Thursday, February 14, 2008

Close to Home

This story comes to you from King 5 News in Washington. The way people with developmental disabilities and mental health issues are treated in the Criminal Justice System is absolutely disgusting. I have highlighted some of the words and phrases that made my eyes widen as I read this piece.

You don't need to have a great understanding of developmental disabilities to see how wrong these law enforcement people were. My hope is that a lawsuit is in the works.

PS... adults don't wear "diapers", they wear Attends or Depends. Also, there's no such thing as an"invalid" when describing a human being.

10:50 PM PST on Wednesday, February 13, 2008
By LINDA BYRON / KING 5 News

PORT ORCHARD, Wash. – In July 2006, a frightened mother called 911 to get help for her developmentally disabled son. But that phone call set off a chain of events that landed him in the Kitsap County Jail and altered his life forever.

Bill Trask walked into that jail healthy and left so damaged he can't even feed himself. His story opens a window into the treatment of the developmentally disabled behind bars in Washington State. Increasingly independent before he went to jail, Trask had the mind of a child, but the physical abilities of a 41-year-old man.

He played sports year-round. "He was very fast, he could run," said Wanda Smith, his Special Olympics Coach. Trask also worked as a dishwasher. His employer called him a "great employee." "On his way to being very successful," said Roxanne Bryson, of the Holly Ridge Center.

But as he became increasingly independent, he started challenging his mother, Marie Watson, the one person who'd always taken care of him. One night, Trask went too far.
"I called 911 because Bill was very angry," Watson said. "He hit me twice."
It was the first time she'd ever called police. She was trying to help her son, but the call would change his life forever. "I can't believe I've kept him safe for 41 years and something like this," she said. "They've taken his life away."

Trask is a different man now. He spends his days in diapers and a wheelchair. He's been like this ever since he left the Kitsap County Jail in August 2006.
On July 27, 2006, when he was arrested for misdemeanor assault, it was obvious Trask was mentally impaired. The officer flagged him as "mentally retarded." The jail as having "mental problems."

Twelve days into his stay, Trask became disoriented - screaming and begging for his mother.
"I'm sure that Bill did not know what was going on, why he was in there," Watson said.
That same day, he was moved to a padded crisis cell for his own safety. "It's not something we like to put people in, because you have to constantly check on them and we do when they're in here," said Sergeant Steve Lawson, of the Kitsap County Jail. "They're on camera the entire time they're here."

Trask now spends his days in diapers and a wheelchair. The KING 5 Investigators reviewed hundreds of pages of jail records and in-house surveillance tapes. The picture that emerges is that of a man disintegrating as jail guards stand by and watch.

On a tape of Trask inside his crisis cell, he's seen slapping the walls, taking of his clothes, sitting on the drain. They move him back and forth between the crisis cell and a less restrictive isolation cell. The jail asks a mental health professional for an evaluation, but she only notes that he will need "special care and handling." The next day when a sack breakfast is tossed into his cell, Trask shoves it down the drain.

"Those are all behaviors that are crying out for help," said Sue Elliott, a spokesperson for the Arc of Washington, an organization that advocates for the rights of the developmentally disabled.
We asked two experts to interpret Trask's behavior. "Well, I think he was probably trying to say he was afraid," said Ed Holen, executive director of the Washington state Developmental Disabilities Council. "He didn't know what was happening to him. Maybe he didn't even know why."

After 15 days in jail, he was released to the person he cried out for - his mother. But he was so out of control she was forced to call 911 again. He was only free for five hours.
"I asked them if they could take him and get him evaluated," Watson said. "They said no… they had to take him to jail."

Back inside, day after day, his jailers watched as Trask became more agitated. He tried to stuff his clothes down the drain. He spun on the floor in his own urine. When guards threw in his meal, he opened it and rolled around in it for hours. "To check a box when somebody is urinating on themselves and putting their food down the drain and not drinking water, and not intervening, makes me angry because that's just something you'd do for anybody," Elliot said. But this time the jail didn't ask for another mental health evaluation.

Twenty-two days after he first entered the jail, a doctor happened to stop by his cell while investigating a possible chicken pox outbreak and recognized that Trask was in danger. Trask was sent to a hospital in an ambulance. "He was dehydrated, he had bacteria in his blood, he had gangrene on four of his fingers, and his kidneys were failing," Watson said.

Experts who evaluated Trask said the dehydration he suffered could have caused his brain damage. He remains an invalid even a year and a half later.

Trask's mother, Marie Watson, said: "I've lost my son. I really have." "He's lost everything," said Smith, his former coach. "He's lost his life." For the people who'd helped him come so far, it's heartbreaking. "I've lost my son, I really have," Watson said.

Sheriff Stephen Boyer oversees the jail. He wouldn't talk to us on camera, but in a written statement told us he's sympathetic to the seriousness of Trask's health situation, but believes what happened is not their fault.

Disability advocates say situations like Trask's are a serious problem in jails, which is why they want special training for corrections officers. The Legislature passed a training bill in 2003, but didn't fund it.
Advocates say Bill Trask's case proves they need to try again.

Autism and Vaccines

On February 5th I posted about a TV show that was going to air an episode about the connection between vaccines and autism. There were some folks in the medical community up in arms, believing this was sending a negative message to parents of young children around getting them vaccinated.

Unbeknownst to me at the time of that writing, an independent survey was being taken in Oregon and California about that very topic. The conclusions were very similar to what I was thinking in my intro. You can read all about it by copying and pasting this link into your browser... http://www.NaturalNews.com/022642.html

Sunday, February 10, 2008

No Place Like Nursing Home

A few days ago the national Centers for Medicare and Medicaid Services released a report on nursing homes throughout the country targeted for high-risk pressure ulcer and/or physical restraint improvement. Pressure ulcers are the same as bed sores, and are a result of someone who can't move without assistance staying in the same position too long. It's always necessary that they be moved in a timely fashion. Physical restraint is when someone's movements are restricted, with the idea of protecting themselves and/or others from aggressive behavior or moving about. It's not always a necessary measure.

Oregon has 33 such nursing homes which I'm listing here. Something to consider when placing a loved one in these facilities.

Targeted for Improvement in High-risk Pressure Ulcer Rates

Targeted for Improvement in Physical Restraint

Name

City

County

State


X

AVAMERE HEART OF THE VALLEY REHABILITATION

CORVALLIS

BENTON

OR

X


MARQUIS CARE AT HOPE VILLAGE

CANBY

CLACKAMAS

OR

X


CLATSOP CARE CENTER

ASTORIA

CLATSOP

OR


X

AVAMERE REHABILITATION OF COOS BY

COOS BAY

COOS

OR


X

MYRTLE POINT CARE CENTER

MYRTLE POINT

COOS

OR


X

OCHOCO HEALTH CARE CENTER

PRINEVILLE

CROOK

OR


X

CASCADE VIEW NURSING

BEND

DESCHUTES

OR


X

REDMOND HEALTH CARE CTR

REDMOND

DESCHUTES

OR


X

HEARTHSTONE MANOR

MEDFORD

JACKSON

OR

X


MOUNTAIN VIEW LIVING CENTER

MADRAS

JEFFERSON

OR

X


AVAMERE REHABILITATION OF EUGENE

EUGENE

LANE

OR


X

AVAMERE REHABILITATION OF JUNCTION CITY

JUNCTION CITY

LANE

OR

X


MENNONITE HOME

ALBANY

LINN

OR

X


TIMBERVIEW CARE CENTER

ALBANY

LINN

OR

X


PIONEER NURSING HOME

VALE

MALHEUR

OR


X

TIERRA ROSE CARE CENTER

SALEM

MARION

OR

X


EVERGREEN PORTLAND H&R CENTER

PORTLAND

MULTNOMAH

OR


X

GRACELEN TERRACE NF

PORTLAND

MULTNOMAH

OR

X


GRESHAM REHAB & SPECIALTY CARE

GRESHAM

MULTNOMAH

OR


X

HEALTHCARE AT FOSTER CREEK

PORTLAND

MULTNOMAH

OR


X

PROVIDENCE CHILD CENTER

PORTLAND

MULTNOMAH

OR


X

REGENCY GRESHAM NURSING & REHAB CENTER

GRESHAM

MULTNOMAH

OR


X

ROSE CITY NURSING HOME

PORTLAND

MULTNOMAH

OR


X

TRINITY MISSION HEALTH & REHAB OF PORTLAND

PORTLAND

MULTNOMAH

OR


X

NEHALEM VALLEY CARE CENTER

WHEELER

TILLAMOOK

OR

X


EVERGREEN HEALTH & REHAB CENTER

LA GRANDE

UNION

OR


X

COLUMBIA BASIN CARE FACILITY

THE DALLES

WASCO

OR

X


EVERGREEN THE DALLES HEALTH

THE DALLES

WASCO

OR

X


AVAMERE REHABILITATION OF KING CITY

TIGARD

WASHINGTON

OR

X

X

EVERGREEN HILLSBORO HEALTH

HILLSBORO

WASHINGTON

OR


X

MARYVILLE NURSING HOME

BEAVERTON

WASHINGTON

OR

X


NEWBERG CARE HOME

NEWBERG

YAMHILL

OR


Saturday, February 09, 2008

Healthcare Heroes

I've written the following as a part of Disability Carnival # 31. The topic/theme of the carnival is "Superman" and will be up on Valentine's day at wheelchairprincess.com

It seems to me that there is danger in proclamations declaring individuals as being extraordinary people while they’re still alive. It has to do with ego and basic psychology. It’s kinda like; “You’ve arrived! There’s nothing more you need to do”.

I’ve seen it before; people being touted as “champions” of a particular cause. In my state they actually have a title known as a “healthcare hero” for someone who has done something to move the system to do what it should have done in the first place. I wonder if the idea is to divert people’s attention away from the failed system. Keep the masses at bay, and let them try to become the next hero. I’ve also noted that these heroes sometimes become complacent following their crowning achievement.

The celebration of the Reverend Doctor Martin Luther Jr.’s birthday is a prime example of what I mean. I don’t know what that’s like in the community where you live, but in Oregon it’s a day of glad handing and back patting to the extreme. There’s very little discussion regarding his bucking the system or calling people out when there was just cause. It’s all about congratulatory remarks about how wonderful select individuals are. Dr. King was never very big on accolades himself...

As for Superman himself; I’ve heard that the story is an analogy, so I’ll go with that idea with a bit of a twist. Here’s my take on it:

We all have green Kryptonite inside of us. Another word for it is “ego”. In the same way green Kryptonite weakens Superman, and can kill him if exposed to enough of it, so can ego make us impotent and take away our powers when out of balance. I think it best to stay away from the beaming admiration of onlookers who inflate the ego, and concentrate instead on the work that lies ahead.

Story of Success

Not all that's going on in our state is bad news. This story comes to you courtesy of the East Oregonian newspaper/website. When you hear over and over about the unmet needs of people with serious challenges, it can really bum you out. I know that personally it gets to me sometimes...
-------------------------------
Journey into the mind

Recovery center has unique mission

Many of the residents of the Blue Mountain Recovery Center come to the hospital caught inside a dark, confusing place - a place that exists inside their own minds.

A simulator invented by a drug company called Janssen Pharmaceutic helps mentally healthy people experience delusions common to schizophrenics, a disorder suffered by many BMRC clients. Using goggles and headphones, you journey into the mind of a schizophrenic who takes a ride on a city bus or going to the grocery store.

It's a frightening journey.

People stare at you from every aisle of a grocery store, a man in a television commercial yells at you, the label on a pill bottle turns into a skull and crossbones. You hear voices in front, behind and inside your head.

Sometimes these delusions lead people to do strange things in real life. One woman, for instance, ended up in police custody after she went into a stranger's house and started hauling the furnishings outside for a yard sale.

Most clients come to BMRC, the smallest hospital in the Oregon State Hospital system, from county mental health facilities around the state. Others come directly from emergency rooms, some handcuffed in the back of police cars.

Most have been civilly committed by the state for up to 180 days.

The recovery center, a palatial, two-story building, sits amid a huge expanse of lawn that is shaded in the summer by large trees thick with squirrels. The structure, though impressively large, is dwarfed by its razor wire-surrounded next-door neighbor - the Eastern Oregon Correctional Institution.

The Blue Mountain Recovery Center is invisible to many Pendletonians who have driven past numerous times, but never noticed its existence or maybe thought it was part of the prison.

The facility looms large for the 60 residents of the center, however.

Director Kerry Kelly said newly arriving residents are awash in an overload of mental stimuli.

"This is a very confusing place to come to initially," said Kelly.

Imagine trying to soak in a new environment and lifestyle while battling voices or waging other internal struggles, Kelly said. Some are paranoid, refusing to eat or drink, thinking BMRC staff wants to do them in.

It takes a while, in some cases, to build trust. Then, staff and patient work together for recovery.

"We agree with them completely that they don't belong here," she said. "The goal is to get them stable and back into the community."

Each client is different, Kelly said, but with a mixture of psychotherapy and drug treatments, most are able to get back on stable footing. One big challenge is convincing some clients they need certain drugs - such as a bipolar person who is in a manic state.

"Without medication, you feel like superwoman," Kelly said. "Why would you want to take medication?"

The drugs cause some unpleasant side effects, such as jitteriness, Kelly said.

Blue Mountain's parent hospital, the Oregon State Hospital, recently made the news after a U.S. Department of Justice investigation revealed numerous civil rights violations including life-threatening use of restraints, infection control issues, violence between residents and other concerns. The investigation took place in 2006 and was released last month.

Kelly said BMRC is not a miniature state hospital with all the same problems, though she admitted it faces some of the same challenges.

"We're working within a very narrow budget and our units are crowded," she said.

Clients sleep four to a room.

"At any given time, there's six to eight people waiting for that bed," Kelly said.

But the similarities end there. Pendleton's hospital isn't crumbling and the clients' conditions aren't as severe. The state hospital treats medical and forensic patients, while BMRC mostly has clients who have been civilly committed.

Fewer patients mean staff can respond quicker.

"We can take care of issues right away if they come up," she said.

Kelly wanted people to know the state hospital started working to improve immediately after its horrible review in 2006.

"Amazing work has already been done," she said.

The Pendleton hospital is smaller than its Salem counterpart. It only has two wards, one coed and the other male.

On Thursday, in the all-men's ward, a 20-something man stood in the hallway shaving as he stared into a full-length mirror on the wall, painted a soft green. A handful of other clients ambled around, some wearing headphones and others conversing.

Two staff members sat with one man who had earlier indicated he wanted to die. Suicidal clients always have two staff members with them at all times, Kelly said.

Thoughts of suicide plague some clients, she said, and staff takes the possibility seriously.

The hospital has two seclusion rooms for clients who are a danger to themselves or others. They are plain with only a mattress and four bare walls. The patient usually is free to move around and a staff member is present, Kelly said.

In contrast to earlier years, Kelly said, the rooms only are a last resort.

"Seclusion isn't a treatment modality," she said. "It's a failure of treatment - something wasn't working right."

The center sometimes goes for months without a client put in seclusion and that's how Kelly likes it.

"We will do anything, including standing on our heads, to avoid using these rooms," she said.

The center's patients eventually ease back into the community, after treatment.

"It's a process," Kelly said. "It happens over days, weeks and months."

Tuesday, February 05, 2008

Big Pharma Strikes Again?

I personally have suspected that vaccines are in fact one (if not the only) cause of Autism. I further believe that it was "ruled out" by doctors and scientists who were rewarded for their findings by big pharma. Apparently a new tv show is going to make this suggestion also. I'll be very curious to see what kind of backlash comes from it. From the internet...

ABC show fuels autism debate; doctors concerned

The premiere episode of ABC’s new legal drama, Eli Stone, may lead parents to believe there is a connection between autism and immunizations, doctors say.

by Leslie K. Tamura Published February 5, 2008 ⋅


MEDILL NEWS SERVICE

Dr. Alan Rosenblatt has given all the recommended vaccines to his own children and urges other parents to do likewise.

Rosenblatt’s recommendations may fall on deaf ears, however, if the premiere episode of ABC’s new legal drama, “Eli Stone,” leads parents to believe there is a connection between autism and immunizations.

“I think that [ABC] is using a very sensitive issue to raise interest in their product,” said Rosenblatt, a North Park neurodevelopmental pediatrician.
During the show’s first episode, a jury awards in favor of the plaintiff who accuses a pharmaceutical company of being responsible for her child’s autism.

“It implies that there is a cause and effect relationship between a mercury preservative in vaccines and the emergence of autism in children that is not consistent with the overwhelming evidence that is accepted by the scientific and medical community,” Rosenblatt said.

Last week the American Academy of Pediatrics argued there is no scientific data supporting a relationship between vaccines and autism and urged ABC to cancel the show’s Thursday premiere.

Dr. Renee R. Jenkins, the American Academy of Pediatrics president, wrote to ABC executives Friday, warning “this program could lead to a tragic decline in immunization rates,” which “could be devastating to the health of our nation’s children.”

ABC said on Monday it would still air the episode but will include a disclaimer about the show’s plot and direct viewers to the Centers for Disease Control’s autism Web site.

Nonetheless, the medical community is still wary about the “Eli Stone” episode.
“There are real health consequences with this drama,” Rosenblatt said.
“What has led to our present state of the public health, compared to one or two centuries ago, [was] the introduction of vaccines,” he said.

The Pediatrics Academy’s Jenkins worries that the episode’s content will influence parents to not immunize, causing “needless suffering and potential deaths of children.”

It is generally accepted by the medical community that there is not a causal relationship between vaccines and autism. Mercury was removed from vaccines in 2000 but the numbers are still going up.

Autism is one of a group of neurological brain disorders affecting child development. Many children with autism have unusual behaviors and interests and have difficulty with social interaction and communication.

Autism is the fastest growing developmental disability, now affecting 22,000 children in Illinois, according to the Illinois Department of Human Services.
Because there is no cure for autism and no causal connection with vaccines, people are looking for easy answers, Rosenblatt said.

This has pediatricians concerned about the influence of fictional shows on health care decisions.

Jenkins said in a news release that “a television show that perpetuates the myth that vaccines cause autism is the height of reckless irresponsibility on the part of ABC and its parent company, The Walt Disney Co.”

The show is already stirring debate on the show’s message board.

“I am terribly concerned about a TV show like this espousing the vaccine-autism theory,” one person wrote Tuesday. “If the creators think this won’t lead to people not vaccinating their kids, they are either purposely ignorant, or downright negligent.”

Another person wrote, “The parents of autistic children have enough to deal with, without having to combat idiotic autism mumbo-jumbo in the media.”
“Eli Stone” was created by Greg Berlanti and Marc Guggenheim and stars British actor Jonny Lee Miller. The new drama airs on ABC, Thursdays at 9 p.m.CST.

Saturday, February 02, 2008

More Exploitation?

It’s all over the internet and every news source throughout the world. I'm talking about the "reports" that Al Qaeda used 2 women with developmental disabilities as unknowing suicide bombers. Folks are outraged that these terrorists would stoop to taking advantage of these women; who in most cases are being called “mentally handicapped”. The media is telling us this story using language that both infuriates and elicits pity. I have to wonder how they know these 2 women had developmental disabilities in the first place. I also wonder how they know these women weren't aware of what they were doing.

I have a question. Where have these same “protectors of the vulnerable” been while people with developmental disabilities have been struggling to eke out an existence in nearly all the countries of the world... for centuries? It seems as though these people are using a label of "mentally handicapped" to further their own agenda(s). People with disability labels are being taken advantage of, so that some people's beliefs and actions can be validated.

Don’t get me wrong; I don’t believe that suicide bombing of innocent civilians by Al Quaeda is anything short of heinous. It just troubles me that people with developmental disabilities, the same group of people that have been virtually ignored by society at large, are now being exploited in yet another way.

Friday, February 01, 2008

How to Create a Religious Following

Some time back I was tasked to find an appropriate group home for my kid who has a developmental disability. We checked out some of the places we were referred to, but he eventually was allowed to stay in the foster home of his choice.

One of the homes we looked at was run by Good Shepherd Communities, which operates group homes throughout the state of Oregon. I knew they are a Lutheran based organization, but there was no mention of them being religion driven.

Today I received a Google alert with the keywords being "Portland developmental disability problem" and found the following as a Help Wanted ad. It would seem that DHS is funding religious organizations. Whatever happened to separation of Church and State??
--------------------------------



Parish Ministry Consultant

Company: Good Shepherd Communities

Location: US-OR-Portland
Base Pay: N/A
Employee Type: Full-Time Employee
Industry: Not for Profit - Charitable
Manages Others: no
Job Type: Nonprofit - Social Services
Req'd Education: Not Specified
Req'd Experience: Not Specified
Req'd Travel: Not Specified
Relocation Covered: No
Posted Date: 2008/01/23

Contact: Martha Titterton Phone: 503-225-1631
Fax: Not Available Ref ID: 125


DESCRIPTION

Reports directly to the Regional Spiritual Life Director, who sets the overall direction for the work. Works cooperatively with management and staff of Good Shepherd Communities (GSC) to ensure that programs and activities are appropriate to the mission and goals of Good Shepherd Communities and are coordinated with other personnel who may be providing spiritual life supports. Trains and orients GSC program managers and staff in the area of spiritual life supports; assists congregations in developing and enhancing spiritual life supports that are inclusive of people with developmental disabilities; recruits and trains volunteers to provide Christian nurture and support for people with developmental disabilities and those who support them; ensures that spiritual life supports are appropriate to the needs and desires of each individual supported by GSC; other duties as may be assigned.

REQUIREMENTS
o Supports the spiritual life of people with developmental disabilities based on an assessment of the individual needs and desires.
o Provides orientation, training, resources and supports to GSC staff in the area of spiritual life supports.
o Coordinates programs and activities with other GSC staff that may be providing spiritual life supports.
o Facilitates the inclusion of people with developmental disabilities in the life of local congregations.
o Provides training, resources and support to congregations serving/seeking to serve people with developmental disabilities.
o Offers resources and support to families of persons with developmental disabilities.
o Work with BLHS religious life staff and resources staff in developing religious outreach materials, curricula, workshops and seminars.
o Maintains effective working relationships with Lutheran judicatories and other agencies supporting people with developmental disabilities.

• Education and/or Experience:
A communicant member in good standing of a congregation of the LCMS, ELCA, WELS, or ELS, a professional church worker on the active roster of his/her district or a college graduate with training and/or experience in developmental disabilities. Special Education courses or Clinical Pastoral Education and three or more years of experience in ministries with people with developmental disabilities are preferred but not mandatory.

o Certificates, Licenses or Registrations:
Applicants must maintain a valid driver’s license and an acceptable driving record.

Other Competencies:
Training in, and commitment to, the Lutheran doctrine and practice and the ability to work with the Lutheran Church on a local and national level. Applicants need to possess a demonstrated ability to work effectively with staff and volunteers, be able to communicate effectively through verbal and written presentations, and have the skill to set realistic goals and implement plans. An applicant must be intrinsically motivated, flexible, patient, an effective listener and communicator, with the ability and desire to work as a team member in a large corporation. Candidates must demonstrate knowledge, compassion and respect for people with developmental disabilities. A person must be willing to promote the spiritual, emotional and physical well-being of each person and seek the greatest possible inclusion in THE CHURCH AND THE COMMUNITY.

Thursday, January 31, 2008

The Longest Month in History

Here we are finally... the last day of January. For the life of me, I can't recall a month that has lasted this long. It's not like it was a bad month. It just feels like 2008 has been hanging around a lot longer than 31 days. New Year seems like a mighty long time ago to me. Maybe it's because so much has happened this month. Any way; you probably have more important things to do than read this thought.

Tuesday, January 29, 2008

Oregon Concept 87 Pondering

In response to the latest, Oregon Legislative Concept 87 (LC87):
SUMMARY OF LC87*: Proposes, in response to an emergency, to change the Oregon code and/or statute and/or rules to reserve a “special fund” in the Treasury (the “Quality Care Fund”), set aside from the fines collected from agencies employing persons found of substantiated abuse, to be reserved for the exclusive purpose of allocating resources to DHS to administer the training, technical assistance and quality assurance necessary to meet their obligation under current requirements of law. *[DAWGOregon’s interpretation of a piece of the proposal].


After much thought about the Quality of Care Fund I’ve come to a few conclusions that I’d like to share with you. I don’t see this as much more than a temporary band aid for the problem of abuse/neglect. I’d like to know what your feelings are.

I guess the plan is to fund training and monitoring through fines levied on agencies where incidents of abuse and neglect of people with developmental disabilities occur. While I agree that this problem must be dealt with immediately, it’s hard to see how this plan will be preventative.

First of all, it seems to me that this concept is short sighted, and will only facilitate the cycle of abuse. The best way to demonstrate this is through a map I made in figuring this out. It’s below the text here.

Secondly, this unsustainable fund asks nothing of anyone other than people who experience abuse, their abusers and the agencies they work for. Isn’t it time that the people of Oregon invest SOMETHING in our citizenry?

I’ll look forward to your thoughts.