty image and became cool again.
Wading through the dark waters of cherry-based liqueurs, and how the category can move forward.
Eight vodka experts muse on where the category stands right now.
Our editors pick the best of the web's booze writing. This week: 2018's must-have bar book, bartenders as spirits blenders, and hospitality 'do's'.
Our editors pick the best of the web's booze writing. This week: doctored drinks, beer science and lessons from history.
Robert Simonson's superb chronicle of the great cocktail comeback should be a set text for anyone, anywhere, calling themselves a bartender.
From Dinah Sanders' book, Art of the Shim, a highball for calorie and sugar hawks.
If you want cocktails with smoky flavours, there's nothing better than the real thing. By Paul Mathew.
The men behind the award-winning New York bar, Sean Muldoon and Jack McGarry, resurrect and revitalise long-forgotten drinks in this extract from their first cocktail book.
A long-time secret from the culinary toolbox that, in the hands of a bartender, produces more flavoursome, consistent and service-friendly drinks. By Paul Mathew.