Diabetes Research “Updates From the Faustman Laboratory at Massachusetts General Hospital”

Posted on October 26, 2016 by Buckroth

http://faustmanlab.org/docs/newsletters/DrFaustmanUpdate_Fall-2016.pdf

“Updates , Fall 2016.

“A Note from Dr. Faustman:

“Great things have happened this year! Most importantly, we began enrolling participants in our Phase II trial. This double-blind, randomized, placebo-controlled study in 150 participants will continue to investigate the ability of the BCG vaccine to reverse type 1 diabetes. Supported entirely by philanthropy, it is a clinical trial by the people, for the people. With this trial, I hope that we will find a way to stop the body from destroying the insulin-producing cells of the pancreas and help the body restore blood sugars to normal levels.

“A decade ago, that may have seemed unachievable, but I believe it is a goal that we are coming closer to every day. We are very proud to be doing this work and thank all who have helped us get here. We are touched by all of the individuals and families we hear from and see who are affected by type 1 diabetes, from the patients that donate blood for our research

to those who send in messages of support. The dedication and energy we are giving to this project is matched—if not exceeded—by the dedication and energy of our supporters. Thank you all!

“On a more sober note, we are very deeply saddened each time we learn about a life lost to type 1 diabetes complications. As you read further, you will see that this is something we touch upon in one of the updates in this newsletter. The loss of life caused by this disease makes our research goals very real to us and very clear – we must find a way to stop type 1 diabetes. I know that we all share this hope, and the Faustman Lab will continue to work towards this goal.

“Please contact us with any questions at diabetestrial@partners.org.

Thank you again!

Sincerely,

Denise L. Faustman, MD, PhD

“Long-Term Follow Up of the Phase I Trial Continues We continue to follow the progress of the patients who participated in the Phase I BCG study. All patients who were randomized to receive placebo during the blinded portion of the Phase I study have now received two doses of the BCG vaccine, just as the patients randomized to BCG did. We expect to publish data on our long-term follow up of all of the Phase I patients in 2017.

“Phase II Trial Updates…We now have over $20 million raised for the Phase II clinical trial. The Phase II trial is a double-blind, randomized, placebo controlled study that will investigate the ability of the BCG vaccine to help those living with type 1 diabetes permanently lower their blood sugars. The primary endpoint of the trial will be to see if BCG helps to lower HbA1c.

‘To date, we have enrolled over 130 of the 150 candidates that we need for the trial, and have given at least one dose of the BCG vaccine or placebo to over 100 participants. We will follow participants over a five-year period. We will keep everyone updated with trial updates as they are available.

“$20 million raised BCG Trials in Multiple Sclerosis…Moving Forward in Italy…Our colleagues in Italy are moving forward with a Phase III trial testing BCG in patients with multiple sclerosis (MS). Led by Dr. Giovani Ristori at Sapienza University in Rome and supported by the Multiple Sclerosis Society of Europe, the trials will look at the clinical effect of BCG vaccinations in patients with early signs of MS. This is a follow up to their Phase II study, which showed that even a single dose of BCG stopped multiple sclerosis progression in over half of patients compared to placebo.

“www.faustmanlab.org

Faustman Immunobiology Lab Research Identifies & Corrects Regulatory T Cell (Treg) Defects in

Type 1 Diabetes. Regulatory T cells or “Tregs” are a type of white blood cell that helps regulate the immune system, and they normally should prevent autoimmune conditions like type 1 diabetes. In our latest type 1 diabetes research paper, we identified a defect in the Tregs of people with type 1 diabetes. Using human blood samples (thanks to everyone who donates blood for our research), we showed how tumor necrosis factor (TNF) is one way to correct this Treg defect. Specifically, TNF treatment of type 1 diabetic Treg cells “awakens” the Tregs so that they become potent and functional again, fighting the cells that cause autoimmunity. Part of what we hope to do in our trials with the BCG vaccine (which is a known way to stimulate the body to produce

TNF) is to awaken these cells to put up a fight. Our paper was published online in Nature Clinical & Translational Immunology in January this year.

“Kiss the Sky to Conquer Diabetes: A Tribute to Murphy (Murph) Roberts. We featured the amazing efforts of Kiss the Sky to Conquer Diabetes (KTS) in our newsletter last year. For those who don’t know, KTS is a mountain climbing group led by Rick Noble. They joined the effort to help raise awareness for and finance our human clinical trials in 2004, and they have since taken

on some incredible climbing challenges in support of these goals. This summer, KTS took on the

Six-Pack of Peaks Challenge, which Rick described as “6 peaks, 82 miles, over 27,000’ of vertical gain and one epic challenge to conquer diabetes!” Right before setting out on the fifth and biggest climb of the challenge, the KTS team sadly learned of the passing of Murphy (Murph) Roberts, the brother of a friend of Rick’s daughter, Sarah.

“While hiking in Utah, Murph experienced a seizure related to his type 1 diabetes. The seizure caused a fall that resulted in a series of complications, leading to his death. Murph, a member of the class of 2017 at Middlebury College in Vermont, is remembered as a great student and person, and an avid adventurer. He was also passionate about finding a cure for type 1 diabetes. As a tribute to Murph and with the blessing and support of Murph’s family, the KTS team has renewed their pledge to “keep climbing until we conquer type 1 diabetes.”

“Dr. Faustman and Charlotte, a young supporter whose very successful rollerskating fundraiser helped benefit the Faustman Lab’s research.”

Insects of Diabetes

Posted on August 28, 2016 by Buckroth

The Insects of Diabetes – A Different Take

Having to deal with insects is unpleasant. But it often has to be done, right? Careers have been exhilarated through the care and most probably the removal of bugs: household spiders, fleas, flies, ants, slugs, snails, beetles, mosquitoes, etc. Add more for emphasis if you would like. You get the idea.

Diabetes has its own specific insects – of a sort. I call them “EIDS,” an acronym for Exercise, Insulin, Diet, and Stress. Not too many people are in favor of attention toward EIDS, but these have to be attended.

Entomologists study such critters, bugs, that not only occupy this planet of ours, but are necessary in the chain of life. Entomology is the scientific field of study that specifically addresses all species of insects. “At some 1.3 million described species, insects account for more than two-thirds of all known organisms, date back some 400 million years, and have many kinds of interactions with humans and other forms of life on earth.” (Wikipedia.com.)

Using entomology as an analogy to diabetology, this is the study of diabetes. It has become a field of expertise, often referred to “endocrinology” pertaining to the practice and concentrated care in diabetes patients. With diabetes having become a pandemic, 400,000,000 people are singularly affected and effected. This does not include the numbers of diabetes caregivers (e.g., parents, siblings, spouses, extended family members, medical personnel, friends, etc.) that witness the daily actions or inactions of their diabetic counterparts. (Wikepedia.com.)

To my astonishment, author Gail B. Stewart wrote that diabetes dates back to “1500 B. C. in the Ebers Papyrus, an Egyptian compilation of medical works containing a number of remedies for passing too much urine.” On to “400 B. C., Susruta, a physician in India, recorded diabetes symptoms and classified types of diabetes.” (Stewart, Gail B. Diabetes. © 1999.) Continuing into A. D. 10, 2^nd century A. D., onto 1869, and 1921, Ms. Stewart further explains the history of diabetes. Not unlike our earthly insect participants, its history has been unstoppable.

Exercise – difficult to accomplish on a daily basis no matter your age. Motivation, encouragement and self-discipline are ingredients to control this particular “insect.” No, it’s unnecessary to join a gym and make yourself promises that you know you won’t keep. Debt enhancement may be your only self-promise! Just start moving! Start small. Move slowly. Begin by walking the length of your driveway and back. There’s no competition. No one is watching you. Do it for yourself. Increase your walking space every day. Every day is important. Pick a time and go for it!

Insulin – don’t forget your insulin! Never ever forget your insulin! No matter if you inject it daily, wear an insulin pump, or pop a pill to help manage this disease, your medications are vital! Medicine is medicine and invented for a purpose – to help you live! It is available for you. It was invented for you. Take advantage of your special-ness.

Diet – Ugh. This ‘insect’ has to be balanced as in acquainting yourself with food groups, portion sizes, times of eating, blah, blah, blah. Everyone in the world is acquainted with this topic! Caloric intake, carb or no carb, low protein or vegetarian, a diet is a diet is a diet. It’s the strictures of diets along with the act of dieting that need your attention. Repeated research has shown that a healthy diet is absolutely necessary – and not just for a diabetic! Medical professionals are in abundance to guide you with this factor. Too many books have been written on this factor! Why? Because it is important! Think about it. What you ingest is part of your daily self-care.

Stress – I think this is the worst insect to even try and avoid! If it crosses your path – and it will, be sure of it – and it approaches you unawares, be still. Just be still. Breathe, listen, blink breathe. Many things are out of your control – accidents, management blame, financial upheavals, etc. – except for you, your self. It is how you control your stress level that will determine your self-health. Many choices are available – for you – in which to indulge and keep your inner peace. That is a healthy state of mind, a healthy state of being. You want to be healthy. Healthy is happy. Happy is a good thing.

Each of these ‘diabetes insects’ effects the other. As in the circle of life or knowing that history repeats itself, diabetics do what needs to be done in order to function on a daily basis. This sounds simple, but it is not.

Hope for a Diabetes Cure – yes, again….

Posted on August 9, 2016 by Buckroth

Important: “Breakthrough: The Case of Murder in the Pancreas”

No one’s sure why renegade members of the immune squad snuff out workers in the body’s insulin factory. Can investigators like Thomas Delong solve the mystery—and stop the attack that leads to type 1 diabetes?

By Jon HoltenJuly 2016 Type 1, Causes, Current Topics, Researchers

Click here to download the print version of this article.

Prologue

By the time Thomas Delong, PhD, arrived in Denver, Colorado, the investigation into the immune attack on insulin-making beta cells that leads to type 1 diabetes had been running into brick walls for 18 long years. The team needed a fresh perspective and a different set of skills, so they imported a specialist.

“He was quite confident that he was going to crack this in six months,” says lead investigator Kathryn Haskins, PhD, a professor of immunology and microbiology at the University of Colorado School of Medicine.

Delong was right about being able to solve the case. He was just off by a decade.

Chapter 1

The hunt began in the mid-1970s, after scientists realized that type 1 diabetes is an autoimmune disorder—the result of the immune system launching a misguided attack within the pancreas and wiping out the beta cells that produce insulin.

The first big break came in 1988, courtesy of a young hotshot named Kathryn Haskins. She discovered that a T cell, one of the white blood cells responsible for protecting the body against intruders, pulled the trigger in the immune response that causes type 1 diabetes in mice. Within a year, she made a positive match on several more disease-causing T cells involved in the assault on the beta cells.

Haskins solved the whodunit. But she remained unclear about the exact motive and the initial victims. “From then on, I wanted to know what in those beta cells is the target,” she says. That remained a mystery well into the next millennium.

Chapter 2

In the spring of 2006, Haskins received a letter from Germany. The writer? Thomas Delong. He was completing a doctorate degree in chemistry and biochemistry at the University of Erlangen–Nuremberg, and he wanted a job. Delong had no background in immunology, but Haskins invited him to Denver to interview.

“It was fortuitous timing,” Haskins says. “We were trying to identify the chemical makeup of the material that triggers the autoimmune response, and he was a perfect fit for what I wanted.” Delong joined Haskins’s lab as a postdoctoral fellow in July 2006.

“I was excited. I knew this could be big,” says Delong, who brought along a personal agenda. He had developed type 1 diabetes at age 12. A physician later told him about genes associated with type 1 diabetes, which got him thinking: “Why did I get this disease? What caused it? It was important to me to figure out.” Set on a career in diabetes research, he took the advice of a friend’s father and chose to study chemistry. After 10 years of college, he crossed an ocean to work with Haskins.

“Handling T cells is very difficult, and she’s a magician,” Delong says of Haskins. “T cells are there to help us. They fight off viruses and bacteria. The problem was [that] she didn’t know why they attack the body’s own beta cells.”

Chapter 3

Delong soon came to think of diabetes-causing T cells as terrorists. His task was to find the initial victim in the terror spree—an autoantigen, a substance within the body that T cells mistakenly target. He began by analyzing the content of beta cells, home to a multitude of proteins, each one a potential innocent target of the T-cell attack.

“Beta cells contain tens of thousands of different molecules,” Delong says. “I broke them open and tried to isolate and purify the proteins. It was detective work.”

He filtered out small, insignificant molecules and separated the rest into multiple batches. When lab-grown copies (clones) of diabetes-causing T cells from mice surprisingly had only a mild response to each batch, Delong chose to focus on the batch that prompted the biggest effect.

He used a high-tech instrument to identify known proteins in the batch. The T-cell clones didn’t recognize one protein in particular as part of a healthy body. Delong figured this was a likely source of the autoantigen, but he didn’t know which part—or why it looks threatening to the immune system.

Since the protein in question naturally spins off a compound called WE14 in other glands, Delong tested WE14 with T-cell clones. Three of the clones fired weakly at the WE14, confirming in 2010—four years after he started—that WE14 is a target for certain types of T cells.

But something gnawed at Delong: If WE14 truly is the T-cell target, why was the immune response to this compound so weak in the lab?

Chapter 4

Frustration was building. Nothing Delong tried in the lab with his target antigens could replicate the way, in the laboratory, reactive T-cell clones declare full-on war on the unfiltered content of beta cells. “That was discouraging,” Delong says.

“We knew that proteins can be modified in the cells, and it could be any one of many possible modifications” that leads to an immune system response, he says. The challenge of determining the correct modification? “Immense,” says Delong.

The body processes proteins through chemical reactions that produce other compounds. For example, human beta cells modify two compounds to bind to each other to form active insulin, which regulates metabolism and escorts glucose to the body’s cells.

“We tried many things, and most didn’t work,” Delong says.

Haskins wasn’t surprised. “We took a lot of wrong paths, which is the way that science goes,” she says.

Chapter 5

While subjecting the protein that contains WE14 to assorted conditions, Delong increased the acidity of the solution—like adding a squirt of lemon juice to a glass of water—and the compound disappeared. That unstable behavior reminded the biochemist of a common group of compounds known as aldehydes, so he mixed the content of beta cells with a chemical that reacts to aldehydes. He found no sign of aldehydes. Instead, the chemical was binding to insulin fragments.

This was an important clue, and Delong made an intuitive leap in the investigation: Perhaps the T cells’ target was a hybrid—half insulin fragment and half a fragment of something else. He needed to identify, beyond a doubt, the unnamed substance.

Chapter 6

If proteins were food items, a mass spectrometer could identify an egg, some milk, a little flour, and so on. But when an egg and milk get together to produce a soufflé, the spectrometer draws a blank. “Mass spectrometry can tell me what proteins are in there, but only if the protein is known … if it’s in the database,” says Delong.

To aid identification, Delong broke down the different proteins into smaller fragments, known as peptides, and then chemically fused fragments of insulin to other peptide fragments, such as WE14, forming entirely new peptides. He called these novel peptides hybrid insulin peptides (HIPs).

“When two different sets of T-cell clones responded strongly to several of these HIPs, our confidence went up exponentially,” he says. “Then we started to look for and devise methods to identify them. It took another half year to do that.”

Chapter 7

Having identified HIPs that were recognized by the T-cell clones, Delong generated a mass spectrometry database containing the unique signature for each HIP. Next, he began to look for the HIPs in the content of beta cells, using mass spectrometry.

This time, the spectrometer identified several HIPs. “That was the eureka moment. Hybrid peptides occur mostly in plants,” Delong says. “[Hybrid insulin peptides] were not known to exist. Nobody had ever seen them before. No one knew they could get fused to each other.”

When exposed to the hybrids, five types of T-cell clones from mice reacted strongly. T-cell clones from the pancreases of two organ donors with type 1 diabetes also had a potent immune response to various HIPs, suggesting the hybrids play a central role as targets of the autoimmune attack that launches type 1 in humans. Eureka!

“This provides such a plausible explanation of how the body gets tricked,” Delong says. The peptides occur naturally in beta cells, but T cells apparently don’t recognize the hybrids as part of the body and treat them as a foreign threat.

Chapter 8

After an article they wrote on their research appeared in the journal Science in February, Delong and Haskins received praised for this discovery.

“Dr. Delong’s novel and exciting work identifying pathogenic hybrid insulin peptides as a trigger of this immune attack sheds pivotal new light on a possible trigger of diabetes and has the potential to enable us to develop novel strategies to tackle it,” says Desmond Schatz, MD, medical director of the University of Florida Diabetes Institute and president of Medicine & Science for the American Diabetes Association.

Since joining Haskins’s lab, Delong has logged other milestones as well. He became an assistant professor in 2012 and a U.S. citizen in 2015. He and Haskins applied for a patent on their library of hybrid insulin peptides, now approaching 8,000, to aid in diagnosing and treating type 1 diabetes. Along the way, Delong started using a continuous glucose monitor to manage his diabetes. He also received a Pathway Accelerator Award, major research funding from the American Diabetes Association (see “Funding Fuels Research,” below).

Epilogue

The discovery that hybrid insulin peptides may play a major role in the development of type 1 diabetes has already inspired new directions for researchers, with clues on how to diagnose, treat, prevent, and cure type 1 diabetes.

“When you make a discovery, a whole new area opens up,” says Haskins, “and our lab is working onall of those questions.”

Learning more about the mechanism used by beta cells to produce hybrid insulin peptides could lead to methods of preventing the autoimmune attack by shutting off either HIP production or the signal telling T cells that HIPs are antigens.

“Our hope is that we can re-educate the immune system,” Delong says. “Maybe we can use hybrid peptides as drugs to induce tolerance by reactive T cells.” The drug would teach the T cells to accept the HIPs—similar to training a guard dog not to go after the mailman.

“We might even be able to reverse diabetes, if you put stem cell–derived beta cells back in the body of a patient [to restore insulin production]. The immune system has memory, so you would need to shield the stem cell–derived beta cells. If you can identify the handful of T cells that attack the hybrid peptides, you shut them down before you put stem cells in the body.”

The researchers also speculate that hybrid peptides could be the target antigens for other autoimmune disorders, such as multiple sclerosis and rheumatoid arthritis. Delong notes that more than 15 percent of people with type 1 diabetes develop other autoimmune diseases. This important research may open the doors to cures beyond diabetes.

Delong sees great potential but cautions that it will take years for their research to result in new care regimens. But when that happens, the presence of HIPs may be used to diagnose type 1 diabetes or identify people at risk of developing it.

“I have always hoped that a cure would happen in my lifetime,” says Delong. “The way to stop diabetes is to figure out ways to prevent it. I think that’s realistic, but these things take time.”

Funding Fuels Research

Thomas Delong, PhD, may be an assistant professor at the University of Colorado School of Medicine, but he doesn’t buy groceries, pay the mortgage, or make a breakthrough diabetes discovery without research grants.

Expenses associated with running his lab, including his salary, are paid for by grants he is awarded by funding agencies, such as the National Institutes of Health and the American Diabetes Association. “You need resources to do your research,” Delong says. “You need technicians who can help you.” Ten other people work on this research.

Delong received a Pathway Accelerator Award and $1.625 million from the Association in January 2015, 13 months before his major research on hybrid insulin peptides was published. The funding has allowed him to focus on research—and not on writing requests for more grant money.

To speed research advances, the Pathway to Stop Diabetes initiative aims to attract and sustain—with a generous five to seven years of financial support—the next generation of diabetes researchers. Delong’s discovery “is validation that we are supporting the right people in the right environment, asking important questions, and uncovering some of the mysteries surrounding diabetes,” says Allison McElvaine, PhD, the Association’s director of Research Communications.

You Can Help

In 2015, the American Diabetes Association received nearly 730 promising diabetes research proposals. The Association was able to fund 84 of those. Too many potential breakthroughs go unfunded—you can help: visit diabetes.org/donate.

Interested in more information about healthy living with diabetes? Click here to subscribe to Diabetes Forecast magazine.

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“Kisses for Cash” Kali’s Story T1D meets T2D

Posted on July 30, 2016 by Buckroth

This third chapter book in the series introduces new characters in Kali’s life. She is now eleven and a half years old, having lived with diabetes since she was two years old, and continues to care for her diabetic dog, Money.

Her Grandmother, recently diagnosed with T2D (Type Two Diabetes) comes to live with the family; Grandma decides to adopt a dog of her own in order to get exercise to help her control her disease as she is unable to handle Money’s girth; a new school friend, Tavius, is introduced while her bff (best friend forever), Wayne, pursues other interests.

Mishaps continue as well as young adventures that lead to learning experiences for all young diabetic boys and girls.

Suitable for all ages, this illustrated chapter book, consisting of 121 pages, is an easy acquaintance to learning about T1D. I am sure you will enjoy it along with the two other books in this series as they were absolutely delightful to write. Please let me know your thoughts! Thank you…A. K. Buckroth (#buckroth, www.mydiabeticsoul.com).

Available at Amazon.com, Goodreads, Smashwords, local libraries, and book stores. Happy reading!

P. S. Book Award received from the Northern California Publisher’s and Authors organization. 🙂

Here’s an excerpt beginning with Chapter 9….

Sitting at the kitchen table, staring at the brown cardboard box that was delivered a couple hours ago, I knew what awaited me inside of it—a new insulin pump. Mixed emotions surrounded me. Sure, I was glad it arrived. After all, it helps me stay alive, stay well. I’m just a little nervous having to put it all together correctly. It’s been more than two years since Nurse Nina first taught my parents and me about the insulin pump, and when I first began using one. Slowly, I recalled all the details.

Mom and Grandma continued to tour the house, getting Grandma settled a little bit. While they were busy doing that, I got busy opening the eagerly awaiting box. I can do this. For one, I’d be able to stop taking four injections every day. Four and a half days of doing that was enough as far as I was concerned. Second, the pump would give my body get the constant infusion of insulin it needs, an automatic squirt every three minutes. I don’t necessarily want to do this. I have to!

It was really nice walking around without it. Different. I felt free, really, not having it clipped to my pants, not having to worry about banging it, dropping it, or getting the tubing stuck on a doorknob or pants zipper or something. But the alternative was bothersome—pausing to get my insulin pack, filling up a syringe, sticking it

somewhere in my body, being careful to remember not to use the same area twice, etc, etc. So many details to remember and plan. Plan, plan, plan. That’s a big—no, huge—part of my every day! Oh well.

Opening the box with a pair of scissors while it rested on the kitchen table, I sat, getting real serious about this process. I concentrated. There was a little white cardboard box inside the bigger brown one surrounded by lots of plastic bubble wrap and more clear packing tape. Protection. Geez, what I call a ‘paper trail.’ It takes a while to get through all this paper. I’ve often wondered if this company knows about recycling. Geesh. Once opened, the new pump gleamed in all it shiny newness. Clear in color, its five command and use buttons were displayed in black bold letters on the front, under the LCD screen. I could see right through it. Such a little thing, it weighs only 3.5 ounces, so I was told. In fact, when some people have seen it attached to my clothing, they’ll ask me “why do you wear a pager?” because it looks like a pager. I answer “It’s not a pager. It’s an insulin pump.” Then I get all kinds of reactions: either they shut up right away, seemingly shocked, not knowing anything about such a device. Or, they get real interested, asking questions of interest with a short conversation.

Set aside are supplies that I already had: an alcohol swab, a vial of Apidra insulin, a 6 millimeter 23 inch infusion set, a reservoir, a AAA battery, and a dime. As I was taught to do, I let the Apidra insulin vial sit out for an hour to become room temperature-ized. I have always used a dime to open the slim battery case. Sure, there’s a ‘plastic unscrew battery thingy,’ but I didn’t know where it was. The dime fit just fine to unscrew the top of the battery case area and insert a new battery. With that done the pump’s LCD (Liquid Crystal Display) screen lit up and blinked on as if happily awakened.

When I pressed the familiar “ACT button,” it displayed various commands, choices of what I wanted or needed to do with it. Pressing the down arrow button, I chose “Time and Date” and pressed the month, the day, and the year. Onto the time of day, I pressed the up and down arrow buttons a few times. The time of day is important for the pump to squirt—release—the hourly programmed dosage of insulin. For instance, between midnight and 4am, it was programmed at the time to give me .4 (four tenths) of a unit as opposed to other day time hours when it gives me .6 (six tenths of a unit).

Next, I gently peeled open a small square reservoir package. This light-weight object arrived in a carton of ten. They looked like small syringes, each with a light blue needle head attached. These hold the insulin inside my pump. Pressing its clear plastic lever back and forth a few times made sure it slid easily in order to move inside the pump. Just a precaution, I guess. It’d be in the pump for about seven days. I made sure it would slide easily to disperse insulin for all that time.

I heard my parents and grandmother enter the kitchen. They were watching me. All was quiet. I smiled.

“You guys don’t hafta be so quiet,” I said.

“Well, you look like you’re concentrating so hard, so serious. We didn’t want to bother you,” my mother remarked.

“Can I sit and watch you, Kali? I’ve never seen such a thing,” said Grandma.

“Sure, sure,” I told her. “It’s almost ready to insert into my leg.”

Grandma looked like—well I don’t know how to describe it. She looked like she was going to cry with her blue eyes wide open and her eyebrows crinkling on top of her forehead. With the attached needle head, I pressed it on to the insulin vial, inserted air into the vial, then withdrew it slowly, pulling on the syringe stick lever to fill it up with insulin. The maximum units the reservoir tube holds is 180. If there’s a problem, the pump will beeeep non-stop until I give it the attention it needs.

For instance, Dr. Ansari, my endocrinologist, calculated that a warning, a loud beep, would sound when there are 20 units of insulin left. If I were to hear it, I would have to look at the LCD screen to see what the pump is telling me first of all. Then I would shut it off by pressing the “ESC”—Escape— button. Ha, I’d like to press a button to escape sometimes, haha. A couple times it beeped non-stop with the screen blinking in upper case letters OCCLUSION! OCCLUSION! OCCLUSION! Just like that. Non-stop. That sound had woken me up a few times. It’s an alarm. Not good. I don’t like insulin pump alarms. This means that the tubing from the pump to my body is blocked and needs to be changed. That’s the only way to fix the situation, to make the beeping stop. Doing that at 3:00 in the morning is horrible. It was Money that actually woke me up one time, pushing me with his nose. The pump’s alarm sound woke him first.

There were other times, too. I’ve been embarrassed when in the mall or in school or out somewhere. I had to immediately stop what I was doing and give my attention to the screaming pump that was clipped to my waistband. I hate that! People around me don’t know what the heck is going on and look at me like I’m weird. Ugh. They just don’t know. Scurrying quickly to the nearest restroom, I’ve had to partially undress, shut off the thing, scrounge in my pack for an extra infusion set or whatever is needed, and change it, fix it. Lots of crazy things have happened while wearing and carrying this thing when I least expected them too. And lots of times I have been unprepared.

Like one time, I was in church with my folks and the pump started beeping—non-stop! OMG! Talk about embarrassing! I couldn’t shut it off. My mother couldn’t shut it off. EVERYBODY could hear it, I swear. We all scooted out of the pew to the restroom. FINALLY quieting it down, I saw it needed a battery. None of us had a battery. So, we left service, had to go home, and get a stupid battery. Ugh. Sure, there’s a picture of a battery on the LCD screen – if I looked at it, I would’ve known that it was low! But I didn’t. Ugh. My fault for sure. I know better now, another part of planning and preparing.

Next, on to peeling open an infusion set, I first calibrated the pump machine, setting my hourly, 24/7 (24 hours a day for 7 days), basal rate. I call that my “squirt rate.”

My mother pretended not to watch me and remained quiet. She kept walking back and forth from the stove, to the sink, to the table, occasionally breathing on top of my head. I wished she would go into the other room!

Finally, the pump was all suited up. Oops, I almost forgot to attach the clip. With that done, I re-thought hard about where the infusion set would go in and on my body. My choices are certain skin areas on either side of my lower belly, two inches away from my belly button; the top, inside, or back of each thigh; either hip, as far as I could reach, or either buttock, as far as I could reach, and the lower, fatty areas of my upper arms.

With Grandma watching me too, I decided to put the infusion set it in my upper thigh. That’s the best place to show—demonstrate to her or anyone—how this is done without having to undress. She got real quiet as I did this. Tearing open a small square envelope with one alcohol swab in it, I wiped the area, making sure it was clean, sterile, free of germs. Next, I opened the sterile packaging that holds the infusion set, removed the sticky paper on the round adhesive tape area that holds it to my skin, then I removed the bright blue plastic covering on top of the metal needle.

The insertion of the needle is like an intravenous needle, but the metal part doesn’t stay in my skin. It’s also called “subcu – subcu – subcutane – sub-cu-tan-e-ous,” phew, which means it doesn’t go into a vein. I held my breath, gritted my teeth, and quickly push the needle into my thigh skin. Phew. Deep breath. I don’t like doing this. It hurts worse in some spots than others sometimes, not always. I don’t know why. Grandma looked like she was going to cry, especially when I pulled the needle out and rested it on the table to be discarded. She stared at it, gasped, and stayed real quiet.

I often get little black and blues from putting the needle in or taking it out. That’s the way it is. Like the little black and blues on my finger tips from testing my blood, I know why those happen – from doing the same fingers spots over and over.

Once the ugly and scary looking metal needle head is pulled out, a plastic infusion set stays in my skin attached to a flat, clear plastic head about the size of a quarter. That rests on top of my skin. The tiny plastic needle-like tube inside my skin is about a quarter of an inch long. Once that is done, I cover the head of it with a thin, clear, 2 x 3 inch sticky paper to keep it in place, to protect it and myself so it won’t come out. It’s thinner than a bandage, comparable to a layer of human skin. All this has to be done the day after tomorrow, again, but in a different body spot.

“Okay, Mom. I’m all hitched up.”

“Good, sweetie. Did you set your hourly basal rate the same way? “

“Yep. See?” I showed her. She gently took the pump in hand to review everything I just did. As the tubing is 23 inches long, gently is a key word. Neither one of us could move too far.

“Looks good. Good job. Now test your blood, count dinner carbs, and take care of Money. I love you, Kali. Supper will be ready in about 20 minutes.” Mom squeezed me tight, as always.

“Kali, you are so brave,” my grandmother told me. She had a tear in the outside corner of her eyes like they were going to pool up and roll down her cheeks. Wiping her eyes with her thumbs, she stated, “I’m glad I was able to see you do this. Now I know more about this pump and how you have to wear it and what you have to do. If it’s all right with you, I’d like to see you do it again when you’re ready. Watching you will teach me.”

“Okay, Grandma. I’ll let you know. I have to do it again in three days. Every three, or sometimes four days, I refill it and do this all over again, put it in a different body spot. Rotate.” I remembered that my last shot with Nurse Mickey was in my “Izzy arm,” the left one. I call it that due to what happened last year when “Izzy the Infuriator” slammed me into the lockers. Three days from now, I’ll put a new one in my upper left thigh or maybe my upper left hip. We’ll see. I go through the same process all over again, the same decisions, the same planning.

Sometimes I forget to tell my parents when my supplies get low. A couple times the pump company had to send them to me by overnight mail. I’m supposed to notify them – my parents, really – when I have ten infusion sets and ten reservoirs left. Then either my Mom or my Dad will call the company and place an order. Usually it’s Mom.

A lot of my decisions of where to put the infusion set depend on the clothes I wear. I prefer pockets in all my clothes, front or back. Skirts my size are more difficult to find with side pockets. My once favorite faded blue jeans skirt had front and back pockets. The front pockets were big enough to hold the pump comfortably and securely.

Dresses? Forget it. I’ve never had a dress with a pocket on it. They just don’t exist. When I do have to wear a dress, like the special one Grandma got me for Christmas, I clipped the pump underneath onto the waistband of my underwear. But doing this makes it more difficult for me to access the pump when I need it. And after a while, my underwear waist bands unravel and get worn out from the pump clip. Oh well. Once diabetes is cured, I won’t have to do this anymore. I think about a cure for this disease every time I go through this. I’d like to be cured—along with the rest of the world! Ah well. As my mother has often told me, “hope springs eternal.”

I don’t cry any more when I do this. Actually, either of my parents used to do it for me. That was more than two years ago, when I first started using an insulin pump. I used to cry. But I know how to do this by myself and I understand why. I still don’t like it. Am I supposed to like it? Nah. I use it to stay alive.

Phew. That’s over—once again.

10.

All the insulin pump preparations with supply set-up, putting in a new battery, re-setting the hourly bolus rates, resetting the timer and date, filling the reservoir with insulin, making sure there are no air bubbles, letting it re-wind, putting it in the pump, attaching the infusion set tubing to my body, replacing the clip, and finally putting it in my body took me about twenty minutes. A long twenty minutes!

Phew!

Re-setting this machine is what took me so long. Otherwise I would’ve had it in my body after only ten minutes. What takes the longest is letting the insulin sit out to get room temperature-ized. That takes about 20 minutes. My Mom did that while I was at Wayne’s. She’s a great planner too.

Back on schedule, I feed Money —before I eat.

Chores? Like sweeping the floor? Not yet. I planned to do that after supper, when I clear the dishes and put them in the dishwasher.

I spent my after school “chore time” at Wayne’s house. That’s okay. It was worth it. I felt good about that but not a hundred percent good. No homework to do seeing as it was almost the last day of school. Heck, there’s lots of other stuff I could do!

“Kali, when is your last day of school?” Grandma asked.

“June 4^th,” I declared with glee.

“And then you’ll be a fifth grader? Is that right?”

“A sixth grader, Grandma, I’m going into the sixth grade. “And summer camp starts July 5^th,” I told her. I couldn’t wait! “Now that you’re here, Grandma, you’ll be able to come with us to drop me off and see the camp. It’s really nice. I like it—a lot! Especially the big field where we play volley ball. And the pond is right behind there with a dock and the canoes and row boats,” I excitedly explained. “The cabins are in a half-circle around the pond with the fire pit at the far end. I’ll show you. We can walk around the who-oo-le place! I can’t wait to see some of my friends, too. Maxine, Lisa, Judy, Cathy. Especially Cathy. She wasn’t on a pump last time. I tried to talk her into it. Maybe she has one now. I don’t know.”

LEADERS VERSUS MANAGERS

Posted on June 24, 2016 by Buckroth

Leaders are original…Managers copy.
Leaders develop…Managers maintain.
Leaders focus on people…Managers focus on systems & structure.
Leaders inspire trust…Managers rely on control.
Leaders innovate…Managers administrate.
Leaders have a large-range perspective…Managers have a short-range view.
Leaders ask what and why…Managers ask how and when.
Leaders have their eyes on the horizon…Managers have their eyes on the bottom line.
Leaders originate…Managers imitate.
Leaders challenge the status quo…Managers accept it.
Leaders do the right thing…Managers do things right.
Leaders always try & maintain a positive attitude.
Leaders do not reveal doubts about a chosen course of action in their subordinates.
Leaders personally accept blame for shortcomings in activities for which they are responsible & generally share the credit for successes.
Leaders do not ask their subordinates to accept sacrifices that they are not willing to make themselves.

(AMERICA ONLINE…”LEADERSHIP PRINCIPLES”)

Just sayin’….

Pros & Cons of the Information Highway: Legal Assistants Should Know

Posted on June 21, 2016 by Buckroth

December, 1994

“Let’s refresh our memories. The Net (Internet) began 25 years ago as a communications system set up by the [United States] Defense Department to link computers at universities with those at other defense research centers. This network deliberately had no central locations, so in case part of it got knocked out in a nuclear attack, the rest of the Net would continue to operate. Since then, the Net has expanded to include universities, corporations, and government agencies around the globe. Individuals get access to the Net through one of these organizations or via a third-party service provider. But with no central governing authority, users have been free to add computers and services to the Internet virtually at will — resulting in near anarchy today!

“These days [1994], the Net is undergoing massive changes. Thousands of new users sign up each day, and more and more companies are doing business over the wires, leading to network traffic jams and debates over access restrictions and usage fees. As government and big business spar over the future of the much-hyped information highway, many fear that the anarchic freedom of the Net may be nearing its end!

“And just the idea of instantaneous information being literally available at everyone’s fingertips, the American imagination has been captured. I would think that uncapitalistic democracies and other countries, in general, that have imaginations, cannot freely express them as America does. You know what I mean. The promise of a limitless electronic frontier – over 20 million users at this writing – is still growing faster than ever, creating mammoth electronic traffic jams on phone and computer networks.

I. Secure Distributed Computing

“The advent of the global Internet has brought about a significant change in the way people communicate and do business. Yet as this global village expands, so does the number of less than honest citizens. Furthermore, much of the hardware and software that constitutes the Internet was designed with only the trustworthy user in mind. As a result, intruders can invade the privacy of network communications as well as read or alter stored information. 1

A. Networks and Computer Security

“At the Massachusetts Institute of Technology, computer-system administrators have been coping with problems of security for more than 10 years. In 1983, in collaboration with IBM, the Digital Equipment Corporation undertook “Project Athena” to provide advanced computing power to students and faculty. Athena is based on the client-server model: users work stations (the clients) do most of the computing, but specialized machines on a campus-wide network handle file storage, printing and other needs. This model has since become a widely used paradigm for much of the Internet!

“When users sit down at a terminal, for example, they “authenticate themselves” by typing an account name and password. Only the owner of a particular account, or case in speaking of the legal assistant, would and should know its password. So, the two in conjunction suffice to identify the user to the system.

“It is important to know that the user assumes that s/he is communicating with the intended computer. If the terminal is connected directly to a specific computer, the user knows that the terminal speaks for that system. When users dial a mainframe via modem, they trust the telephone company to connect the telephone call to the computer system that corresponds to the dialed number.

“As long as a computer’s internal security is not sabotaged, the mutual trust between user and mainframe remains in force until the user logs out. The system assumes that all the keystrokes it receives have been typed on behalf of the user. And the user assumes that all information appearing on the screen comes from the appropriate computer system.

“Now, let’s assume that employment of humans, especially college-graduating humans, will not be eliminated by this superhighway. “Estimates from state to state on the number of jobs that the superhighway projects and competition from local telecommunications companies will create are in the tens of thousands per state. Critics are quick to deflate the numbers to more modest proportions, but the expectation of new jobs within the telecommunications industry is never disputed. 2

“Well now, I for one could dispute that phraseology, but that would constitute another research project! On the positive side, one employable aspect involves the placement of the fiber-optic network throughout the nation.

“And with all these humans speeding on this Information SUPERhighway, it will be difficult to set any speed limits on it! The limits soon will be raised from the 14,400 and 28,800 bits per second speeds that most computers are using. For instance, AT&T Paradyne, based in Largo, Florida, has introduced a new 33,600 bps (bits per second) modem. This speed can transmit about 42,000 words per minute. “The faster speed should help accelerate the transfer of medical images over the telephone, as well as improve desktop videoconferencing, mobile computing, [paralegal researching and indexing,] and interactive games.

II. New Laws

“Now that software is available, creating international standards, new laws will become a major issue. Laws will have to be “revamped.” There are a lot of issues relating to privacy, security, and liability associated with information that may be private or confidential. There are also a lot of regulations — legislational types of issues — in terms of intellectual property rights for information that is made available electronically that can be copied and distributed very easily.

“For example, when there were no automobiles and people were only travelling at a peak speed of five or ten miles an hour, there were far less accidents, and now that we have automobiles, it’s changed our way of life. On the other hand, we have had to work out liability insurance and automobile inspections and driver testings and point systems, emergency vehicle laws, right of way….4

“One Great disadvantage of this ever-increasing superhighway trend is the fact that users will be constantly accessible in their homes, cars, or just about anywhere they go via personal communicators (cellular phones). All in all, the United States Constitutional laws were not drawn up to protect the country’s citizenry from privacy break-ins in their computer systems, never mind their on-line information!

“At this point, the important thing to consider is that the ‘highway’ is still in the works.

III. New Words

“On the perspective of disadvantages versus advantages, legal assistants as well as people in general, especially students, will need to know what the heck futuristic novices-to-experts are talking on-line about.

“The following in a minor list of phrases that this researcher thought applicable for present review of the future:

Active attackers – those who introduce false data into a network to corrupt its normal functions.
Archie – a system that keeps track of files available for downloading on the network.
Bliatherer – a user who takes three screens to say something when three words would suffice.
Broadcast based – every one of the computers connected to a network cable has access to all the information that flows through that cable.
Cyber-cad – the electronic equivalent of a lounge lizard, often seen prowling Usenet single groups.
Cybernetic-watchdog – this namesake of the great three-headed dog that once stood guard at the entrance to the underworld is the hear of “Athena’s” security.
eMail – provides access to regional and international mailing lists also known as listservs.
Flame – to offend, insult, or otherwise bludgeon someone else electronically, usually in retaliation for real or imagined offenses. As in Flaming – the electronic equivalent of an old-fashioned village stoning, where the natives hurled insults and obscenities directly at your head. From time to time, flame wars still break out between rival tribes on the Net, consuming everything in their path. Getting caught in the middle of a flame war is like going to a weenie roast where you are the weenie!
GNN – (global networks navigator) – part online newspaper, part hypertext almanac with connections to hundreds of sites on the Net.
Gopher – a menu-based program that tunnels between different computer networks in search of information.
Hackers – those who break into computers on the Internet by exploiting well known, yet often unrepaired, system vulnerabilities.
Internet – an international inter connection of thousands of computers via ordinary telephone lines (also known as “the Net”); a complimentary information source; a research tool; a communication tool; provides cost-effective access to a number of substantive resources, including documents and databases.
Kerberos – an authentication system which avoids sending readable passwords across network links.
Key-Distribution center (KDC) – mediates all transactions by means of encrypted digital certificates we call “tickets.”
Login name – a name by which a system knows a user.
Lurker – someone who reads articles in Usenet groups without posting any.
Lynx – a graphical interface used to view documents on the World Wide Web.
Mosaic – see Lynx.
Net-God – a long-time, revered, and usually omniscient Internet user.
Netiquette – an informal set of rules for proper behavior on the Net, often ignored.
Newbie – someone who is new to the Net; often preceded by the word “clueless.”
News group – a discussion area that addresses a specific issue; are accessible via a news reader program that usually runs on the UNIX operating system; a person may ask or answer questions, post comments, or go on the rant.
Passive attacks – simply listening to network traffic without disrupting its flow.
PBX – Private Branch Exchange telephone systems, printers, copiers, and fax systems.
Surfer – a Net dude/dudette.
Spamming – spraying out messages to every newsgroup or e-mail address, not unlike flinging canned meat into the blades of a rotating fan.
Spewer – a network user who believes everything he of she types is of interest to everyone.
Spoofing – false identity.
Snail-mail – United States Postal Service.
Telepathy – Microsoft Corporation’s series of specifications describing how devices and programs on individual PC’s interact with the PBX (see above).
Telnet – a communications protocol that lets you control another computer from a distance.
Unix – a complex, powerful operating system used extensively on networked machines, best avoided by Newbies; the Net’s common operating system.
Usenet – a network featuring thousands of electronic conferences on a dizzying array of topics.
Veronica – a program that tracks down information across different computer sites using keyword searches.
WWW (World Wide Web) – a graphical, hypertext system used to navigate the Net.

IV. The I-Way “Trend” vs. Virtual Reality

“Who’s going to pay for all this?” Geez, how many times in my lifetime have I heard that question?

“At this point in my research, I realize that people do not readily understand that they have to find a way to fund all this information. In an interactive environment, viewers can elect not to look at ads, which make them less effective as marketing tools and dulls their appeal as money-makers for the services that incorporate them. Basically, this thought pertains to the case of most magazine advertisements of which are funded by the selling of those advertisements.

“In conclusion, the information superhighway is still a network of dirt roads. Road signs are few, and finding legal information you can use can be difficult.

“Most of the law-related information online today is not very useful to the average consumer. Much of it is raw data – sort of like C-Span on cable television.

“Don’t get discouraged! There are a lot of people online to chat with. With the millions of people online nationwide, it is fairly easy to find thousands of people who share your interests and concerns. You can have public conversations and share advice, all without incurring long-distance charges. The result is similar to talk radio, except there is often no host, everybody gets a chance to be ‘on the air,’ and everything said gets preserved in a log that can be read later.

“All in all, the ease with which an intruder can perform illicit acts means that the network is not inside the security perimeter of the distributed computer environment. If the network is outside the perimeter, than one must somehow protect data packets as they carry information between workstations and servers. Every packet must be authenticated as it crosses the security perimeter represented by the network. 5

“Questions to ask could be: Will computer companies be able to understand, much less meet, the diverse needs of consumers? Will these companies be big players in the convergence of digital technologies, from TV to telephones to PCs?

“What’s really happening is that stuff is just formulating right now. A lot of things are going to have to shake out and settle down and you’re going to see alliances come and go. (I am excited about all that’s going on!) It’s really going to change the way we do a lot of things, but it’s going to take a little more time. Enter into this with caution, but extreme optimism.” 6

REFERENCE LIST

Computer Currents, “Through the Internet with Gun and Camera” by Daniel Tynan, November 7, 1994, pp. 24 – 32.

NOLO News, “Law on the Information Superhighway” by Albin Renauer, Spring 1994, pp. 9 & 14.

PC Novice, “The Information Interstate, Superhighway Or Superhype?”, by Tosca Moon Lee, September 1994, pp. 80 – 83.

Scientific American, “Secure Distributed Computing” by Jeffrey L. Schuller, November 1994, pp. 72 – 75.

******* That was 1994. Look at us now!! Just sayin’….

A. K. Buckroth

Who is A. K. Buckroth?

Posted on June 8, 2016 by Buckroth

A. K. Buckroth is one of 13 siblings, 11 of whom are alive today. Four of those siblings have diabetes. A brief synopsis of her working life began as a babysitter, on to being a grocery store cashier, a factory worker, a wife, a mother, an executive assistant, an administrative assistant, a four-degree student, a legal document assistant, a California notary public, a property manager, a mult-business sole proprietor entrepreneur, a copyeditor and proofreader, a dog walker, a published and award-winning writer, a public speaker, a tutor, an advocate…with so much more to come. Her biggest life challenge has been to maintain this busy life with diabetes.

Having been diagnosed with diabetes at the age of two and living through more than five decades managing the trials of this disease, A. K. Buckroth (aka: Andrea K. Roth-Ross) has written from the heart through her first book, My Diabetic Soul – An Autobiography. Diabetic children have become a main concern to Ms. Buckroth. Therefore, two children’s books were written pertaining to the life of a T1D. After all, she was a child and remains a “T1D.” She believes her writings to be one of the best representations of life with this disease. Her books attract so many readers, especially youngsters, who need to identify that having this disease is a day-by- successful-day procedure. Proceeds of books sold go toward The Barton Center for Diabetes Education in North Oxford, Massachusetts.

Ms. Buckroth has received numerous awards for her books to include the “Katie Maxwell Award For Outstanding Achievement In Writing, 2010;” the “Gary Dubois Dare to Dream Award, 2012;” the “Sherrie Dortch Letters Award, 2012;” the “Joslin Diabetes Center Award for 50 Courageous Years With Diabetes – Triumph For Man And Medicine,” 2013, Boston, Massachusetts; the “Wyvern Award For Community Guardianship,” Worcester, Massachusetts, 2014; the “Eli Lilly Diabetes Journey Award,” Indianapolis, Indiana, 2015; and the Northern California Publishers & Authors Award, 2017.

Classified as a “T1D” (Type One Diabetic), she has written encouraging books for young readers and their care givers: Me & My Money…a child’s story of diabetes, and Me & My Money Too…a child’s story with diabetes, Book Two, reflect the life of a diabetic child and the child’s adopted dog, Money, also diagnosed with diabetes. This particular book brings attention to the factual pandemia that diabetes exists in animals – all kinds of animals – and has risen to over 300% in the last decade.

Kisses for Cash…T1D meets T2D Book Three, brings attention to a grandparent and grandchild sharing knowledge and care of their disease. After all, Ms. Buckroth knows all too well about being a juvenile diabetic and this pandemic issue. These are illustrated chapter books, approximately 110 pages each, available at Amazon.com, Smashwords.com, Goodreads.com, Kindle, Nook and numerous e-book facilities.

As a Global Diabetes Awareness Advocate, she frequently speaks to organizational audiences about this disease – its pros and cons. Yes, diabetes has pros! She has claimed that this disease has not only taught her but the world to take special care of their bodies through diet, exercise, medication, and being stress free. Being stress free may be the most difficult of personal duties. All of her articles and informational links are available at www.Buckroth.Wordpress.com. A. K. Buckroth is available for messaging on facebook, Linkdin, and especially at www.mydiabeticsoul.com. #buckroth to see more.

Dr. Elliott P. Joslin

Posted on June 7, 2016 by Buckroth

Today, June 6, is Dr. Elliot P. Joslin’s birthday. Why is this important to me? He was the first doctor in the United States to specialize in diabetes and was the founder of today’s Joslin Diabetes Center in Brookline (Boston), Massachusetts. I am a diabetic. I met Dr. Joslin while on an outing to his home as a child camper with the Clara Barton Birthplace Camp. Still in existence, it is now known as the Barton Center for Diabetes Education.

Dr. Joslin was the first to advocate for teaching patients to care for their own diabetes, an approach now commonly referred to as “DSME” or Diabetes Self-Management Education. He is also a recognized pioneer in glucose management, identifying that tight glucose control leads to fewer and less extreme complications.

He was born in 1869 in Oxford, Massachusetts, and educated at Leicester Academy, Yale College, and Harvard Medical School.

Joslin first became interested in diabetes while attending Yale when his aunt was diagnosed with the disease, with no cure and little hope. He made diabetes his focus while attending Harvard Medical School, winning the Boylston Society prize for work later published as the book The Pathology of Diabetes Mellitus.

His postgraduate training was at Massachusetts General Hospital, and he also studied with leading researchers in matabolism from Germany and Austria before starting a private medical practice in Boston, Massachusett’s, USA, Back Bay in 1898.

In 1908, in conjunction with physiologis Francis G. Benedict, Joslin carried out exensive metabolic balance studies examining fasting and feeding in patients with varying severities of diabetes. His findings would help to validate the observations of Frederick Madison Allen regarding the benefit of carbohydrate and calorie-restricted diets. The patients were admitted to units at New England Deaconness Hospital, helping to initiate a program to help train murses to supervise the rigorous diet program.

Joslin included the findings from 1,000 of his own cases in his 1916 monograph The Treatment of Diabetes Mellitus. Here he noted a 20 percent decrease in the mortality of patients after instituting a program of diet and exercise. This physician’s handbook had 10 more editions in his lifetime and established Dr. Joslin as a world leader in diabetes. Two years later, Dr. Joslin wrote Diabetic Manual – for the Doctor and Patient detailing what patients could do to take control of their disease. This was the first diabetes patient handbook and became a best seller. There have been 14 editions of this pioneering handbook, and a version is still published today by the Joslin Diabetes Center under the title The Joslin Guide to Diabetes.

When insulin became available as therapy in 1923, Joslin’s corps of nurses becam the forerunners of certified diabetes educators, providing instruction in diet, exercise, foot care and insulin dosing, and establishing camps for children with diabetes throughout New England, USA.

Dr. Joslin adopted a multi-disciplinary approach, working with nurses in education, surgeons and podiatrists for limb salvage and foot care, pathologists for descriptions of complications and obstetricians for assessment of fetal risk in diabetic pregnancy. The first hospital blood glucose monitoring system for pre-meal testing was developed under his direction in 1940, and was the forerunner of modern home-monitoring systems.

Dr. Joslin was also the first to name diabetes as a serious public health issue. Just after WWII, he expressed concern to the Surgeion General of the United States Public Health Service that diabetes was an epidemic and challenged the government to do a study in the town of his birthplace, Oxford, Massachusetts. The study was started in 1946 and carried out over the next 20 years. The results would later confirm Joslin’s fear that the incidence of diabetes in the United States was approaching epidemic proportions. He has been named as being, along with Frederick Madison Allen, one of the two leading diabetologists from the perio between 1910 and 1920.

In 1952, Joslin’s group practice became officially known as the Joslin Clinic. In 1956, the office was moved to is current location at One Joslin Place in Boston. Joslin Clinic was the world’s first diabetes care facility and today maintains its place as the largest diabetes clinic in the world. I am glad to write that I was a patient there, beginning in 1968.

Dr. Joslin was adamant in his position that good glucose control, achieved through a restricted carbohydrate diet, exercise, and frequesnt testing and insulin adjustment, would prevent complications. This was debated for decades by other endocrinologists and scientists, and the American Diabetes Association was divided on this subject from its inception. Joslin’s approach was not validated until 30 years after his death, when in 1993, a 10-year study, The Diabetes Control and Complications Trial Report was published in the prestigious New England Journal of Medicine. This study demonstrated that the onset of diabetes complications was delayed by tight glucose control, something Joslin had argued decades prior.

Dr. Joslin died in his sleep on 29 January 1962 in Brookline, Massachusetts.

(Retrieved from: http://en.wikipedia.org/wiki/Elliott_P._Joslin)

Also, My Diabetic Soul – An Autobiography by A. K. Buckroth, 2010.

Law & Computers, 1994

Posted on May 20, 2016 by Buckroth

This paper, now historical, was a required research paper at El Camino College in Torrance, California. The credits received were toward my Associate Degree in Legal Assistant studies. My main purpose to present it here is to highlight present students – and other interested parties – to know, acknowledge, and appreciate what “it was like back then,” 1994.

I. INFORMATION HIGHWAY

“The “Information Superhighway” is a vision of the idea that eventually all homes and business will be connected electronically and that all sorts of information will be available for downloading into your home or office. Exactly how this information will be delivered remains a major topic of debate. With faster networks on the horizon, more connections between networks, and more services available, there is no question that new applications will change the way we use information ‘at the office’ as well as at home. Currently, traditional providers, and public utilities, are vying for the right to provide the lines that will deliver this kind of information. Nationwide computer networks will impact business long before they enter every home.

“Already more than 50 percent of office workers in the United States use computers and nearly half of the PC’s in the United States are now connected to networks. All sorts of information is now available through corporate networks. It ranges from a simple email to schedule management, and on to more complex procedures such as management of transaction date and information handling.

“Most major companies could not operate without computer systems. Executives have realized managing these computer systems is a important as the managing of their manufacturing facilities or their products.

“Well, the legal profession is no different. Legal Assistants/Paralegals are entering the legal profession in a time of exceptional turbulence. It is a place of opportunity as well as risk; a necessary phase of the system’s adjustment to new challenges. The future of Paralegal work in litigation is high technology — legal database research, computerized litigation support, and general office administration computer skills. If the much-hyped “information highway” is constructed, then cable television will own the high-occupancy fast lane. The fiber-optic networks now being assembled in most areas by the companies that bring you Cable News Network and the Discovery Channel are by far the best conduits for information

A. FIBER-OPTIC NETWORK

“The fiber optic industry has rapidly transformed the way the world send and receives information. Optical fiber, first discovered in the early 1970’s, holds a large percentage of the communications links installed my major long distance carriers and local telephone operating companies. And these companies utilize fiber optic cable.

“Made from fine strands of glass that can bend and flex, optical fiber is used to transmit consumer telephone traffic by pulses of light. Thinner than a single human hair yet stronger than steel, optical fiber can carry thousands of times more information that conventional copper wire, and just tow optical fiber can transmit over 24,000 telephone conversations sumiltaneously.

“Because it is smaller and weighs less than copper, optical fiber utilizes less space and is easier and less expensive to install. The material is also immune to electromagnetic interference, and telephone conversations transmitted over optical fiber are virtually impossible to tap.

“As the 21st century nears, fiber optics has begun its trek into the next major frontier: fiber to the home. Ever-increasing demands for the latest, fastest, and best communications technology will make fiber optics a technological necessity. Applications of fiber optic technology already in use in the home and office include high-definition television (HDTV), home banking, shopping and tax services, rapid computer graphics transmission, videophones with high-quality images, a new generation of home and office security systems, and extended data-communications services.

“Optical fiber can carry a lot, and we are not just talking bits and bytes! Taken in bulk, it would take 33 tons of copper to transmit the same amount of information handled by a half pound of optical fiber. Tapping into a personal computer connected to an optical network brings the office to your fingertips. Interactive video networks make it possible to shop and bank from home, rent a movie without setting foot in a video store, or check out the current stock market reports over the TV. And there’s more!

B. CABLE SYSTEMS

“Videoconferencing at your personal computer, computer-aided designs for engineers and subcontractors along with “virtual reality” games are coming in the next few years via your local cable system. Most likely with new dictionaries containing these new words and phrases!

“The Legal Assistant profession SHOULD NOT miss out. This whole theory is a worldwide spider web of neurons that will cost billions. For eight unregulated years from 1984 to 1992, the Cable industry raised subscription rates and boosted profits by not hiring enough employees to handle the growth. After consumer complaints, the industry was re-regulated in 1992 by the Federal Communications Commission (FCC). Yet with this happening, rate rollbacks made the health of the cable industry bad. Problems include high debt levels, the huge cost of system modernization, pending competition from telephone companies, and direct-to-home satellite services must-carry rules that force cable systems to tie up precious channel capacity by obligating them to transmit obscure as well as popular local broadcast stations, and the FCC-mandated rate caps that threaten to limit cash flow and access to credit lines.

“All in all, if these companies should lose the will or the wherewithal to build the electronic expressway, the days of computer-aided design and virtual-reality games over cable will remain fictitious. The traditional office is changing fast, thanks to rapidly evolving workgroup applications and new communications technologies. For years, people have been talking about the “office of the future.” In many ways, that future has arrived. New software, new hardware, and new means of communications help us work together.

C. CYBERSPACE

Cyberspace is electronic communicating: electronic communications involving the usage of a computer and a modem. It means almost anyplace computer users are “online.” This term was originally coined by William Gibson in his novel entitled “Neuromancer” to represent a universe of interlinked computers, a sort of futuristic Internet.

“What is a Modem? A telephone hookup that allows computer operators to send message via their telephones to a receiving computer. Cyberspace basically involves new forms of expression such as the discussions that take place in CompuServe (page 6). For example, on Internet “newsgroups” or the conferences on online services such as America Online and CompuServe, a hundred people may each contribute a few lines to a discussion. A main concern was copyright protection in that it protects expression, not ideas or facts. For instance, information in a telephone book or a weather summary can be freely used. On the other hand, the expression used in an essay on telephones or a creative explanation of weather systems is protected by copyright even though the underlying data and ideas are not.

“What does owning a copyright on an expression mean? Simply, that no one else can copy, distribute, display or adapt that expression without the copyright owner’s consent. This consent may be give for free, for a fee, or on the condition that an appropriate attribution be given. It is always a good idea if you send material into cyberspace to explicitly state the conditions for its use and reproduction.

II. WAYS A LEGAL ASSISTANT CAN HELP MAKE OUT LEGAL SYSTEM FAIRER< FASTER, CHEAPER, AND MORE ACCESSIBLE

“According to Working Woman Magazine, the Legal Assistant/Paralegal position has been near the top of the national job-growth chart and plans to stay there for at least 10 more years! Paralegals are an attorney’s right hand, preparing cases for court by researching facts and precedents, obtaining records and summarizing depositions. Presently, entry-level salary is $21,000 0 $25,000; mid-level, $25,000 – $40,000; supervisors and specialists $45,000 – $75,000. Having the knowledge, intelligence and background of computer literacy and its presently growing and developing communication factors will make the Legal Assistant/Paralegal even more marketable!

“As expressed in a local newspaper, The Press Telegram of October 18, 1994, “Computer are taking over the workplace, the classroom, even the home. And unless you speak their highly complicated language, you could be left out in the technological cold.”

A. LAW ON COMPU-SERVE

“ONLINE = Computer + Modem, whereas a modem, as defined by the New Webster’s Unabridged Dictionary, is “a device used in radio detection that converts data to a form that can be transmitted as by telephone to data-processing equipment, where a similar device reconverts it.”

“CompuServe is accessible with any communications software. It also has its own software: CompuServe Information Manager, which is available for Windows.

“CompuServe is the granddaddy of the major commercial online service; it has been around since 1979. Owned by tax-preparing giant H & R Block, CompuServe has grown into a worldwide online service. CompuServe’s primary clientele is lawyers and much of its law-related material is by and for lawyers, but non-lawyers can still find useful information and even get some free legal advice.

“When a Legal Assistant connects to CompuServe with his or her own communications software, they will encounter a rather cumbersome text-only interface — no button, icons, graphics, or pull-down menus. And a mouse cannot be used. Instead, an operator navigates through a seemingly endless series of numbered lists, or by typing “GO” commands (for example GO LAWSIG) to go to a particular area or “forum.” “Forums” are special interest areas where the operator can find discussions and libraries of downloadable files on a particular topic. Each forum divides its message and file libraries into a dozen or so subtopics. This makes it easier to find discussions and files of interest. And, CompuServe Information Manager provides a graphical user interface to most of CompuServe’s services, allowing a Legal Assistant to point and click to his or her destination. Not only is this easier than trying to remember cryptic commands or wading through lists, it also lets the user compose and read e-mail and do some browsing off-line, without incurring connect time changes!

“The very active Legal Forum (GO LAWSIG) is the best place to find law-related files and discussions. THe Legal Forum’s discussions and file libraries are divided into 14 sections, as follows: GENERAL [0], Computer/Tech Law [1], Attorney Wanted [2], Law Firm Economics [3], Legal Research [4], Software/Automation [5], Lawyer To Lawyer [6], Related Professions [7], LAW STUDENT [8], ***HOT TOPIC 888[9], MUNICIPAL PLANNING [10], Demos, Vendors [11], SUPREME COURT [12], and Bar Room [14].

“Hundreds of people weigh in with their opinions on issues ranging from estate planning to gun control. The majority are lawyers, and although you don’t have to be one to join in, most of the discussion groups are not all that fruitful for non-lawyers. Sometimes, however, people ask legal questions in the forum, and sometimes they get answers. As with forums of this type, the quality of this free advice varies, just as the quality of lawyers does.”What sets CompuServe’s Legal Forum apart from legal forums on other services is the size and breadth of it library of downloadable files. There are more than 1700 law-related files to choose from, with dozens of new ones uploaded by forum member every week. The forum’s library is divided into the same 14 sections as the discussions. Among the more useful files in the Legal Forum’s libraries are: the full text of newsworthy Supreme Court cases (Library 12); Word-processing templates and macros for automating legal pleadings and documents (most are for WordPerfect 5.1 or Word for Windows 6.0 – Library 5); Windows Help files containing the complete text o The U. S. Constitution; The U. S. Bankruptcy Code and Rules; Federal Rules of Evidence; Federal Rules of Civil Procedure (Library 4); Articles about the law, especially intellectual property (Libraries 0, 1, 4, 10 and 11); Countless applications and macros designed to help legal assistants and lawyers keep track of documents and billable hours (Libraries 3, 4, and 5).

“One particularly useful feature on CompuServe is the ability to read the contents of downloadable text-only files on screen, without having to download them. You can browse through files, particularly articles, and decide which ones you want to download and store on your hard disk!

“CompuServe Pricing. The standard price is $8.95 per month, which includes unlimited connect time to “basic” services. Accessing the forums mentioned, will cost an addition $9.60 per hour ($0.16 per minute) at 9600 baud or $4.80 per hour ($0.08 per minute) at 2400 baud. Call 1-800-848-8199 with your modem to sign up.

“Once you are a member of CompuServe, you can download Information Manager directly. Type GO CIMSOFT and follow the directions once you get there. It cost $10 to download, but you get a $10 credit toward you connect time charges.

B. LAW ON PRODIGY

“Prodigy was conceived by a partnership of two giants: IBM and Sears, Roebuck & Company. Like its corporate partners, Prodigy is huge with something like two million subscribers. It is the largest commercial online service that offers information a consumer can browse through along with files and software that can be downloaded.

“Prodigy has many services. It provides news, weather, sports galore, U. S. Government economic indicators, user polls and bulletin boards. The bulletin boards have been known to be difficult to use. To get to them, the operator must click a series of buttons on a number of screens, and it can be difficult to find the bulleting of interest.

“An intensive index of Prodigy services can be searched by typing words that describe what you’re interested in. Prodigy calls the terms in its index “JumpWords.” When you type the JumpWord “Law,” Prodigy provides no matches. Entering “Legal” gets results, though not what you might expect: Prodigy jumps you to a colorful, full screen ad for L’eggs., Hanes and Bali stocking and lingerie, complete with pictures of the companies wares!

“There is a well-hidden legal bulleting board, and here is how to find it: (1.) On the opening screen, click the Business/Finance button. (2.) On the next screen, click the button labeled The Office. (3.) On the next screen, click Office Board. (4.) From the Topic List you see, select “Legal & Govt. Matters.

“There are about 100 different subjects under the Legal & Government Matters topic on the Office Bulletin Board (also called the Home Office Bulletin Board). But they contain very little discussion. Only 160 notes had been posted in all of these subjects during the last six weeks, the period available to browse through.

“Although Prodigy provides little hard legal information, there are some good, law-related items. The Court TV service contains several news stories on current topics and a bulletin board that lets you post questions to the host of “Prime Time Justice.” You can also get a schedule of legal education courses aimed at lawyers which would also be useful to the Legal Assistant and other non-lawyers.

“Prodigy does connect to the Internet, but only to send and receive e-mail. You can’t gte to any of the legal resources available free of charge from the Internet. Therefore, Prodigy uses miss out on the opportunity to conduct legal research on this and rapidly growing collections of networks and databases.

“Prodigy Pricing. Prodigy users must install special software, available for Windows, DOS and Macintosh to gain access to the services. Prodigy software is sold in stores for $20 to $50, but don’t buy it there. You can get it free ($4.95 for shipping and handling) by calling Prodigy at 1-800-PRODIGY. The kit you’ll receive entitles you to 10 hours of free use during your first month of service. After that, it’s $14.95 per month for unlimited access to the basic features plus two hours of extra services such as stock quotes, company news, and airline reservations. Extra services cost $3.60 per hour. E-mail messages cost $0.25 each. There are additional charges for downloading shareware.

C. AMERICA ONLINE

“As we have already read, being online is the ability to get information, any type of information, through a computer. This costs money and takes skills not everyone has. First, of course, you must have access to a computer and a modem. Second, the most feasible way to get online information is to pay for a subscription to a commercial online service such as Dialog, CompuServe, America Online (where the rate per hour is about $3.50), Lexis/Nex (the rate per hour averages $46.20) or West law.

“Although paralegals are not always involved in doing legal research, they need to be familiar with the online databases that are commonly used for legal research: LEXIS and WESTLAW. Both are available as online services(meaning that you must dial into them with a modem for which you pay a subscription fee plus online charges).

“This simultaneous construction of the electronic “information superhighway” is a less obvious but equally serious threat to libraries and the free flow of information. Much useful information is simply not available in conventional printed form. It is now available only online, through a computer. Existing books are being repackaged for sale to electronic form! But, being online certainly does help the Legal Assistant with research time and efficiency. For instance, this would allow the Legal Assistant to get current legal information immediately without buying a lot of information s/he would not actually need and that would go out of date. It would also be useful to get quick updates on changes tot he law. And the electronic bulletin board would be used for people (Legal Assistants in particular) to post messages with comments, suggestions or questions.

“America Online offers far superior Internet access that includes Gopher menus and WATS searches to help find information in databases, mailing lists (discussion groups), newsgroups as well as sending and receiving e-mail. And just in case you didn’t know, a “gopher” in computer land is an Internet term for an electronic search tool. It locates topics, files, or documents that match a computer user’s interests. By the end of 1994, America Online users should be able to transfer files and telnet (log on to remote computers from their own computers) on the Internet.

“To obtain information on American Online, or, to start your software, pull down the GO TO menu and select KEYWORD. Then type LEGAL and then click OK. You will go to the Legal SIG forum. Open the Legal SIG Software Library. You may have to click the “List More Files” button a few times and scroll down the list to find all the files.

“The key to using an online service is knowing how to log onto the service (each vendor has its own log-on procedures) and how to formulate the request using the right key words. in this regard, the paralegal might do some of the same things that an “information broker” does, and as a result, in some cases, it might be cheaper to call a professional researcher than to spend time and money doing the research. There is a wealth of information available at one’s fingertips through online services.

E. INTERNET

“Intenet is an “international interconnection of thousands of computers via ordinary telephone lines. It is a complementary information source. It has also been described as “the global network of computer networks” and has become the fastest growing communications medium. Let’s see how WEBSTER’S measures up in their latest dictionary!

“The “NET,” as it is referred to, offers free access to government documents, statures and case opinions, as well as the opportunity to directly communicate with global and neighborhood colleagues.

“For the paralegal, the NET is an information research pool providing cost-effective access to a number of substantive resources, including documents and databases.

“This 25-year old computer system that most of us are just learning about can connect us to libraries, newspapers, universities, businesses, and customers! Even our children! The world is wired! Internet began as a child of the Cold War: a headless, decentralized data network designed to function in the aftermath of an all-out nuclear attack.

“Mike Toner, in his Press-Telegram article of October 31, 1994, writes that “the doomsday network developed by the Defense Department’s Advanced Research Projects Agency grew to include more research institutions with more diverse interests. By the late 1980’s, it had been absorbed by the National Science Foundation’s NSFNET, an electronic backbone linking U. S. supercomputing centers, dozens of government agencies, and a rapidly growing list of universities.

“Then in 1991, the government ended restrictions on the use of the Internet for business and Congress decided to spend $2 Billion over five years on a major network expansion. Phew! This expansion is now known as the “information superhighway.” The NEW BACKBONE, when completed, will be able to deliver a billion bits a second, roughly equivalent to an entire Encyclopaedia Britannica in six-tenths of a second!

“Let’s compare television. It is, for now, something you watch. And the telephone is fine for one-on-one conversations. As defined by Mike Toner in the same article of October 31, 1994, “Internet allows individuals to interact, share, argue, preach, plead, court, annoy, or harvest information in a way the world is only beginning to explore.”

“Click, click and your commute to the library can become an electronic commute that can give you instant access to the library’s card catalog. Geez, what paralegal would not have fun with this?!

“Already the demand and rapid growth has produced the electronic equivalent of gridlock, making destinations unreachable for hours at a time. It’s a new frontier and we’ll see what evolves.

F. E-WORLD

“eWorld is Apple Computer’s new online service. Anyone with a Mac, a modem, and a phone line can explore eWorld. All new Macs come with eWorld software already installed. If you have an older Mac, you can get the software for free from Apple by calling 1-800-775-4556. There is a self-help law center that contains a discussion board where you can exchange tips on do-it-yourself law and discuss everything from legal reform to lawyer jokes.

“E-mail provides access to regional and international mailing lists. But, to gain access to mailing lists, you must be connected to a provider such as America Online, CompuServe, and Prodigy that presently offer limited Internet access, but are planning to expand their services.

III. CONCLUSION

“In researching this project, I have actually been fascinated with what I did not know. Communicating through technology has advanced at the speed of sound. Presently, I am glad to be back amongst the computer operators of my era, ready to tackle, obtain, and become up-to-date myself with what has been going on around me!

“All in all, I am able to partially explain (and educate) another interested party on getting started on the information highway and would like to share this information with you:

Necessary Equipment: A computer, a telephone, a communications program, and a modem. High-speed modems are recommended.
Getting one: If you don’t have access through an employer or academic institution, you’ll need a personal account. They come in two basic flavors: a dial-up shell account that connects your computer to one that is already “on” the Internet, and dial-up connections that make your computer a functioning part of the Internet.
Shell accounts: The dozens of providers include: Delphi Internet — (800) 695-4005 with five free hours and monthly rates as low as $13.00 for four hours of connect time. Netcom — (900) 501-8649, $17.70 a month for unlimited connect time. CRL — (415) 381-2800. $19.50 initialization fee plus $19.50 a month. Pipeline — (212) 287-3636, which offers five free hours and easy-to-use Windows-style Internet services starting at $15.00 a month, plus local access and/or phone charges.
Direct connections: THese give users more control over Internet ventures and make it possible to use MOSAIC, a sophisticated software tool developed the National Center for Supercomputing Applications in Champaigne, Illinois, that integrates text, sound, photos, and motion pictures. The dozens of providers include Atlanta-based MindSpring Enterprises, Inc., (401) 888-0725, a small firm whose goal is to provide convenient and economical Internet access. The firm sells a $35.00 custom package of freeware and shareware programs that have everything you need to get started and charge $15.00 a month (plus $1.00 an hour after 15 hours) for unrestricted Internet access.
Software notes: If you like to do it yourself, you can download MOSAIC free from teh National Center for Supercomputing Applications, (217) 244-4130, but the program must be configured with other network software, most of it available free or at nominal cost. Bundles of network software are available as “Internet in a Box” developed by Spry, Inc., and the “Internet Membership Kit” by Ventena Media.
Major on-line services: America Online, CompuServe, and Prodigy offer limited Internet access, but are planning to expand services.

BIBLIOGRAPHY

Hopper, Commodore Grace Murray, United States Navy with Mandell. Professor Steven L., Bowing Green State University. Understanding Computers, © 1984, West Publishing Company, 50 West Kellogg Boulevard, P. O. Box 43526, St. Paul, Minnesota, 55165.
Hussey, Katherine Sheehy with Benzel, Rick. Legal & Paralegal Services on your Home-Based PC, © 1994, Windcrest/McGraw-Hill.
Parker, Charles S. Understanding Computer & Information Processing, © 1992, The Dryden Press, 301 Commerce Street, Suite 3700, Fort Worth, TX, 76102.
Webster’s New Universal Unabridged Dictionary, © 1972, Simon & Schuster, New World Dictionaries, 850 Euclid Avenue, Cleveland, Ohio, 44114.

REFERENCES

The Press-Telegram: October 8, 1994 — “FCC ready to change cable TV pricing” by Jeannine Aversa, p. E1; October 10, 1994 — “Catching Up On Computers” by Rachel D’Oro; October 31m 1994 — “Election databases offer everything rom Assembly to Wilson” by Daniel De Vise, P. A1 & A6; October 31, 1994 — “Internet jam-packed with election data,” p. A1; October 31, 1994 — “Turn on, hook up and plug into THE NET,” pp. C6 – C12.

Working Woman, June, 1994; “Hottest Careers — The Best-And-Worst-Jobs For Women,” pp. 45 & 46.

PC Magazine, May 1994; “The Changing Office” by Michael J. Miller, pp. 112 – 128.

Vital Speeches Of The Day, August, 1994; “Law in a Time of Turbulence” by Mary Ann Glendon, Professor of Law at Harvard University, pp. 620 – 622.

FW Financial World, “Crossroads” by Russell Shaw, pp. 52 – 55.

PIRELLI Fiber Optic Cables, Reference Guide, April, 1993, provided by an employee of the Pacific Bell Corporation of Southern California.

Nolo News Legal & Consumer Information for Everyone, Summer, 1994: “Law on CompuServe” by Albin Renauer, pp. 18 & 19; and “Copyrights in Cyberspace” by Steve Elias, pp. 20 & 21; Nolo News Legal & Consumer Information for Everyone, Gall, 1994: “How the Online Revolution Threatens Libraries” by Steve Elias and Monica Jensen, p. 17; “Law on Prodigy” by Dale Mark Ross, PP. 20 & 21; and “Self-Help Law Centers on Internet, eWorld” by Alvin Renauer and Fred Horch, pp. 22 & 23.

Law Office Computing, Feb/Mar, 1994, “Connecting On The Internet” by Josh Blackman, pp. 68 – 73.

NOTE FROM AUTHOR: I truly hope you enjoyed reading this blog. It’s just as simple as that! Thank you. #buckroth.

“The Philosophies of Terry” By Theresa Viola Buckroth, 1929-2014

Posted on May 19, 2016 by Buckroth

Originally typed in the Spring of 1987 for her Philosophy class thesis at Clark University in Worcester, Massachusetts, my mother, Theresa V. Buckroth, had this to share…

“I could begin with “Once Upon A Time,” but this is not a fairy tale; rather it is a mixture of realities that could be made into a collection of short stories.

“My philosophy of life at times is that the planet on which we live or exist is a “scum ball,” covered with a compositions of cells in various shapes and forms. The “living earth” being the giant cell, devouring, regurgitating constantly, swallows its own vomit. There is a constant avoidance in all of us to admit to the constant decay surrounding us. Rather, men mentally annul this, creating an instantaneous beauty in his psyche; fleeting even as it is being observed; gone, then recreated elsewhere in another self pleasing form. The term for this is called “survival,” in which we lie and are deceitful to ourselves, thus enabling us to accept and tolerate our existence.

“Decay is constant. Change is constant. The cell will die and shatter to form new cells. Metamorphically, how can something be new when it is made from something old? Old is old – always. Being born human has the same implications.

“Always having been a wonderer, never a doubter but a questioner, I go along, breathing the physical, which seems to always be out of tune with the mental. This is in reference to aging. Perhaps there is a connection in which both will terminate into an energy. There is a belief that a soul leaving the body upon death shatters into atoms, ions and cations, to share themselves in the formation of new souls. There is much to contemplate, but the cell does not allow the time. If the cell did allot a period of time to the soul, spirit, or whatever its descriptions may be, it might be given time for research in limbo. Perhaps it does, and the designer has allowed the means of escaping regurgitation via the soul.

“You may think me pessimistic and too imaginative. My preference in addressing myself is that of being realistic, with the “real” being a constant changing of blends. Real is now, a second from now, or a split second from now, then it is no longer real. Whatever it was, along with its definitions, becomes unclear, replaced, always waiting and wondering, wondering what the waiting is for. As a Catholic, are you wondering where God fits into all of this (I presume you are)? I wonder too. Being told and taught that God “is,” neither makes me a believer nor a doubter. It is often irrelevant to everything as a whole, but probable in parts.

“To know that I “am” has always been a constant amazement to me. Why “me?” To behave as I do, and think by being is a singular, is presumptuous, but there it is. Avoidance of thinking a truth is not in my nature, but the questioning, not in question form per se, is always close to the surface of my being. Acknowledging everything, all with reasons, accommodated by present, past and future events, is to me accepting what is, for what it is explained to be at that moment.

“How much the physical senses interplay with the physical energy (soul or spirit) is always under scrutiny; which is which, in play at a certain instance. Each is called up for use, alternately or together, through circumstances. Survival of the present physical would naturally call on the physical senses; but what of want for continuance after decay of the physical? Do the physical aspects interfere with the intuition and exploration of the mind? I believe that both the soul and the body play games with each other, both being a separation, yet together. Each is real and unreal; termination of one (physical) is known; termination of the other (soul) is unknown, a theory.

“I have always played various ages, often having to escape into roles only to return, sometimes as if by force from a guide, not knowing a better word for it other than a conscience. The mundane escape being often the unrealistic escape. Dreaming, for example, is a form of escape where our mind takes us away from present awareness, often only for a few seconds, enabling us to become that which we may prefer to be at that instance. Lengthy dreams may be interpreted as an intermission between life and death; a sample perhaps of what is in store for us after termination of the physical.

“This part of my philosophies were easy to convey (hopefully understood and properly interpreted). It is in the examination of ones true thoughts and feelings, in consideration with other humans which is difficult. It is thus, as policies and cultures are always changing, making opinions and theories difficult to convey for understanding and acceptance; whether it is to be “right” or “wrong” for that place in time. Everyone wants to claim the acquisitions of truth and knowledge. Once one appears to have accomplished some or all of a section of learning, the problem is where to utilize it so that it would be advantageous to all concerned. For example, my philosophical views are a “mixed bag.” There are many avenues for thought that are time consuming, especially when there is a continuation of new thoughts being offered for process. In other words, where is a person most useful? Advice often given is that one must look back into oneself and try to be truthful which is very difficult. Also, it calls for self analysis, a dangerous approach for a novice. Thus far, my philosophies emphasize the question of my “being;” it being without a definite definition.

“You asked for it (my philosophies), now you got it (them). Now I will probably get “it” (your negatives and hopefully positives) for telling “it.”

“Here is my attempt at reasoning the culminations of “Terry Philosophies:” I was once a declared Democrat, uncomfortable in what I witnessed such as their inner self-destructive policies. I became a Republican, trying to counter this, which is a small contribution toward attempts for the continuance of a balanced, “Democratic” government. It was a difficult stand; advertising my beliefs in what I had learned. Many close friendships became alienated from me as I became “different” in my thinking, none of which have been replaced. Republicans are in the minority where I reside. Perhaps I have become a “thorn in their side” by independently coming to my own conclusions (or, so I think I have). In spite of their ignorance of me as I am, or would like to think of myself as being, I aspire no great super intelligence for problem solving. I do care about all humans. Having been reputed as being a humanitarian, I am yet to solve completely one humanitarian problem, not even on an individual level, my own included.

“Raised to be a conservative, perhaps classical in nature, in a middle-to-lower-middle social class, there are instilled beliefs that I find difficult to change. A person is what they are born into including their religion and station(s) in life. This being a near truth, it is almost impossible to change one’s course in life. All classes being necessary for a cultural hierarchy, “equality” most likely will bring a smirk to one’s features, expressing a joke from within. Evolution or Darwinism has demonstrated to us that we have millenniums to go before the possibility of reaching the plateau of equality. Try stepping out of your “class” as I have and you will find that there is always the telltale clue of residue from whence you came. Perhaps my naiveté shields me from many insults as I am incapable of recognizing them as such, but rather think of them as another persons’ views. A constructive form of criticism sets me off [and toward] self re-evaluation. I welcome this as I want to know how others view me. I view myself differently from most others and do appreciate corrections if they prove to be positive on the whole.

“Roles I have played in life have been many. Some of which I played without realizing it. Most were accomplished by circumstance, not by choice. Choice came into being only after the fact, e.g., when my mind became aware of the reality of my circumstances. A constant learning process, never truly graduating like a classroom with numerous subjects being taught, all at the same time; each book page containing the unexpected. More and more lessons to be learned, some never to be questioned because of fear in the answer; others to be questioned continuously in search of and for truths and knowledge.

“Never – or extremely seldom – do I plan (perhaps subconsciously). I am often overtaken and turned, not being quite sure whether I had thought to have expressed or exercised a deed set in motion. Thus, never have I felt truly liberated. Therefore, I disqualify myself from being a liberal. One has to know how to act the part before accepting the role. Many connotations of fatalism have been thusly written, but my past life negates this as I will explain.

Born to immigrants during the depression, my independence surfaced at a very early age and was frowned upon by most except the patriarch of the family. My allowed freedom taught me much of human nature and natural science; exploring much, but only allowed to keep the knowledge to myself. There were few capable of understanding or of showing any interests in my newfound knowledge. The so called “working class” never allowed the full extent of wanderlust, neither was there acceptance in fields of endeavor. The “working class” is a type of slavery with the branding of hierarchy intimidated. Distinctions of class will always be in this society as in all societies from the insects on up the ladder of the superior beings in nature. That being the “thinkers,” the human. We, or I, as a person from the “working class” am allowed into the “upper class” only to perform a service, even though I may have attained more knowledge (degrees) than those for whom I perform the services. Therefore, knowledge could be said to be to all important as implied today, but rather the station in life into which one is born.

“Perhaps there is a form of bigotry in all of this; an intolerance to those other than one’s own “class.” I may also be of this make-up, whereas I at times have resented the intrusion of someone into my own “class” other than those which are of an equal “rank.” As other have done to and for me, enabling me to make slight transitions for improvement, while being reminded of one’s station in life. I too hope to help others ameliorate without giving up or sharing my “rank.” Neither am I persuasive in thinking I am alone in this attitude. Hope is in the offspring where education may assist some to slip through the “cracks” into the “upper classes,” or more likely to marry and bear offspring directly into the “upper classes.” The “lower class” parent may never be accepted, but the offspring will, that is, have access to prestigious schools, elevating them to a “rank” of higher distinction.

” The learning process never stops regardless of class until the mind stops its assimilations of knowledge. Oftentimes the physical survives without the mind (brain dead). We are constantly exposed to knowledge and therefore forced to think. I often wonder if the thought processes vary due to genetics. Most likely the answer in “yes” as humans have predispositions for acquiring, coding, and encoding the experience of the exposure to life. Therefore, education must include experience in the elementary years and expand, but only in accordance to choice and potential.

“My first recollection pertaining to my own education took place upon entering first grade. I rebelled against having to be placed in a public school. The classroom was dark and dingy. Singing songs about “Jack Armstrong, The All American Boy” [which] recommended eating the cereal “Wheaties” – did not interest me. Millbury Street School[, Worcester, Massachusetts] is where these experiences took place and are rooted in my memory. Complaining to my parents was to no avail. They did not have the funds to provide me with a parochial education. In desperation, I recall informing my mother of taking the matter into my own hand and enrolling myself in St. Mary’s parochial school [Worcester, Massachusetts]. She evidently didn’t believe me or thought I could never accomplish my desire to leave the dungeons of Millbury Street School (which hasn’t changed except to worsen in is decay. I have since acted as a substitute teacher there for a kindergarten class). The next recollection I have pertaining to this incident is that of walking a distance, opening very large, heavy door, and looking for the Mother Superior’s office. Attending Mass at Our Lady of Czestochowa probably prompted this, as I no doubt observed St. Mary’s students at Mass. Since then, I have a great appreciation for books and knowledge, proving that parochial education in the elementary grades is essential. This formal parochial education continued to the eighth grade. There was definitely no funding the ne high school at St. Mary’s. Public school lasted for three more years. The family patriarch, a blue collar worker, was forced to quit his employment due to an illness that was to last ten years. There were no provisions for medical care as there are today. Families took responsibilities for paying expenses in such matters. Also at this time [1945], was with Japan [and the United States] broke out. Monies were scarce as our country’s economy was having its problems. The military offered good paying jobs. My two [older] brothers joined the [military] service, discontinued their educations, sending money home [as soldiers]. I also left school to work in factories for the “country’s defense.” Employment was chosen for you and once you were placed, in whatever factory the employment bureau thought suitable, it could not be changed without having to go through bureaucratic procedures or a doctor’s note. Education became secondary. Our country needed warm bodies to perform certain duties: everything of a material nature became important, everything except the human which was expedient. Necessities for war were taught in the schools, including the need to kill other humans in order to save the country. No one really understood, but “trust” in the ruling class was brainwashed into most of the population. Disagreement meant you were a traitor. This was accomplished by teaching young men that the uniform was a symbol of peace and manhood and being classified “4F” (unable to perform in combat) [which] meant you were less that a man. Men directly involved with the manufacturing of armaments were deferred. Education for girls was turned off and only their hands were necessary for the manufacturing of armaments to “keep our men going,” meaning killing or be killed. There were no mental challenges, i,e., pertaining to knowledge as a form of wisdom, or logic as a form of meaning. All of this was discouraged. After the war ended, very few went back to school. It again was discouraged, especially for the female who, I suppose, was to marry and be taught to rear a family, perhaps to replace the population that were killed in the war. Men were more fortunate, that is, those that survived and were encouraged to finish their educations under the government “G. I. Bill.” It was the lost Viet Nam War that tuned things around in education. John Dewey’s (an educator in the 1940’s) Liberal form of education drew in importance, i.e., an education for everyone on an equal basis. Trade competition from foreign countries affected the United States’ economy; education in technology was encouraged. Specialization has taken precedence over the advise of past philosophers and educators such as St. Thomas Aquinas, an ancient educator, [along with] Richard Hutchins and John Dewey, modern educators. They believed in an equality in education for everyone according to potential without favoritism. It is true that education should be for all, but the type of education given is what is most important, i.e., one that encompasses the needs for all men.

“It was during this time of student unrest [that] rioting for increased freedoms of choice and equality that I returned to school. In the late 1970’s, government grants were being offered [i.e.,] financial aid for minority groups and those in the poverty level. I was in the latter category, even though I had a full time job. Five children, a need for improvement, and government aid spurned me on to furthering my education. It took me seven years going full and part time to three colleges in two states for me to get a degree in Liberal Arts. My college education began with courses specified for a career in health which I later changed after being exposed to other choices. Liberal Arts was the more sensible choice as I hoped it would widen the field wherein I would have a better chance of finding a job. Employment in the teaching area where I found myself suitable and useful (a humanitarian service), made me aware of competition for college graduates with more degrees, i.e, Masters and Doctorates. This would give me more permanence and security in my chosen field of teaching. I enrolled myself full time for a Master’s Degree in Education, taking a full time job and more student loans, hoping and preying while devoting most of my time to school courses. Perhaps this time a new degree will enable me to be employed full time in teaching and taking courses part time toward a Doctorate Degree. As I have intimated earlier, my elementary education instilled in me a need for seeking knowledge in many areas as are available according to my social class. Nothing lasts forever, especially the good things, and I am taking as many advantages as I can while they are offered.

“With all these positives, I fear that history is being repeated as women are once again encouraged to seek an education in order to get into the work force. This insinuates that women will once again replace men in the work force. In this subtle way, the government is in need, as if in a private war of economics and on the verge of collapse. In a gradual process, we are entering a Socialistic form of government. “Classes” have rebelled fro many years at times with violence and continue to do so, for human needs and more equality. Unless educators are heeded and their policies adhered to, the population as was in past history — when our country was strong — will never be. Than again, one never knows fully the predictability of a population when there is strength and determination in the core. Acknowledgment of personal needs and group activities increase the chances of survival.

“Regarding idealism, realism, and pragmatism concerning all of the above, I “think” I lean toward realism but I cannot be sure as nothing is certain. Beginning with idealism in relation to metaphysics, I am in part agreement concerning the investigations into nature. Idealism is divided into ontology: that which deals with the nature of “being” and epistemology which deals with the limits of human knowledge. This began with the philosophies of Aristotle, whose works were arranged by Andronicus, another philosopher in 79 B. C. Today’s new thoughts pertaining to the formation of the idealistic movement developed in the United States in the second half of the 19th century. They were taking place in religious and philosophical areas. The main tenets of idealism are that God is omnipresent and that the soul or spirit is reality. Man in nature is attuned with a divinity can only perform good deeds. Diseases here on earth are mental in origin. The mind, with this same power, also has the power to heal diseases. On this train of thought, I have serious doubts having been taught human sciences. By the same token, I have witnessed a spiritual healing in which seven segments of exorcism were [that] were administered successfully by a Catholic priest in a Catholic church gathering. It was both frightening and amazing to see! Perhaps there is truth in God’s being the sole of reality and illnesses is due to the failure of man to recognize this. Then again, what is truth as questioned by Plato, the Greek philosopher who implied that there was no such thing; only what is real is acceptable, i.e., the spirit is joined with the physical, outside the body. The idealist, or more the dreamer in my definition [is] one who prefers failure in truth as man’s unity with God causes all negatives on earth. This is where everything can be found, including all answers to all questions. They also believe that the mind is where its at, if only people would realize the minds’ spiritual potential. These to me are not accessible, but nice to think about, especially in times of trouble, when nothing on earth can help in a given situation. Idealists also believe that all objects of knowledge come from man’s senses, as they are mental states and everything is created in the mind.

“Realism on the other hand metaphysically theorizes logic as being realistic. Abstractions such as man are independent from materialistic objects. Again, Plato doctrines are considered, i.e., the universe consists of only words without substantiation, and objects are reality in existence. St. Thomas Aquinas maintained that the universe was in man’s mind with a foundation surrounded by reality. Conceptualists believe that the universe exists in the concept of ideas emitting from man’s mind only without any help from the outside. Materialists consider matter to be reality and conscience is the human nervous system. Naturalists believe that cause and effect is and by nature is sufficient. I bring all of this into the writing as to me it is all related. Realism to me is a series of objects that can be perceived substantiating the reality and separate existence outside the mind which is also an epistemological view. Nature and all its contents, tactile and otherwise, can be experienced via ideas and the intellect.

“Pragmatism is both a metaphysical and epistemological in their doctrine(s). This entails a persons personal “guess” by which one determines whether an experience or happening is due to either the natural or the unnatural. It is like “walking the fence,” whatever pleased the intellect at a given time will prove to be sufficient in filling in the blanks; epistemology being knowledge and its concept studied is truth, perception, and evidence. The relationship between what a person knows and what they object is known as. Again, Plato enters with defining epistemology as the existence of an unchanging world with invisible forms and ideas; none of which contain certainty in knowledge. Objects are imperfect; only mathematics and philosophy are considered real. An unseen world is the goal, or should be, of a human.

“Aristotle believed that knowledge comes from direct experience. It was he that set down the first rules of logic. I find myself also agreeing with this line of thought: that knowledge comes from perception, but also is used as a guide in life and not as a means to an end. St. Thomas Aquinas followed Aristotle in points of logic where the human intellect gains the knowledge of nature, but only via God. Modern logic in accordance to John Locke includes inductive logic, i.e, knowing is not derived intuitively, but rather from experience or the reflection of a man’s mind on a given subject or activity. He was somewhat of a skeptic.

“Pragmatism in itself was formed by Charles Pierce, William James, and John Dewey at the turn of the 20th century. Their empiricism maintained that knowledge is an instrument of action and beliefs and should be interpreted according to their usefulness with rules for their predictability. Logical empericists clarify definition and rules of inference using science, for example, with words such as: knowledge, perceiving, and probable. These are used as verbal rules to make definitions clear.

“Every thing is constantly debated which oftentimes adds to my confusion as to what is true and untrue; [what] is certain and uncertain, and on and on. All is clear or unclear at different times and is different areas depending, I suppose, on what is in “synchronization” with whatever, i.e., body and mind, mind and the innate, the innate and the subconscious, etc.

“Maybe I am none of the things I think I am. My views and beliefs may appear otherwise to another person reading my philosophies. I would more likely be very surprised if someone agreed with my philosophies. Perhaps I really don’t know the true meaning of an idealist, realist, and/or that of a pragmatic, but at least I do think and try to fathom the depths of philosophers. There is one thing I am sure of pertaining to the majority of humans: they are materialistic. Their realms consist mainly of substances composed of various elements use mainly for personal purposes. They fantasize life on earth as a place where all said materials must be gathered and treasured as they deem themselves “classless” without them. As Cardinal Cushing once said, “I came into this earth naked and I will leave this earth naked,” a humble and charitable person by we can pattern ourselves. Close your eyes and everything disappears until you open your eyes again; but the eyes and the [other] senses are not forever. When your eyes are closed, you know that you are still “you,” which does not disappear, meaning the spirit or the soul.

“Who taught me all I know and what will teach me what I have yet to learn? How much was innate at birth? How much experience have we assimilated? What is more important and should take most of our energies — the plateau during life or the plateau after death? We think we are taught to think from the womb, and therefore must learn, teach, and learn again which is infinite in life. Science has taught me that life is a rom of energy and that these energies should be put to use in all physical areas. How much is spent on thinking and learning? I would like to know how much energy is used for mental exercises in comparison to physical exercises during a specific lifetime.

“I once rad of a man who made a study of weighing a person immediately before and after death. Each time, the body weighed two ounces less after death. He also did the same for various animals, but the weight stayed the same. No one weighed him immediately before or after his death. Many lessons could be derived from this, even for myself as I neglected to cut out ad same the person’s name or the article. Who really cared about the study other than the experimenter himself? Why not? As for me, it would mad a good study, as good as or better than those done by some of our greater scientists. It would be in the Idealistic belief that the two ounces were that of a soul being freed of the physical. Those to whom I have mentioned this took it as a joke and maybe it was, but not to the man who was making the study.

“Nothing really changes. There are and always have been good things and bad things in my life. Perhaps to a different degree than, say, those “stuck” in perpetual ignorance and poverty, or those endowed with great intelligence and wealth. My life, I think, as I can never be totally sure (depending on the interpreter), has fluctuated between ignorant and lower middle class, middle class, upper middle class, and back down to lower class with some gained intelligence. All of this, or part at least, depended on the economy of our country.

“The last of my “wonderings” is one that has been continuing from my youth to this present day: that is the hypocrisy of the human. From what I have witnessed and observed, hypocrisy stems mainly from fear of harm to one’s person, i.e., in various forms from another human. Therefore, a person must by hypocritical and not vulnerable. I sound pessimistic but I really don’t want to be. The times I am happiest is when I look into the eyes of an infant or a very young child and witness an unparalleled beauty and innocence. It makes me smile and feel warm inside. Is what I see at the time really true or am I searching fro beauty to give me joy and hope? Questions, always questions and never enough answers.”

Theresa Buckroth, ED 601-1, Spring, 1987

Speak, Show and Tell…with author A. K. Buckroth

Inclusive of Diabetes Awarenes for the General Public.