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Second Breakfast: Brush Up Your Shakespeare 9: The Hollow Crown (Part 2)
cmmelv / July 13, 2014
Part 1, Part 2, Part 3, Part 4, Part 5, Part 6, Part 7, Part 8
My original working title for this article was "Second Breakfast: Brush Up Your Shakespeare 9: The Hollow Crown, Part 2: Henry IV, Part 1", but I decided against it.
The Hollow Crown: Henry IV, Part 1 (2012)
The Plot: Decades after the conclusion of Richard II, Henry IV (Jeremy Irons) faces his own insurgence after losing the loyalty of the bombastic young Northern Lord Henry Percy (a.k.a. Hotspur) (Joe Armstrong), who leads a contingency of Englishmen possessed of the belief that Henry's kingship was ill-earned. With the King gradually worsening in health, the responsibility of halting Hotspur's rebellion falls to the Prince of Wales, Hal (Tom Hiddleston), who up until this point has shirked all responsibilities of nobility to hang around taverns and bars, mainly in the company of the old, portly, drunken reveler Sir John Falstaff (Simon Russell Beale).
Henry IV, Part 1 is among my top five favorite Shakespeare plays ever. It functions incredibly well as one part of four (or eight, depending on how you're counting), but also perfectly as a standalone work. Hal's character arc, continued in Part 2 and Henry V is not only Shakespeare's best, but among the best ever in fiction. His relationship with his father is complex and layered; only slightly less so than his relationship with Falstaff. In these three characters, Shakespeare captures an insightful cross-section of manhood, covering a wide range of qualities, humors, emotions, and faults, constructing a deep psychological understanding of humanity. Though all three of Hal's appearances are important, Part 1 is really the best play. Now, you may wonder if because this is a personal favorite of mine I'll be extra-hard on an adaptation of it. The answer is, if I'm going to be totally honest, probably yes, but I'm going to try my hardest to be fair.
Lolz, fairness.
The film is directed by Richard Eyre, who's become fairly experienced with Shakespeare over the years, but in my opinion is always just slightly lacking. Still, he gets things close. At the very least, his direction is generally inoffensive. While Rupert Goold, who directed Richard II, occasionally drifted into self-indulgence, he still provided a richly formalist visual style peppered with symbolism and layered images. Eyre's style lacks this, but only because he focuses so heavily on his actors and characterization. The only major flaws are in the lengthy soliloquies. There are four important ones throughout the play: one for Hal, one for Henry IV, and two for Falstaff. Henry's is cleverly staged and works very well. For Hal's and one of Falstaff's, Eyre adapts the technique used by Laurence Olivier in Hamlet: representing the internal monologue by way of voiceover narration. I didn't really like it when Olivier did it, but it was especially problematic here because we get voiceover from two separate characters, but only once each, which rather befuddles the conceit of the narration. Rather than maintaining this for Falstaff's other soliloquy, though, Eyre has Beale break the fourth wall and look directly at the camera, addressing the audience. This is incredibly jarring. It's the kind of error I would expect from a newcomer like Goold, but certainly not a veteran like Eyre.
Fortunately for Eyre, these grievances are minor and forgettable in the presence of the performances, which are so good as to repair all other wrongs. When Jeremy Irons is the weak part of an ensemble, you know you're doing well. Irons doesn't do anything particularly wrong, but he lacks flair and ingenuity. When comparing him to Tom Hiddleston, he comes across as an experienced actor who thinks he doesn't have to try as hard because he's the most famous member of the cast. Hiddleston on the other hand, who's a very nice man in person, provides a spot-on reading of Shakespeare's best character. In every delivery of every line, every facial expression, every slight movement, every stance, Hiddleston captures the complexities the character, devoting equal time and energy to faults and virtues. I was excited when I first heard about the casting, and was far from disappointed upon actually viewing the performance.
Of course, this face has never disappointed in the past…
And then there's Falstaff. I remember thinking of Simon Russell Beale as an odd choice for the character. The character is rotund, slovenly, witty, and overall hilarious. He's considered by actors, critics, and academics alike to be one of the greatest clown characters of all time. Beale takes this comedic persona and without altering a word of the dialogue, transforms him into a tragic hero. There's not a minute he's onscreen that my heart isn't breaking for him. Though he tries to be funny and lighthearted, he cannot hide the overwhelming sadness and desperation he feels at Hal's looming coronation. Falstaff loves Hal, despite the verbal abuse and constant mockery, and in loving Hal he knows him intimately, and he knows that when the time comes, Hal will not shirk his royal responsibilities, and he will abandon Falstaff. Eyre and Beale construct a pathetic and hopeless world in the taverns of London. There's a heavy monotony to the revelry and drinking. We get the impression that Falstaff and his companions lead the lives they do simply because that's what they're used to, but if they once loved it, they do no longer. Hal is the only thing that Falstaff truly loves, and he's going to lose him soon. Though a braggart and coward, Falstaff is the most sympathetic character in the film. Beale's performance should never be forgotten. It's rare to find a flawless performance in film, and I think even rarer to find a flawless performance of a famous Shakespeare character in film. I can say with some confidence and certainty that this is the best realization of Shakespeare's character I've ever seen on film. As a side note directed to people who know this play well, the "I do, I will" moment is perfect.
I love this man.
The other performances hold up. Joe Armstrong's Hotspur is appropriately fiery, Michelle Dockery does a nice job as Lady Percy, and Julie Walters is an absolute gem as Mistress Quickly. The others fall into place do what needs to be done. I can't wait to see how Hiddleston handles the full three-play character arc, and I definitely can't wait for the depression that will surely follow Falstaff's final appearance. I'm going to be sullen for the rest of that day.
July 13, 2014 in Movie Review, Second Breakfast. Tags: Brush Up Your Shakespeare, Falstaff, Henry IV Part 1, Jeremy Irons, Joe Armstrong, Julie Walters, Michelle Dockery, Richard Eyre, Rooster Illusion, Second Breakfast, Shakespeare, Simon Russell Beale, The Hollow Crown, Tom Hiddleston
Second Breakfast: Brush Up Your Shakespeare 17: The Hollow Crown (Part 5)
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One thought on "Second Breakfast: Brush Up Your Shakespeare 9: The Hollow Crown (Part 2)"
anag7 says:
I too enjoyed the performances of the movie version. Hiddleston especially did an exceptional job! This story surprised me, because I didn't think I'd actually like it. All you ever hear about Shakespeare's work is "Romeo and Juliet" or "Much Ado About Nothing." No one takes time to delve into some of Shakespeare's deeper plays (understandably so, since they can be hard to read at times), so I assumed it was because they must not be as good. Of course, I was wrong. This one and "King Lear" are probably my favorites he's done. Thanks for the post!


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Arsenal head of football Raul Sanllehi has learnt lesson if Marcelino link is true
by James Beavis share
2 minute read 4/12/2019 | 06:00pm
This article is part of Football FanCast's Transfer Focus series, which provides opinion and analysis on recent transfer news…
According to the Spanish version of Goal, Arsenal have been in contact with free-agent manager Marcelino about their vacant managerial position following Unai Emery's exit last month, and it suggests that head of football Raul Sanllehi may have learnt his lesson.
What's the word, then?
Well, Goal report that the Gunners have been in contact with the former Valencia manager despite Freddie Ljungberg being in temporary charge, and suggested that the 54-year-old would be interested in being his fellow countryman's successor at the Emirates Stadium.
The report says that the north London outfit have received positive reports about the coach who was sacked by the La Liga club in September, and that they like his methods.
Can you get full marks on the Ultimate Arsenal Quiz? Test your knowledge below…
How much did Arsenal offer the FA back in 1998 to buy the old Wembley Stadium?
Around £50m
Around £200m
It would obviously be cheaper to get the Spaniard rather than poaching another manager currently in work, too.
Sanllehi learnt his lesson
Some Arsenal fans may look at the appointment of another Spanish boss after Emery as a negative, but there are plenty of reasons to suggest that Marcelino could be a good fit for the Gunners.
Would Marcelino be a good Arsenal appointment?
According to talkSPORT, he was hugely popular among the La Liga outfit's fan-base – the total opposite to Emery, especially towards the end of his reign – and the Emirates faithful could certainly do with having someone they can believe in.
In addition, he took Los Ches back into the top four in La Liga for two consecutive seasons following successive 12th-placed finishes previously, suggesting he can quickly turn a crisis around – something the north London side are on the verge of right now.
In doing that, Valencia also only conceded 35 times – one fewer than Barcelona – in their 38 Spanish top flight matches last term – and with Arsenal already letting in 21 in 14 Premier League fixtures in 2019/20, it suggests he could bring some much-needed defensive discipline to the capital as well.
Finally, talkSPORT suggests he was sacked because he spoke out about the owner when it came to transfers, and that is something else that perhaps Arsenal require if they are to move forward.
A manager that is willing to push and question the board should be much-welcomed by supporters, who must be growing tired by their lack of progress in recent years.
Having been the 'unanimous choice' of the Arsenal hierarchy – including Sanllehi – in 2018, it appears as though he might now have learnt his lesson with the pursuit of Marcelino.
In other Arsenal news, Gunners fans have been reacting to the link with Marcelino, and many are unimpressed…
Article title: Arsenal head of football Raul Sanllehi has learnt lesson if Marcelino link is true

redpajama_set_name: RedPajamaCommonCrawl


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A review of Rose Interior by Tracy Ryan
Reviewed by Beatriz Copello
Rose Interior
by Tracy Ryan
Giramondo
96 pages, Paperback, April 2022, ISBN 9781925818963
Tracy Ryan is an award-winning novelist and poet. She has published five novels and Rose Interior is her tenth collection of poetry. I was not only impressed by Ryan's prolific production but also her talent as a poet. Ryan's work is aesthetically pleasing and thought provoking.
Ryan's work focuses on the nature of place and space, as well as the notion of 'home', which not only materially exits on a place but also has a space in our mind, a space associated with feelings and memories. Rose Interior is divided into three sections, one titled "A room within a dream", the second section is "For this inside/an outside" and the third section is named "World". The poems in the first section of the book take the reader into the poet's physical house, including the garden. The poem "The Sun Room", which is from the first section gives an idea of the poet's deep relationship with her environment:
what will emerge here
vertical blinds that soar
to a gable
worthy of church
or weird chapel
glassed-in
poem-home.
In this space are plants, ornaments, flowers, and settings described beautifully, with poems that are like waves: you ride them and sometimes you are shaken or jolted and sometimes you flow with the water. I was fascinated by a poem titled "Etruscan Love Song" which describes one of the great masterpieces of Etruscan art, the Sarcophagus of the Spouses. This poem led me to think about failed relationships and what remains.
It is obvious from the poems that Ryan knows a lot about plants. One poem titled "Herb Robert" encouraged me to look up the plant, which is a geranium native to Europe, Asia and North Africa. This geranium has many names such as Red Robin, Fox Geranium, Crow's Feet and Death Come Quickly. This poem in short lines very cleverly and visually evokes the plant:
a choral mass
by virtue of each
feeble & reedy voice
joined to the next
and the soars
blood-stemmed
arterial in reach
along every edge
you choose to travel
and some you don't
ubiquitous at this
time of year but not
to be overlooked
just because slight,
pink & delicate
The second section in the book "For this inside / an outside", is more personal, exploring memory, reflections and detailed observation. Some are nostalgic while others are very descriptive and poignant. There is a rich domesticity in this section, from daily trivia and machinations to the sounds of life at home and collections like ornaments which sit in obvious places. We observe ornaments daily, we clean them, we change their position, they have memories attached to them as Ryan explores so beautifully in "Mother of Pearl":
Your lustre
like jewel but functional
platter for other treasure
placental & mirror-like
if mirror were clouded
over. I held you when ill in
the short, ordinary manner
that seems years to children
accorded some token
to distract them: sweet puzzle
of gilded lily, silvered, one-sided
slippery disc, elusive
of definition.
In the third section of Rose Interior Ryan's poems deal with topics issues such as schooling children during the pandemic and global warming. In a number of these pieces, Ryan speaks to the younger generations, for example in "World": "The beautiful world is still there I tell myself fortnightly." This is a poignant reminder of the beauty that surrounds us and the importance of seeing that against the many urgent and impending issues that surround us. Ryan's poems in Rose Interior explores inner space as well as the outside world of plants and animals, real or imagined, relationships, experiences and feelings. It is an exquisite and transformative collection.
About the reviewer: Dr Beatriz Copello is a well-known reviewer, writer and poet, she is also known for her sense of humour. "Her poems are sensuous, evocative and imaginative. Beatriz Copello is one of Australia's foremost poets," wrote Julia Hancock, ex-editor of Allan & Unwin and Freelance editor and journalist. Copello's poetry books are Women Souls and Shadows, Meditations at the Edge of a Dream, Flowering Roots, Under the Gums Long Shade, Lo Irrevocable del Halcon (In Spanish) and her last book Witches Women and Words published by Ginninderra Publishing. Her poetry has been published in literary journals such as Southerly and Australian Women's Book Review and in many other print and Electronic Publications. Fiction books by author are: A Call to the Stars, Forbidden Steps Under the Wisteria and Beyond the Moons of August (Her Doctoral Thesis).
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The following are a list of common questions that seem to keep popping up on the support lists and on the AtariAge forums (in no particular order):
There are some graphical bugs in a game I'm playing, or the emulation seems to be inaccurate in some way.
The answer to this one should be obvious, but surprisingly enough, it isn't. If you think you've found a bug in the application, let us know about it. Perhaps it isn't a bug after all, but if it is, we can't fix it unless we know about it. Free and open source software is a two-way street, and users should report problems whenever they find them. In return, developers are usually happy to fix their programs, if possible. But keep in mind that reporting the bug doesn't guarantee an immediate fix; there may be other issues that need to be fixed first. But we can guarantee what will happen if you don't report a bug, and the developer never finds out about it - nothing.
In some games, the image seems to be off-center, usually pushed to the right.
Most (all?) of the time, this is caused by accurate emulation of the video processor in a real console. In other words, the same thing would happen on a real TV. Since Stella is all about emulating a real console as closely as possible, this is not a bug, and won't be 'fixed'. Technically, it is known as HMOVE blanking, the specifics of which you can find documented in the Stella Programmer's Guide.
Stella crashes immediately after starting, or seems completely broken.
My advice in this case (before reporting it as a bug) is to delete the settings file, and restart the application. The settings file is stored in different places depending on the operating system you're using:
Windows 7/8/10: Open Windows Explorer and type '%appdata%\stella' into the address bar. This will bring you to the directory where Stella stores its settings. Find and delete/rename the file named 'stella.sqlite3'.
macOS: Open Finder, and navigate to your home directory, then Library/Application/Support/Stella. Find and delete/rename the file named 'stella.sqlite3'.
Linux/UNIX: Find and delete/rename the file named '$HOME/.config/stella/stella.sqlite3'.
Very Important: Un-installing and re-installing the application will have absolutely no effect on your settings file. This is a commonly reported practice, but it is completely unnecessary. In all but the rarest cases, there will be nothing wrong with the application itself, so it doesn't need to be re-installed.
I can't find instructions on how to accomplish a task, or the manual is too long and I can't be bothered to read through it all.
Stella is a complex program which has many goals. It is meant to be an easy-to-use emulator for those wishing to just jump in and play a game, but it also comes with very complex developer options. As the saying goes: 'with great power comes great responsibility'. There are many options to explain, and as such, the manual is necessarily long.
That being said, recent versions of the manual are organized into 'Getting Started' and 'Advanced Configuration' sections, with many subsections below those. So don't be discouraged by the size of the manual. Most of the time, much of the manual can be ignored completely. And if all else fails, you can use the search function in your web browser :)
Where can I find some ROMs, and how do I start playing a game?
This is mentioned near the very beginning of the manual. The premiere website for all things Atari-related is AtariAge. As for how to start playing a game, I refer you to the 'Getting Started' section of the manual, as mentioned in a previous FAQ item.
When starting Stella and entering the ROM launcher, it sometimes takes up to 30 seconds to see the list of ROMs.
This could be caused by several issues; the most probable reason has been fixed in version 3.5. Otherwise, you could be attempting to access ROMs stored on a (slow) network drive. This one is outside the scope of Stella. Perhaps check your network settings, cables, etc to diagnose the problem.
After starting a ROM, there can sometimes be a delay of up to 5-10 seconds before the game starts playing. Or after exiting Stella, there is sometimes a similar delay.
This could be caused by several issues, but most of them are related to a 'timeout' in some way. If your ROMs are stored on a network drive, accessing them may be slow if your network is slow. This one is outside the scope of Stella. Perhaps check your network settings, cables, etc to diagnose the problem.
Another frequent problem occurs specifically for Linux users with respect to sound servers. The audio library that Stella uses will try several sound devices in sequence until it finds one that works. If you're not using 'PulseAudio' or any other sound server, it can take up to 5 seconds or more before Stella realizes this. The easiest workaround is to specifically tell the audio system which device you'll be using. Place the following in your startup script:
export SDL_AUDIODRIVER=alsa
Yet another problem is that you could have an obsolete 'stella.pro' file that is being read each time Stella starts. As Stella now has a built-in ROM properties database, you no longer need use an external one. Any external database will override the properties built into Stella, and will cause the application to start more slowly. Normally, your stella.pro file will be quite small, and only contain changes for specific ROMs you're interested in. This means it will either be non-existent or a few kilobytes in size at most. If you find one that is over 400KB, then it's probably obsolete and should be edited down or removed entirely.
I've located some ROMs and can get them to start in Stella, but I don't know how to actually start/play the game.
There are several issues to consider. First, some games need to be 'started' with the Select or Reset button, while others may use the joystick fire button instead. These games start up in a sort of 'demo' mode and wait for you to indicate that you are ready to play the game. Now, which game requires which button(s) to be pressed (if any) leads to the second issue ...
There were manuals included with most games sold for the Atari 2600. These manuals will explain in detail how to start the game, how to play it, etc., and are available in the AtariAge manuals area. Explaining every single game out there is beyond the scope of the Stella project. In fact, most of us developers probably haven't even played every single game out there.
I can't seem to move around in a game, or I don't know what controllers are being used with it.
Most games use the standard joystick controllers. Every game that Stella knows about (in its internal database) includes information about the controller type, so you normally would never need to set it manually. Now, to see which controller a game is using, you can either look at 'Game Properties' in the user interface, or turn on 'ROM Info mode', which shows game snapshots and other useful information. And of course, you could read the manual for the particular game too.
OK, that's half the solution. The other half is knowing how the controller is 'mapped' to Stella (ie, which keyboard key, mouse button or gamepad button/axis corresponds to which event on a real system). For this, see the various mappings in the manual. The defaults mappings are usually fine, but Stella is very configurable, and these mappings can be changed to your own preferences. This is explained under 'Advanced Configuration' in the manual, and is beyond the scope of this FAQ.
There seems to be a 'deadzone' when using a Stelladaptor/2600-daptor(II) and real paddles in certain games when using Stella in Linux.
This problem is caused by SDL2 using 'evdev' joysticks by default, but not having the ability to actually change the deadzone. An external application has been developed, located at evdev-joystick.tar.xz, which will let you set the deadzone to 0 and have smoother paddle movement. Download this application, decompress it, and follow the included instructions.
I'm experiencing sound issues, and the emulation doesn't sound authentic compared to a real system.
Always make sure you try setting the sound 'fragment size' to 512 bytes before reporting this as a bug. In fact, try playing with the various options under 'Audio Settings' to see if it makes any difference as well.
I'm experiencing sound issues, sound only works with the first ROM accessed; after returning to the ROM launcher and starting another ROM, sound is disabled.
This bug has been fixed as of Stella version 3.5. Please upgrade if you haven't already done so. For reference, the original bug report is included below:
Based on feedback, this seems to happen in very specific circumstances: people using Windows with an ATI video card in OpenGL mode. I suspect it's a bug in either SDL or ATI drivers, but haven't been able to track it down yet. For now, the only workaround is to completely quit Stella and start it again (which admittedly makes the ROM launcher essentially useless).
I'm developing a new game or downloaded a homebrew ROM that uses a custom controller, and I can't get Stella to recognize it.
By default, Stella will use its internal database to determine what controller type to use for a ROM. If there is no entry, it will try to detect the controller by analyzing the ROM. This may fail for new ROMs that have been released since Stella was last updated. In this case, the default is to assume a joystick controller.
If you want something other than a joystick, then you'll have to add custom properties for the ROM. Go to Options -> Game Properties -> Controller, and change to the desired type. Then click 'OK'. These settings are now saved, and need not be entered again.
Note to developers: Each time you recompile your ROM, you're essentially creating what Stella considers a new ROM image. As such, the game properties you set previously won't work, and will have to be entered again. If you're doing this often (in an edit-compile-test situation), consider using commandline arguments to set the controller type, which is much faster than navigating the UI.
When Stella exits from fullscreen mode, the icons or windows on my desktop are re-arranged. Similarly, exiting from external 'frontends' sometimes causes the display to be repositioned/shifted.
This problem has been fixed in version 4.0, which uses SDL2 behind the scenes. Stella will now use the desktop resolution when switching to fullscreen mode, so a video mode change never actually happens.
What options should I use to get the most authentic emulation possible?
In my experience, using Direct3D/OpenGL rendering mode with vertical sync enabled will result in smooth graphical performance. Of course, this is only true if your system supports vertical sync, and in general is only useful on monitors with a 60Hz refresh rate (all current LCDs). Finally, there are some Blargg TV effects that you might find interesting. Overall, to get more authentic looking emulation video-wise, you need to use a hardware-accelerated video mode (Direct3D/OpenGL/ES). If your video card doesn't properly support hardware acceleration, consider upgrading it to one that does :)
In terms of sound, try setting the fragment size as small as possible while not introducing any distortion. The smaller the size, the more accurate the audio 'resolution'.
In terms of controllers, consider using actual 2600 controllers. Several options exist, such as the 2600-daptor, Stelladaptor, or Bliss-Box.
Copyright © 1995-2021 Bradford W. Mott, Stephen Anthony and The Stella Team
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Atari 2600 Links
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Music Reviews • December 5, 2001 January 3, 2023
Visitor Jim
Kinda cute and quirky alterna-edged pop. Touches of an acoustic style slide through the songs, with a radio drawl that makes me think of Barenaked Ladies, but I can't quite figure out why. Maybe a little more along the lines of Cake, but with more straight ahead rock n' roll. Or if Corky and the Juice Pigs (or something like that) were into singing better songs with more instruments. The hooks are sharp, the production is clean, and there's a nice feeling of space between the notes. Never too full, letting the songs speak softer.
Fortune Records: http://www.fortunerecords.com
alternative rock Barenaked Ladies Cake Corky and the Juice Pigs Fortune Records Marcel Feldmar Visitor Jim
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Citizens United and its Impact on Constituency
by mygedanken | Apr 30, 2017 | Blogroll, Politics, Rants and essays
When I was growing up, My father was active in politics. You would never see him on the stump, and he never ran for office. He was a critical member of various politicians' teams, mostly republican. One thing he was particularly good at was fundraising. I remember him telling me, "The small donation from a family is important. If the person who handles the family money will give you $5.00, you have to understand what that means. $5.00 is a roast and all the fixings (this was the 60's, after all). That is at least one family meal. They have given you a meal off of their table. If they will give you that, they will give you their vote. These donations are a sign that they are with you."
Was the small donation also a way to gain influence over the candidate? Probably, but it didn't matter. The donation was small, and their were a lot of them in relation to the district. Lots of donations of similar amounts meant that the influence was dispersed across a whole lot of families. The politicians had to listen to a lot of people with a lot of different ideas if they wanted to fund their campaigns and win their elections. While they hated having to beg for donations, the process led to democratic (small d) representation. Those families, and their neighbors, were the constituency, and the politicians never forgot it.
When I returned to Colorado in 1989, I joined up with the Douglas County Republicans, because I lived in Douglas County. We were immediately involved in the local elections and midterms. I was looking forward to putting into practice the things I had learned from my father. However, something had happened to Colorado politics while I was away. I was told, "We don't do fundraising that way any more. It is too hard, too time consuming, and undignified. We have big dollar sponsors now. All we have to do is select candidates that our sponsors can support." And so it was. At the time, the big donors were people like Marvin Davis and Philip Anschutz and corporations like major banks and large developers. It soon included the Koch brothers and other donors at the national level. While the smaller donations were never turned down, they were no longer the focus of fundraising. With the change in fundraising came a change in the constituency. The politicians no longer had to accommodate the families who made up the small donor class. They had to accommodate the big donors. And the influence was no longer dispersed, it was concentrated. The constituency was now the wealthy individuals and corporations, who seemed to have the same policy focuses.
Then came the The Bipartisan Campaign Reform Act of 2002, also known as McCain Feingold Campaign Finance Act. But first, a bit of history on campaign financing.
The first federal laws concerning campaign finance were passed in 1867 to prohibit Navy yard workers from being solicited for campaign funds. I don't know why this law was passed. Over the years, other laws were passed to regulate campaign financing. Essentially, these laws were meant to limit contributions to ensure that wealthy individuals and special interest groups did not have a disproportionate influence on Federal elections, prohibit certain sources of funds for Federal campaign purposes (i.e., the Tillman Act prohibited corporations and national banks from contributing money to national campaigns), control campaign spending (laws passed in 1910 covering U.S. House of Representative races, and 1911 to add the Senate, both laws limited the amounts that could be spent on a candidate's election), and require public disclosure of campaign finances to deter abuse and to educate the electorate (essentially the Federal Corrupt Practices Act of 1925). The public disclosure was an important element of the regulations passed.
However, these laws were approved without including a way to enforce them. Thus, the campaign finance provisions of all of these laws were pretty much ignored. In 1971, Congress passed a more rigorous set of disclosure provisions under the 1971 Federal Election Campaign Act as the primary law regulating political campaign spending and fundraising. It focused on increased disclosure of contributions for federal campaigns.
After Watergate, Congress passed the Federal Election Campaign Act Amendments of 1974, which put new limits on contributions to campaigns. Unfortunately, within four years, the FEC had decided that donors could donate unlimited money to political parties, but not the candidates themselves, as long as the party used that money for "party building activities" such as voter registration drives, but not to directly support candidates. Political parties still used this money to support their candidates. This money donated to parties became known as soft money. In 1992, President George HW Bush vetoed a bill restricting use of soft money.
Because of a series of scandals (including Enron) brought the issue of campaign finance to the fore of public consciousness in 2001, and the McCain-Feingold bill was passed. The important provisions of this act included a prohibition of national political party committees from raising or spending any funds not subject to the federal limits previously set, and limited the use of issue advocacy adds. It also prohibited any issue advocacy ad from being paid for by a corporation, including non-profit issue organizations, or union general treasury funds. It also included a ban on foreign corporations or foreign nationals being involved in decisions regarding political spending. Mitch McConnell was a major opponent of this act.
To comply with McCain-Feingold, many "527s" have been registered. 527s get their name from section 527 of the IRS code. 527s are mostly funded by wealthy individuals, labor unions, and businesses. While 527s existed before McCain-Feingold, they became more popular after it was passed.
McCain-Feingold had in it a section known as the "millionaire's amendment," which tried to equalize campaigns by increasing the legal limit on contributions to candidate when his opponent used personal wealth to overwhelm the spending of the candidate. As McCain said, "Money does buy access in Washington, and access increases influence that often results in benefiting the few at the expense of the many." In other words, the millionaire amendment was specifically designed to offset the ability of the very wealthy to buy elections. This is the provision that the Supreme Court ruled as unconstitutional in the case known as Citizens United in 2009. Specifically, Citizens United struck down campaign financing laws related to corporations and unions. The minority argued that the court erred in allowing unlimited corporate spending, arguing that corporate spending posed a particular threat to democratic self-government. However, it did also make it easier to hide the source of funds. According to President Barack Obama, "With all due deference to separation of powers, last week the Supreme Court reversed a century of law that I believe will open the floodgates for special interests—including foreign corporations—to spend without limit in our elections. I don't think American elections should be bankrolled by America's most powerful interests, or worse, by foreign entities. They should be decided by the American people. And I'd urge Democrats and Republicans to pass a bill that helps to correct some of these problems." He also said the decision was, "a major victory for big oil, Wall Street banks, health insurance companies and the other powerful interests that marshal their power every day in Washington to drown out the voices of everyday Americans."
In fact, the Supreme Court decision in 2009 did make it easier to hide where soft money was coming from. The elections of 2012 and 2016 are evidence of this fact. Now our elections are largely financed by the 1%. We know that Robert Mercer was a major contributor to the Trump campaign. We know that Sheldon Adelson largely funded the failed Newt Gingrich campaign and was sought by all the Republican candidates in 2016. We also know that the Koch brothers have invested heavily in elections throughout the country from school boards to state assemblies and legislatures to U.S. Congress and President. So financing campaigns has been moved from the family donations to the company donations to corporate and special interest donations to the 1%. So the influence, and thus, the constituency, has shifted accordingly.
However, these are the things we know about soft money. The difficulty in finding out the sources of funds in the soft money world opens up a whole new problem. Because of the lack of transparency, there is every possibility that a significant portion of that soft money is in fact laundered money from foreign sources. We do know that there are questions about several individuals involved in the Trump campaign as to whether they have been laundering money. There are transactions, for example, that Manafort has been involved in that have all the earmarks of money laundering. It is not a far stretch to ask whether the Trump campaign was an experiment in a new way to launder money. If the Trump campaign was benefiting from laundered money, was he the only one? If politicians were accepting money from foreign sources, then who do they represent? Does the influence belong now to foreign entities? Are these foreign entities now the true constituency of our politicians? This is a really scary thought. Imagine if the real constituent to whom our congress and President are responsible to is Vladimer Putin. Perhaps the time has come to ask our congresspersons, who are your real constituents?


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Leptotarsus igniceps är en tvåvingeart som först beskrevs av Alexander 1928.  Leptotarsus igniceps ingår i släktet Leptotarsus och familjen storharkrankar. Inga underarter finns listade i Catalogue of Life.

Källor

Storharkrankar
igniceps

redpajama_set_name: RedPajamaWikipedia


Precalculus – In Precalculus, students extend their work with complex numbers from Algebra II. They connect their understanding of trigonometry and the geometry to express complex numbers in polar form. Students will begin working with vectors, representing them geometrically and performing operations with them. They connect the notion of vectors to the complex numbers. Students also work with matrices and their operations. They see the connection between matrices and transformations of the plane, that a vector in the plane can be multiplied by a 2×2 matrix to produce another vector. They also find inverse matrices and use matrices to represent and solve linear systems. Students extend their work with trigonometric functions, investigating the reciprocal, functions and their graphs and properties. They also work with polar coordinates and curves defined parametrically, and connect these to their other work with trigonometry and complex numbers. Finally, students work with more complicated rational functions, graphing them.
Alongside Grade 11, Grade 12 explores physical and human geography. The course introduces the foundational concepts that we use to map and visualize the earth: from latitude and longitude to topography and ecology. The course also presents concepts of human society: demographic and cultural studies, and basic elements of anthropological inquiry (building on many of the concepts learned in the previous year). After establishing these concepts, the course explores the unique geographical situation of world regions.
Environmental Science –Environmental science is the systematic study of the intersection humans and nature. An interdisciplinary field, environmental science draws from many areas of inquiry to help us understand the worlds in which we live and our proper role in them. Grade 12 will learn about the most amazing features of our planet and that they are the self-sustaining ecological systems that make life possible and the rich diversity of life that is part of, and dependent upon, those ecological processes. They will discuss the concerns about pollution and land degradation dated back at least 2,500 years. They will also analyze population growth, food shortages, scarce energy supplies, air and water pollution, and destruction of habitats and biological resources are all serious threats to our environment and our way of life.


● Connectors:HDMI 2.0a (TX/RX, CEC, Deep Color, 12 bits, xvYCC, MHL 3.0), 2x USB 2.0, 1x USB 3.0, audio / video analog output (both analog and digital outputs are active at the same time), S/PDIF optical digital audio output (Toslink), LAN Gigabit (10/100/1000 Mb/s), Wi-Fi 5G, SD / MMC card reader, AC connector, AC button On/Off (at the back), LED display on front panel controlled with RC.
● Sata Connector :Easily and quickly connect external SATA HDD (up to 16 TB pre formated HDD) to the Zappiti Mini 4K HDR with fast connexion (up to 6 Gbit/s in SATA III).
● Ethernet: 10/100/1000 Mb/s LAN + WAN.


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SHARPEN :: HOME (1) | SHARPEN - Photography News, Business, Art Happenings, Equipment Reviews, and more!
February 24, 2015. The Young Photographers Alliance held its annual Mentoring Program Exhibition. Featuring the work of 11 teams that spanned the United States, Canada and England, the show is entitled "Boundaries." Opening Reception Photography by Thomas Donley.
The Hasselblad Masters Contest is now open for entries.
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Join our docents for a history hike at Fairbank, an important transportation hub during the silver boom in and around Tombstone. The walk will last approximately 1.5 hours; it entails a quarter mile walk around the town on roads or walkways and a .8 mile (total) walk to the town cemetery down a rough trail, to include a short, rocky, uphill stretch. The tour of the town site will include the restored schoolhouse, the mercantile building, the town cemetery, and other remnants of this historic railroad town. Fairbank was the longest-lasting ghost town along the San Pedro River, with occupation spanning 1881 to 1972. The tour will focus on the many colorful events and personalities of the town.
Where: Hike departs from the Fairbank Schoolhouse.
Admission: Admission is free, and donations are gratefully accepted.
For additional information, please call (520) 417-6960 or (520) 508-4445.


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Home / Health Minister Vaughan Gething "turning down science-based advice" on testing says Rhun ap Iorwerth
Health Minister Vaughan Gething "turning down science-based advice" on testing says Rhun ap Iorwerth
Plaid Cymru's Shadow Health Minister Rhun ap Iorwerth MS has criticised Health Minister Vaughan Gething for playing down projections in a leaked report for the numbers of tests Wales will need to track and trace coronavirus.
Speaking in the Welsh Government Press Conference today, Vaughan Gething said the numbers in the leaked Public Health Wales report were not "final" and it was "not the confirmed national plan".
However, Plaid Cymru Shadow Health Minister Rhun ap Iorwerth MS accused the Health Minister for "rejecting the evidence" presented to him.
Mr ap Iorwerth said the Minister was turning down science-based advice.
The Shadow Health Minister said the Welsh Government should set its sights on reaching 30,000 tests a day as outlined in the report – rather than "putting obstacles in the way".
Plaid Cymru Shadow Health Minister Rhun ap Iorwerth MS said,
"Having asked experts to advise on a comprehensive test, track and isolate policy is the Minister now rejecting the evidence they've presented to him?
"The Minister can't argue on the one hand that he is guided by the science while on the other turning down the science-based advice.
"If it's been identified – as I believe is correct – that we'll need something 30,000 tests a day, then we should be setting sight on reaching that, not putting obstacles in the way. "
← We need parity amongst all Healthcare workers regarding Death in Service Benefit, says Rhun ap Iorwerth
Confirmed that Westminster gazumped Wales's Covid-19 testing deal with Roche, says Rhun ap Iorwerth →


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Anesthesiology Closed Claims Study
Darrell Ranum, JD, CPHRM, Vice President, Department of Patient Safety and Risk Management
Study Sections
Anesthesiology Claim Frequency and Cost
Anesthesiology Tooth Damage Claims
Factors that Contributed to Tooth Damage
Anesthesiology Claims Excluding Cases with Tooth Damage
Anesthesiology Injuries Excluding Tooth Damage
Comorbidities in Anesthesiology Claims Excluding Cases of Tooth Damage
Most Frequent Anesthesiology Case Types Excluding Tooth Damage
Case Type: Improper Management of Patient Under Anesthesia
Case Type: Improper Performance of Anesthesia Procedure
Observations and Summary
Risk Mitigation Strategies
The Doctors Company has studied anesthesia medical malpractice claims (written demands for payment) since 2007. Our first study involved 640 claims that closed from 2007–2012 and was published in the Journal for Healthcare Risk Management in 2014.
In June 2019, we repeated the study for 587 claims that closed between 2013–2018. The goals for these parallel studies were to determine whether the number of patient injuries had decreased and to identify any new trends in claims involving anesthesia care.
We segregated claims alleging tooth damage (272 claims) and reviewed them separately. Rates of claims and costs of claims (indemnity and expense) were compared between time periods for all anesthesiology claims. Pain medicine claims were also excluded from these studies.
Study years
All claims
Claims for tooth damage
Claims excluding tooth damage
2007–2012 640 144 496
Total 1227 272 955
Read the study design
Regardless of the outcome, all cases that closed within those time frames were included in this analysis. This approach helps us better understand what motivates patients to pursue claims and gain a broader overview of the individual and system failures and processes that resulted in patient harm.
This study, reinforced by expert insights and relevant case examples, focuses on the following areas:
Most common case types.
Most common patient injuries.
Injury severity.
Factors contributing to patient injury.
Strategies for mitigating risk.
Our approach to studying anesthesiology malpractice claims began by reviewing the types of cases represented in these claims to capture the key clinical issues.
We then looked at patients' injuries to understand the full scope of harm. Physician experts for both the plaintiffs/patients and the defendants/physicians reviewed claims and conducted medical record reviews. They identified factors that caused patients harm and determined whether the standard of care was met. Our clinical analysts drew from these sources to gain an accurate and unbiased understanding of actual patient injuries.
Causes, when known, were attributed to contributing factors. Contributing factor categories include clinical judgment, technical skill, patient behaviors, communication, clinical systems, clinical environments, and documentation.
Our team studied all aspects of these claims and identified risk mitigation strategies that physicians can use to decrease the risk of injury, thereby improving the quality of care.
Anesthesiology has led other specialties in reducing the risk of harm to patients since the mid-1980s, when the Anesthesia Patient Safety Foundation (APSF) was founded. Since then, clinical practice guidelines have been published by APSF and the American Society of Anesthesiologists (ASA), which have standardized some aspects of anesthesia practice.
Expectations are high to make administration, management, and monitoring of anesthesia safer because of the significant improvements to care with pulse oximetry, capnography, ultrasound-guided central line placement, transesophageal echocardiogram (TEE) monitoring, screening for obstructive sleep apnea, airway classifications, and patient health classifications.
The frequency of claims, including lawsuits, filed against anesthesiologists stayed the same for nine years (2005–2013). A small decrease in the rate of claims, between 1 and 2 percent, occurred in 2014 and in 2015. The decrease in the rate for the 14 years was less than 3 percent.
When compared to the reduction in the number of claims filed per 100 FTEs in other specialties, the percent reduction for anesthesiologists was very small. Even if we associate fewer claims with fewer patient injuries, the best that can be said is that there has been only slight improvement.
Rates of Anesthesiology Claims per 100 FTEs
Historically, the frequency of anesthesiology claims has been lower than most other physician specialties. The rate of claims for anesthesia are better when compared to three other clinical specialties. However, other specialties are gradually reducing the frequency of claims while anesthesiology has remained between 3 and 6 percent for more than 14 years. For example, since 2011, the rate of claims for internal medicine physicians matches that of anesthesiologists.
Rates of Claims by Specialty per 100 FTEs
Anesthesiology mean indemnity was 12th out of 25 clinical services between 2013 and 2018. These rankings are based on the average indemnity for all anesthesiology claims compared with the average indemnity for other clinical services insured by The Doctors Company that had more than 40 claims that closed between 2013 and 2018.
Clinical services with 40 or more paid claims sorted by mean indemnity 2013–2018:
Anesthesiology Clinical Service Chart
Anesthesiology median indemnity was 19th out of 25 clinical services between 2013 and 2018.
Clinical services with 40 or more paid claims sorted by median indemnity 2013–2018:
When viewed by year, mean and median indemnity for anesthesiology claims fluctuated significantly.
Mean Indemnity and Expense for Paid Anesthesiology Claims by Assert Year
Mean indemnity paid
Mean expense paid
Mean and Median Indemnity for Paid Anesthesiology Claims by Assert Year
Median indemnity paid
Tooth damage claims continue to make up almost a quarter of all anesthesiology claims (22 to 23 percent). Although tooth damage claims are less expensive than most other types of anesthesia-related injuries, their processing and handling costs can impact the cost of medical malpractice insurance.
Tooth damage claims as a percentage of all anesthesiology claims:
of all anesthesia claims
Rate of paid tooth damage claims:
of tooth damage claims
Mean indemnity for paid tooth damage claims:
Median indemnity for paid tooth damage claims:
Mean expense for paid tooth damage claims:
Median expense for paid tooth damage claims:
Tooth damage claims are ubiquitous in situations where intubation is necessary. The numbers captured in our system are not fully representative of all tooth damage claims experienced by the physicians and organizations insured by The Doctors Company. Some groups and organizations choose to adjudicate these claims without submitting them to their professional liability insurance company.
Some patients have anatomy that creates challenges to intubation and other patients have poor dentition. It is essential to evaluate patients preoperatively to determine their dental condition and airway challenges. Plan for airway techniques least likely to damage teeth at risk. In cases of short neck, overbite, limited neck extension, and other anatomical challenges, anesthesia professionals can take precautions against tooth damage. In case of poor dentition and severe gum recession, patients need to be aware of risks to their teeth.
In most tooth damage cases, documentation indicated that patients were informed of the risk of tooth damage. The injury was known to the patient as a risk of the procedure (84 percent). In only 3 percent of tooth damage cases was poor technique identified.
The other primary factor determining the outcome of these cases was documentation (13 percent). The two areas of inadequate documentation were lack of descriptive preoperative clinical findings related to dentition, airway, and anatomy and informed consent listing tooth damage as a risk.
According to claims specialists, defense of tooth damage claims is more likely to be successful when anesthesia professionals document the preoperative condition of patients' dentition, record descriptions of airways, and choose an appropriate intubation process.
More than one in five anesthesia claims (22 to 23 percent) allege tooth damage. For this reason, we segregated tooth damage claims from all other anesthesia claim types to provide clear insights to the other anesthesia patient management issues.
Claims and suits excluding teeth damage claims
Paid claims
Percent of claims with payments
2007–2012 496 145 29.2%
In cases excluding tooth damage, mean indemnity and expense increased by 12.5 percent and 36.0 percent respectively between the two time periods included in this study.
Anesthesiology claims mean indemnity for paid claims:
An increase of $46,657 (12.5 percent)
Anesthesiology claims mean expense for paid claims:
Median indemnity did not increase when the two time periods were compared. However, median costs for defense (expense) of anesthesiology claims increased by 37.1 percent.
Anesthesiology claims median indemnity for paid claims:
An increase of $0.00 (0 percent)
Anesthesiology claims median expense for paid claims:
When tracked by year, trend lines for mean and median indemnity and expense have increased over time.
Mean Indemnity and Expense for Anesthesiology Claims by Year
Median Indemnity and Expense for Anesthesiology Paid Claims by Year
The trend for more expensive anesthesia claims and suits continues. In 2009, only 19 percent of claims resulted in payment greater than $500,000, but by 2018, this category rose to 36 percent of anesthesiology claims. Most anesthesiology claims remain in the $1 to $499,000 range but the percentage of claims in this category decreased over the last 12 years, from 81 percent in 2009 to 64 percent in 2018.
Anesthesia Claims by Value Range
The second study found the same types of injuries and at the same percentage of claims as in the first study. Along with a slight decrease in the frequency of anesthesiology claims, it appears that even with the introduction of new technology in recent years, the safety of anesthesia care has not changed in more than a decade. Maybe technology is not the only area where improvements can be made.
Note that the number differences may not be statistically significant. Also, patients may suffer more than one injury so the total is greater than 100 percent.
Top 10 Anesthesia Patient Injuries
Claim count 2007–2012
Percent of total 2007–2012
Death 113 23% 107 23%
Cardiac or respiratory arrest 68 14% 87 19%
Organ damage* 80 16% 84 18%
Nerve damage 85 17% 77 17%
Ongoing pain 64 13% 63 14%
Need for surgery 36 7% 45 10%
Adverse reaction 48 10% 39 8%
Puncture or perforation 33 7% 39 8%
Sensory impaired 31 6% 33 7%
Mobility dysfunction 38 8% 32 7%
*In 2007 through 2012, 98 percent of organ damage claims were brain injuries. In 2013 through 2018, 93 percent of organ damage claims were brain damage injuries.
Across anesthesia claims (excluding tooth damage claims) there was not much change in the percentage of claims where these comorbidities impacted the patients' clinical results. The greatest increase was seen in hypertension, from 3 percent in the earlier study to 9 percent in the 2013–2018 study.
However, there was a sizable impact of comorbidities—patients who suffered harm as a result of improper anesthesia management during surgery—when compared to all other anesthesia claims.
2011–2012*
No comorbidity impact on outcome of care 71% 59%
Obesity 19% 19%
Hypertension 3% 9%
Cardiovascular disease 5% 7%
Diabetes 4% 6%
Smoking 4% 5%
Obstructive sleep apnea 2% 5%
*Note that coding of comorbidities in medical malpractice claims began in 2010 (partial year) so studies of comorbidities began in 2011.
The three most common case types made up 63 percent of anesthesia claims in 2007–2012 and 65 percent in 2013–2018.
Anesthesia case types excluding tooth damage
Percent of claims 2007–2012
Improper performance of anesthesia procedure 169 34% 126 27%
Improper management of patient under anesthesia 110 22% 145 32%
Positioning related 34 7% 29 6%
Improper management of surgical patient 31 6% 25 5%
Improper performance of treatment or procedure 25 5% 15 3%
In the first study (2007–2012), improper performance of anesthesia procedure (intubation, injection of anesthesia into a peripheral nerve, injection of anesthesia into spinal canal) was the most common type of claim or suit. It decreased in injuries in the later years. It was proposed at the time that the decline may be due to the introduction of new technologies, like ultrasound-guided regional anesthesia. The downward trend continued in the 2013–2018 study, dropping to 27 percent of anesthesia claims. However, the second study (2013–2018) found that the case type of improper management of patient under anesthesia increased by 10 percent from the earlier study.
Top Two Case Types as a Percentage of Anesthesiology Claims by Year
Twenty-four other case types made up the remaining 37 percent and 35 percent of anesthesiology claims in these two time periods.
Claims identified as improper management of patient under anesthesia were due primarily to respiratory, central nervous system, and cardiac complications. These complications were due to comorbidities that were present before the patient was taken to surgery.
Claims of this case type, with inadequate history and physical as a contributing factor, averaged more than two comorbidities per patient. In these cases, 67 percent of the patients had at least one comorbidity. This was two times higher than the percentage of claims with a comorbidity for the rest of the anesthesia cases where only about a third of cases had a comorbidity that impacted the outcome of care.
Comorbidities for anesthesia claims (excluding tooth damage) including all case types except improper management of patient under anesthesia, 2013–2018
Obstructive sleep apnea 4%
Chronic pulmonary disease 2%
Hypertension 5%
Renal disease 2%
No comorbidities impacted the outcome of care 64%
Comorbidities for anesthesia claims with the case type improper management of patient under anesthesia (including contributing factor, inadequate history and physical) 2013–2018
Obstructive sleep apnea 25%
Chronic pulmonary disease 17%
In claims of improper management of patient under anesthesia with inadequate history and physical as a contributing factor, obesity impacted patients' care in almost three times as many cases as other anesthesia cases. Obstructive sleep apnea was six times more likely to impact the outcome. Hypertension was three times more likely to impact patient's surgical results. The other comorbidities impacted care outcomes more than twice as frequently.
In these cases, anesthesia providers were managing conditions unrelated to the purpose of surgery but that ultimately were the cause of the patient harm. It appears that many patients were not healthy before surgery started.
Less common comorbidities and other conditions that complicated surgery included clotting disorders (factor 5 mutation), low potassium, interrupted aortic arch, CVA, anticoagulants, asthma, advanced patient age, CHF or COPD, previous damage to airway, MVA and other trauma, pregnancy, and alcoholism.
A review of these cases revealed limited opportunities to conduct preoperative assessments. Older and sicker patients needed closer investigation but production pressures often limited testing and input from attending or referral physicians. These pressures also limited anesthesia professionals' opportunities to recommend safer locations for anesthesia care (e.g., hospital operating room vs. ambulatory surgery or GI or cardiac labs) or to prepare for complications that might occur as a result of multiple comorbidities or complicated health histories.
Increases in complications and injuries for patients in cases with improper management of patient under anesthesia was also seen in the severity of patient injuries. These patients suffered high-severity injuries in 62 percent of these cases compared with 16 percent of high-severity injuries in all other anesthesiology cases (excluding tooth damage cases).
Percent of Claims 2013 to 2018 with Case Type Improper Management of Patient Under Anesthesia
Percent of Claims 2013 to 2018 Excluding Case Type Improper Management of Patient Under Anesthesia
This highlights the potential for harm in patients with comorbidities and who may not have had adequate history and physical examinations prior to surgery. This data raised the following questions:
Were the comorbidities known prior to administration of anesthesia?
Did anesthesiologists and CRNAs have opportunities to adequately assess patients in advance of surgery? Pre-op assessments are important for the anesthesia professional to determine ASA and Mallampati scores and to prepare to handle complications that may result from comorbidities (bleeding, respiratory complications, mean arterial pressures, cardiac conditions).
Did anesthesia professionals have opportunities to refer patients to specialists to evaluate patients' comorbidities?
Did anesthesia professionals take adequate precautions and make adequate preparations before anesthetizing patients with comorbidities?
Should additional steps be taken prior to surgery for patients who have comorbidities?
Patients may suffer from a wide variety of comorbidities. Some may not be discovered without a thorough history and physical including family history of cardiovascular disease, respiratory conditions, allergies or bleeding disorders.
Other conditions that impacted the outcome of anesthesia care included aspiration of stomach contents; sudden drop in oxygen saturation, blood pressure, and/or heart rate; laryngospasm; and low mean arterial pressures. Anatomical structures like tracheal stenosis and short neck, caused difficult intubations and prone positions caused displacement of endotracheal tubes.
Factors that contributed to patient injuries in the case type improper management of patient under anesthesia included improper selection and management of therapy (44 percent). In most cases, this referred to management of complications that occurred during surgery. Fifty-five percent of these cases had respiratory complications, central nervous system complications, adverse effects of anesthesia, or cardiac complications.
This also referred to the types of anesthesia and the routes of anesthesia that were selected for these patients. Reviewers pointed to patients' conditions or comorbidities that should have prompted anesthesia professionals to consider other options.
Read a case example
A 56-year-old morbidly obese male with a history of hypertension, diabetes, sleep apnea, and elevated cholesterol presented to ambulatory surgery center for knee arthroscopy. Following a brief pre-op assessment, he was rated as ASA III Mallampati III. It was decided to use LMA with 100 mcg of Fentanyl and 2 mg Versed followed by inhalation anesthesia.
After the procedure, the LMA was removed and the patient was moved to PACU. The patient was unresponsive for about 20 minutes and exhibited signs of respiratory distress. Efforts were made to open the airway with jaw thrusts and nasal trumpet. The anesthesiologist determined that the patient was suffering from congestive heart failure, aspiration, or pulmonary edema.
The anesthesiologist administered 40 mcg of Narcan. The patient began to awaken but had oxygen saturation readings in the high 70s. The patient was encouraged to take slow deep breaths. Rhonchi were heard and the patient complained of shortness of breath. The EKG reading was unchanged from the pre-op test.
Thirty minutes after the first dose, a second dose of 40 mcg Narcan was administered with no improvement. Oxygen saturation remained between 79 and 88 percent. Albuterol was given with little effect. The patient's respiration rate was 44.
The patient was reintubated. Copious pink frothy fluid was suctioned from the ETT. The patient received Propofol and paralytic agents with the code team present to assist. The patient's heart rate continued to decline to about 45 beats per minute. The patient was transferred to a hospital emergency department.
Upon arrival in the emergency department, the patient was in asystolic arrest. Attempts to place a transvenous pacer were unsuccessful. The NG tube returned 400 cc of brown coffee-grounds gastric fluid. After 30 minutes of CPR, the patient was pronounced dead.
The autopsy report noted no apparent airway obstruction, so the pathologist determined that the cause of death was flash pulmonary edema. Negative pressure pulmonary edema (NPPE) is a form of flash pulmonary edema caused by forceful inspiratory efforts made against a blocked airway. Toxic levels of ropivacaine were found in the patient's blood. The pathologist noted hypertrophic cardiomyopathy and grossly enlarged heart.
Plaintiffs argued that the LMA was removed too soon with sleep apnea and a class III Mallampati score. They raised questions about the high levels of ropivacaine and wondered if it contributed to bradycardia. They said that the reintubation took too long resulting in high end-tidal CO2. They also noted inconsistent documentation between PACU nurses and the anesthesiologist.
Some defense experts were supportive of the care, stating that the cause of death was probably from a fatal arrhythmia due to hypotension and enlarged heart. They questioned if undiagnosed pulmonary hypertension would explain the failure to respond to Lasix. It was noted that both of the patient's parents had died suddenly following surgeries. The assumed cause was coronary artery disease.
The second most common factor for this case type was technical performance. Most of these cases referred to poor technique used in resuscitation and poor technique in intubations.
Patient assessment issues referred to inadequate histories and physicals. As noted above, inadequate H&P had a significant impact on patients with comorbidities. This factor included failure to address abnormal findings and failure or delay ordering diagnostic tests.
A 29-year-old female delivered a baby and then requested tubal ligation that day. Twenty minutes after receiving spinal anesthesia, she began having respiratory difficulty with decreasing oxygen saturation. She was intubated and lung sounds were auscultated but there was no improvement in low end-tidal CO2 levels. She began having seizures and had only a faint carotid pulse.
The outcome was a patient in a persistent vegetative state. Concerns raised by physician reviewers were the delivery day return to surgery because of the higher risk for gastric aspiration. Possible causes included high spinal, bronchospasm, misplaced ETT, and vasovagal response. Following surgery, the surgeon learned that the patient had been ill with an upper respiratory infection for about two weeks.
A 72-year-old male was taken to surgery for a full thickness rotator cuff tear repair. The pre-op assessment was documented with ASA III and Mallampati score of I or II.
Surgery was successful and the patient was transferred to ICU. However, he expired a few days later.
Concerns about his care included poor documentation of the preoperative assessment. The patient had a history of respiratory failure during previous surgeries that required reintubation. In this case, it was determined that the patient had been extubated prematurely in PACU.
Almost all factors related to patient monitoring were for inadequate monitoring of patients' physiological status. Low mean arterial pressure and severe acidosis resulted in blindness. A drop in end-tidal CO2, likely due to an airway obstruction, was not noted and resulted in encephalopathy and death. Lack of documentation of breath sounds and slow response to drop in CO2 and heart arrhythmia resulted in anoxic brain injury. A patient's oxygen levels dropped rapidly, and the low pulse oximeter readings were assumed to be due to equipment malfunction. It was later discovered that breathing circuit tubes had disconnected.
A 26-year-old female was taken to surgery for an elbow fracture repair. During surgery, it was discovered that the tourniquet had remained inflated too long, resulting in nerve damage. Plaintiffs raised concerns about the level of monitoring the patient had received during her surgery.
A 71-year-old female received a translumbar epidural steroid injection by a pain management specialist. The anesthesiologist planned to provide MAC, but he delivered propofol in four doses for a total of 350 mg for the short procedure. The patient developed respiratory distress (O2 saturation of 70) and bradycardia (40 bpm). The patient was resuscitated and transferred to ICU.
The outcome was short-term memory loss and loss of emotional control. The patient is unable to perform household chores. Experts raised concerns about the slow response to the patient's changing status.
A 42-year-old female with a history of asthma, GERD, and BMI of 36 presented with abdominal pain. She was diagnosed with occlusion of cystic duct following a prior cholecystectomy.
The patient was scheduled for an ERCP at the hospital. Her ASA score was 3. The plan for anesthesia was MAC with IV sedation.
A stone was found in the common bile duct. During the procedure, the anesthesiologist was unable to obtain an end-tidal CO2 reading. A second machine was requested but it showed the same reading. The patient began to experience bradycardia (40s) so she was intubated. Her condition continued to deteriorate requiring CPR. A heart rhythm was obtained but the patient did not regain consciousness. She expired several months later.
Reviewers were concerned about the delay in identifying respiratory compromise. They also noted the lack of timely initiation of appropriate resuscitative measures.
A 58-year-old patient with diabetes, BMI of 36, and Stage Five renal failure presented with a necrotic toe. She was admitted for surgery following dialysis. An IV was started in the non-AV-fistula arm, the same arm where her blood pressure was monitored.
When IV anesthesia was administered, the patient's heart rate dropped into the 60s. The blood pressure monitor was turned off to give additional medications. When the blood pressure monitor was restarted, no blood pressure was readable. The patient's heart rate dropped into the 30s. The patient was given Atropine, epinephrine, and Phenylephrine.
The patient's heart rate increased but remained in the 50s, so more medications were given. When surgery was completed, the surgeon left the OR. The patient had no palpable pulse and no pulse oximeter reading.
Chest compressions were initiated, and the patient was intubated. A short time later, the patient had a blood pressure of 130/50, but she did not regain consciousness. Her seizures started a short time later. The patient was moved to ICU where she was diagnosed with diffuse anoxic brain injury. Life support was terminated a short time later and the patient expired.
In the claim brought by the patient's family, experts on both sides criticized the anesthesia care. There was very limited documentation regarding the patient's vital signs. The surgeon and the rest of the surgical team were not notified that the anesthesiologist was having difficulty maintaining a reasonable blood pressure.
A 35-year-old female experienced an iliac artery tear during introduction of trocar for laparoscopic hysterectomy. The procedure was converted to open and the artery was repaired. The patient received several units of uncrossed-matched packed red blood cells. The surgery then proceeded.
During the procedure, the patient's blood pressure continued to drop. The mostly illegible documentation revealed that the patient's blood pressure moved from being in the 70s to the 50s.
Following the conclusion of surgery, the patient gained some level of awareness but was unresponsive to verbal stimuli. Also, her respiratory rate decreased over the next several hours until she was in respiratory arrest. The patient was resuscitated but a CT scan revealed cerebral edema and brain death.
It was later discovered that the anesthesia professional had not noted the mean arterial pressure that remained below 50 mmHg for more than 30 minutes following the laceration of the patient's artery. He was also criticized for inadequate care following surgery. It was the sudden respiratory failure following surgery that resulted in cerebral edema and death.
In the most recent study, improper performance of anesthesia procedure was the second most common case type, accounting for 27 percent of anesthesia claims. The factor identified most frequently by physician experts as having contributed to patient injury was technical problems that were known risks of the procedure (88 percent of the cases of this type). In these cases, patients were aware of the risks prior to surgery. Only 11 percent of these cases were due to poor technique.
This factor was identified in procedures such as intubation of the respiratory tract (46 percent), injection of anesthesia into peripheral nerve (27 percent), injection of anesthesia into spinal canal (14 percent), and injection of anesthesia into a sympathetic nerve (2 percent). Intubation cases resulted from injuries during intubation or from improperly located endotracheal tubes, causing hypoxia. Injection of anesthesia into spinal canal cases occurred when the injection was incorrectly placed as spinal and not epidural anesthesia.
Injection of anesthesia into a peripheral nerve or peripheral nerve blocks sometimes resulted in nerve damage from inadvertent injection into nerves. The frequency of these cases has decreased in recent years due to the use of ultrasound-guided needle placement. In a few of these cases, it was speculated that the injury came from the tourniquet. As with all cases, lack of or inadequate documentation (18 percent) may have impacted the quality of care and later, the ability of anesthesiologists to defend the care that they provided.
1. Technical performance
A. Injury was known to the patient as a risk of the procedure 77%
B. Poor technique 11%
2. Insufficient or lack of documentation
A. Informed consent 9%
B. Review of participation of care 5%
C. Clinical findings 3%
3. Selection and management of therapy
A. Invasive procedures 4%
B. Medication related 2%
4. Communication among providers
A. Regarding patient's condition 2%
B. Information lost in transition of care 2%
C. Failure to read medical record 3%
A 55-year-old female was scheduled for hip arthroplasty. She had a history of pulmonary emboli, rheumatoid arthritis including severe arthritis of the left hip. Her preoperative scores were ASA 1 and Mallampati II.
After three attempts to intubate with a MacIntosh rigid blade laryngoscope, the anesthesiologist noted blood in the patient's mouth. The patient developed laryngospasm and attempts at rapid intubation were unsuccessful. The procedure was canceled.
The patient complained of pain in her neck. She had signs of infection and stridor. A CT scan revealed subcutaneous emphysema and perforation of the hypopharynx. The surgeon ordered an otolaryngology consultation. The patient had a successful surgical repair of the injury to her hypopharynx.
The patient experienced a full recovery but continued to complain of neck pain and difficulty swallowing.
Experts opined that there was an inadequate assessment prior to surgery. There was no evidence that the anesthesiologist reviewed the patient's medical record. He did not account for the patient's rheumatoid arthritis-caused stiff and possibly unstable neck and did not attempt to view the patient's vocal cords. They believed that the inability to see the patient's vocal cords should have prompted the use of a flexible laryngoscope. The blind attempt to intubate caused the patient's injury.
A 46-year-old male was taken to surgery for clavicle fracture. The anesthesiologist utilized general anesthesia and a right interscalene block guided by ultrasound.
The surgeon performed an ORIF using fluoroscopy. No complications were noted, and the patient was discharged the same day.
After discharge, the patient experienced numbness in his right arm. The surgeon thought it would resolve. Later it localized as pain and weakness in the right hand. A neurologist diagnosed the patient with incomplete brachial plexus palsy and then brachial plexopathy.
Experts disagreed as to whether the interscalene block was appropriate for this surgical procedure. Some said that the nature of the fracture increased the risk of brachial plexus injury. However, they agreed that documentation was lacking details of the procedure. There was no informed consent discussion regarding the risk of interscalene block. Defense experts believed that scar tissue rather than the procedure caused the problem.
Claims filed against anesthesiologists have historically occurred less frequently than claims experienced by other specialties. However, other specialties have experienced gradually decreasing rates of claims while anesthesiology has remained between 3 and 6 percent of the cases for the last 14 years. This raises the question, what do anesthesia professionals need to do to continue to reduce the frequency with which claims are filed? A study of these claims and suits seems to indicate that inadequate preoperative assessments were a significant factor.
The mean indemnity for anesthesiology claims placed this specialty 12th out of 25 clinical services in the years 2013–2018. Anesthesiology median indemnity was 19th out of 25 clinical services during those same years.
Tooth damage claims continue to make up almost a quarter of all anesthesiology claims (22 percent to 23 percent). Although tooth damage claims are less expensive than most other types of anesthesia-related injuries, their processing and handling costs can impact the cost of medical malpractice insurance, and tooth damage is a source of great patient dissatisfaction.
According to claims specialists, defense of tooth damage claims is more likely to be successful when anesthesia professionals document the condition of patients' dentition, document airway anatomy, and record the intubation process.
The trend for higher indemnity in anesthesia claims and lawsuits, continues. Since 2009 when only 19 percent of indemnity payments were greater than $500,000, the percentage of indemnity payments in 2018 that was greater than $500,000 jumped to 36 percent.
The cost of defense of anesthesia claims continues to increase. The trend lines over the last 12 years shows upward slopes. Both mean and median defense costs increased by more than 36 percent when comparing costs of claims between 2007–2012 and 2013–2018 study years.
The most common case type in the 2007–2012 study was improper performance of anesthesia procedure. However, in that study, we saw a downward trend over those years for this case type. That finding was borne out in the 2013–2018 study where we found that the case type improper performance of anesthesia procedure dropped by 7 percent and became the second most common case type.
In the 2007–2012 study, the case type improper management of patient under anesthesia was the second most common. In the 2013–2018 study it was the most common, having increased by 10 percent between the two studies.
Claims identified as being improper management of patient under anesthesia, were due primarily to respiratory, central nervous system, and cardiac complications. These complications were due to comorbidities that were present before the patient went to surgery.
Claims with the allegation improper management of patient under anesthesia averaged more than two comorbidities per patient. In these cases, 67 percent of the patients had at least one comorbidity. This was two times higher than the percentage of claims with a comorbidity for the rest of the anesthesia cases where only about a third of cases had a comorbidity that impacted the outcome of care.
The following strategies can assist physicians and other providers in reducing risk and improving quality of care:
Include information in informed consent discussions about anesthesia risks including special positioning risks and risks of special procedures like nerve blocks and arterial lines. Patients with dental appliances or poor dentition should be informed of the risks.
Work with surgeons, proceduralists, and healthcare organizations to ensure adequate time for preoperative assessments and testing. Some anesthesiologists report pressure to proceed with surgery when they have not had time to do more than a cursory review of the patient and his or her history.
Include a review of the patient's previous experience with anesthesia in the history and physical. When possible view previous anesthesia records.
Tailor anesthesia plans for each patient to specifically address any abnormal findings or comorbidities identified during the history and physical.
Fully document the preoperative anesthesia assessment. In one case discussed in this study, the existence of obstructive sleep apnea should have dictated removal of endotracheal tube or LMA only after the patient was awake and able to respond. Patients with difficult airways should be awake and able to respond to commands before airways are removed.
After patients are extubated, airways sometimes close due to obstructive sleep apnea, neck swelling, hematomas, laryngospasms, etc. For these reasons, equipment for performing emergency cricothyrotomies or tracheostomies must be immediately available in case attempts to reintubate fail.
Patients may suffer from a large variety of comorbidities. Some may not be discovered without a thorough family history of cardiovascular disease, respiratory conditions, allergies, or bleeding disorders. Prompt patients to be prepared to discuss family history before presenting for preoperative assessments.
Even fasting patients may accumulate large amounts of fluid in their stomachs. Caution should be taken when intubating to reduce the chance of aspirating vomit.
One complication of placing patients in the prone position is inadvertent dislocation of endotracheal tubes. Close monitoring of these patients is important. The surgeon should be notified if there are concerns about respiration rates, end-tidal CO2 levels, oxygen saturation, or any other monitored metric or vital sign.
Mean arterial pressure is a factor in cases involving bleeding and in cases involving positioning. Patients can suffer brain injury from inadequate oxygenation during surgery if the mean arterial pressure and cerebral perfusion pressure are not maintained within a safe range for each patient.
The most common procedures in cases of alleged improper performance of anesthesia procedure include intubation of respiratory tract and injection of anesthesia into peripheral nerve, spinal canal, or sympathetic nerve. The most effective defense is good documentation.
The most common factor that contributed to patient injury was complications of the procedure. These injuries were known to patients as risks of the procedure. Poor technique was found in only about 11% of anesthesia cases. When patients suffer from known complications, create opportunities to talk with patients and/or their families. Patients may not remember informed consent discussions or the content of the consent form document they were provided, and may not understand that the injury that they experienced was known as a risk of the procedure. Help patients understand and offer to answer their questions, thus building trust and providing explanations that patients deserve.
Decisions about providing care to patients in the appropriate setting is often made by anesthesiology professionals. Pre-op assessments performed at least a week in advance of surgery provide time to schedule patients at an appropriate location where a higher level of care is available if needed.
Documentation is essential for providing good care and for defending that care, often years after the services were provided.
Rare situations don't require extensive discussion since anesthesia professionals know how to provide high-quality care. However, the following circumstances from case reviews may be instructive, so they are included here:
The patient was given a paralytic agent but not anesthetized (failed to turn on the anesthetic gas so there was a period of awareness).
Records were suspected of being fabricated because they did not fit the clinical picture.
Burns from radiation or previous surgeries resulting in scar tissue made intubation difficult—not identified in the patient's history and physical pre-op assessment.
The purpose of this study is to identify those rare circumstances that result in patient harm. Although anesthesia professionals provide excellent care for almost every patient, there is value in seeing those situations where circumstances prevented good care.
Our hope is that this summary of data that arose from medical malpractice claims will serve as a reminder that excellent clinicians can find themselves in situations where they are fighting to save patients' lives. This data shows that comorbidities can complicate the delivery of good anesthesia care. It reinforces the importance of thorough histories and physicals as a way of identifying potential problems and preparing to address them in the administration of anesthesia care.
Ranum D, Shapiro F, Chang B, Urman D. Analysis of patient injury based on anesthesiology closed claims data from a major malpractice insurer. J Healthc Risk Manag. 2014;34(2):31-42
Anesthesiology,
Closed Claims Studies


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Amy Waldman 's first novel, The Submission, was published in August. It has been named Esquire's Book of the Year and a New York Times Notable Book for 2011 and was short-listed for the Guardian's First Book Award. Her fiction has appeared in the Atlantic and the Boston Review.
I was forced to read Hardy's Return of the Native in school, and it was torture (I never finished it). Not sure I can ever bring myself to read him again. Is it possible I will enjoy him after all these years? Maybe….
I loved Tess of the d'Urbervilles as well.
I've shied away from Jude the Obscure all this time because I do not think I have the stomach for it. I think I will go on doing so.


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The evolution of artificial intelligence
Why I started making parallel computers
W Daniel Hillis	Scientist
91. Why I started making parallel computers 98 01:28
92. The evolution of artificial intelligence 106 03:12
93. Not realising the importance of our inventions 87 02:57
94. Why the Internet is designed with security flaws 100 02:47
95. Hacking the elevator's controller 77 02:14
96. The culture of inventing 95 03:00
97. My close encounter with an elephant 73 02:40
98. The benefits of owning a fire engine truck 77 02:15
99. A ride with drunk Spanish Tall Ship officers 68 04:57
100. A computer made out of Tinkertoys and escutcheon pins 86 02:35
When I was a graduate student I was very interested in making a thinking machine, artificial intelligence. But I knew that the computers that we had available at the time were not nearly powerful enough to do it. So I had to make a computer that was thousands of times more powerful. Actually it turns out I had to make a computer that was millions of times more powerful. But I started by making one thousands of times more powerful. And I knew that, you know, to get neural networks and things we needed much more computing power than we were going to get.
And so that's why I started making parallel computers, was to make a thinking machine with them. So that's why my company was called Thinking Machines. And indeed, eventually, that method did work. It turns out they needed to be even more powerful, but pretty much exactly the methods that we were trying for training computers with neural networks, are pretty much exactly the ones that are working now. And the parallel computers are pretty much exactly like the ones I made. But they just needed to be much faster. So technology had to improve another factor of a thousand before it became possible. But it's interesting how close the ideas are of how that works. Or how they worked, to what we were trying to do then.
W Daniel Hillis (b. 1956) is an American inventor, scientist, author and engineer. While doing his doctoral work at MIT under artificial intelligence pioneer, Marvin Minsky, he invented the concept of parallel computers, that is now the basis for most supercomputers. He also co-founded the famous parallel computing company, Thinking Machines, in 1983 which marked a new era in computing. In 1996, Hillis left MIT for California, where he spent time leading Disney's Imagineers. He developed new technologies and business strategies for Disney's theme parks, television, motion pictures, Internet and consumer product businesses. More recently, Hillis co-founded an engineering and design company, Applied Minds, and several start-ups, among them Applied Proteomics in San Diego, MetaWeb Technologies (acquired by Google) in San Francisco, and his current passion, Applied Invention in Cambridge, MA, which 'partners with clients to create innovative products and services'. He holds over 100 US patents, covering parallel computers, disk arrays, forgery prevention methods, and various electronic and mechanical devices (including a 10,000-year mechanical clock), and has recently moved into working on problems in medicine. In recognition of his work Hillis has won many awards, including the Dan David Prize.
Title: Why I started making parallel computers
Listeners: Christopher Sykes George Dyson
Tags: Thinking Machines
Date story recorded: October 2016
Date story went live: 08 August 2017


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Sam Elliott is one of the most iconic character actors of our time, and he probably never had a choice in the matter. Before he utters one gravely bass word, the craggy, mustachioed face and lanky frame already conjure a laconic drawl and the scrape of old boots on a dusty, creaking floor – a cowboy/sheriff/tough guy/mysterious loner straight out of Central Casting. Or as Elliott puts it with typical wryness, "I'm not one of those actors anyone's going to confuse with a chameleon."
Growing up, his dad didn't even confuse him with an actor, telling him he had "about a snowball's chance in hell," of becoming one. Elliott knew otherwise. More importantly, he knew that acting wasn't about making money, and that his longevity depended on being careful of the roles he selected. Childhood movie matinees cemented his admiration for men who – in or out of tall hats and tall boots – stood for something. "I've turned a lot of stuff down because it's not the kind of guy that I wanted to represent myself as being," he told Variety. "I've certainly played an asshole from time to time…but there's enough assholes in the world."
After doing plays throughout his school years, he moved from Oregon to L.A. to pursue acting. Most peg The Big Lebowski as his big break, but his first one came in 1976, courtesy of a director's wife who mistook him for another actor. It landed him his first lead in a film called Lifeguard, a film rich in real life parallels, for those who choose to sniff them out. He plays a guy struggling with the decision to do what he loves versus succumbing to pressure to do – and be – something else. You wouldn't have known that from the movie's marketing, but we'll let him tell you that story.
A steady stream of supporting film and TV roles followed: The Shadow Riders, Gone to Texas, The Quick and the Dead, Tombstone, Buffalo Girls, You Know My Name, Mask and Conagher (which he also co-wrote and produced). If they play on his taciturn toughness, they also pay tribute to his instincts as an artist. "I've often thought that any actor's best work is the stuff between the lines." Nevertheless, he was thrilled when he got the script for The Big Lebowski, figuring it was his chance to do something different. Until he read it. They'd cast him as a cowboy. Well, if even the Coen brothers see you as an inscrutable wrangler, maybe it's time you just accept it. So he did, playing an ex-Marlboro Man in Thank You for Smoking, and earning money between jobs putting his trademark voice to work in commercials for the American Beef Council, Coors beer and Ram Trucks.
It's a funny business, though. Two years ago, the industry seemed to notice something that'd been pretty obvious all along. While fans have called him "87 percent testosterone," his brand of masculinity doesn't rely on explosions, bulging ego, bulging muscles or roaring soundtracks. It derives from character, confidence, decency, ease, and if need be, friendly menace. In other words, nuance.
In 2015 alone he had three indies at Sundance: Digging for Fire, I'll See You in My Dreams, and Grandma, for which many demanded he receive Oscar consideration. Variety wrote that in his 10 on-screen minutes, Elliott created "a fuller, richer character than most actors do given two hours," going from "welcoming host to angry jilted lover to open wound, with devastating effect." RogerEbert.com's more succinct verdict: "Elliott gives a performance that sets the movie on emotional fire." I'll See You in My Dreams proved he could master comedy without ever departing from his artistic core, The Guardian pointed out, "Elliott's yacht-owning Bill exudes cool, getting laughs out of the audience with merely a glance."
This year, he gets a much-deserved lead in The Hero, playing Lee Hayden, a fading western star who tries to mend fences with his family as he faces a medical crisis. You can't ignore the irony of the role, nor can you imagine anyone else playing it. "Elliott succeeds in pulling you into Lee's emotional orbit and holding you there," said The Hollywood Reporter. "It's a low-key, largely reactive performance, and all the more moving for it: The actor's most memorable moments don't come via tantrums or tearful breakdowns, but in scenes where he simply looks and listens — wounded, hopeful, resilient and, yes, heroic." Variety called it "a love letter to a talent that was until recently widely enjoyed, while remaining strangely under-appreciated."
Even if this "rediscovery" prompts an eye roll, we've got no quarrel with more screen time for Elliott, especially when it shows us more sides of his talent. He took some convincing to try his first multi-cam sitcom (Netflix's The Ranch), but he's quickly become the best thing about it. He's still not completely at ease with the format, but someone who's still willing to be uncomfortable after nearly five decades in the business is someone who should remain in the business. He's guest starred on Parks and Recreation, Grace and Frankie and Justified, and recently signed on to 2018's remake of A Star is Born, in a role co-star Bradley Cooper reportedly wrote specifically for him. Elliott's a humble straight shooter who's grateful for every moment of his long career, which thankfully doesn't appear to be headed anywhere near the sunset.
© Copyright 2014, Sam Jones Pictures. All rights reserved.
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