People ask me why I blog. I sometimes ask myself that very question (always after beating myself up for not writing more often). The reality is, I blog for several reasons. Number one: More people are getting information from the Internet and social media. Second, it's a simple and inexpensive way to communicate and reach broader audiences than ever before. Third, it offers interactivity – a way for readers to respond and create a dynamic conversation. It is, after all, called social media. And finally, the traditional news media, especially local TV news and newspapers, sadly don't have the resources to cover healthcare the way they used to. Don't get me wrong. I LOVE newspapers, and unlike some national figures I can actually tell you which I read daily. But NJN is the only news channel that I receive that really covers New Jersey news.

So to answer that initial question: I blog to share information and perspective on the important healthcare issues that affect us all. We're also on Twitter, and I invite you to follow us at "NJhospitals." Of course, there are numerous additional opportunities in the social media space – Facebook, You Tube, Linked In and many others. If you've gotten this far, you're clearly a reader of blogs. So I'd really like to hear your opinion: How do you like to receive healthcare information online, and where should we go next? The possibilities are truly limitless.

Yesterday morning I awoke to the news that the six fishermen lost off the coast of Cape May were located, safe and sound, by the Coast Guard more than 1OO miles out to sea. Then later, as a I drove home from work, I heard the welcome news that the rescue process had begun for the Chilean mine workers who have been trapped 2,000 feet underground for 69 days. What wonderful news for the individuals rescued and their families, friends and loved ones.

It is gratifying to hear good news in a 24-hour news cycle filled with grim updates about the economy and political sniping. But there is another side to this story, and that is the countless hours, days and – in the case of the Chilean miners – months of work by countless rescue workers joining together for the long-awaited result as the whole world watched. The U.S. Coast Guard and all of those involved in the Chilean rescue did their jobs wonderfully, tirelessly and we thank them for being heroes each and every day, even when we aren't watching, and even when we aren't aware of the work they do.

My guilty pleasure during the work week is waking up and running downstairs to catch a half hour of the Morning Joe program on MSNBC before my husband and son wake up. I have watched the show for years. It provides thoughtful debate and dialogue and showcases numerous differing perspectives on an issue, which isn’t usually the case onmost cable TV news channels.

The show is led by host Joe Scarborough, a former Republican Congressman from Florida who gives a conservative but pragmatic viewpoint on the issue de jour. He’s joined by Mika Breznienski (yes, I had to look up the spelling), who gives intelligent commentary plus she sometimes acts as the Mom on the set when the boys get off subject. Add to the mix a wide range of guest commentators like Pat Buchanan, Harold Ford, Arianna Huffington and the guys from Politico.com (one of my favorite Web sites), along with Willie Geist, who has his own show – “Way Too Early” at 5:30 a.m. – and who also plays a key role. I watch them for normally a half hour. After that, the rest of the family wakes up and my son commandeers the TV to watch SportsCenter.

Obviously, I’m no casual observer of Morning Joe, so I was thrilled to learn that NJHA was able to get Joe Scarborough to be our keynote speaker at the NJHA Annual Meeting Jan. 14 in Princeton. I think he will be a great speaker, will be honest during Q & A, and since he will be unchecked by Mika, who knows what he will say? I encourage all NJHA members to consider attending. (Watch this site in the coming days for registration information.) This is our premier member event, where we will be installing our new Board chairman and other officers. It promises to be a great day.

We in the hospital community were disappointed by the recent ruling of a New Jersey appeals court in which a panel of judges decided not to rule on a case that centered on some very difficult issues regarding end-of-life care for hospitalized patients. It was a 26-page opinion that essentially said “the case is moot.” (As a lawyer I can appreciate why it sometimes takes 26 pages to explain a non-decision.)

Why are we disappointed? The medical community, along with patients and family members, need reasonable, responsible and compassionate procedures for the care of patients in their final days when further medical intervention would provide no relief or benefit. This lawsuit was filed against a hospital by a family member pushing for continued medical interventions for a dying patient. I sympathize with them, having seen similar circumstances in my own experiences. The hospital, however, thought it best to end those medical interventions because they didn’t meet medical protocols and were in essence doing little more than drawing out the patient’s death. These are difficult ethical issues that society must face as our population ages and technological advances can greatly prolong the dying process. In the end, the appeals court ruled that it didn’t have enough information to provide this much-needed guidance and encouraged the Legislature to take up this important issue.

Our goal as healthcare professionals is to provide the highest level of care that is medically necessary and appropriate, care that protects our patients from unnecessary pain and preserves their human dignity. These difficult issues will continue to confront physicians, patients and their loved ones until we honestly and sensitively address the conflict between the marvels of medical science and the natural limits of the human body and spirit.

This case has generated some spirited discussion on Web sites and news blogs. Some people have accused hospitals of wanting to deny care because of the cost to the facility. There is no doubt that medical care is costly. However, that is not what is at the core of this matter. This is a human issue, not a financial one. And the undeniable human reality is that sometimes more care is not better care. Sometimes, more care does not add to an improved quality of life. Sometimes, providing care is medically futile. It is a difficult issue for anyone to confront, and certainly a tough conversation to have with family members and loved ones. I know – I’ve been in the midst of such conversations with doctors, nurses and my own family members. It is never easy to hear, and it is never easy to have to be the one to decide. Difficult as it is, this conversation will have to continue in the public arena. In the meantime, make sure your loved ones know what you want – and what you don’t want – should you find yourself in such a situation. Make an Advanced Directive so your wishes are clear to your loved ones and your medical team.

One of my best-read blog entries wasn’t about healthcare, but baseball. My husband and son are diehard Phillies fans. And while I truly love the Fighting Phils, I also love the New York Yankees. As I posted here last fall, the most recent World Series was hard to watch in my home. But we all joined together Monday night to root for the boys from Toms River, who beat an excellent team from Bucks County, Pa., to make it to Williamstown to the Little League World Series. I think it’s the 10^th time a team from Toms River has advanced this far. There’s something special about watching kids play baseball. The Toms River team was down 4-1 early in the game but fought back to win 8-5. My son plays Little League so he could relate to the players from both teams. I watched as the moms in the stands clutched each other as their kids came up to bat, and we all watched the joy of the Toms River team as they celebrated their come-from-behind victory – as well as the sadness of the kids from Council Rock-Newtown as they looked on. Toms River is reportedly playing a team from Ohio this Saturday. Go Toms River, New Jersey!