In 1982, computers disguised as game machines were just starting to become a consumer product. Atari was popular for it's games like Donkey Kong and Pac Man. The Commodore 64 was also becoming popular. I bought an Atari but was more interested in it's word processing capabilities than I was the games. The games didn't hold my interest very long at all. I have never understood why one would think it was an accomplishment to win a game when the same energy could be applied to some real accomplishment in life.
As I was going through nursing school, I was becoming more interested in the early computers. A new company named Apple, with it's founders Steve Jobs and Steve Wozniak had released their revolutionary computer called the Apple II and IBM soon came out with their personal computer which quickly became the standard of the time. By this time, I was following computer development in the news and news magazines related to their development and getting on line with the first on line service called Compuserve. I had grown tired of the Atari's limitations and was interested in something more powerful. I remember reading in a magazine about something new that was coming out from Apple, which they called Macintosh.
The early IBM PC's were not really "user friendly" at all. Everything was done by typing in arcane commands on a command line in something called DOS which had been created by a young company called Microsoft and it's founder Bill Gates. This was fine for business users but not really much fun. The new Macintosh that was coming out was the first computer for consumers that would use a graphic user interface, (GUI), and something called a "mouse." Instead of typing in codes, one just clicked on little pictures called "icons." You could do everything on a Macintosh that you could do on a PC but in addition to the word processing and spreadsheets, you could also do something new called desktop publishing. The Macintosh had enormously more appeal for artists and other creative types as well. It was the computer for "the rest of us." It was released with the iconic George Orwellian 1984 Super Bowl commercial. Computing would never be the same.
At about this same time, in my nursing program, we wanna-be nurses were learning how to write "care plans." A care plan is a document that describes a patients problems and the goals for those problems and the interventions to reach those goals. It is a kind of roadmap of patient care for the bedside nurse. While we were studying how to write care plans in my classes, we were having a hard time keeping the same kind of documents updated at my job on 4-East at Saint Francis Hospital. Patients would get admitted and the nurse would sometimes do all the paperwork involved in the admission except for the care plan or the care plan was written quickly and often incomplete. The Joint Commission on Accredidation of Hospitals were emphasizing care plans about that same time and so the managers at my job were nagging staff to write better care plans and keep them updated.
I got tired of hearing management nagging the staff to do care plans without coming up with any realistic plan or means for getting them done and I figured out a way to write some standardized care plan templates that one could just use a copy machine to copy onto our forms. Although this technique for doing care plans was a big time saver and staff and management loved the idea, the problem with that was that the care plans were not specific to the patient and could not be easily editable. This caught my imagination and in a staff meeting one day with our medical director, Dr. Anderson, I suggested that we could "computerize" care plans.
I explained that from what I had been reading about computers and something called databases, care plans would be a great project for computerization. Dr. Anderson seemed intrigued by the idea. I let him know that the Macintosh was supposed to be something that anyone could use. He encouraged me and actually got funding for a new Macintosh computer. There was a little confusion as to ownership initially as he had also told one of the Social Workers, who had their office elsewhere that she could use the Macintosh. Once the computer had been purchased, I felt like it was my responsibility to see that it warranted the outlay of funds which came to about three thousand dollars if I remember correctly and I saw to it that it stayed on the psychiatric unit where the entire nursing staff would have access to it rather than just one Social Worker.
When the Macintosh arrived, I was excited by the graphical user interface. The screen was only about nine inches and black and white but it used something new for computers, called icons, to navigate through commands. I read everything I could find in my spare time about using the machine and searched for software that would help me do care plans. Almost every day that I could, I would clock out after my shift and then stay on the unit to work on the Macintosh.
At first, I just tried putting the same standardized care plans I had written earlier into a word processing program. The problem was that we were using pre-printed forms and it was difficult to get the text to line-up on the pre-printed forms. The only solution in my mind was to actually put the pre-printed forms onto the computer. One of the programs I experimented with early on and which worked well initially was Filemaker. The forms could be put into the database and the nurse could select a standardized care plan but they were still not able to customize it completely. Eventually I read about a new relational database program called 4th Dimension made by a company called ACIUS. I could create separate databases that would relate to one another. I could creaate a database of nursing problems that could merge with a database of patient information.
By this time, I had gone into debt to buy my own Macintosh. I had gotten a copy of the database software, 4th Dimension, which came with several thick manuals and I would sit up all night at the computer, trying to get it to work. In the beginning, 4th Dimension itself was a little buggy and it made it difficult to know when it was me that was making programming errors or if problems were being caused by the initial bugs in 4D. As the bugs got worked out in 4D and I got better in my programming skills, what I would eventually call "MacNursing" started coming together.
The database was developed initially for the needs of Western Psychiatric Center at Saint Francis hospital and eventually almost all of the written forms for the admitting process were transitioned into the computer database. The nurse would enter the patient data and then select patient problems specific to the patient and then could edit those problems and truly customize the care plan to each individual patient. The forms were put into the official medical record and passed inspection by Joint Commission. Even the California State 5150 and 5250 forms were approved and printed from the MacNursing database.
When the Western Psychiatric Center budget got tight, a new position was created around my computer program and the admitting process as it became more efficient for a nurse with typing and computer skills to admit patients using my computer program. An admitting process that had been slow, cumbersome and ineffecient, now became much faster and thorough.
Western Psychiatric Center would continue to use my program for admitting patients for the next ten years. Although Saint Francis never compensated me for the hours of work I had done on my own time to develop the program up to that time, I was okay with that since there was never any question as to who owned the rights to the MacNursing. After I had resigned and left Saint Francis, they did hire me to come back and customize a new version of the program for them and I was compensated for that work.
Meanwhile, one of the nurses and a social worker at Saint Lukes hospital across town heard about my program and contacted me and made arrangements to come and see what I had acomplished at Saint Francis. They got their own Macintosh computer and raised funds to pay me to customize a program for their use. The problem at Saint Lukes, I believe, was that they did not have a "MacNursing" evangelist there as Saint Francis had in me. In those days, nurses most often did not type and most felt intimidated by computers. There were very few hospitals that even used computers in those days and if they used them at all, they were primarily for billing purposes rather than nursing purposes. Once Saint Lukes had paid me for their own version of "MacNursing," I don't think that the staff were willing to adapt to the program. Change is always difficult and nurses that were used to writing everything out by hand found it easier to do things in the way they had always done them rather than learn a new way of doing things. The learning curve would take time and most nurses were not willing to put in that time and I don't think they were given any extra time to do so.
By this time, I was getting visits from from others in the healthcare field that heard what I was doing at Saint Francis. I received visitors from Kaiser Permanente. I was more than willing to show anyone and everyone what I was doing as I truly was an evangelist for computers in nursing, especially Macintosh computers in nursing as I believed the Macintosh was actually user friendly and so it was nurse friendly.
I rented at booth at the California Nurses Association, nursing Convention in Oakland sometime in the late eighties and showed my program there. I rented an extra Mac and an overhead projector so that people walking by could see the program on a big screen. There was some interest but it did not lead to any new consulting jobs or sales.
At one point in the 80's, Apple contacted me and invited me, to their offices at One Post Street in San Francisco for a meeting of developers that were using Macintosh computers in health care. There were probably 10 or 15 entrepreneurs at the meeting. The only company I remember, though, is A.D.A.M. which had developed an anatomy application that ran on the Mac. After this first meeting with Apple, I was invited to a small conference of Macintosh healthcare developers where we could show our work to business persons and venture capitalists that might be willing to invest. I had no business background and a terror of public speaking. I had not been informed that there was going to be an opportunity to show my product to a group and had not prepared for that. When an Apple representative came and asked if I was ready to do my "presentation," I answered that I had not prepared a presentation and did not want to try to improvise one. This is probably one of my greatest regrets in life- a missed opportunity.
Apple continued to be supportive though. When Apple moved from black and white to color monitors, they loaned me a color Mac to rewrite my program to add color to it. Milton and I drove down to the Cupertino headquarters to pick up the loaner Mac and I was able to keep it long enough to re-write MacNursing.
A year or two after I had been at the C.N.A. convention in Oakland, I signed up for a booth at the American Nurses Association's convention in Boston. That was My sister, Donna, took a train from Seattle and met me there to help with my booth that weekend. I had rented a couple of Macs and had a similar set up as in Oakland. This time, there was much more interest and I met Elaine Lloyd, MS, a nursing administrator for the spinal cord injury unit in Palo Alto. We made arrangements for a meeting after the convention.
In nursing, it was never necessary to wear a suit. With my MacNursing business, I had to buy a couple of suits to feel like I was in "business." I loathed wearing a suit or tie buy I convinced myself that I had to wear the costume to fit the part. "Business" was very stressful for me. I always felt like I was playing a "role." I had to attend various meetings at the V.A. spinal cord injury unit and others seemed to think at the time that my program might even be used at other V.A.'s across the country but I think my lack of business experience was evident and this was another missed opportunity.
While consulting with the V.A. in Palo Alto, Elaine and Linda Toth, MS, RN another nurse manager wrote an article called "Development and Testing of Computer Software for Nursing Assessment and Care Planning at a Spinal Cord Injury Center" which was published in the SCI Nursing, a publication of The American Association of Spinal Cord Injury Nurses. The three of us went to Las Vegas for a convention of Spinal Cord Injury nurses and they presented the findings of the paper, published August 1994.
By the time my consulting at the V.A. ended, they had a network of about 10 computers running my program and they had used my consulting services for about ten years. Eventually, it was mandated that the Palo Alto V.A. use a different program that was in use elsewhere. I was told by the charge nurses that the new program did not do anywhere near as much as my program did but that didn't matter to the bureaucrats at the time.
Over the years after that, I would see some of my ideas from those early years integrated into the programs of others. I don't really know if that was because the developers had seen MacNursing or if they had come up with similar ideas on their own.
Development and Testing of Computer Software for Nursing Assessment and Care Planning at a Spinal Cord Injury Center
E. Elaine Lloyd, MS, RN; Linda L.Toth, MS, RN; Sylvan Rogers, RN
This paper describes a pilot project using a Macintosh personal computer and customized software to computertize nursing admission assessment and care planning data. The project setting is a 47-bed Spinal Cord Injury Center with two inpatient units and an outpatient department serving approximately 1,000 patients with spinal cord injury at a Department of Veterans Affairs Medical Center in northern Califronia. The computer software development, implementaiona, and evaluation are described. This sofware was found to be a low cost, customized approach to computerizing spinal cord injury admission assessment data and care planning which reduces repetive writing and facilitates continuity of care. Personal computers and this sotware have provied the mechanism for establishing a spinal cord injury patient database.
When I first lived at 3727 College Avenue in San Diego, it was with mom and George. I was taking adult school classes at Hoover High School evening adult division by this time and trying to get high school credits. I was taking a creative writing class, philosophy class and a drama class. The Philosophy class was where I first learnd of the Bhagavad Gita. The Drama class led to my being in my first play in San Diego. I had done a little theater in high school in Seattle. My drama teacher at Hoover seemed to take a liking to me and cast me as the thief in Jay Friedman's play, "Scuba Duba." I was on a macrobiotic diet for a while during that time and she complained that it affected my performance because I had no energy. After about a week of eating nothing but raw brown rice and water, I was hallucinating and I am sure she was right about my performance!
Mom and George moved to an apartment they rented in the Los Angeles area when George got a job there and left Roger and I to live in the College Avenue house in San Diego. I had several significant events in that house. One was reading "The Psychedelic Experience." The second was going to the Newport Pop Festival. The third was coming to terms with the fact that I was gay. The fourth was going before the San Diego Draft Board to explain to them why I was a Conscientious Objector. I don't remember the order of these events though.
In June, while living in the house on College Avenue, I heard about the Newport Pop Festival that was going to take place over a three day period between June 20th and 22nd that year. I suppose this was a precurser to the Woodstock Festival that would take place later that summer on the East Coast.
Although not as widely reported on and without any theatrical release, the Newport Pop Festival was attended by 150,000 fans and was the largest pop concert up until that time. It took place at Devonshire Downs ractrack. I know that April Nellans came and I think Rosie Flores attended as well. I think that April had a Citroen car at the time and drove up but I thinik I actually hitchhiked there. I'm not sure that I brought a sleeping bag and I don't know that I slept much that weekend anyway. If I did, it must have just been in sleeping in the dirt which is entirely possible.
On Friday, June 20, 1969, Albert King, Edwin Hawkins Singers, The Jimi Hendrix Experience, Joe Cocker, Southwind, Spirit and Taj Mahal all played. If I remember correctly, Jimi Hendrix was in a fowl mood and gave the finger to the audience and walked off early.
On Saturday, June 21, 1969 Albert Collins, Brenton Wood, Buffy Ste. Marie, Charity, Creedence Clearwater Revival, Eric Burdon, Friends of Distinction, Jethro Tull, Lee Michaels, Love, Steppenwolf and Sweetwater played. (I don't remember all this from memory but was findable on the internet).
On Sunday, June 22, 1969 Booker T & the MGs, Chambers Brothers, Flock, Grass Roots, Johnny Winter, Marvin Gaye, Mother Earth, Buddy Miles, Mother Earth, Eric Burdon (jam), Poco (formerly Pogo), The Byrds, The Rascals and Three Dog Night. Jimi Hendrix played again and I think he apologized to the audience for Friday and wanted to make it up to them for his being in such a foul mood previously. .Of course he was incredible. There is video of his performance on youtube.
Up until this time, I had been having intermittent sexual encounters with men. This would often be related to hitchhiking. Back then, there was no such thing as a "gay" consciousness really and most of the men that I had these enounters with were closeted and I think most of them felt ashamed and guilty. What was typical of the time was to be picked up hitchhiking and be told that I would be taken to wherever I wanted to be taken after I agreed to have sex with them and had allowed them to take me elsewhere first. Usually, the sex was oral and afterward, once the man driving had their sexual needs met, I would often be left in the middle of nowhere and had to find my own way back. Sometimes I would be further away from my destination than when I had first entered their vehicle! There was no sense of camaraderie or brotherhood or pride that would come in a couple of years after that when the "gay" movement started coming together at the end of the sixties and beginning of the seventies.
The American Psychiatric Association still considered homosexuality a mental illness until 1974, a full five years away. Occasionally I would become depressed about my sexuality. At that time, I had not really come out to anyone. I had experienced my first actual "relationship" with another man that went beyond just adolescent play or quick, meaningless hitchhiking episodes. There came a time that I was realizing that I really was a homosexual and I was realizing it was something that I couldn't change and that this was who I had always been and was who I would always be. It scared me to come to that realization. I had always been able to rationalize that I was just going through a phase or something but now I know that it was more than just a phase. There was no one I could talk to about my feelings and what was going on in my life. I was becoming pretty desperate and possibly suicidal. I think I called a suicide hotline or something but somehow I got the name of a psychotherapist. He had his office near Balboa Park and I made an appointment to see him. I remember being pretty distraught at the time and having much difficulty getting the words out to say why I was even there. When it finally did come out that I was homosexual, he asked me if being homosexual was what bothered me or people attitude towards my being homosexual. He let me see for the first time that being gay was not the problem. The problem was with the attitudes of others. It changed my life.
During this period, while living on College Avenue with Roger, I read "The Psychedelic Experience," a manual based on the Tibetan Book of the Dead By Timothy Leary, Ph.D., Ralph Metzner, Ph.D., & Richard Alpert, Ph.D. It was during the same period that I was studying the Bhagavad Gita in the philosophy class at Hoover night school. I made plans for a "guided" trip using Leary, Metzner and Alpert's book. I taped all of the verses from the book and planned music that I would listen to including the song "Tomorrow Never Knows" by the Beatles that had the lyric "turn off your mind, relax and float downstream..." I planned each thing I would eat during the journey.
I obtained some mescaline and one night when I was alone in the house, I proceeded on the trip. I swallowed the gel capsule containing the tan colored powder that was derived from the peyote cactus. The effects were similar to L.S.D. for me and, of course there is never any way to know what you are actually getting with street drugs. It may have been L.S.D. and just sold as mescaline. Psilocybin was another hallucinogenic drug that had similar effects to L.S.D. and mescaline. The differences were subtle but, for me, with L.S.D., there was always kind of a chemical taste in the mouth. I was told at one time that L.S.D. was cut with strychnine and that it what caused the taste. That never made since to me since strychnine is a poison and I recently looked it up and apparently there is no documentation of L.S.D. every being cut with strychnine so maybe it was just an urban myth.
Most of the night went accoring to plan except when Roger and Steve Arnez came in. There was some disruption but the trip itself seemed to account for such disruption as the entire point was to let go of all positive and negative and to go with the flow and not get attached to either positive or negative. It was another life changing event in that it illustrated the nirvana and enlightenment of non-attachment and letting go. I felt that it was made clearer than ever to me what my ego was and how it was possible to let go of some of that as well.
The Viet Nam war was escalating by this time and when a young man turned eighteen, you were expected to register for the draft. I had known a couple people that had served in Viet Nam and they were never the same afterward. One was a close friend I had when still living with Darlene and Chuck in Seattle. I know it's strange that someone could be a close friend at one point in one's life and then you are not able to even remember theri name forty years later but that is the case. His mom had an answering service and had a big switchboard in their big purple house. She was the first person I had every known that was into Yoga and she brough her son and I to classes in Seattle. I learned progressive relaxation in those classes. After I left Seattle, her son either joined the service or was drafted and I didn't see him for a couple of years. The next time I made contact with him, he was cold towards me and seemed to be seething with anger toward the world. We never did get together after that.
Mark Heideman was another close friend that served in Viet Nam. He had been the bass player for the Luv Please and I don't remember whether he joined or was draftered either. It seems like there was some advantage to joining if you thought they were about to draft you anyway and so it seems like a lot of guys would panic and join rather than waiting for the draft. Mark was shot by friendly fire while in Viet Nam and was disabled after his return. He seemed to have some bitterness as well but was still friendly to me. For some reason, instead of continuing to live in Southern California where we had known him from, he settled in Oregon. Maybe it was because of his wife? I believe he was in Salem at one point. I saw him when hitchhiking through one year and he was single and another time he was married with children.
Zutter was a friend that we met in Toppenish that was in the National Guard already when we met him. He would serve a weekend here and a weekend there and I think he had thought that he could avoid going to Viet Nam but serving in the Guard. At some point that no longer was the case and his unit was being called up and he was going to go. I think that he just didn't report for duty which made him A.W.O.L. and he got arrested. Somehow he escaped though, and fled to Canada. A couple of years later Henry, Leslie and I went up to see him in Calgary with his wife and I think he might have had a child by then. That was the last I saw him although we corresponded for a while.
Roger considered shooting off a toe. I'm not sure if he was just kidding at the time but I actually think he was serious. By the end of the sixties and the beginning of the seventies, it had become evident what a debacal and waste of lives Viet Nam was.and young men were scrambling to escape this meat grinder. At some point during this period, I was in Toppenish and would drive Roger to a quack psychiatrist in Yakima that gave him shock treatments. This same doctor had also given these bogus, useless treatments to both Irene and Darlene and various time.
The truth is, I don't remember ever seeing Roger depressed about anything up until that point in his life, and believe the initial intention of the electro shock treaments was to avoid unnecessary death or maiming in a foolish old man's war. I would drive him to the doctor and then pick him up afterward, dazed and confused with his eyes bright red. Although shock treatments were then and continue to be a controversial treatment for depression, it seems to me that in Roger's case, they were the initiation of problems with depression rather than a cure.
I had known since I was a small child that I would never serve in the military. When Roger would play with is little army men, and wanted to see John Wayne World War Two movies, I had absolutely no interest. When adults would be sitting around discussing their wartime experiences or anything related to combat, I knew that this was something that I would do everything I could to avoid.
I started working on my conscientous objector status long before I turned eighteen. I had written a paper explaining my philosophical beliefs at the time and why they were not consistent with the military. I documented every war protest that I participated in which was only a few by that time. You might ask why I didn't just tell them I was homosexual. The answer to that is that I really wasn't that certain myself up until just about the time I had to go before the draft board. I knew that there were many young men that were heterosexual that were trying to get out of the military by saying they were homosexual and many were drafted anyway. Regardless, I prepared for consientous objector status.
The entire process eludes me now but I know that there came a time that I had to go before the draft board in San Diego and present my case and defend my beliefs. I believe that you submitted forms and your rationale for why you could not serve militarily and then an appointment was made and you went before the board. I think there were about six people that I had to talk to. I did add at the last minute that I thought that I might be homosexual just as insurance although ultimately, the deferment I was givan was a consientous objector status. This did not entirely exempt me from service though. I could still be called up to serve as a medic but at that time, you were also given the option of finding your own position in a non-profit, community service type job and that would be what I would attempt to find for the next couple of years.
While living on College Ave, I know that I traveled to San Francisco for a visit. I don't remember how I got there that time. Possibly I hitchhiked. Somehow I found Leslie and she was essentially living on the streets at that time. I must have gone there for the holidays as I remember drinking champagne with her in Northbeach. At that time, the streets of Northbeach were closed off for New Years Eve and there were thousands of people in the streets. By the end of the evening, we were pretty much falling down drunk. What was amazing to me was that you could actually be falling down drunk in front of the San Francisco Police and they didn't seem to care at all. In San Diego, if we had been acting that way, especially as young as we were, we would have surely been arrested.
I think it was on that trip that I had my first real gay "affair." Leslie and I were hanging out in the Northbeach area and we met a guy whose name eludes me now but it seems like it was Don. That would be strange since my name was still Don at that time and it seems like if his name were Don that I would remember it more easily? Regardless, he was staying in what could probably best be described as a flop house. It was one of those hotels where you could get a room for a couple bucks a night. The bathroom was down the hall. There were a lot of those in San Francisco at the time. Later they would all be torn down and the Transamerica Pyramid and the Holiday Inn would be built.
This guy was an admitted homosexual, ex-heroin addict and somewhat of an intellectual in my eyes. He was probably in his late twenties or even early thirties. I know he seemed older and so much more worldly. Leslie and he slept on his full size mattress which I think was on the floor with no frame under it. I slept on the floor in my sleeping bag but with my feet exposed. Sometime during the night, I felt something wet on my toes. It startled me at first but either he hushed me or I was just too stunned to make any sound. He was actually sucking on my toes and I, in my naivetae had never heard of such a thing before. I enjoyed it and I think he may have actually done a little more beyond that but it was long ago and I don't remember all the details. I do know that Leslie left the next day and I remained with this man for a several days or maybe a week or a little beyond a week. I was pretty infatuated with him. Bob Dylan's "Lay Lady Lay" played on the radio.
During the day we would go to City Lights bookstore and he would steal books and we would walk around the block and he would scuff up the books on the sidewalk and then bring them to the used bookstore which was practically next door to City Lights bookstore. He would sell the books at the used bookstore for a few dollars and then we would go to Clown Alley and eat. During the time I spent with him, I was introduced to some new variations on sex which had never even occurred to me. In my innocence, I would have thought that some of the things we were doing would cause immediate death!
There are a few people in your life that make a big difference and even though I can't remember this guys name for sure now, he was a person that made a difference. The reason that I feel like he made such a significant difference in my life is that he gave me a reading list. On the list were Sartre's "No Exit," and "The Stranger." Albert Camus, Alduous Huxley and Kafka were on the list. It was a list of probably twenty or more books that I probably never would have read otherwise. It was like he opened some new doors for me and I always apprecieated that. I tried to stay in touch after returning to San Diego but he didn't encourage my romantic fantasies. Years later, I saw him for a moment in front of San Francisco General and he had started shooting up heroin again and somehow a needle had broken off in his arm.