Black lung expertise with a little sass

Who says speakers of note don't come to Lee County, Virginia?  If someone here in Jonesville had told me that a nationally-known scientist and medical examiner was to be visiting the area I probably would have rolled my eyes at them and said "Really?" too. Nonetheless, last Thursday I had the (free) privilege and entertainment of hearing Dr. Joshua Perper speak locally on the issues of: coal workers' pneumoconiosis (i.e. black lung), typical, medically-recognized symptoms, and necessary medical proof that a coal worker needs in order to collect medical benefits from the afflictions of black lung. Like I said, Dr. Perper is a medical examiner of national esteem, most widely known for his efforts as chief ME in Broward County, Florida for 17 years (1994-2011) and performing the autopsy of former Playboy model and actress Anna Nicole Smith. He's basically Alex Woods of CSI Miami! You see the similarities, right?:

       
Images taken from: http://www.tvrage.com/CSI_Miami/character_guide?character=691
http://articles.sun-sentinel.com/2011-09-07/news/fl-perper-press-conference-20110906_1_zvi-harry-perper-medical-examiners-commission-illegal-pill-sales

Yeah, me neither. In addition to his work at a medical examiner, toxicologist and forensic pathologist, Dr. Perper has done a great deal of research on coal workers pneumoconiosis. His talk was remarkably enlightening, highlighting in some very accessible ways via explanations, pictures, etc. the key components of black lung and why it is so harmful. For example, smokers can immediately begin improving their respiratory health by ceasing to smoke. Not true for coal workers who have been exposed to coal dust due to their labor in the mines; the dust particles that enter their lungs will remain there forever. Thus, years after not working in the mines, an individual will still have those particles floating around in his lungs, causing scratching and scarring of valuable lung tissue.

Another commonly posed question deals with the pollutant particles that millions, even billions of city inhabitants inhale daily as they go about their normal lives. Isn't this dust just as dangerous to the lungs, and why haven't all those individuals also developed black lung like coal workers? Dr. Perper explained that development of black lung does not occur, even if the pollution is from coal waste product substances, because there are distinct kinds of minerals and particles released from the rock when it is extracted in its raw form (within the mine). Thus, coal workers are exposed to a more raw, dangerous form of the coal dust not present in the "refined" pollution of a city. In conclusion, my asthmatic self (and subsequent interest in the respiratory system and other breathing conditions), plus my undying curiosity, plus a part of my undergraduate student self that misses the weekly chance to hear a speaker on any given topic thoroughly enjoyed listening to Dr. Perper's presentation. Unfortunately, it seems that the extensive medical proof necessary to legally and medically establish that a former coal miner has coal workers' pneumoconiosis is nearly impossible to provide with convincing certainty to the proper authorities-- many of whom I assume are in the back pockets of the coal company giants. A combination of breathing capacity tests/studies, lung biopsies, chest scans, proof of working in the mine for an elongated period of time and finally, a certified autopsy by a certified medical examiner are all integral for a coal worker or his widow to receive financial compensation for the condition. It seems like sort of a crazy, sad reality.

The "little sass" that I mention in this post's title came from Dr. Perper himself and his presentation style. His talk was hosted in the newly renovated Lee Theater which opened just a little over a month ago. The first quirkiness emerged within the sound system's set-up. Dr. Perper was initially stationed behind a podium with a microphone but it quickly became evident that: 1) the microphone had not been readjusted for Dr. Perper's height and 2) Dr. Perper did not want to be limited by the confines of that podium to do his speaking. Many muffled words, a few giggles (mine) and strained looks (from cute little coal workers' widows) from the audience, and 4 gentlemen approaching the podium later and Dr. Perper finally emerged to stand in front of the podium, microphone in hand, to continue delivering his talk. The best part though was the antics that surfaced with whomever was controlling Dr. Perper's powerpoint presentation from the balcony. This individual seemed to have trouble not only with paying enough attention to change the slide on Dr. Perper's (very clear) hand cue, but also with the backward versus forward concept of advancing the presentation's slides. At one point of elevating frustration, Dr. Perper commented "It's not a car you know." The audience died with laughter but the tech controller must have been mortified. Let your imagination add here the doctor's unique character standing front and center: a Romanian who escaped Nazi rule during WWII, sought asylum and education in Israel, earning degrees in medicine and law, an immigrant to the United States who studied forensic pathology at Johns Hopkins and worked for the cities of Baltimore, Pittsburgh and Broward County (Fort Lauderdale, Florida). He was the epitome of a strong, straightforward personality-- all business.  I'm still not sure why the technical execution of the presentation was such an issue; how much more simple can advancing slides in a Powerpoint presentation be?

Lesson for the week: never, ever underestimate who might boldly cross the threshold of the Lee Theater. You might be pleasantly surprised.

Appalachia Service Project is BIG!

Since my first official job (way back in 2006) as an assistant to the summer maintenance staff at Payne Elementary, I have worked for a variety of non-profit and educational institutions, within a variety of hierarchical organizational structures. Apart from technically working for the U.S. State Department (which obviously employs thousands of individuals) under the confines of my Fulbright grant, I have generally worked for much smaller entities. At Homes on the Hill in Columbus, Ohio, our staff of 8 individuals occupied the second floor of a church in the Hilltop neighborhood. As an intern with La Plaza in Indianapolis, I was one of three summer interns working alongside a summer program staff of approximately 8 teachers plus our program director, plus other La Plaza staff (not involved with our Summer Discovery program) totaling maybe somewhere between 10 and 15 individuals. Finally, in Argentina, I worked on school staffs composed of anywhere between 30 and 100 teachers/professors. In those last school environments, I didn't know all my other colleagues on staff, primarily because all teachers are not present at all times in the school facility (unlike their professional counterparts in the US). This consistent coming and going of educators (throughout the school day) is what permitted me to work in three distinct schools throughout the year. But I digress from this post's point about my current employment and Appalachia Service Project's sheer size....

Sometimes I have moments where I must remind myself that Appalachia Service Project is an extremely large organization. At our headquarters in Johnson City, Tennessee, there is a staff of approximately 30 people working year-round. During ASP's summer youth program in 2013, there were just over 14,000 volunteers deployed to work on home improvements in Appalachia, guided by over 100 summer staff, construction consultants and other support staff. Those volunteers completed over 3,600 projects in homes, serving 537 families and 1,405 individuals. If you add on to all those numbers the work that we do here in the year-round centers, yes, the picture and vision grows even bigger. Each of the 4 centers operates with a staff of 4 Lilly Fellows (that's me!) and a Center Supervisor, and last year the year-round centers worked with a total of 3,000-4,000 adult volunteers (if I'm not mistaken). Certainly not to be forgotten are other support staff at each of our centers. Our cook here in Jonesville is a total hoot, and our maintenance guy and his sidekick are always good for a laugh and juicy local gossip over a cup of coffee. Without invoking too much negative imagery, ASP is a monster.

I imagine you're getting the big picture organizationally of ASP at this point, but occasionally I myself lose sight of that overall framework and get stuck mentally in my little bubble here on the hill in Jonesville. Sometimes this is a difficult battle to fight as we generally are so busy working with volunteers and families in Lee County. While I'm living here, I imagine that it will be just two or three times per month that I venture beyond our county lines, and fewer times than that I will interact at length with our central office staff in Johnson City. I have already seen in some ways how this can shape our identity as a year-round center, for better and for worse.

Most recently, at the end of October, ASP hosted a large advancement/philanthropy event called Work Miracles in Johnson City. The weekend brought together a great number of ASP's (financial) supporters to hear updates on what the organization is doing and how it is dreaming and planning to do bigger and better things. I, fortunately, was able to take Friday "off" from work here in Jonesville to travel to Johnson City and assist in some final event preparations as well as enjoy the kick-off festivities of that evening. However, besides the year-round Tri-Cities staff (who live in Johnson City), I was the only individual from any of the year-round centers able to be present at this very important organizational event. Besides the networking interests, that essentially, necessarily plague any young professional, I had a genuine interest in attending Work Miracles to capture a better understanding of how our mission, vision, work out in the field with volunteers and relationships within our community all come together in this identity that I might embrace to answer the question: What does it mean to work for ASP?

I'm just over two months into my role as a Lilly fellow and will have only 10, short months more in this particular role at the year-round center to define and decipher and, occasionally, muddle my way through what it means to work with this gentle giant that is Appalachia Service Project. Because it's big, there are a lot of layers to work through in regards to organizational values, hierarchy, partnerships, goal setting, working relationships that ultimately feel like family...and the list could go on an on. The layers are anything but simple and the inquisitive, analytical, motivated part of me wants to dig into all those layers, understand them quickly and efficiently, and then reassemble them in a way that makes sense (for me and ASP). Just like any homemade chocolate cake, the more layers it has, the greater chance the chocolate of the mission statement and the cream of relationships with families in the community will mix (pardon my awful, love-of-baking fueled analogy). And so, I doubt that I will devour the layers quickly or efficiently, but, instead will be a better connoisseur of the organizational culture feast before me if I simply take it in one "forkful" at a time within the lines of this blog.