Brad Warthen's Blog

St. Paddy's at Yesterday's

Here I am standing at the bar in Yesterday's. So where are y'all?

This is not the usual crowd. Very young, very green, quite drunk, generally speaking. I'll need at least another pint before I can tolerate them. I think I'll have one of those Bud Lights in the special St. Paddy's green aluminum bottles. I don't like light beer, but one must bow to the conventions of the day.

"Born Under a Bad Sign," which I must add to my playlist, was just playing on the rather loud PA. Before that, it was "Up On Cripple Creek," which can't be beat, anyway you cut it. Levon Helm!

Anyway, I'm not going to be here all night, so if y'all want to hoist one with me, you'd best shake a leg. Quick's the word and sharp's the action. Time and tide wait for no man, and so forth.

See, I'm just taking a beer break in the middle of cleaning out my office. I'll be doing it all weekend and much of the week -- 22 years of accumulation, or accretion, or whatever (I'm a notorious pack rat) makes a heap o' cleaning up. My task is like that of Hercules in the stables, or, if you're not into classical allusion, that of the noble wee machine, Wall-E.

Some silly bugger knocked his beer over so hard it splashed on my hair -- and worse, onto the Blackberry. Drunk as Davy's sow, he must have been.

Somebody passed the word for Duncan, and he came to join me. I broke the news to him about my leaving the paper. He was disappointed to learn it. Duncan's a great guy. While he was here, a young guy who knows my daughter stopped by to say he's a fan. Of course, he doesn't take the paper -- he reads my column at his parents' house on Sundays. Which is one of our problems.

I'm going to have a Yuengling before I go back to the office. Then I've got a lot of work to do. See ya.

Have a heart, Mayor Bob

When I get home tonight I'm going to be in trouble with the lady who writes the checks at my house. She was already ticked that I got a parking ticket yesterday. One day I lose my job, the next I bring home a ticket. Her position is that it's not that hard to avoid them. I was determined not to get another.

So on the way into town, I stopped to get a dollar's worth of change at Food Lion. So I was set.

The following things happened:

• I parked a block and a half from the federal building, but fortunately there was 54 minutes left on the meter, which was great. Despite my misadventures, I got back in time.
• Then I went to get breakfast, and as I dug in my pocket for the four quarters, and it was empty. Yes, when I got my keys and phones and such out of the little tray after going through the metal detector at the federal building, I had left the quarters. So I ran in and ate and got back to my truck within 15 minutes, and no ticket. Good.
• I had a lunch appointment with Bob McAlister (who has written a column that is sort of about me, which we will run online tomorrow) at the Summit Club (where he is a member and I am not, so I was his guest). I started to leave the office with plenty of time to get there, but I got slowed down by friends wanting to wish me well on my way out of the building. I finally got to the truck, and realized I had no change. I went back into the building, got two dollars worth, and another friend offered best wishes.
• I parked in front of Trinity Cathedral. Figuring on an hour, I put in enough for an hour and twenty minutes (that is, a dollar), and ran to meet Bob.
• One hour and twenty-four minutes later, I got to my truck and had a ticket.

I'm not sure what I'm going to tell Mamanem about this. It's not like I can sneak this by her; she keeps the checkbook.

You know, Mayor Bob (and council), you might lighten up just a LITTLE in this awful economy. I'm trying to keep the meters fed, I really am. But I can only move so fast sometimes, and I can only spend so much of my life thinking about making sure to have change in my pocket. I spent WAY too much time on that today, and still failed to avoid the wrath of Lovely Rita.

The unspeakable horror

This was a terrible day for news about children.

The awful thing is that the front-page story about the boy shot and killed by his brother while they were idle on a "snow" day was not the worst, most appallingly horrific such news in the paper.

It was awful enough. In my long career in this business, I am often shocked at how unbelievably trivial the incidents leading to domestic homicides (the most common kind) can be. Although I can't remember whether this happened in Tennessee or Kansas or South Carolina (the three places I've worked), the archetype in my mind was a case in which two grown men who were related to each other (I want to say an uncle and his nephew) were drinking heavily, and one shot the other after the quarreled over what to watch on TV.

This case exceeds that one in sheer awfulness, and not only because it was children involved. These boys were arguing over who would sit where while they watched TV. The mind reels, this is so terribly sad and unnecessary.

And those words -- "terribly sad and unnecessary" -- are so pathetically inadequate. You have to be a better writer than I am to describe it adequately, and I mean a MUCH better writer. Conrad got at it with Kurtz' raw whisper, "The horror! The horror!" Obviously, you don't have to travel to deepest Africa to find the Heart of Darkness.

Then there's Dostoevsky, of whom I was reminded in reading the second, and even worse, item in today's paper. Ivan Karamazov, world-class cynic, told his idealistic brother, "You see, I am fond of collecting certain facts, and, would you believe, I even copy anecdotes of a certain sort from newspapers and books, and I've already got a fine collection." They tended to be of horrific incidents of unspeakably terrible things being done to children, and they confirmed him in his dim view of humanity.

This second story would have fit perfectly in his collection. Before I share it let me warn you that this is by far the most horrible, shocking, painful-to-read thing I have ever posted on this blog.

That said, here it is:

SUMTER, S.C. -- The parents of five South Carolina children have been charged after their 1-year-old boy starved to death in a Sumter home crawling with rats and roaches, authorities said Tuesday.
    The toddler, who has not been named, was found unresponsive Monday at a home that Sumter County Coroner Harvin Bullock described as filthy and unsuitable for living.
    The child was taken to a hospital, where he was pronounced dead, Sumter Police Chief Patty Patterson said.
    A police report listed the toddler's weight as 4 pounds.
    The boy's parents have been arrested and charged with homicide by child abuse and unlawful conduct. Kevin Dewayne Isaac, 25, and Marketta Sharnise McCray, 23, were in jail Tuesday awaiting a bond hearing, and it was not immediately clear if they had attorneys, police said.
    If convicted on the homicide by child abuse charge, Isaac and McCray could face life in prison, and Patterson said more charges could be forthcoming.
    The boy's twin sister, whose weight was listed as 9 pounds, has been hospitalized for malnutrition, and three other children in the home have been placed in state custody.
    Those children - ages 4, 6, and 9 - are being checked out by physicians, Patterson said.

As I read that in the paper this morning, it struck me as so massively tragic that the pages of a newspaper seemed far too frail and insubstantial to support it. The item -- which is about a child who was a twin, and almost exactly the same age as my precious twin grandchildren -- should have dropped through the page, through my breakfast table, and plunged straight into the netherworld before I could see it. Yet there it was.

Ironically, today was the same day that The New York Times editorialized, again, to this effect:

We were horrified to be reminded that the nation still has not plumbed the depths of the Bush administration’s abuses....

Remember when I wrote about that several months ago, about how easy it was to inspire "horror" in the eyes of the NYT editorial board? I even wrote a follow-up to provide a little perspective on things we should truly "watch with horror." I even included some pictures that were very painful to look at.

But you know what? This news about this poor child starved to death is harder to take than what I cited before. You see something like this, and you want to be distracted from it. You say, by all means let's talk instead about how filled with horror we are at that awful George W. Bush and the unspeakable things he did. Let's indict him. After all, the NYT accuses him of "mangling the Constitution." Let's have show trials, 24/7 on television. I promise to shout and wave a pitchfork. Anything to avoid thinking about that little item I read in the paper this morning.

Because I don't want to think about that any more.

Down with team-building games

Count me among those who do NOT get worked up about city councils and other public bodies treating themselves to lunch. If you ask me whether taxpayers should have to pay for sandwiches for council members and staff during a meeting that stretches through meal time, I'll say no. But I'm not going to get worked up about it such petty-cash disbursements. It's the much larger spending decisions the elected officials make while they're chewing their pimento cheese sandwiches that matter.

I had to smile over Belinda Gergel's pot luck offering, and Mayor Bob's disclosure that he consumed two Life Savers, but paid for them himself. Mayor Bob can be a witty guy, in a dry sort of way.

But I DO get all worked up and indignant over learning that that same body, Columbia City Council, spent $3,000 on a "leadership seminar focused on team-building" at their retreat at the end of last week.

No, wait; I should clarify. It's not the $3,000 -- excuse me, $2,950. It's the fact that they spent anything, including the precious time, on such an exercise. No offense to Juan Johnson, the H.R. whiz who led them through such vital activities as the one in which they had to "work their way through a maze without talking to each other," but what possible good did this do? I mean, pick an issue (say, homelessness), and the council members have already demonstrated amply that they can wander in a maze without talking to each other.

To confess, I have a deep-seated prejudice against team-building exercises. The senior staff here at the newspaper used to have to undergo these embarrassing ordeals. One year we went whitewater rafting in North Carolina. Oh, you think that's bad? Another time, we went to Frankie's Fun Park, where we -- among other things -- played laser tag. I was mortified at the thought that a reader would see and recognize me, and tell the world before I could zap him. Besides, my laser gun didn't work, and I kept getting killed, which did not help my morale a bit.

Now, I'll confess that I can get into a game as well as anybody, and after griping and moaning louder than anyone in the room, I might end up playing more enthusiastically than anyone. (My favorite team-building exercise ever, which I actually had to go to Miami for: We were shown the first part of "Twelve Angry Men." Then we had to guess in which order the 11 jurors would change their minds and agree with Henry Fonda. I got them all right except for like the eighth and ninth, which I had switched.) But I have never fooled myself into thinking I wasn't wasting time. I've always been aware that I had work that needed doing, and this foolishness was getting in the way.

We don't do these things any more. Why? Because we don't have the money to waste, that's why. If we DID have the money, though, and were bound to waste it, I'd vote that we spend it on paving our sidewalk in gold, or something -- anything to avoid a team-building exercise. I'm not a curmudgeon about most things, but I am about this.

Do any of y'all have experience with these things? And have you, or your organization or its customers or anybody else EVER benefited from it? Maybe it's me; I've never had much trouble confronting people and telling them what I think, or working in teams, and have never seen any need for ice-breakers. Maybe they help some people. But I doubt it.

Praying for some leadership in Columbia

We had various speakers today at Columbia Rotary talking about homelessness in our community, including Amos Disasa from Eastminster Presbyterian, speaking on behalf of the Midlands Interfaith Homelessness Action Council (which he acknowledged that, as organization names go, is a mouthful).

Saving me from taking a heap of notes, Rev. Disasa mentioned the group's Web site, at which you can read the following:

More than $9 million has been raised to build a Homeless Transition Center in downtown Columbia.  Yet this badly-needed facility is facing opposition from near downtown neighborhoods as well as some political leaders.

It is our prayer that the faith community will rally behind the Transition Center.  The starting point is to educate yourself on the need for the Center.  You will find valuable information and perspective in the slide show above.

Then we hope you will sign the petition below and that you will get others to sign it, as well.  We want our city leaders to understand that there are many more of us who support the center than those who oppose it.

When the MIHAC was formed 18 months ago, who could have dreamed that our community could have made so much progress?  But we are not there yet, which is why this petition campaign and your help are so crucial.  Read the petition that follows, please download it, sign it and encourage others to sign it.  With your help we can light the way to end homelessness.

By the way, as I mentioned in a comment a little while ago on my Sunday column post -- after Rotary, Jack Van Loan mentioned that he'd received word that the mayor is mad at him over the subject of my column. Jack said his reaction was to tell the person who told him that to give the mayor his phone number...

The blessing of a potential candidate

By BRAD WARTHEN
Editorial Page Editor
On a brilliant, warm February afternoon, I was holed up in a darkened booth in an Irish-themed pub talking local politics. Not exactly James Joyce’s “Ivy Day in the Committee Room,” but a reasonable Columbia facsimile.
    Jack Van Loan was holding court at his “office” in a booth at Delaney’s in Five Points — files and organizer on the table before him next to his coffee, his briefcase opened on a nearby bench. From such locations Jack makes and takes his multiple calls getting ready for the big St. Patrick’s Day event March 14, and talks Five Points politics.
    Last year, he was blessing Belinda Gergel for the 3rd district City Council contest that she eventually won. This time, he was pushing someone for mayor.
    It was Steve Benjamin, whom I’ve known for years; we endorsed him for state attorney general in 2002. But Jack wanted to “introduce” him as his candidate for mayor, and I wanted to hear what Jack — a force in the Five Points Association since 1991 — had to say about him.
    Jack says the necessary ingredient in leadership is courage — something he knows about, having been imprisoned at the “Hanoi Hilton” with John McCain. He says Steve Benjamin’s got it. “He’s not a Goldwater conservative,” which would be more to Jack’s liking. But “This is my guy.” If he runs.
    Mr. Benjamin says he’ll decide whether to take on Mayor Bob Coble “in the next couple of months.” No later, because he will need the full year running up to the April 2010 election. Jack agrees: “A year’s nothing.”
    What this would mean is that Bob Coble would face something other than the “usual suspects” opposition that has tended to characterize his re-elections. Last election, Kevin Fisher mounted the most serious race in a while, but that was weak compared to what Steve Benjamin would do. He wouldn’t just be a focal point for the discontented. He has the name, connections and credibility to challenge the mayor in the very heart of his political support.
    And now, confidence in Columbia’s leadership is at a low ebb. City finances are an inexcusable mess; the police department is reeling from a string of problems. The city manager has quit, after the council couldn’t get its act together to evaluate him. The seven elected political leaders seem incapable of summoning the will to cope with anything, from homelessness to closing a deal to provide more parking spaces in Five Points (a very sore point for Jack).
    “I have a great relationship with Bob Coble,” says Mr. Benjamin. “On my worst day, he’s been a great acquaintance.” Further, he says he doesn’t doubt the mayor’s dedication to the city.
    So, as he says the mayor himself asked him, why consider running against his friend Bob? While he still hasn’t made up his mind, “reasons become clearer every day — every morning after I read your paper.”
    If he runs, the campaign will be positive, and “aspirational.” He wants to grow old here. He wants his children to raise their children here.
    To hear his wife or law partners tell it, he’s already involved in “too many things:” Among them, he’s chairman-elect of the Greater Columbia Chamber of Commerce, and vice chairman of the Columbia City Center Partnership. I don’t find it unusual to run into him twice in the same day, at unrelated community events.
    “I think we lack a clear and cohesive vision about where this city needs to go,” he says. More than that, he understands that the city lacks the means for translating any such vision into effective action.
    In other words, he advocates replacing Columbia’s unaccountable, failed council-manager government with a strong-mayor system. A full-time mayor with responsibility for, rather than politically diffused detachment from, the day-to-day executive functions of the government is necessary “for a city trying to make the next leap — from good to great,” he says. “Some say it’s a third rail,” but “it’s hard to look somebody in the eye and say I want to run the city, and then say you don’t really want to run the city.” Under the current setup, not a lot of people would want the job — at least, not a lot of people a reasonable person would want to want the job.
    He mentions several important issues the city has yet to cope with — transportation, clean air and water. But it is on homelessness that he draws a sharp contrast. He says the proposal of the Midlands Housing Alliance to establish a multi-purpose center to fight homelessness at the Salvation Army site “is sound, is 95 percent of the way towards being funded, looks like a certainty and certainly fills a void.” As a former resident of the Elmwood neighborhood, he understands concerns, but believes “some strong, good neighborhood agreements” could reassure folks such a center would not be a detriment.
    Mr. Benjamin is a veteran of the last failed effort to establish such a center, which was undermined by the City Council. That experience “put us on notice that if something’s going to happen, it may have to happen in spite of elected city leadership.” Various stakeholders, from business leaders to service providers, came together in the Housing Alliance to provide that missing direction, and now Mr. Benjamin says the city should step up and do its part, which would include providing operating funds.
    “I don’t get the impression that the city leadership thinks it’s a problem,” says Jack Van Loan. Referring to Cathy Novinger of the Housing Alliance, he adds, “That gal would have made a damned fine general officer in the Air Force. She can make a decision without stuttering.”
    It’s a quality that the former fighter pilot values, and one he suggests that he sees in Steve Benjamin.
And while it’s far too soon to say who should win, if Mr. Benjamin gets into the race, Columbia will have its clearest chance in a long while to pick a new direction.

For links and more, please go to thestate.com/bradsblog/.

My band's playlist

You know that event over the weekend I mentioned attending back here? It was a fund-raiser for Hand Middle School over at Gallery 701. And while a lot of folks did come up and converse with me about newspaper business, our dialogue was somewhat constrained by the fact that it was hard to talk over the sound of the band.

The band was a group of local lawyers who call themselves The Sugardaddys, as in the candy. That, of course, is not nearly as cool a name as what one of the band members told me they thought about calling themselves, which was "Lawyers, Guns and Money." That band member, by the way, was bassist James Smith, also known for his nonmusical work at the S.C. House and in Afghanistan with the National Guard.

The band was pretty good, and in fact their opening number was one I think I'll add to my band's playlist -- The Band's "The Weight." That song would fit right into my band's ouevre, or idiom, or what have you.

Oh, you don't know about my band? Well, it's just in the planning stages, where it's been since about, oh, 1971. The thing is that first I've got to come up with a cool name for it. I mean, you're not going to see me settling on something like "Sugardaddys" just to move things along. No, I'm taking my time; I want to get this right. For awhile there I was sort of enamored of "Wireless Cloud" as a name, but I've moved on. Suggestions are welcome (up to a point). I may end up with the one that a friend suggested many years ago, after inadvertently learning my first name: "Donnie B. and the All-Night Newsboys."

But I did draft a preliminary playlist of cover songs a couple of years back. I meant to post it on the blog, but didn't get around to it or something. I ran across it the other day, and here it is:

• Don't Look Now
• Can't Be Too Long
• Paint It Black
• I've Just Seen a Face
• Simple Kind of Man
• Bring It On Home
• Mustang Sally (but only if I can line up the Commitmentettes)
• Knocking on Heaven's Door
• Hard-Headed Woman
• Soldier of Love
• Lawyers, Guns and Money (hey, it was on the list before James mentioned it)
• The Pretender
• Desperado (Don't know how this got on here)
• One More Cup of Coffee

This list, now that I look back on it, is WAY incomplete and poorly thought-out. For instance, as I say, I don't know how Desperado got on there (watching too much Seinfeld, maybe). If I went with anything Eagles-related, it would have to be Don Henley's "Dirty Laundry." And when it comes to Beatles covers, I'd do "I Should Have Known Better" way before the one listed above -- or "Eight Days a Week."

And this doesn't even get into my original material (perhaps mercifully).

Anyway, once the name is set and the playlist is all worked out, I'll see about trying to line up some actual musicians. Oh, and a manager. Don't be bugging me with gig requests; that's for the manager to deal with. All in good time.

Sunday preview: Ivy Day in the Committee Room (5 Points version)

    Old Jack raked the cinders together with a piece of cardboard and spread them judiciously over the whitening dome of coals. When the dome was thinly covered his face lapsed into darkness but, as he set himself to fan the fire again, his crouching shadow ascended the opposite wall and his face slowly re-emerged into light....

        -- from "Ivy Day in the Committee Room," by James Joyce

In the middle of a brilliant, unusually warm February afternoon (Thursday), I was holed up in an Irish-themed pub talking local politics. Jack Van Loan was holding court at his "office" in a booth at Delaney's pub in Five Points. And when I say office, I mean "office," with his files and organizers on the table before him next to his coffee, and his briefcase opened on a bench close at hand. From such locations Jack makes and takes his multiple calls getting ready for the big St. Paddy's Day event (March 14) and talks Five Points politics.

Last year, he was pushing Belinda Gergel for the 3rd district council contest that she eventually won. Today, he was conveying his blessing upon another (potential) candidate -- this one for mayor.

The candidate, or potential candidate, sat in the dark with the bright light coming in the window behind him so that I was talking to a silhouette -- a little like the effect when you talk to Joe Riley in his office down there at the Four Corners of the Law, with that huge cathedral-like array of windows behind him, and the fluid light of the Holy City radiating all about him. This was a little more prosaic than that, but then this wasn't the mayor yet, just a potential candidate.

Who was the candidate? Well, that's him in the very bad phone picture above, with Jack at his right. Shouldn't be hard to figure out. The thing about this candidate was, I needed no introduction. We've endorsed him for statewide office in the past. But my friend Jack wanted to introduce him as his candidate for mayor in next April's election, and I wanted to hear what Jack -- a force in the influential Five Points Association since 1991 -- had to say about him. It wasn't exactly Joyce's "Ivy Day in the Committee Room" and we didn't talk about Parnell, but by Columbia standards it would do.

Anyway, the rest of the story will be in my Sunday column, so tune in.

Palmetto Health comes out swinging

Well, you're not going to be surprised to know that Palmetto Health is not a BIT pleased that Providence Hospital and Lexington Medical Center have cut a deal on open-heart and left it out. Palmetto Health issued this statement at 4:37 this afternoon, after the other two parties made their big announcement:

IMMEDIATE RELEASE
Feb. 25, 2009

Statement by Charles D. Beaman, Jr., CEO, Palmetto Health

I have great respect for the dedicated professionals associated with Lexington Medical Center and Providence Hospital. However, I am surprised and very disappointed that the leaders of those hospitals excluded Palmetto Health when they negotiated a private agreement regarding health care delivery for the Midlands of South Carolina.

Palmetto Health is the largest provider of health care in the area.  We have been urging collaboration and cooperation from the beginning.

Frankly, I am at a loss to understand why a private agreement regarding health care delivery would be negotiated and announced that excludes the region’s largest hospital system.  Our goal is to provide the best, most efficient services to the families of central South Carolina.  It is simply not possible to develop a regional health care delivery plan that excludes Palmetto Health.  

Here are just a few of the questions left unresolved by the private agreement negotiated by only two of the region’s hospitals:

• Will Lexington Medical Center agree to support Palmetto Health’s plan to build Parkridge Hospital in the Irmo area?  That plan was approved by state officials in August of 2007.  The community involved is eager to have a hospital in their area.  But progress has been blocked for nearly two years by legal maneuvers.
• Will we have sufficient trauma coverage for our region? If open heart surgery must be provided in a hospital that has one of the busiest ERs in the area, why not consider providing trauma services in that same ER?
• Will we have adequate behavioral health services for our region?  Right now Palmetto Health is the only inpatient provider for unfunded patients.  As the state continues to cut services for inpatients and outpatients, our regional hospitals need to work together.
• Where are the oversight and the spirit of cooperation to provide care for the uninsured and underinsured who are showing up in growing numbers at the region’s only safety-net hospital – Palmetto Health Richland?  Is open heart surgery the only service worth sharing?

At Palmetto Health, we remain willing to cooperate and collaborate with other hospital systems to create a true regional health care delivery plan.  And we urge our colleagues in the health care delivery system to focus on the full range of services needed in these difficult economic times. 

In the mean time, our friends in Lexington County can rest assured we will continue to support them in their specialized heart care needs.  Just last week, a patient from Lexington County had his heart blockage removed within 19 minutes of his arrival at Palmetto Health Heart Hospital after being transported there by Lexington County EMS.  We remain ready and able to accommodate patients needing our care.

# # # # #

In those four bulleted items, Chuck Beaman sets out the biggest beefs that Palmetto Health has long held in terms of getting the short end of the stick on Midlands health care -- it treats the most indigent patients, and it maintains the expensive trauma services that the other hospitals don't have to provide because IT does. That's why it was so important to Palmetto Richland to develop it's expanded open-heart program, because it brings in revenue it needs to offset those expenses.

That question, "Is open heart surgery the only service worth sharing?" is about as loaded as a question gets. Lexington has argued all along that it needed open heart because it was getting such a disproportionate share of acute cardiac cases coming into its ER. In that case, the other hospitals have said, why don't you beef up ER -- which would COST money, rather than bringing it in the way open-heart does. Now, Providence isn't saying that, and is getting $15 million, and Palmetto Health is feeling very isolated and neglected.

Note that the release doesn't promise to keep opposing Lexington's CON request on open-heart, but says it will be happy to continue serving those patients at the Richland campus, which one of course reads as meaning the same thing.

Bottom line: Two of the combatants have made peace. But the war's not over.

The war is over -- between Providence and Lexington Medical

Just to briefly mention what I've been up to on this Ash Wednesday, we had a meeting this morning with representatives of Providence Hospital and Lexington Medical Center. They had come to jointly announce a major breakthrough -- they've stopped fighting over whether LexMed should be allowed to do open-heart surgery.

As you know, Lexington has tried everything it could think of in recent years -- regulatory, legal and political -- to get around the fact that DHEC has said (in a shocking, rare instance of DHEC saying "no" to anyone) that they can't do bypasses. Providence and Palmetto Health have been on the opposite side of the table, arguing that a third such program would be duplicative and damage the quality of overall care in the Midlands by reducing the number of procedures they do below the level considered necessary for maintaining proficiency.

We have agreed with Providence and Palmetto Health on this. In fact, we also opposed Palmetto Health expanding its heart program several years back, on the same grounds, but DHEC approved it. We have maintained that yet a third such program would be insupportable.

But now two of these three parties have decided to stop spending millions fighting each other, and after months of negotiations have agreed on the following:

• Providence and Lexington Medical will ask DHEC to "de-certify" one of Providence's four open-heart surgical suites.
• The two will then ask DHEC to certify ONE such unit at Lexington Medical.
• Lexington will drop its challenge to certificates for expansion for Providence Northeast.
• Lexington will pay Providence, in three installments, a total of $15 million to compensate it for the lost revenues from de-certifying a unit.

So what's missing? Well, Palmetto Health. What we have here is a classic 1984 sort of situation: Eastasia and Eurasia have always been at war with Oceania. But now Eurasia and Oceania are friends. Does that mean they are now at war with Eastasia -- I mean, Palmetto Health? Well, no -- at least not at this moment. But Palmetto Health is not a part of the peace agreement, and it's hard to see how the overall battle over this issue is over until it is. We'll see in the coming days.

All of that is not to take away from what a huge breakthrough this is. This has been a very, VERY bitter battle that has distorted local politics as well as spending all that money on lawyers and such. As one who lives right behind Lexington Medical, I can tell you I've caught a lot of heat over this emotional issue, as has the newspaper. It's been tough to get people to look beyond the feelings to the larger issue. (One way I've tried to do that personally has been by pointing out that if I were having a heart attack, I'd have to be transported right past Lexington, only a mile from my house, to Providence -- but that I believe that situation is best for the community overall, in terms of better outcomes for more patients in the Midlands.)

Now, suddenly, it's over? Well, this part of it is. And I find myself torn between on the one hand celebrating the end of a really destructive conflict, and wondering why it's suddenly OK for an experienced open-heart team to be replaced by a startup? Mind you, I'm sure Lexington Medical will do as a good a job as anyone could starting such a program. It's an excellent hospital, and takes tremendous pride in doing everything it does well. Still, all things being equal, would we not be better off with the established team at Providence doing that portion of the region's procedures?

The thing is, politically and financially and in other ways, all things were NOT equal, and continued conflict had its cost. So I can see why Providence has agreed to this even as I have reservations. Lexington Medical is giving ground, too, by the way, aside from giving up money -- it still has objections to the wisdom and advisability of the Providence Northeast expansion. But it's dropping those concerns in the interests of agreement.

By the way, as a brief primer on the importance of money in all these considerations: When Providence started doing open-heart decades ago, it wasn't a money-maker. The Sisters of Charity did it because somebody in South Carolina needed to. Later, open-heart surgery became very lucrative. And while I fully believe that all parties believed they were also doing what was best for their patients, the money has played a big role at each step in these battles. Palmetto Richland, with the largest share of indigent care and an extremely expensive trauma unit, needed to expand into heart surgery to have something that brought in revenues. Lexington didn't want to be left out of that. And Providence, which has struggled financially in recent years after an ill-advised partnership with a for-profit corporation (which the good sisters mortgaged their convent to get out of), could ill afford to give up the revenues.

That's the simplistic, "it's all about money" explanation. There are other factors at work as well. One of them is that the treatment of heart disease is increasingly moving beyond open-heart, often to less invasive therapies. That's one reason why Providence was unwilling to give up part of a pie that was diminishing in overall size. But it also seems to be a reason why it is willing to give it up now -- open-heart isn't the future the way it once was, so Providence sees no point in continuing a wasteful fight over a portion of the diminishing number of such procedures to be done in the future.

Meanwhile, if I heard it right today, Lexington is NOT giving up its objections to a certificate involving the main Providence campus. So all is not sweetness and light, with all conflicts behind us in this community.

But no doubt about it, this is a major step by these two very important local institutions. It's huge. But it's SO huge, and complicated, that much remains to be sorted out.