madewell music

Haggling For Healthcare

This morning, as I left an excellent physical therapy session at University Hospital, I felt so happy that I have assembled a great team of therapists! Yesterday I had acupuncture followed by a brachial plexus session. This morning, in spite of limited function and range of motion, I felt great as I went to PT!

Waking up pain-free is a big deal and should not be taken for granted.

In May 2025, my family physician told me that I was boringly healthy. Approximately four weeks later, all of that changed. I was someone who was completely disinterested in healthcare and insurance, except for numbers on a budget spreadsheet when I was the Director of a Metropark system.

That has changed.

My dear wife just got a notice that the cost of her supplemental healthcare coverage was going up 80% this year. There may or may not be alternatives. In addition to the ever-changing and evolving costs and the myriad of details involved with managing insurance, there is the issue of the quality of service.

Northeastern Ohio is globally recognized for its healthcare providers—both University Hospital and the Cleveland Clinic are world-renowned. That being said, while both have remarkable attributes, in other regards, they miss the mark. The process of “therapeutic recovery” has been an interesting adventure. First of all, I was surprised to find my therapy was divided into two categories: physical therapy and occupational therapy. One would intuitively think that physical therapy would apply to all manner of physical motion and activity, and occupational therapy would apply to lifestyle and managing fundamental daily activities. I had no idea that physical therapy stopped somewhere along the arm and occupational therapy took over from that point down to the hand.

This begs the question: Is the elbow "no man’s land?"

My experience with the Cleveland Clinic occupational therapy program has been excellent; however, my experience with their physical therapy program has been very disappointing—and please remember, I was looking for a therapeutic team. I have seen somewhere in the neighborhood of 12 different physical therapists associated with the Cleveland Clinic. I would say three were great; the rest were somewhat indifferent caregivers or clinical at best. Ultimately, I gave up on the Clinic because I felt the Clinic had given up on me.

In June, I received an order for extended PT from my Clinic shoulder doctor. At my next scheduled PT session, I was told I was done with physical therapy. It seemed my age was a factor, as well as my score on the quantitative measurements the Clinic uses. This survey, by the way, did not account for the diversity of my injuries.

So I had to “shop around.” Shopping for healthcare providers and practitioners is a procedure that I never expected to deal with, and I’ve never had any practical experience with. I had no choice, as my hope of a collaborative therapy team approach to my recovery was dashed apart by what I perceive as a quantitative versus qualitative approach in the Clinic’s physical therapy department. This forced me to shop around to build a comprehensive team. Hence the title for this essay: “Haggling For Healthcare.”

I am in a relatively luxurious position of not worrying excessively about healthcare costs; however, navigating through my insurance programs and the billing procedures from hospitals and caregivers has been concerning. Last year, for example, I had two helicopter rides. Both of those were billed in the neighborhood of $70,000. I have no idea what my total healthcare expenditures were for 2025, but it had to be a staggering number.

Looking back to the date of my crash, I’ve received some remarkable, lifesaving care. I’ve made remarkable progress, and I'm still alive. That being said, in addition to the mental and physical demands of healing, I have been appalled at some of my experiences. I found myself thinking: We all need personal advocates to help us navigate through the bureaucracy of our contemporary healthcare system. Then an internal voice screamed:

“No… no, we don’t!”

We don't need another layer of bureaucracy. What we need is a simpler, more compassionate system. We do not need a system so layered with bureaucracy that it gets bogged down by economically driven networks, procedural quotas, and quantitative measures that strip away caregiving compassion and qualitative recovery.

An old woman in a market negotiating with vendors comes to mind. To quote Mick Jagger from the opening lyric in Mother’s Little Helper: “What a drag it is getting old.”

Especially when you have to haggle just to heal!

And The Rain Came Down 

This evening I watched the rain come. 

We have a lovely porch here at the creek house. Its truly a shame we don’t use it more often. Tonight, I knew a storm front was passing through, so I waited for the rain. 

Down in southern Ohio, they have been getting rain all summer, but that is not the case here in the NE corner of the state. In our particular location, we have been exempt from the rainfall just a few miles away, but not tonight. 

We got a decent, but brief, thunder shower. 

I checked the radar, and marked the front as it traveled from the west side of Cleveland, on east into Lake County. 

I had an acupuncture session yesterday and experienced a serious nerve flair up this afternoon. My internet health reference, Janet, indicated that this was to be expected, and I should do nothing tonight. Watching a rain-shower pass seemed like a perfect activity.

And it was. 

The storm had an appropriate amount of thunder to announce its progress, and I sat with my phone on my lap intending to get a little bit of video to document the moment it hit. Every now and again, one of these weather events comes roaring up, or down the valley with astounding ferocity. But that was not the case tonight. 

As the thunder got closer, a gentle rain started, and gradually increased in intensity until it was raining pretty hard, but nothing overly dramatic. 

It was lovely. 

We have been experiencing a mild drought and we really needed the rain.

Whenever a nice rain sets up, I recall starting to write my song, The Skies Turned Grey. 

The song was recorded for my second album, Arrow Creek. The highlight is Caroline Quines’ exquisite harmonies. 

I was sitting in the airport across the gate from one of the national news anchors. We were both watching the news as Hurricane Katrina was about to slam into New Orleans. We had both been at the White House Conference on Collaborative Conservation in St. Louis. He was leaving early to get back to cover the storm, I was leaving early because I felt the whole thing was a sham. 

The George W Bush Whitehouse had orchestrated the event to create “input” to begin dismantling the Clean Water and Endangered Species Act(s). The proceedings from that conference were overshadowed by the horrific effects of that storm.

Ah the recollections that come to mind. 

Finally, some rain!

Our little place, here in this corner of Ohio, has been concerningly dry. And such was the case last year.

Living by a creek and having a shallow well, I am prone to notice such things.

While it’s been really “dry” for the past few years, this appears to be a good year for wildlife. The toad hatch was abundant, there are two does with twins, and one with a single fawn eating our hostas. I’ve had several encounters with our own young yard skunk, and I keep trying to encourage the groundhog tunneling under the barn to move! We’ve seen an eagle fly through our tree canopy sever times this summer, which is unusual, and I am completely content with watching each day unfold. 

That’s a problem.

This is a very high maintenance property, and am increasingly tempted to simply watch everything I can see in this world around me, evolve under the powers of natural succession and entropy. 

I even find that process beautiful.

Now this attitude doesn’t bode well for upkeep or projects.

There is vegetation that should be controlled and wooden structures that need to be repaired. 

Recently, I started humble efforts to get the barn cleaned up. I vacuumed the loft studio, organized some things, hauled some trash away, and gave away some furniture and building material.

That was good.

It’s always interesting when I am in periods like this, I have all kinds of music in my head. I really should be committed to capturing these melodies and the lyrical lines, but that requires work.

Another problem of sorts, I have truly enjoyed the listening space that I have created in the barn. I have a lovely sounding stereo, and my music collection was greatly enhanced with a gift from a dear friend, of both CDs and vinyl records.

I go through a self-directed therapy session for either my arm, hand, or both while I’m reclining on a massage table located in the center of the stereo field. After I’m done with the session, I continue to enjoy listening to music.

Other than the fact that I’m still carrying some constant level of pain, and my left hand and arm aren’t working to an except-able level, I would say I’m living an ideal existence

I go through a self-directed therapy session for either my arm, hand, or both while I’m reclining on a massage table located in the center of the stereo field. After I’m done with the session, I continue to enjoy listening to music.

Other than the fact that I’m still carrying some constant level of pain, and my left hand and arm aren’t working to an except-able level, I would say I’m living an ideal existence

Well, I might be getting something back that resembles motivation. Mary Jo is out to a dance recital at the museum of art. While she is gone, I took it upon myself to vacuum the loft in the barn. As is the case with good intentions, my plan was to move down the steps, removing cobwebs, dust, and debris.

I got to the bottom of the stairs and decided I should take a little bit of a break.

Ah the B3!

I thought this would be a good time to continue importing music into my Brennan B3. It’s a storage device that can hold upwards of 5000 CDs. You can control it with your phone. You can control it with a computer or a tablet. It’s got Bluetooth capability. It’s quite an impressive unit. My big complaint about it is it does consistently read Grace Notes. Grace Notes are the digital identifier codes embedded in any contemporary album. I’ve found it is better to transfer or rip my music in small batches, and add labels if I need to. It seems to be easier this way. 

There are merits to this approach.

It makes you aware of how much music you actually own, and maybe forgot about.

I needed to sit still awhile and cool down, so this was a perfect time to transfer music files, keep a eye on the titles ect. and listen to two new records from a couple talented friends. In The Meantime, by Brant Miller, and Mortal, by James Curly are both excellent records. 

So good in fact they warranted several plays and before I knew it, it was 3:30 and I was starving. 

I went back to the house and found some minestrone in the fridge, put some in a bowl to microwave and decided I’d have a few nuts while that was warming up. 

I promptly knocked the filling out on my front right tooth!

Now this is the third time this summer that I’ve done that. Part of the problem is my left hand doesn’t work and in my impatiences,I have used my teeth to open a bunch of things, like plastic bags, and to take off shirts. I’m giving my front incisors a good workout.

Call me a barbarian if you will, I was just trying to get something to eat! 

They say things happen in threes, and chipping my tooth is not all that I have done to myself this summer.

I burnt my left hand yesterday morning, cooking some eggs, right above where my hand meets my wrist, and you guessed it, this is the third time I have burnt my left hand (or arm) in the past five weeks.

Don’t worry though! My left hand and arm are still numb on the lower side, so it didn’t hurt, but second degree burns are still nasty! I wont post a picture!

The first time I burnt myself, I was reaching for a coffee cup and I rested my wrist on a coffee pot. I didn’t even know it. That was a really nice burn too! Nearly 2 inches long and an inch wide! A week later I burned myself and almost the same location while I was making some eggs.

So I’m feeling a little beat up at my own doing!

This prompted me once again to sit still, hence this pedestrian rambling! 

While I was cleaning up the barn, I came across this little cup that’s been tagging along with MJ and I for over 45 years!

While we were living in Oxford, a friend of ours from Louisiana came up before school, got in session and stayed at our apartment for a few days. He happen to drive us to the hospital when our first daughter was born. Fields left us that little cup as a souvenir. 

It’s funny how certain things make the cut and don’t wind up in the trash or Goodwill and it’s also funny that I would come across the Dan Fogelberg song “Souvenir” today while I was moving music files!

One year on!

I sat down to journal today motivated by some troubling emotion associated with my physical therapy. I have come to realize that it is incredibly important to have the right therapist. Regardless of base line technical skill and capabilities, a shared recovery goal is essential, and without that, “the team has no coach”.
What an interesting and amazing year.

I certainly regret the mental pain and agony I have caused my family and friends as the result of this accident. Obviously, this was not intended. But I have enjoyed so many experiences and interactions over the past 12 months. 

Yesterday was quite the day. I toured some out of state guests around. They were in town for my crash anniversary gig. I drove them around the wine country, and to several of the parks I hand a hand in acquiring and developing while working for Lake Metroparks. 

What a nice way to spend the day on the  actual anniversary date of the crash. We went to several parks along the Grand River and to Lake Erie Bluffs. Quite the personal  legacy to reflect on. I suppose I look at those projects with a little more pride after my near death experience. I am certainly appreciative of the opportunity afforded me to be involved with such things. 

Combine my career in the parks and conservation field, with the experiences I have enjoyed with my musical endeavors, and I have had quite the ride.

Sunday was simply lovely. It was an gig close to the anniversary of my crash. I was surrounded by a host of talented musicians, family and friends, and we had a wonderful afternoon. This was the third such event since I had my accident when I was the recipient of a tremendous demonstration of love.  ! How can a person be so fortunate? It is not often that an individual gets to observe such manifestation of love and support. 

This is not the only time I have been the recipient of such kindness, most notably, after the flood of 2006. While our house was nearly destroyed, with help and the encouragement of friends and family, it was rebuilt and restored better than the original condition. 

Like the aftermath of this crash, it took over a year to recover from the flood.

I suppose someone could look at these experiences and think I was exceptionally unlucky, but I have an alternative view. What a gift it has been to actually see and experience this. I really do believe I have lived, and continue to live, a charmed life.

I have had the opportunity to interact with many exceptional professionals over the course of this ordeal and I am always appreciative of opportunities to interact with great people, and many of these folks are truly great people. 

These experiences have enriched my life, and I already had a very rich life. 

I am presently sitting in my sunroom enjoying my second cup of coffee. I am looking out at dappled sunlight on a lush blanket of vegetation. I just came back from a stroll down by the creek and re-filling the oriole feeder. When I take a little walk like that, the birds scold me if they are out of jelly.  

And as I went out to fill the feeder, I couldn’t  help but feel what a tremendous privilege it is to be here, and I not only mean this location but I mean here, right now, and what a tremendous privilege it is to be embraced by love.   

I am amazed at the cerebral nature of relearning how to move. With my hand, I find that trying to think about, and break down every nuance of moving a digit is helpful in getting that finger to move. When I maintain the right perspective, it’s fascinating, but it is also mentally exhausting. For example, I have been trying to flex my thumb to no avail, until I realized I had to rock the base of my thumb backwards before the first joint would bend forward. Yes, I have to mentally “tell” each joint what to do. Very very trippy! 

I still can’t pick up a set of car keys with my left hand, so playing a guitar in a traditional format is impossible. 

I continue to “experiment” with open guitar tunings and various methods of securing a slide to my left hand. I do find joy in making a little music, but I sometimes don't feel like learning a new instrument at this stage of the game!

In addition to exploring ideas for new songs, I have been going over my existing catalog and converting appropriate songs to a “slide” format.

You wouldn’t think a shoulder was that involved with holding a guitar, but it is.   

My shoulder is still partially frozen, and the therapy movements hurt, but I have been feeling that joint release bit by bit. My friend Kelly left one of her portable message tables in my barn, and that is where I do most of my shoulder work.  

I am the subject matter of a presentation my occupational and physical therapists are sharing with their peers, and I have been making little videos of my therapy innovations for them to use. I call these “Steve Tricks”. I made one of these in the downstairs of the barn. My occupational therapists said it looked like I made that clip in a “murder barn”. She is a big fan of murder mysteries. I guess that’s a cool thing? I don’t know.

A prologue of sorts.

It was a beautiful day. This was nothing unusual in a string of beautiful June days. I had preformed the night before with my friends Jono Yowell and Mark Dershaw. Both are extremely talented musicians and remarkable people. I have made music with a tremendous number of people over the years and certainly felt grateful whenever I was working with Mark and Jono. They are great players. We had played at a little place in the quaint village of Fairport Harbor called the Lyric Bistro. We had a fairly good night, not one for the ages, but a couple good moments, shared with a receptive crowd. 

I had just gotten off the phone with a dear friend, Martin Stansbury. Martin has helped me with my last two recording projects, mastering “Hometown Blues”, and producing, engineering, mixing and mastering “Haunted”. Martin and I had been talking about my desire to change my performance routine and focus on more listening venues. 

I had been doing about 75-100 shows per year. The majority were local wineries and I had been working to shift to a preponderance of community concerts, listening rooms and house concerts. Over the past few years I had been making good  progress with this regard, performing not only in Ohio, but also a half a dozen nearby states. As you might image there is a great reward associated with performing at a house concert or a good  listening venue.

I came downstairs from the loft studio in my barn and made a conscious decision to move my instruments and gear from my Ford F150 to my little “gig” car. A 21 year old Toyota Rav 4. I remember making this decision, and I had some feeling it was a significant choice, and it was. Less than an hour later, my gig car had a mechanical failure which resulting in a horrific crash with a tractor trailer. This occurred on I-90 at the Varooman Rd access ramp on the edge of the Paine Creek valley. 

One of my friends believes this valley is a “thin place”. A place where the spiritual dimension is close to this world. I don't profess to have any insight on such thoughts, but I can attest to a significant number of suicides and accidents that have occurred in this valley. I even referenced Hell Hollow in my song “Haunted”, which happens to be the name of my fourth album. 

As I was merging onto the highway, a semi was in the left lane. A unusual service light came on and the car swerved toward the truck. I reacted by pulling the steering wheel hard to the right. I remember skidding through gravel toward the guard rail. Evidently, my car bounced off the guard rail and directly into the path of the semi. 

I had a few brief moments of lucidity. One occurred when I was in the back of an ambulance when my sister in law suddenly appeared. I remember telling her I thought that I broke my shoulder. The second occurred when my wife appeared at the Tri-Point emergency center. She was telling me that I was involved in an accident and was going to be taken to the University Hospital in a helicopter. 

I did break my left shoulder blade, clavicle, sternum, and a half dozen ribs. I also a fractured ankle, incurred four fractures in my pelvis, lacerated one of my kidneys, and had a brain bleed.

MJ and her sister were heading to the winery where I was scheduled to play that afternoon. Unfortunately they drove through the crash scene. Lori pulled her car off the road and told MJ to stay put. She climbed into the ambulance and spoke to me before the EMT’s chased her out. She and MJ followed the ambulance to Tri-Point where I was transferred to the helicopter. And that is when MJ talked to me.

I found out later that the wreck was captured on a video camera on the truck. An Ohio State Patrolman told me that he had never seen anyone live through a wreck like that.

And so begins this story of recovery.

Last night I properly held a guitar!

Last night my buddy, the amazingly talented Bill Lestock, came over with intention of sharing a captivating melody with me. Actually, it was much more than a melody, it was a multi part song. He was interested in my thoughts and possible lyrical contribution to the work. He played it through twice, and then we captured a video performance. 

We talked about Bill’s thoughts and mental images for the song and had a really great discussion. I always enjoy finding out what images are in the mind of an artist when a song comes to them. And this is a great song.

Afterwards, I tried to entertain Bill with a few of my tunes. I was playing my resonator guitar on my lap and after a while I had to take a rest. My fingers go numb from the Velcro tape holding the slide to my hand.  Billy asked me if I could play anything on a standard guitar. Without thinking about it, I picked up my resonator guitar to illustrate that I still was unable to hold a guitar properly. My left shoulder, arm, wrist and palm were traumatized so severely from my accident that whenever I had tried to hold a guitar in a normal position, I couldn’t. I simply could not imagine being able to get my hand to reach and bend like that. It seemed that my entire arm had shrunk, and my wrist would never be able to flex like it needed to.
 

Much to my surprise, I felt the neck of my resonator guitar slide nicely into the palm of my left hand. I was dumbfounded. For the first time in over ten months, I could feel a guitar neck in the palm of my hand. I told Bill that I could not do this last week. I know, because I tried. This entire recovery process is a mental trip. I can’t help but wonder as profound an advancement like this is, will it be the last?

Don’t ask about making chords, or even playing single notes, but I’ll take each step for what it is.

I’ll let this old mule haul the blues away!

Howdy! So its been a while since I did a general “health/recovery” update. I’m doing remarkably well all things considered. Mobility in my fingers continues to improve, but good Lord it is a long slow process. I have on going stretching and massage for my hand, TENS electro therapy and a host of items to touch, pickup and move.  My shoulder is gradually getting better, but that also is excruciatingly slow. I have a regime of shoulder stretches, some actually use ropes and pulleys! Big fun and to quote not one, but all three of my crack doctors “Wow you have got to bust that shoulder loose!”. 

No kidding! 

A frozen shoulder is a big deal, and takes a long time to recover. And it hurts too, but nothing like the brachial plexus pain. That stuff is other worldly! I went to my pain doc this week because the nerve pain has returned, and at times, it is quite severe. He wrote another script, this time for for Cymbalta but I would prefer to not layer yet another drug on the Lyrica and extra strength Tylenol I’m taking. I made an appointment with an acupuncturist. Unfortunately, that’s not until mid June! We’ll see what happens, but in the meantime I will keep slogging along. 

I’ve been trying to walk 5000 steps or more a day in addition to keeping up with my hand and shoulder exersizes. As far as work around the house, my hand issue gets really frustrating and is more mentally debilitating than physically limiting. Generally I can figure out how to get things done, its just getting over that little mental speed bump!  When we had the last big snows, my snow thrower and my tractor had some issues and I was able to get them resolved regardless of single digit temps and a gimpy hand… so I can do what I need to, when I need to!

Music

I’m continuing to work on my lap slide playing. Thanks to my friend Andy Cohen, I learned this: ORthograde=how you normally hold a guitar rather than lap-o-grade. I am practicing Lap-o-grade!

I have a live stream coming up June 6th I believe with Mike Ward and Joy Zimmerman. They are both delightful people and great songwriters, so stay tune. Also, to celebrate the anniversary of my wreck, I’m having a “do” at Kosecik’s Winery. This was the place I was heading when the fateful event occurred. I’ll try attaching a link here to one of my new tunes.

Hope to see you soon! 

“Old Dude-isms”

I’ve reached a new epoch in my life, trying to prevent squirrels from eating the bird seed. This used to be a serious challenge for my dad. I don’t want to relate the incredible lengths he went to devise various “foils” for his adversaries, but I will say on a couple occasions my mom would say “Clarence get out there and take that down! Why that might hurt one of our great grand babies!” And reluctantly he would go remove whatever ingenious rig he had assembled to thwart the local squirrel community. Somewhere I have a picture of my mom staring at my dad, who is staring out the kitchen window pondering the battlefield. 

I haven’t fallen that deeply into the crevasse but I certainly appreciate the depth. We have a tube feeder handing from the soffit of our sunroom. I pull the seed feeders down at the end of April and put them back up in November. I normally get to about the end of December before the squirrels figure out they can come across the roof and dangle off of the drip edge then lower themselves down to a smorgasbord of seeds, conveniently dispense through these nice size holes in a plastic tube. 

Due to my convalescence, I’ve been spending a lot of time in a recliner in the sunroom, being driven crazy by squirrels, lowering themselves down to the feeder to chow down on our birdseed. It probably wouldn’t bother me if they ate a little bit and left, but they park themselves there and will eat nonstop for five minutes if you don’t interrupt them. so I came up with a very simple notion that I would put a monofilament loop connecting the birdfeeder to the middle hook in the facia board of the soffit. I made the assumption that the squirrels would not be able to grip the mono filament and I would have a preventative barrier between the seeds and squirrels.

It worked for 26 hours.

The big debate is this a challenge or should I walk away? I don’t know.

What I do know is I have to be careful or I will slip over the edge of a continuous slide into old dude-isms. I’m already a wreck about constantly wearing sweatpants and a down sweater.