Jonathan Klemens, FSA Scot, and member of Clan Gregor, is an accomplished writer, antiquarian, and pharmacist, with numerous published essays, articles, and fiction in local, national, and international magazines, a college textbook, e-books, and various web sites. Topics include Integrative Medicine, health & fitness, leadership & ethics, and Scottish culture & history. He is also the author of Mountains and Rivers: Complementing Your Healthcare with Alternative Medicine.
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"Words are, of course, the most powerful drug used by mankind" ~ R. Kipling
Choking black smoke permeated the river air, smelling of a well-stoked hardwood fire, as a magnificent stern-wheeler struggled to free itself of a shoal of Mississippi mud. The southbound steamboat was only 50 yards or so off shore providing a spectator view of a stranded beauty desperately churning its great wheel.
“Good Lord!” I exclaimed. “The boat’s stuck in mud!” I’ve had the personal experience of being stuck in mud up to my ankles and realized that this was a most difficult situation not easily resolved.
Through the haze, we could clearly make out the tall black stenciled name Regina on the white plank siding of the main deck. Toby had stayed the night and we had just finished breakfast when we heard the ominous distress whistle that compelled us down the well-traveled path to the lofty bank overlooking the river.
After what seemed like an hour, the Natchez finally arrived keeping a safe distance from the perilous mud. Three lifeboats were launched carrying several deck hands with massive hemp ropes. The crew of the helpless Regina, using leather gloves, secured the hemp ropes to the main deck, while suffering the well-anticipated ridicule. After numerous attempts, and much more smoke, the Natchez was finally able to dislodge the vessel from the clutches of the river mud.
Toby and I had been totally spellbound as if under the trance of a parlor hypnotist. At last, regaining my senses, I blurted out, “We have always loved this river and we ain’t gonna forget this in due time!”
“Quite right, I reckon,” Toby replied. “Our memories will always be connected to the “Miss.”
Nearly every day, Toby, Becky, Digger and I stood at this same spot overlooking the river to cheer steamboats on towards New Orleans or St. Louis. Memphis was becoming a hub for tobacco trade and Mississippi river traffic was on the rise. We devotedly tracked the twin billows of thick black smoke until they were swallowed by the horizon. It was fun to imagine who or what they were carrying and to speculate their final destination.
The Gregor family occupied thirty acres in Ashport, Tennessee, situated on one of the wider sections of the Mississippi, north of the Hatchie River, since the spring of 1832 when Grandpa Duncan migrated from the Catawba River Valley in North Carolina.
Martin married Marion Campbell, after a short courtship, in the summer of ’49, and just two years later, into the village of Ashport, I was welcomed as William Martin Gregor. Becky was born nearly four years later. I recollect her always being small and delicate and that we almost lost her when she was stricken with croupous pneumonia. Providentially, her indomitable spirit prevailed and she recovered, although with a decidedly sickly constitution.
Martin worked as a carpenter just as his daddy had done—an honest trade by any standard. He could swing an axe better than most, but also possessed the fine skills to create a custom gunstock, a comfortable rocking chair or a beautiful inlaid cabinet.
Our modest white clapboard farmhouse, always painted and good repair, set facing the river just far enough away to avoid occasional floods. To the south was a large vegetable garden not far from the woodshop. A full barn and a privy were around back.
Fields of sweet golden corn, durum wheat, and fresh hay provided other essentials. I helped with the crops and in the workshop while Becky’s chores included caring for the horses, feeding the chickens, and the daily gathering of eggs. The family dog was a floppy-eared Bluetick Coonhound named “Digger,” for obvious reasons, and he often accompanied us to the river and swimming hole.
During the summer months, I remember the entire family and Digger sitting on the front porch watching spectacular sunsets of scarlet, yellow, orange, and shades of blue. These serene evenings provided a comfort from the day’s heat, with the moon reflecting its opalescent beauty on the vast water just beyond the bank.
One evening, Becky unexpectedly surprised us, “I have a fun idea …” She began quickly capturing the plentiful fireflies and delighted us with fascinating canning jar lanterns while chirping crickets and bellowing bullfrogs supplied a pleasing musical accompaniment composing a symphony interjected with rhythmic staccatos from countless katydids in distant trees. Indeed, Becky made that family evening quite special and memorable.
Toby often spent time with Becky and me. Toby and I were the same age, however he was of large frame just like his Pa, the sole village blacksmith. He wasn’t much for idle talk and was quick to get to the point in any conversation, most often with a touch of his unique humor. With our common interests, we both became rather fluent in basic “river life” jargon and quite learned of the various positions of the boatmen: Engineer, Leadsman, Striker, Mud Clerk, Cabin Boy, Deckhand, and so on. However, the most glorious of all was the “Pilot.” We both had expectations of someday piloting a famous steamboat, but not just on any river—it just had to be on the Mississippi, the “Grand Daddy” of all rivers.
“Toby, mark my words, someday we’ll be piloting the biggest and fastest steamboats, and when we pass, we’ll duly sound our whistle in proper respect to one another.”
Toby excitedly blurted out, “We’ll both be master pilots—the most famous of all steamboat pilots on the mighty ‘Miss’!”
Becky, in feminine contrast, entertained decidedly domestic interests and enjoyed imitating mother, especially in taking care of the family and preparing meals. One particularly sweltering day, Becky wore her white cotton Sunday dress against mother’s wishes. Although she knew she could easily get into trouble, she obstinately continued to create her magnificent mud pies—an earthy offering from the mighty river—like deliciously prepared tarts of fruit.
I can still feel the gentle warmth of the mud as it caressed our bare feet along the river’s edge. She gently patted firm pies and carefully positioned them approximately an inch apart on a smooth pine board that Pa had made especially for her.
In spite of her gentle nature, she was not averse to bragging about her culinary skills.
“The Mississippi certainly makes grand mud! Just right for a tasty pie! Billy, you rightly know, I bake the best tastiest mud pies in Lauderdale County and perhaps the entire state of Tennessee.” She boldly stood there at the edge of the majestic water, her hands on her hip like “Cleopatra” before her beloved Nile.
As usual, I played along, “Rebecca Gregor, you are the best mud pie baker on the Mississippi shoreline no matter what the county or state!”
That was more than enough to make her happy. I was always quite patient with her for I was always somewhat afraid of losing her to another infirmity. However, her innocent play did in fact benefit my needs. On many occasions, I swiftly confiscated any juicy worms that she would unearth in her “baking” process. This serendipitous squiggly bait would serve me well on my fishing days.
I wasn’t much for book learnin’, but we did have a rather distinctive school—one of the only two-room schoolhouses in the western part of the state—largely due to the benevolence of local citizens and a few hard working carpenters. As you might have guessed, my Pa was one of those carpenters that added that prestigious second room.
Some less fortunate areas had no schools or had difficulty finding a schoolmaster of any sort. Paper was scarce and most of our ciphering was done on slate tablets that had been used for far too many years. Bound books were scarce and students had to share the few primers and hornbooks that had been purchased or donated to the school.
Miss Fulbright always favored recitation and spelling and I always dreaded the thought of being selected. However, I did occasionally practice with the abacus and earned a “Reward of Merit” for my proficiency. However, this award always meant more to Ma and Pa than it did to me.
Having a school is one thing—making one go to school regularly is another. I was far, far too rambunctious to be cooped-up like one of our scrawny chickens so there were many days where I did not gaze upon that educational edifice, but to swim, fish with my lucky catfish pole or whittle with my stag-handled Barlow. However, I swear playing hooky was solely for religious reasons. These “reverent” pastimes seemed to bring me measurably closer to God than those tedious hymns that I was forced to sing at Sunday Services—except maybe for Amazing Grace, which for some inexplicable reason, imparts a certain warm feeling and calmness of mind. Besides, I did not have a voice pleasing to God and Reverend Ramsay, or quite frankly to anybody, within ear shout. Obviously, school was not my first love and most figured that I would just follow in Pa’s footsteps and learn the trade.
Close to the school was the small Presbyterian Church, simple but effective. Adjoining was the cemetery where we often visited Grandpa Duncan’s grave after Sunday Services. On nearly every visit, Becky reverently placed fresh flowers before the weathered cross, adorned with a hand-carved saltire.
Ma, as usual, complemented Becky on her floral selection, “My sweet Becky, you have done such a beautiful job once again. I never saw such pretty flowers. I’m sure Grandpa loves them as much as we do.”
Although Pa barely uttered a word, I know he deeply missed Grandpa. I could see it in his face—his glistening eyes. Grandpa, having passed at 90 years, witnessed a wealth of history that spanned an era from the Revolution well into the new century.
Without a doubt, the highlight of every summer was the July 4th Celebration, however the Memphis celebration of ’60 was by far the most memorable. The festivities were to last a full three days and feature a turkey shoot, bonfire, boar roast, baking contests and naturally a grand display of fireworks. Unfortunately, there was no baking category for Becky’s fabulous mud pies.
The family made plans to travel to Memphis and this was indeed special; as a lad of nine, this was only my second trip to the city. To add to the excitement, Toby was traveling with us and we were going to stay with family friends near the wharf.
The recollection of that July 1 is still fresh in my mind. Toby and I were, as you might expect, at our favorite swimming hole at Wilson’s Bend. This adventurous swimmer’s “Mecca” was generally accepted as the largest and deepest, but most treacherous, in the area. Toby and I certainly could attest to that. Toby nearly drowned the previous summer; I fortunately was able to release his trapped foot from an underwater snag.
However that day, we really didn’t get around to much swimming or even surveying the hole for new potential dangers. We were too excited about the upcoming midday arrival of the stern-wheeler Majestic and the side-wheeler City of Memphis.
Toby exclaimed, “Do you think we’ll get close to the steamboats? At least closer than 50 yards. Perhaps we can meet a real pilot”.
I answered, “I certainly hope so. We’ll be close to the wharf. I trust we can look over the boats and perhaps board one, at least on the Main Deck.”
Our travel to Memphis was a long bumpy ride with our overwhelming anticipation making the journey seem endless. When we finally arrived, the steamboats were much more impressive than expected and our eyes were as big as a Tennessee full moon. We were attracted to the magnificent boats like paper-white miller moths compelled to a flame on the darkest night.
Our accommodations were within short walking distance of the wharf, which was swarming with visitors and onlookers. A deckhand invited all to board the Majestic for a more personal adventure and naturally we were quick to make the most of this opportunity. And, what a striking boat it was with handsome varnished wood and polished brass trim, dual black smoke stacks, multicolored flags and banners and a magnificent wood paddle wheel. Even Becky was impressed! It smelled of smoke, grease, brass polish, and river. It was just marvelous!
We excitedly explored all three decks, like young greyhounds in pursuit of a rabbit—the Main Deck, Boiler Deck, and the Hurricane Deck with the Texas Cabins—taking in everything like a giant sea sponge.
From the Hurricane Deck, we attentively watched deckhands and slaves unload a variety of satchels, crates, bales and trunks from the City of Memphis onto the sloped stone-paved wharf. The details of every move were carefully noted and etched into our memories, as if we were to be dutifully quizzed.
We even got the opportunity to man the glass enclosed Pilot House and take the wheel. We imagined cleverly evading shoals and perilous debris, and skillfully maneuvering narrow passages, on our way to New Orleans. It brought back memories of the Regina that was grounded not so far from shore. Certainly, if we had been piloting that boat, that mishap would have never occurred!
Toby exclaimed, “Sandbar on the port, mud to the starboard, a log to the forward—we are surrounded!” We both laughed and declared that if pilots, we could get out of any tough situation.
The Majestic's steamboat whistle sounded often throughout the day as children, and some adults, each had a turn to pull that “privileged” white cord.
We reluctantly agreed to leave the dock and began leisurely walking above the levee, straining to catch a final glimpse of the steamboats, as a large orange sun was closing our day of exploration. In anticipation of the large crowd, the water wagon had just made a final pass wetting-down major dirt streets to curtail the dust.
I suddenly whiffed the malodorous aroma of a cheap cigar as a young man, slender stogie in hand, attempted to overtake us.
“Pardon me folks, do you know the location of tonight’s bonfire.”
Ma responded, “I believe it’s up on the bluff. We’re headed there now if you would like to accompany us.” He accepted our kind invitation and introduced himself as “Sam.” Several years earlier, he had lost his brother, Henry, in the tragic steamboat Pennsylvania explosion at Ship Island seventy-five miles south of Memphis. At least 100 passengers were killed or injured in that boiler explosion. I’m sure it was quite difficult for Sam to return to this area.
The fire was just being ignited as we approached the summit. The fragrance of burning hardwoods and southern pine saturated the entire bluff with dense smoke rising to the tallest trees. The masses began to settle into a large ring around the crackling inferno, somewhat like a theatre-in-the-round, as everyone jockeyed for a comfortable position to enjoy the festivities and entertainment of a small brass band.
When the bonfire finally erupted into full blaze, Sam engaged in what he enjoyed most—storytelling. The warm glow of the fire revealed a thin young man in his mid-twenties, of average height, well dressed with wavy auburn hair and large muttonchop side-whiskers. He was quite adept at yarns and tall tales and Becky, Toby, and I were amused and captivated by his genuineness and quick wit. At times, I swear it was as if he was addressing his tales directly to Becky and me.
An occasional long gray ash fell from his cigar as he entertained our family and about ten others who had joined our little group. Many of his stories were based on his experiences and adventures as a steamboat pilot on the Mississippi. He spoke passionately from the heart and his captivating characters came to life in the dancing wisps of smoke and flame tongues as he methodically galloped from one fascinating tale to another.
During a break between a sequence of stories, Sam and I had the opportunity to chat. He declared that he had just piloted the City of Memphis into dock and was awaiting a new assignment. Sam made me feel at ease and conversation came naturally. I spoke of things of which I thought were of common interest like fishing, swimming and of course steamboats—you know—the river life.
He eventually engaged in more serious conversation, about my book learnin’ and my interests in school. He was quick to reckon that I didn’t give a lick about schoolin’.
Sam continued, sincerely with just a hint of sternness, “Billy, the river life is definitely adventurous, but there is so much more. You should really think about staying in school until the age of twelve. I left school after the fifth grade and I have always regretted my lack of further study. I could have faired much better.”
I politely acknowledged his well-intentioned guidance.
“Sam,” I said with a half-hearted commitment, “I occasionally like the challenge of a numbers puzzle, but I can’t honestly say that I like school. I’ll do my best—no promises. There is so much to do on the river.”
Sam’s wit and acumen fascinated me and part of me wanted someday to be like him, however I believed my destiny was always with the river. I thought to myself, here was the real thing—an actual river pilot—and all he wanted to talk about was my lack of schoolin’. I was awkwardly disappointed and quickly changed the conversation back to the comfort of the river life that Toby and I enjoyed so much.
When the fire dwindled, Sam said his farewell and we retired to our temporary dwelling on Front Street, completely exhausted from a full day of adventure and entertainment. The two steamboats had unleashed nearly 400 new visitors in the city and rooms were scarce. Sam had prudently reserved a room at the nearby Lowry House and we were not to see him again.
Six moths later, the southern states succeeded from the Union of the United States of America persuaded by a passionate speech for succession by Governor Isham G. Harris. The “Stars and Bars” was tacked on the schoolroom wall in clear sight for all students to contemplate what may lie ahead.
The War for Southern Independence came right to the Mississippi banks in 1862 when Union Forces laid siege to Memphis and established the Headquarters for General Grant. We all thanked the Lord that Ashport was barely distant enough to be spared the devastation of war.
Pa was less fortunate. He had volunteered for the Tennessee Twenty-third and was wounded on April 6 at Shiloh. He took a Union ball in the right leg that left him with a measurable gimp requiring a hickory stick to navigate. Days of rain caused the pale-leathered leg to ache bringing back painful memories of that horrendous two-day battle.
Pa rarely spoke of the war, however I do recall a rare emotive moment: “That horrendous day at Shiloh, I will never forget. Death was everywhere. We lost 10,000 sons that day. Nevertheless, I do not regret my service to the Confederacy. It had to be done.”
Lamentably, the war also had an unexpected toll on Toby and me. The war had devastated riverboat traffic on the major rivers and the number of steamboats that we cheered from our river vista slowly dwindled. The glorious antebellum steamboat culture was never to return and we were saddened as one of our major pastimes was forever diminished. Nevertheless, our profound passion for the Mississippi would forever remain with us.
Life sporadically treats us to unanticipated twists and turns and the grandiose plans of youth are often not realized. A score and two years have passed since that spectacular July 4th celebration and neither Toby nor I pilot a steamboat on the Mississippi, or any river. Toby is the only blacksmith in Ashport, as was his daddy, and I eventually attended a small business school in Nashville.
Over the years, my bookkeeping training has well served me as I plugged away at various jobs and eventually made my way up to the Head Accounting Clerk at the Cotton Exchange on Union Avenue just a short distance from the river’s edge—a well respected position in booming Memphis. I can now occasionally afford to take a meal at the Peabody just a few blocks away.
I’m still a bachelor and courting Emma, a sweet lass employed by Madison’s Millinery Shoppe on Beale Street. She moved from Covington just a year prior. Becky married well and tends to her stately home and four children in Tupelo. Her culinary skills blossomed and she now bakes delicious confections of fruits and nuts, like wild blueberry scones and Dundee cakes, just as mother had taught her. I don’t see her as much as I should. Ma and Pa still live at the Ashport homestead and I visit them nearly every month. Digger is long gone.
As you might have surmised, that young gentleman that encouraged me to continue my studies later published under the name “Mark Twain.” Looking back, my evening with Samuel Clemens did not make me a famous writer, a wealthy humorist, or a man of letters, however he did teach me the value of a well spun yarn and a story told from the heart. On that momentous evening, Sam somehow influenced me to persevere through school in spite of my many youthful aspirations. I didn’t realize how important that evening was until years later. But, he was right. My dogged determination and his advice and encouragement resulted in a very successful career.
I never spoke with Sam again, however I closely follow the news and rumors of Mr. Twain and attempt to read his latest articles and stories. I just acquired his recent book, “Life on the Mississippi” and anticipate that it will refresh memories of joyful childhood adventures with Becky and Toby along that river that we all love so much.
I can still feel the cooling breeze off the river, smell the sweet aroma, and feel the warmth of the dark rich river mud. One might say, “That’s just mud—childish nonsense.” True, it is mud, but it is Mississippi mud—it is our mud! I can clearly see little Becky creating her earthy confections with great love. It brings me great comfort and reminiscences of a much simpler time. These are the memories that stick with me—these are the memories that I cherish most. I will never forget Becky’s Mississippi mud pies and that exceptional summer night in Memphis.
Copyright © 2008 by Jonathan Klemens
All rights reserved
The Protestant Work Ethic - Just Another "Urban Legend?"
"Hi Ho! Hi Ho! It's off to work we go!" Like the words in the Disney cartoon melody, every day people merrily trek to a job they apparently enjoy. Are these people misguided social dwarfs out of synch with the rest of the workforce? Well, these people are for real - another "Urban Legend" bites the dust! Even though we often give lip-service to the "work ethic," it really does exist and it is stronger than one might expect. Frank Lloyd Wright, the famous 20th Century architect, stated, "I know the price of success: dedication, hard work, and an unremitting devotion to the things you want to see happen."
The "work ethic" is personified by those who have found work that provides both a service to society and personal satisfaction. It is their passion - their life "calling." One's calling can follow any career path - writer, accountant, missionary, teacher, auto mechanic, carpenter, cook, social worker, attorney, or brain surgeon. It takes commitment and hard work, but you enjoy it and it feels like the right fit for you. You may actually become so intensively involved and committed that your "calling" becomes "one" with the company or organization's mission.
Encompassing centuries, this commitment and dedication to hard work has been exemplified in such societies as the Amish, Mennonites, Hutterites and the Shakers. The Shaker phrase attributed to Mother Ann Lee, the founder of the Shaker sect: "Put you hands to work, and your hearts to God," encourages a simple life of hard work and spirituality. We might also identify with Ben Franklin as another example who espoused his philosophy of avarice and strong work ethic.
How could this concept of a work ethic develop and endure in a society where the concept of "entitlement" now seems to be so prevalent? The roots begin with Max Weber (Vaber), one of the leading founders of modern sociology, and his renowned work on modern social science, The Protestant Ethic and the Spirit of Capitalism. In the 1930s, after the book was translated into English, the U.S. workforce began its on-going love affair with the "Work Ethic" - a social trait that would become the backbone of American enterprise and world leadership.
The arduous work of capitalism, according to Weber, is closely associated with intrinsic Protestant religious beliefs and behavior. Only in the West has rationalization in science, law, and culture developed to the extent where political, technical, and economic conditions depend on highly trained government officials. He further states, "However, all the peculiarities of Western capitalism have derived their significance in the last analysis only from their association with the capitalistic organization of labor."
Historically, certain Protestant denominations had a strong influence on the members' development of business acumen and the ethic of hard work. These Protestants developed a sense of economic rationalism that emphasized diligent and dedicated work. Each and every Sunday, Methodist and Presbyterian ministers extolled the virtues of the "Work Ethic" to their congregations through lengthy and tedious sermons.
According to Weber, the following traits characterize a strong work ethic:
▪ FOCUS ON WORK - We know how precious our time is and that it is limited. We must have a passion and strive for excellence in our work. Work time should be used efficiently and wisely with a desire to make money as a fruit of our labor and not spend it irresponsibly.
▪ UNPRETENTIOUS AND MODEST - We should act and dress appropriately - dress should not be flashy to attract attention or cause distraction to others.
▪ HONEST AND ETHICAL: One should possess and exhibit strong ethical beliefs, and a moral code of behavior, i.e. The Ten Commandments. To do the "right thing" when no one is watching.
The power of a free labor force has made capitalism a very powerful force in our society. Riding high on the wave of post WWII patriotism and intense business competition, we became rightfully proud of our fast-growing economy and the image of hard working Americans. We take pride in who we were and what we produce as a nation. The greatest and most successful nation on earth! Although the original religious aspects eventually faded, the "Work Ethic" is firmly entrenched as a powerful and valued American social trait.
Unquestionably, we do not desire a workforce dominated by mindless "robots" even with a good work ethic. We need innovative thinkers and committed leaders that can guide us through the 21st Century and beyond. It is essential that we continue to build a strong labor force committed to an indomitable "Work Ethic" - workers that are honest, ethical, and rational.
We also need leaders that will not be afraid to work and who will take the responsibly to guide new projects and develop employee potentials to exceed projected goals. We need people passionate about a mission. A good "Work Ethic" is essential to a strong economy, and a strong vibrant society.
Ancient Celtic Myth, Magic, and Medicine
The ancient Celts were an enchanting and mysterious pre-Christian people with a romantic and legendary history – a people of heroes, wizards, and fairies. Julius Caesar stated that the Celts (Gauls) were “brave, but headstrong and impetuous.” These indomitable clans, identified by their language and culture, migrated from Central Europe and populated much of Western Europe, Britain, and Ireland until they were supplanted by the Romans, and later, Christianity.
The origins of the Celts in Britain are lost in remote antiquity, but many scholars now believe these mysterious tribes made their earliest appearance in Britain somewhere around 1500-1000 BC. Their migration to Britain occurred progressively over hundreds of years as they populated and ruled the modern day regions we know as England, Ireland, Scotland, Cornwall, Brittany, the Isle of Man, and Wales. The Celtic languages today are split into two camps: P-Celtic is the old Briton, similar to Welsh, Cornish and Breton; Q-Celtic is Scots Gaelic, Irish, Manx, and the extinct Celtiberian of Spain.
The Celtic social structure was a mix of religious cosmology, animism, and democratic idealism with each tribe holding its own territory consisting of agricultural, forest, and wilderness lands. Other lands were worked in common for the chieftain, priests, the sick, and the poor. They were a fearless people; both men and women were trained as warriors.
Celtic society in Britain perpetuated many of the shrines and feast days of the earlier megalithic times with the most important Celtic feast days being the four annual “Fire Festivals.” Celtic beliefs were polytheistic and their pantheon consisted of as many as four hundred deities. They also believed that upon death the soul transmigrated to other humans, and even other life forms. Later, with the advent the of Christianity, Druidism did not vanish, but merely transformed, and even when the historic St. Brighid converted to Christianity, she and her followers kept the sacred fire at Killdare.
The various Celtic clans or tribes were unified by their common priesthood, the Druids. The word “Druid” is derived from “dru” meaning “truth” or “someone immersed in knowledge.” The Greeks were the first to record the word “Druidae” dating back to the second century BC. The various clans had their own sacred tree, crann bethadh, or “Tree of Life” standing as a totem in the middle of their territory. These Druid priests, men and women, preserved religion, law, scholarship, and science and had paramount influence over all with their sacred authority. They managed the higher legal system and courts and it took up to twenty years of training before being initiated into the order. Bards (keepers of oral tradition) and Ovates (philosophers and keepers of prophecy and divination) were in turn instructed and trained by the respected and erudite Druids.
Prior to the availability of Western alphabets, Celtic stories were largely passed on as oral tradition. The ancient storytellers of romantic myths fortunately preserved the beauty of Celtic culture. Interestingly, many of the mythical stories were not committed to paper for the first time until around 600-90 AD by predominately Christian monks.
The most famous Celtic legends are those of King Author and the wizard Merlin, the poet of Tweedsdale. The true identity and origin of Author is obscure and controversial. Even though the Arthurian Tales were written in Welsh (Welsh, was also the language of southern and central Scotland in the 6th Century), many historians now believe, based on historical and geographical evidence, that some of the romantic and heroic adventures of King Author actually took place in Strathclyde, Scotland. Some historians further conclude that Author may have been Clinoch, the King of the Britons. The original location of Camelot is still very much obscure with several areas in England and Wales laying claim. Merlin, the famous advisor and mentor of Author, was a Druid wizard, prophet, bard, tutor, and keeper of arcane secrets. He was rumored to have been the son of an incubus (demon), and a mortal woman who was a princess and later a nun.
The ancient Druids were also Shamans (female: Shamankas) as well as clergy, and their costumes often included long white robes, headdresses, and feathered capes. They often carried a rowan wood scepter (slat) as a sign of their power and rank which could be used as a wand to perform magick (magic). Druid magic is dependent on a sound and healthy awareness of nature and the spirits and gods who live in nature. It is rooted strongly in the four natural elements: earth, air, fire, and water. Many spells correspond to one or more of these elements. The four compass points each had a significant corresponding color: North – black, South – white, East – red, and West – grey. Druid rituals intertwined the use of the four elements, direction, colors, magic stones, incense, and the lunar calendar.
Birds including the raven, swan, goose, owl, eagle, ouzel, and crane were considered sacred in the Celtic culture. Other divine animals included the dog, cat, wolf, bull, boar, stag, horse, bear, salmon, ram, serpent, and butterfly. These animals are often depicted in intricate knotted patterns. The number three was also sacred to the Druids and had magical powers. This is exemplified in the Celtic triquerta, nonegram, trefoil, and the Triangle of Manifestation.
Many trees were also hallowed including the rowan, hazel, oak, and yew. The veneration or worship of the oak tree or oak-god was commonplace in Celtic and non-Celtic Europe; it could be used as food (acorns ground for flour) and to build shelter. Gatherings and festivals were often held in sacred oak groves.
The “little people” consisting of Dwarfs, Brownies, Elves, and Fairies are also a fascinating aspect of Celtic culture. These wee life-forms were deemed to be spiritual beings to whom the credulity of mankind has given an imaginary existence. The fairies, referred to as the “good neighbors,” were beautiful miniatures of “the human divine form,” in contrast to other less fortunate diminutive creatures. These prankish neighbors resided underground or in little green, rode upon milk-white steeds, and their clothing was most brilliant.
Leprechauns, a lucky and often imbibing type of male fairy, have become self-appointed guardians of ancient treasure (left by the Danes) burying it in crocks or pots. Their association with the rainbow and finding the “pot ’o gold” has forever ensconced the rainbow as a sign of prosperity.
The Gruagach (groo-gach) is a type of Brownie (Ulster House Brownie) that is believed to have traveled across the Atlantic with the sons and daughters of Ulster as they made new homes in the Colonies in the mid 1600s. They are still believed to exist to this day and are especially associated with the McKeen (Bann Valley) and McGregor families that landed in Boston harbor in 1718. All of these fascinating fantasy creatures are more readily seen by those gifted with “Second Sight,” or the ability to see invisible objects, supernatural visions, and premonitions.
The esteemed Druids were the learned elite – the authority on just about everything including medicine. Their medical proficiency included the use of Medicated baths of herbs and milk, sweating-houses, trephining (drilling holes to relieve cranial pressure), sutures, probes, a crude stethoscope (made of a horn), healing oils, “healing stones” (still used in 17th C Scotland), and the use of rituals, spells, visions, and invocations. The Druid maxim for good health was, “cheerfulness, temperance, and exercise.”
Healing magic might also involve invoking a deity of health and healing such as Airmid (Irish), Diancecht (Irish), Laeg (Irish), Meg the Healer (Scottish), Miach (Irish), Ariadne (Welsh/Cornish/Breton), or Clota (Scottish). Airmid was the daughter of the God of Medicine, Diancecht. She was a magician and herbalist adept in all the healing arts.
Astronomy and astrology was also used to aid in medical diagnosis. They worshipped the sun and the moon and had a rudimentary conception and veneration of the closest planets in the solar system. Every celestial event was an omen.
Herbs are plants used for aromatic, savory or medicinal purposes and often had associations with specific Celtic deities. Druids were especially skilled in botany and the use of herbs and poisons. Dosage forms included teas, Tinctures, Fomentations, syrups, and salves, Commonly used herbs include: Anise, Blackthorn, Caraway, Chamomile, Dandelion Dill, Elder, Eyebright, Foxglove, Wild Basil, Wild Garlic, Ginger, Hawthorn, Horse Radish, Ivy, Juniper (The berries were believed to have protective properties and were burned in the Scottish Highlands for purification), Lavender, Mint, Mistletoe (Favored by the Druids, and oaks sporting mistletoe, were most sacred. This herb was also seen as a sign from the Otherworld), Plantain, Rosemary, Rowan (Believed to avert the evil eye and very protective.), Skullcap, Sorrel, St. John’s Wort, Valerian, and Yarrow (A sacred herb used as a love charm and one of the famous herbs of the “Lancashire Witches”).
Other “cures” of a superstitious nature included: ingesting a fried or roasted mouse for smallpox or whopping cough, placing gold rings in the ears for sore eyes, swine’s blood to remove warts, preserved serpent heads for treating snake bites, the healing power of used Baptismal water, and the use of amulets and talismans. The numerous sacred wells and lochs also offered healing powers for both body and mind.
Interest in the mysterious Druids has survived over many centuries. The Ancient Order of Druids was revived in 1781 in London and it is fascinating that Sir Winston Churchill was initiated into the Albion Lodge in 1908. Druidism also still exists in America with the two largest Druid Orders being Keltria and the A.D.F.
Fortunately, the history and beauty of Celtic culture have been preserved in customs and legends, art, music, literature, and antiquities for all to explore. When we realize that the simple eloquence of Celtic knotwork expresses the interconnection between destiny, the Three Worlds, and the human soul, we appreciate that it is not so simple, but beautiful, intricate, and intriguing. Through the continued study of the myth and magic of this legendary culture, we can better treasure the influence of the fascinating people called the Celts.
The Quaich – Scottish Cup of Friendship and Hospitality
The quaich, or quaigh, (pronounced “quake”) —a cultural icon—is the traditional Scottish drinking vessel consisting of a shallow cup, with two horizontal handles (lugs). It is a simple utilitarian design that dates back well over four hundred years. The earliest written reference to a quaich dates back to 1546, however its use had already been long established in Scottish culture.
The quaich is uniquely Scottish and not related to the English and American single-handled (rarely with two handles) porringer and the French tastevin.
Derived from the Gaelic word “cuach” meaning shallow cup, this ancient beaker originated in the Scottish Highlands and was commonly used to drink fresh water from a spring or “burn” (Scottish term for steam) or to savor an occasional dram, or two, of spirits at an inn or tavern. The precursor to the quaich was probably a scallop shell used in the Scottish Islands and Highlands. Macabre Celtic legend suggests that Druids filled the quaich with blood from the heart of sacrifice victims.
The quaich was a personal drinking cup, generally not shared with others—never leaving the hand—for fear of “poisoning,” or “watering down” the whisky, and was commonly carried on a belt or affixed to a saddle as a “stirrup cup.” The small size made it easy to carry on extended journeys.
Originally they were made of wood, perhaps a simple carved piece of wood. Others were constructed of wooden staves, with the skillful joining of the staves in the center of the shallow cup and sometimes concealed with a pewter or silver medallion, sometimes engraved (“print”), or a coin. Later versions were made from leather, stone, horn, or bone, and eventually various metals.
In the late 17th Century, quaichs were beginning to be made in pewter and silver. Silver quaichs were first mentioned in the 1660s and many were engraved to resemble the old wooden staves. Some quaichs are combinations of pewter, wood, or horn with decorated pewter, silver, or brass rims and sometimes gemstone ornamentation.
The cups are made in various sizes that originally measured spirits in “fingers”—one finger, two fingers, three fingers etc. Each finger was approximately a dram (1 dram = 1/8 ounce). Some larger rare quaichs were used for ale, with the largest surviving examples having a capacity of about 1.5 pints (192 drams)!
Sir Walter Scott, the prolific Scottish historical novelist and poet, was particularly fond of a glass bottom quaich. In 1745 it had traveled from Edinburgh to Derby with the Scottish Army in Bonnie Prince Charlie's canteen. The clear glass bottom enabled the drinker to keep a suspicious eye on his companions.
A more romantic glass bottom version quaich was constructed with a double glass bottom in which was kept a lock of hair—the owner could drink to his lady love every time he raised the quaich!
King James VI of Scotland gave Anne of Norway a quaich as a wedding gift in 1589 and the custom continues today. Quaichs (quaiches) are often used at wedding ceremonies to symbolize that the newly joined couple trusts each other enough to share (quaff) from the same cup.
In Kilmuir (island of Skye), there is a wooden Quaich that was formerly used as a baptismal font and thus began the tradition of using a quaich as a baptismal or christening gift. At christenings, a quaich is often proudly passed around and ceremoniously drunk from to honor and celebrate the new addition to the church family.
Historically, they were also used as a “rite of manhood” gift to men who had at last attained the “drinking age.”
Quaichs make treasured gifts as tournament trophies, achievement awards, reminders of cherished memories, or quality tokens of respect and friendship. These special quaichs are usually made of hallmarked pewter or silver and are often engraved and decorated in intricate Celtic detail. Sometimes, a matching base, called a “plinth,” is used to accentuate the display of the quaich. Many quaichs are passed down through generations and become cherished family heirlooms.
Yoga for Health and Fitness - The Seven Major Energy Centers (Chakras)
Yoga is one of the most famous and globally widespread of India's traditions. It has existed as a system of exercise, breathing, and meditation for over 5,000 years. The word "Yoga" means "to join or yoke together" - bringing the body and mind together into a harmonious experience. The exercises are designed to apply gentle pressure to the glandular system thereby toning the glands and improving total health. The breathing techniques are based on the principle that the "breath" is the source of life in the body. Meditation calms the mind and body and prepares one to handle stress.
The Upanishads (ancient Hindu texts) define Yoga as a state of gokumu jisho "extreme nothing self nature." Essentially, one's consciousness becomes himself. According to Tsuruji Sahota: "When the five senses stop their function and the judging mind stops its function as well, people call it the ultimate state. To control the organs of the body is regarded as Yoga." The organs are controlled and toned by drawing energy up through the seven major energy centers, or chakras. The ultimate goal is to reach the topmost chakra and achieve self-illumination. When certain postures and disciplines are followed, energies that have accumulated and stagnated are moved through the chakras. The practicing of Yoga releases these stagnant energies that would potentially cause various ailments (see below).
THE SEVEN MAJOR ENERGY CENTERS (CHAKRAS)
CROWN CHAKRA - SELF-ILLUMINATION RELATED TO BRAIN, PITUITARY AND PINEAL GLANDS
THIRD EYE CHAKRA RELATED TO EYES, PITUITARY AND PINEAL GLANDS
THROAT CHAKRA (ETHER) RELATED TO LUNGS, VOICE, EARS, NOSE AND THROAT
HEART CHAKRA (AIR) RELATED TO HEART AND CIRCULATION
SOLAR PLEXUS CHAKRA (FIRE) RELATED TO DIGESTION
SACRAL CHAKRA (WATER) RELATED TO GENERATIVE AND SEXUAL FUNCTIONS
BASE CHAKRA (EARTH) RELATED TO GENERATIVE AND SEXUAL FUNCTIONS
Each chakra is related to a specific area of the body, such as the head, heart, sacral area. Some add an eighth Thymus Chakra.
Even though Yoga predates Hinduism by several centuries, it is often mistakenly associated with this religion. It must be emphasized that Yoga is not a religion it has no creed or fixed set of beliefs. One does not need to be concerned about conflicts with one's beliefs.
The scholar, Patanjali, compiled one of the earliest texts related to Yoga. He devised basic Yoga theories and practices in his text called Yoga Sutras as early as the 1st to 5th century B.C. Most forms of Yoga practiced today are based on variations of his system often referred to as Classical Yoga. Even though Americans were first introduced to Yoga during the late 1800's, it didn't become popular until the 1960's, and then as part of the youth culture. In recent years, many are realizing the value Yoga to manage stress, limber a stiff body, improve health and well-being and better understand oneself.
One can better decide if Yoga offers something of personal benefit by considering the eight steps of Classical Yoga:
1. "Restraint" - Refraining from violence, stealing, lying, hoarding and casual sex.
2. "Observance" - Attributes of purity, contentment, tolerance, remembrance and study.
3. "Physical Exercises" - The actual exercising step.
4. "Breathing Techniques" - Special breathing techniques.
5. "Preparation for Meditation" - Refers to "withdrawing the mind from the senses."
6. "Concentration" - Being able to hold one thing in the mind for a period of time.
7. "Meditation" - Being able to focus on one thing, or nothing, indefinitely.
8. "Absorption" - The realization of the essential nature of self.
Physical exercise, breathing techniques, and meditation are the core of most modern Western Yoga classes. Yoga practice is non-competitive. You proceed at your own pace. Relaxing the muscles and keeping them warm is very important. There is an old Yoga quote that states: "Even iron will bend when it is warm!"
There are actually over a hundred different schools of Yoga. Some of the more popular schools to consider include:
Hatha Yoga - Based on physical movements, postures, and breathing techniques (most
Raja Yoga - Called the "Royal Road," it incorporates exercise, breathing, meditation
and study (a well rounded school of Yoga).
Jnana Yoga - The path of wisdom (considered the most difficult path of Yoga).
Yoga is a system of techniques that can be practiced by most adults of any age or physical condition. Even those with physical limitations can benefit from yoga. Women menstruating, pregnant, or nursing should not practice Yoga. Ideally, the best way to start the practice Yoga is to find a qualified instructor. A second alternative would be to purchase a good book or tape. If you're not sure where to start your search for Yoga classes, check out adult education programs, holistic centers, family YMCA programs, health food or nutrition stores or community newspapers. CAUTION: A qualified instructor is essential to learn proper technique and to prevent injury.
Ethical Considerations of Privacy and Cyber-Medical Information
In 1818, British author Mary Shelley's tale of Dr. Frankenstein's infamous creation startled and captivated a receptive audience. Just as the macabre, but resourceful, doctor created life from non-life that terrorized the local countryside, we have created a "cyberspace monster" that "lives" and knows no boundaries. It may not actually terrorize us, but we are likewise captivated by it. It profoundly influences and impacts our everyday activities, but it is also out of control and has spawned many controversial issues involving free speech, censorship, intellectual property, and privacy. The free market and society norm may, in some measure, be capable of regulating these issues and eventually help allay many of our concerns. A major and controversial concern that requires additional discussion is safeguarding the confidentiality of private medical information.
Expectations of Privacy and Private Medical Information
According to attorney and privacy law specialist, Ronald B. Standler, "Privacy is the expectation that confidential personal information disclosed in a private place will not be disclosed to third parties, when that disclosure would cause either embarrassment or emotional distress to a person of reasonable sensitivities" (Standler, 1997). Another theorist, Ruth Gavison, defines privacy as "the limitation of others' access to an individual with three key elements: secrecy, anonymity, and solitude." Secrecy or confidentiality deals with the limits of sharing knowledge of oneself. Anonymity deals with unwanted attention solitude refers to being apart from others (Spinello, 2003). Basically, we want to protect the integrity of who we are, what we do, and where we do it. Regardless of our definition, the right of privacy usually concerns individuals who are in a place reasonably expected to be private. Information that is public record, or voluntarily disclosed in a public place, is not protected.
The open architecture of the modern phenomenon that we call the Internet raises very unique ethical concerns regarding privacy. Information is sent effortlessly over this vast global network without boundaries. Personal information may pass through many different servers on the way to a final destination. There are virtually no online activities or services that guarantee absolute privacy. It is quite easy to be lulled into thinking your activity is private when actually many of these computer systems can capture and store this personal information and actually monitor your online activity (Privacy Rights Clearinghouse, 2006). The Net's underlying architecture is designed to share information and not to conceal or protect it. Even though it is possible to develop an adequate level of security, with an acceptable risk level, it is at enormous cost and considerable time.
Medical records are among the most personal forms of information about an individual and may contain medical history, lifestyle details (such as smoking or participation in high-risk sports), test results, medications, allergies, operations and procedures, genetic testing, and participation in research projects.The protection of this private medical information falls under the area of medical ethics. The realm of medical ethics is to analyze and resolve ethical dilemmas that arise in medical practice and biomedical research. Medical ethics is guided by strict principles or standards that address: Autonomy, Beneficence, Nonmaleficence, Fidelity, and Justice (Spinello, 2003). The principle of Autonomy includes a person's right to be fully informed of all pertinent information related to his/her healthcare. A discussion of medical ethical principles and patient rights leads us to further discuss legislation designed to maintain and protect these cherished rights.
Access to Private Medical Information and the Health Insurance Portability and Accountability Act of 1996
Since 400 B.C. and the creation of the Hippocratic Oath, protecting the privacy of patient medical information has been an important part of the physician' code of conduct. Unfortunately, many organizations and individuals not subject to this strict code of conduct are increasingly requesting this private information.Every time a patient sees a doctor, is admitted to a hospital, goes to a pharmacist, or sends a claim to a healthcare plan, a record is made of their confidential health information. In the past, all healthcare providers protected the confidentiality of medical records by locking them away in file cabinets and refusing to reveal them to anyone else. Today, we rely on "protected" electronic records and a complicated series of laws to maintain our confidential and private medical records.
Congress duly recognized the need for national patient record privacy standards in 1996 when they enacted the Health Insurance Portability and Accountability Act HIPAA). This act was effective April 14, 2003 (small health plans implementation date was April 14, 2004) and was meant to improve the efficiency and effectiveness of the nation's healthcare system. For the first time, federal law established standards for patient medical record access and privacy in all 50 states. The act includes provisions designed to save money for health care businesses by encouraging electronic transactions, but it also required new safeguards to protect the security and confidentiality of that information (Diversified Radiology of Colorado, 2002).
There are three essential parts to HIPAA: Privacy, Code Sets, and Security. The Security section is further subdivided into four parts: Administrative Procedures, Physical Safeguards, Technical Security Services (covering "data at rest"), and Technical Security Mechanisms (covering "data in transmission").
The intent of the HIPAA regulations is to protect patients' privacy and allow patients greater access to their medical records. The Act specifically addresses patients' Protected Health Information (PHI) and provides patients with greater access to and modification of their medical records. Prior to providing patient services, the Covered Entity must first receive the patient's consent to share PHI with such organizations as the insurance billing company, the billing office, and physicians to which the patient may be referred. Individuals must be able to access their records, request correction of errors, and they must be informed of how their personal information will be used. Individuals are also entitled to file formal privacy-related complaints to the Department of Health and Human Services (HHS) Office for Civil Rights.
Under HIPAA, codes are standardized to improve safety and security of health information. According to these new standards, a code set is any set of codes used for encoding data elements, such as tables of terms, medical diagnosis codes, procedure codes, etc.
The security section is divided into four major parts:
1. Administrative, which requires documented formal practices, the execution of security measures to protect data, policies and procedures regulating conduct of personnel in protecting data, security training, incident procedures, and termination policies.
2. Physical Safeguards relate to the protection of physical computer systems, network safeguards, environmental hazards, and physical intrusion. One must consider computer screen placement, pass code protection, and computer locks to control access to medical information.
3. Technical Security Services refers to PHI stored on the computer network and how it is securely stored and accessed. Those using the PHI must be logged on and authenticated. An audit trail of authenticated access will be maintained for 6 years.
4. Technical Security Mechanisms refers to PHI transmitted over a communication network such as the Internet, frame relay, VPN, private line, or other network. PHI transmitted over a communication network must be encrypted.
There are also some noticeable shortcomings to HIPAA. The act did little to actually make health insurance more "portable" when an employee changes employers. Also, the Act did not significantly increase the health insurers' accountability for wrongdoing with provisions that are often difficult to monitor and enforce. There is also much confusion for patients, as well as healthcare providers, in regard to the interpretation of the act (Diversified Radiology of Colorado, 2002).
Other Laws, Regulations, and Decisions Regarding Private Medical Information
Besides HIPAA, there are important state regulations and laws, and federal laws and legal decisions, concerning the privacy and confidentiality of medical information (Clifford, 1999):
The Privacy Act of 1974 limits governmental agencies from sharing medical information from one agency to another. Congress declared hat "the privacy of an individual is directly affected by the collection, maintenance, use and dissemination of personal information ...," and that "the right to privacy is a personal and fundamental right protected by the Constitution of the United States ..." (Parmet, 2002).
The Alcohol and Drug Abuse Act, passed in 1988, establishes confidentiality for records of patients treated for alcohol or drug abuse (only if they are treated in institutions that receive federal funding).
The Americans with Disabilities Act, passed in 1990, prohibits employers from making employment-related decisions based on a real or perceived disability, including mental disabilities. Employers may still have access to identifiable health information about employees for reasonable business needs including determining reasonable accommodations for disabled workers and for addressing workers compensation claims.
Supreme Court decision in Jaffee v. Redmond: On June 13, 1996, the Court ruled that there is a broad federal privilege protecting the confidentiality of communication between psychotherapists and their clients. The ruling applies to psychiatrists, psychologists and social workers.
Freedom and Privacy Restoration Act of 1999: Designed to prohibit the creation of government unique medical ID numbers.
Managed Care and Cyber Threats to Private Medical Information
The introduction of the Internet and the advances in telecommunications technology over the last two decades allows us to access vast amounts of medical information, regardless of time, distance, or remoteness, with relative ease. This cyber access to medical information has profoundly changed how healthcare providers treat patients and offer advice. No longer are there barriers to the efficient exchange of health information and critical life-saving medical information. In addition to the many benefits of cyber access to medical information, there are also serious threats to our personal privacy and our medical information.
The intense interest for the protection and privacy of medical information is driven by two major developments. The first is the growth of electronic medical record keeping that has replaced paper records. A report from the National Academy of Sciences states that the healthcare industry spent between $10 and $15 billion on information technology in 1996 (Mehlman, 1999). This was the year that the Health Insurance Portability and Accountability Act was passed with most of the expenditure attributed to converting hard-copy information to electronic formats.Electronic medical records (EMRs) present a significant threat to maintaining the privacy of patient-identifiable medical information. This medical information can be retrieved instantaneously by anyone with access and passwords. Although hard-copy medical information can be easily copied, electronic records are much more easily copied and transmitted without boundaries.
The second major development that concerns the privacy of patient information is the overall growth of managed care organizations. There is a demand for an unprecedented depth and breath of personal medical information by an increasing number of players. In contrast to traditional fee-for-service healthcare, the provider of care and the insurer can be the same entity. In this situation, any medical information in the possession of the provider is also known to the insurer. This is common in all forms of managed care, but most evident in closed-panel HMOs. This sharing of information increases the fear that the insurer may use the data to limit benefits or terminate insurance coverage (Mehlman, 1999).
Some managed care companies are reporting private medical information to an extreme in requiring providers to report to case managers within twenty-four hours any case that is considered a high risk potential for the client, a second party, the employer, or the managed care company. Examples include such things as possible danger to self or others, suspected child abuse, potential threats to national security or the client organization, client's request for records, complaint about Employee Assistance Program services or threat of a lawsuit, and potential involvement in litigation including confession or knowledge of criminal activity. No mention is made concerning client privacy or rights regarding the release of this information. Nothing is also said about what will be done with the information that is shared (Clifford, 1999).
Another issue with managed care companies is the large volume of data processed and the carelessness in handling medical information. A salient example deals with lost records as noted in a 1993 survey sample of San Francisco Bay Area psychologists. In this survey, 59% of reports were mailed or faxed to wrong persons, charts accidentally switched, or proper authorization not obtained (Clifford, 1999).
Maintaining and Protecting Electronic Private Medical Information
In order to maintain and protect valued private medical information, we must always be vigilant and proactive. Basic steps can be taken prior to using electronic information sharing. For example, when signing a "Release of Information" form, read everything carefully. If not clearly understood, ask questions. Also, remember that HIPAA grants you the right to request that your healthcare provider restrict the use or disclosure of your medical information. Make sure those who ask for information are properly identified and authorized to collect this information. Finally, make sure that the person collecting information uses at least two "identifiers" to ensure proper identification of patient (e.g. name, last four of social security number, address, telephone, number, birth date etc.
When dealing with electronic and computerized medical information, the situation gets more tenuous and much more complex. Secure networks and websites, passwords, firewalls, and anti-virus software, are unquestionably the first steps in a plan of protection. Passwords must be complex, using numbers, letters, and cases, yet also easily remembered. To maintain security, experts suggest that passwords be changed every 90 days or if they are believed to be compromised. In addition, any private medical information sent on the NET or non-secure networks should be encrypted. Encryption (64 or 128 bit) is translating information into a secret code where a key or password is required to read the information.
Further security is provided by using privacy enhancing P3P frameworks, filtering software (e.g. MIMESweeper), message authentication codes "(MACs), and "digital signatures." The Platform for Privacy Preferences Project (P3P) is a technological framework that uses a set of user-defined standards to negotiate with websites regarding how that user's information will be used and disseminated to third parties (Spinello, 2003). This P3P architecture helps define and improve cyberethics, improves accessibility, improves consistency, and increases the overall trust in using cyberspace. MACs utilize a common key that generates and verifies a message whereas digital signatures generally use two complementary algorithms - one for signing and the other for verification.
There has also some creative technology proposed for maintaining and protecting private medical information. In October 2004, the "VeriChip" was approved by the FDA for implantation into the triceps of patients. The chip is about the size of a grain of rice and is inserted under the skin during a 20-minute procedure. This invisible chip stores a code that can scanned to further release a patient's private medical information. This code is then used to download encrypted medical information. The procedure cost is about $150-200 (MSNBC, 2004).
Another more commonly used medical information tool is the "smart card," a credit card sized device with a small-embedded computer chip. This "computer in a card" can be programmed to perform tasks and store important information. During an emergency, paramedics and emergency rooms equipped with smart card readers can rapidly access potentially life-saving information about a patient, such as allergies to medication, and chronic medical conditions. There are different types of smart cards: memory cards, processor cards, electronic purse cards, security cards, and JavaCards. These cards are tamper-resistant, can be PIN protected or read-write protected, can be encrypted, and can be easily updated. These unique features make smart cards advantageous for storing personal medical information and are popular throughout the world. In Germany and Austria, 80 million people have the capability of using these smart cards when they visit their doctor (Cagliostro, 1999).
There is also a recent proposed government plan to create a national system of electronic health records (EHRs). Details include the building of a National Health Information Network that will electronically connect all patients' medical records to providers, insures, pharmacies, labs, and claim processors. The sharing of vital information could improve patient care, include more accurate and timely substantiation of claims, and be an asset to public health in emergencies. The goal is to have it operational by 2009. Even with laudatory goals of saving money, making medical care more efficient, and decreasing drug reactions and interactions, there are still inherent dangers to this national plan. There are valid concerns that pharmaceutical companies may attempt to market a new drug or device for your specific medical condition. There are also strong worries of exploitation and abuse of personal data. Who will monitor access to the information? There are also concerns that lenders or employers may rely on private medical information to make business decisions. Then there is always the ever present fear of hackers and pranksters retrieving your personal information. There are still so many questions unanswered (Consumer Reports.org, 2006).
In conclusion, we are now stuck with a "Cyberspace Monster" and all of its advantages and shortcomings. When we use cyberspace, we can have no expectations of privacy and we must accept a level of risk. Therefore, when transmitting and sharing private medical information, we must be always aware to take precautions in safeguarding our privacy as much as possible by using secure networks, P3P architecture, passwords, firewalls, encryption, message codes, digital signatures, and devices like smart cards and "VeriChips." Medical records are among the most personal forms of information about an individual, but we are challenged to find a balance between society's interest in protecting medical confidentiality and the legitimate need for timely access to critical medical information especially with fears of influenza pandemics and bioterrorism. When this information is transferred into electronic format, we have heightened concerns about maintaining and protecting this private data. With managed care, there is a demand for an unprecedented depth and breath of personal medical information by an increasing number of players. While the HIPAA provisions are a welcomed start in protecting our private medical information, we must remain vigilant of the ever increasing need to protect this special information.
Cagliostro, C. (1999) Smart card primer.
Clifford, R. (1999) Confidentiality of records and managed care legal and ethical issues.
Consumer Reports.org (2006). The new threat to your medical privacy.
Diversified Radiology of Colorado (2002) History: HIPAA general information.
Mehlman, M. J. (1999) Emerging issues: the privacy of medical records.
MSNBC (2004) FDA approves computer chip for humans.
Parmet, W. E. (2002) Public health protection and privacy of medical records.
Privacy Rights Clearinghouse (2006) Internet privacy resources.
Spinello, R. A. (2003) CyberEthics: Morality and law in cyberspace. Jones and Bartlett Publishers, Sudbury, MA
Standler, R. B. (1997) Privacy law in the USA.
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