Thursday, August 25, 2016

Postmedia's Thomson, not Alberta Premier Notley, uses overheated rhetoric

Quick and dirty blog to get something off my chest. Respect Edmonton Journal's @Graham_Journal and have done so for years. I'm going to disagree with his latest column and criticize him. Because he's not above criticism, though Edmonton Journal colleagues will likely dump all over me for daring to do so. 

Lately Graham has morphed into a typical Postmedia journo whose biases show via use of ridiculing language, similar to that typically used by journalists in National Post during Alberta and Canadian 2015 elections. Was it because they believed what they wrote or to please CEO Paul Godfrey? You decide.

Examples of language in this Graham Thomson's column: 
Notley's overheated rhetoric roasts her own credibility (24 Aug. 2016)
Note over-the-top, overheated pejorative language he uses: 
  • crowed Notley
  • ram through
  • wildly out of touch
  • railroaded the vote
  • ridiculous logic 
  • crowed Notley
  • ridiculous rhetorical flourishes 
  • verbal flame thrower
  • demonize conservatives
  • rhetorical cheap shot
What struck me most in this column, even more than his Postmedia ridiculing language, and makes me wonder if he's gone over to the 'dark side' (sub-consciously fearing for his job or listening to too many rightwing politicos?), was Graham trashing Notley for saying of PCs:
“Their idea was that if you fire thousands of teachers and teacher’s aides and school support workers and nurses and nurse’s aides and people who work in the hospitals that somehow the price of oil would go back up.”
Graham's sarcastic comment: 'Really?' Then he further ridicules the Premier to support this false accusation.
To me, Notley's rhetoric (price of oil would go back upclearly meant nothing more than the PCs habitually believing that saving money by cutting education and healthcare staff will make everything alright. Because that's the longstanding PC/WRP fix for all of Alberta's ills. That and giving the oil industry tax breaks. 
I for one will never forget the 1990s when PC King Ralph cut 40% from the province's lab medicine budget plus devastated healthcare funding in general, with laboratory technologists, nurses, physicians out of jobs, fleeing overseas if they could. The ramifications for Alberta were devastating for decades. 
That's the legacy of the PC's go-to fix for saving money, balancing budgets, rather than increasing taxes (in line with rest of the world) on energy companies. Or other strategies like diversifying economy by moving to sustainable energy so that oil prices do not control Albertans' lives, the main legacy of PC's 44+yr reign.
A short blog. Thomson's language is overheated, folks, undermining his credibility. Rachel's speaks to Alberta's history of decades of PC rule and its sad legacy.

Saturday, May 07, 2016

Postcards from the ED in Greater Edmonton (Musings on a battered woman)

A mini-blog on what you observe in an Edmonton, Alberta hospital emergency department (ED) - a small anecdote that I thought worthwhile to relate that occurred in the University of Alberta Hospital.
  • A policeman accompanies a young (20ish) black woman into the ED, She is brutally beaten up with severe bruising all over her face and scrapes on her hands as if she had been dragged on cement. 
  • She avoids eye contact with other ED patients, sits quietly with eyes focused on the floor. 
  • The policeman speaks in respectful and kind tones to the young woman and explains he's going to talk to a physician and she should remain in the ED waiting area. 
  • A well dressed woman, perhaps a minister, accompanying an older disoriented woman, leaves her charge, approaches the young battered woman, and sits beside her quietly saying a few words. The young woman begins to cry silently, with tears streaming down her face. 
  • The policeman comes out of the ED 'pod area' with a physician who looks at the young woman and says, yes, let's take her in immediately.
MUSINGS
In reviewing this 'slice of life' both I and my spouse begin to cry. When you see the results of violence on an individual human being it makes it so much more real than statistics. 

We don't know if this young woman's beating was a case of domestic abuse but it may have been. This issue has only gotten worse in Alberta since the collapse of oil prices and resulting economic downturn.

Source: Domestic silence: Meet the faces of abuse (by Jana G. Pruden, Edmonton Journal, 15 Nov. 2015)
Alberta has one of the highest rates of reported intimate partner violence in the country. There were almost 13,000 calls to police in the province in 2013, nearly 8,000 in Edmonton alone. 
A recent report by The Alberta Council of Women’s Shelters showed more than 10,000 women and children stayed at shelters between spring 2014 to spring 2015, and nearly double that — almost 19,000 women and children — had to be turned away because of lack of space. There were more than 50,000 crisis phone calls to shelters in the same period. 
Since August, four women have been killed in alleged or confirmed domestic homicides in the Edmonton area.
As someone who observed up close the abuse of a beloved aunt for years, I'm well aware why victims may stay with abusers, especially if they have multiple children to care for, they have never worked outside the home, and abusers provide a roof over their head and food on the table. 

About the young victim's demeanor in this case, with eyes focused on the floor, we wonder if she wrongly feels shame at being beaten up, as if it reflects on her worth, not the character of whoever battered her. That possibility is sad indeed. 

A map of Alberta's women shelters includes Fort McMurray. It's currently unknown if its facilities survived the wildfire. In any case, please consider  donating to Alberta's shelters. They need your help and support day in day out, year in, year out.

Thursday, May 05, 2016

While my guitar gently weeps (Musings on the political fallout of the Fort Mac fires)

Updated: 6 May 2016
This Thursday, on his regular spot on CBC's Edmonton AM, Paul McLoughlin, publisher of Alberta Scan, brought up the politics of the catastrophic Fort McMurray wildfires. I'm glad he did because it's been on my mind ever since the widespread devastation of the wildfires became clear.

Until now, I've been afraid to write anything because of potential twitter bullying. As someone with atypical ideas on sensitive subjects, I fear that tweeps with tens of 1000s of followers may casually and wittily trash ideas that clash with their world view. Then their followers retweet it and some may even jump in to dump all over me for having a different opinion. Been there, done that. Such is today's Twittersphere. But so far I've never suffered the unforgivable abuse some celeb female tweeps have. Fingers crossed I never will.

This blog is not about the suffering of those affected by the devastation or about their strong spirit and 
resilience or about how Albertans and Canadians have rushed to their aid. Others have written and will write on these important features as the weeks and months of the disaster's recovery and relief progress.

Instead the blog offers a few musings on 
  • What comes next, after the Fort Mac wildfire is controlled and we're into the recovery phase and 
  • How informed citizens should monitor the behaviours of politicians and their operatives. 
The blog's title is from a 1968 Beatles ditty by George Harrison,While my guitar gently weeps.

Of course, it's an unwritten rule - and common human decency - that politics should never be mentioned early in the game when the lives of many people are so profoundly affected, in this case suddenly and rapidly. During the crisis, the important things are for all concerned to concentrate on saving lives and key infrastructure, and getting the disaster under control.

But 'natural disasters', regardless of their multiple contributing factors, often portend political disasters too. Think Hurricane Katrina and the undoing of George Bush.

MUSINGS - WHAT NEXT?


What can go wrong with disaster recovery?
Well, the possibilities are endless and include:

1.When a disaster has widespread and long term negative consequences to people's lives, opportunities for screw-ups abound. It's worse if the disaster has never happened before or if it's the biggest of its kind, because few or no templates for what to do exist, except in general terms. But the devil is always in the details.

2. Fort Mac's disaster has not occurred in a vacuum, which also complicates what can go wrong. Alberta already suffers from over-reliance on oil revenues, thanks to 44 years of PCAA governments. Rachel Notley's NDP government has opted to run deficits rather than cut back on education, healthcare, infrastructure, and more. Those on the right of the political spectrum already judge maintaining social programs at the expense of a deficit to be a huge blunder and show the NDP's incompetence.

The bill for Fort Mac's disaster recovery is likely to run into the $billions. The funds will come from the Alberta and Canadian governments and insurance companies. Already large government deficits will grow. How many Fort Mac citizens had adequate insurance on their properties and possessions is another matter.

3. Invariably, governments cannot respond to the needs of thousands of devastated citizens soon enough. The needs are too many and life doesn't stop because of the disaster. Many competing priorities exist and government must deal with them. Other emergencies may arise.

4. That's when those affected by the big disaster start screaming about how the government is doing nothing. We've all seen it on the news and it's heartbreaking for the folks involved. But it doesn't mean governments have failed. Only so much can be done and, in the view of those suffering, seldom will it be timely enough and sufficient.

5. Also, all media delightfully supply a megaphone for the victims. Especially Postmedia, which consistently runs anti-NDP propaganda. They'll have a field day once the b*tching starts and make sure every Canadian knows about what an awful job Alberta's NDP (and Canada's Liberals) are doing on the Fort Mac file.

What can go right with disaster recovery?
Well, the government and its civil servants, who carry much of the load of disaster response and recovery, can do their best, do most things right, and get some credit from citizens. 


It helps if local media are fair and balanced and some are. Unfortunately, many good folks have lost their jobs due to cutbacks, but some remain, including the Edmonton Journal's 
However, Postmedia's near monopoly has an effect. One or two voices of reason tend to be drowned by multiple big-name columnists writing for the National Post, promoting Postmedia's party line/orthodoxy, and carried in local newspapers that are part of its chain.

MUSINGS - WHAT TO MONITOR?
Let's return to the unwritten rule not to take political advantage from a tragic disaster like Fort Mac's wildfires. So far Alberta's opposition parties have not overtly stooped to benefit from the tragedy.

WRP's Brian Jean, a resident of Fort Mac, is a naturally sympathetic figure as he personally lost much due to the wildfires.

More interesting is this tweet from WRP political operative, Vitor Marciano. Even if a genuine Jean moment, it's self-serving. Most folks who do truly selfless things don't take pictures and have operatives distribute them to the masses.

So I suggest citizens interested in politics monitor the Twitter accounts of politicians on the right and their surrogates, including those in the media. Will they bond together and fully support the Alberta and Canadian governments in their Fort McMurray recovery efforts over the difficult challenges on the long road ahead? Or as soon as folks complain, will they use it for political advantage?

My guess is that sooner, not later, politicos and their operatives will start to dump on Notley's government (Trudeau's too) over the handling of the Fort Mac tragedy. Bet on it. They'll distort events and spin anything for political advantage. And the Fort Mac wildfires give them an opportunity like no other.

At first it'll be subtle, because they're not stupid. The foundations have been laid already with Marciano's self-serving tweet portraying WRP Jean as hero-personified. Of course, I could be wrong  - and hope so - but time will tell. 

SUMMARY
As noted, this blog focuses on political aspects of natural disasters and their aftermath. The scale of the Fort Mac tragedy presents enormous challenges to all levels of government and the private sector too. As such, it will serve as a valuable case study in not only disaster relief and recovery but also in the politics of disasters. For the latter, it's useful to monitor a government's political opponents to document how they attempt to gain political advantage.

In the meantime, please support the 
Your donation will be matched by both the Alberta and Canadian governments.

FOR FUN
What to do when you see the future and can do nothing about it? Write a blog, of course. 
Some lyrics unused in the final version caught my fancy:
I look at the trouble and see that it's raging,
While my guitar gently weeps.
As I'm sitting here, doing nothing but ageing,
Still, my guitar gently weeps.

Tuesday, April 12, 2016

The sound of silence (Musings on Alberta Health emergency depts)

Updated: 15 Apr. 2016
Brief blog on something I experienced 6 April 2016. I tripped and fell in the public parkade of the apartment complex I've lived in for ~25 yrs and was taken by EMS to Edmonton's UAH ~ 2 blocks away. Why and how I fell isn't important. For the record, some suggest I could possibly sue (who knows?) but am not interested. I like living here and the stress involved just ain't worth it. 

My aim in writing the blog is to document what it's like to have a concussion and what folks experience in emergency apartments

As a sports fan I've read about the awful toll on football players and others by concussions but as a senior citizen I never expected to experience one myself. 

In brief, I tripped over a raised piece of metal (what doesn't matter) in the public parkade that runs between the multiple buildings in my apartment complex. I've fallen before on icy sidewalks but this fall was different. I was astounded to feel my face smack violently against a concrete floor. I'll never forget the shock.

CONCUSSION
Now I know what it's like to have a concussion. After I fell and my head hit the cement, full-force, I heard and saw maintenance guys rush over and say "Let's put a pylon over this" (the raised piece of metal). They tried to lift me to my feet immediately, but I muttered no-no-no because I didn't know what parts of my old bod were still working.


But then the effects of the brain rattling about in skull must have taken hold because I recall nothing from that point until I 'awoke' in the apartment complex office, pretty groggy, and my spouse was there. I had no idea where I was or how I'd gotten there or what day it was, etc. I still recall nothing of how I got to the office after I fell. Suspect that's gone forever.

But I've since learned that two office staff took me to the office (not EMS or maintenance staff). Once there they apparently asked me if they should call my spouse and I looked at them blankly at which point they likely thought, "Oh! Oh! No one's home!" and called EMS. 


Amazing how with a concussion you can seem to be awake but not take in any stimuli at all via eyes and ears.

Going to the emergency department (ED) at UAH was the usual nightmare. I know because I've accompanied seniors there many times. I was in the ED from about 1 pm to 6:45 pm. Had multiple x-rays of rib cage and right elbow, plus a CT scan of head. No broken bones and noggin is okay. 


Fall caused pain and suffering, albeit limited, but still ongoing. Screaming muscles improved in a few days, have bruises in places I cannot show. Suspect rib cage pain will take months to alleviate. It seems worse now than earlier. Rib cage especially hurts when lying down, coughing, laughing, blowing nose. Not a big deal but definitely aggravating and stressful. 

But will never forget the shock of my face smashing violently against concrete.

EMERGENCY DEPARTMENT TIDBITS
Here's the main point of this blog. Take what you will from this narrative. Its point is to motivate improvement in Alberta's health care system.

NOISY EMS STAFF
At UAH I was on a gurney situated in a separate space between the ED proper and ambulance bay. EMS staff were noisy - very LOUD - as they met and happily chatted with colleagues they had not seen for awhile. So boisterous that I eventually had to ask them to be quiet as they were giving me a headache. EMS guy who brought me there did explain to colleagues that I had a concussion and they should be quiet. 

But eventually more and more EMS staff met in that space and their chatter was incredibly loud and distracting and sometimes bordered on inappropriate.

UNPROFESSIONAL EMS STAFF
On past visits to the UAH ED with seniors I'd experienced similar narratives so wasn't surprised. It seems some AHS EMS staff are unhappy campers. They especially gripe about the shifts they get or, more importantly, don't get, and how they want to be transferred to another location.

And there seems to be a particular guy (dispatcher?) that some feel doesn't like them and hence bugs then relentlessly. He's apparently quite short (4 ft something and married to xxxx) and has never really worked at any real EMS job. 

Do EMS staff think patients within hearing distance are deaf? Or have they never been educated about professionalism?
 

ED LACK OF PRIVACY
Unsure if this is correctable but I heard VERY intimate medical and personal details of folks in ED 'cubicles' on both sides of mine. I did not know the patients but it's conceivable I may have. 

Also heard a patient argue repeatedly with successive nurses and physicians demanding that no matter what their tests showed, and even if her symptoms did not fit, she was certain she had a blood clot in her thigh and they must do an ultrasound. 

That's it for now.

For FUN
This Simon and Garfunkel ditty seems appropriate.

Thursday, March 24, 2016

To be or not to be (Musings on IPF and Esbriet)

Updated: 25 March 2016
Print friendly version (pdf with links)

Another blog on my spouse having idiopathic pulmonary fibrosis (IPF) and its treatment with pirfenidone (Esbriet®). See Further Reading for additional resources.

The theme is how do patients with an incurable disease make decisions when the treatment has adverse side effects that make life miserable. Who helps them?

IPF - BACKGROUND
In brief, idiopathic pulmonary fibrosis (IPF) is an incurable, chronic progressive disease typically affecting people over 65, in which the lung's normal connective tissue is replaced by scar tissue. Scar tissue forms when the body has an injury anywhere, but in IPF, for unknown reasons, the scarring (fibrosis) does not stop as it normally does. 

IPF's cause is unknown but the disease causes the lungs to become stiff and impairs their ability to function, i.e., move oxygen into the bloodstream and body tissues.

IPF has a median survival of 2-4 years from diagnosis. Most patients die within 3-5 years but some patients live much longer. See a simplified diagram of ways IPF typically progresses.

IPF - TREATMENT

Until pirfenidone (Esbriet®)) no effective treatment existed for IPF. In clinical trials Esbriet® was shown to decrease scarring (fibrosis formation) and the incidence of death from all causes and from IPF alone. See below for more details.

Cost: Esbriet® was funded in the UK and elsewhere before in Canada but it now is, In Canada Esbriet® costs provincial governments ~$43,000 CDN per patient per year.

DILEMMA
Esbriet® gives IPF patients hope for a longer life but, to some, that comes at an incredible cost to quality of life due to side effects.

The good stuff 
Although not a cure, Esbriet® offers the hope of maintaining lung function as measured by FVC (forced vital capacity - how much air a person can exhale during a forced breath). In IPF, FVC is a key measure of disease progression. Esbriet® doesn't improve FCV but does slow its decline.

Esbriet® has also has been shown to offer patients better life expectancy. For example, after one year:
  • 3.5% of patients on Esbriet® (n=22 of 278) died from all causes, versus 6.7% on placebo (n=42 of 277), a reduction of ~48%. 
  • 1.1% (7 of 278) died from IPF related causes versus 3.5% (22 of 277), a reduction of ~68%.
Of course, given the type of IPF disease a patient has makes such statistics iffy at best. No one knows how an individual's IPF will progress.

The bad stuff 
Unfortunately, Esbriet® has many side effects, also known as adverse events/reactions. It's important to recall that all drugs have side effects, ranging from harmless to severe reactions that require drug cessation.  

Also, with any drug's side effects, an individual may experience none, some, or all. A given side effect may show up immediately or only after being on the drug for awhile. Plus some side effects occur more commonly, others are rare. 

A complicating factor with side effects is that identifying them as directly related to the implicated drug can be difficult. The side effect may be due to drug interactions, a symptom of a co-existing disease, etc. 

Identification is easier if a side effect is well documented as commonly occurring and stops when the drug is stopped, even temporarily. This applies to sun sensitivity and Esbriet® (see below).
Adverse events related to Esbriet® include:
  • abdominal pain
  • bloating
  • gas
  • nausea
  • constipation
  • diarrhea
  • vomiting
  • decreased appetite
  • taste changes
  • difficulty sleeping
  • hot flushes
  • headache
  • indigestion, heartburn, or acid reflux
  • itchy, dry, or red skin
  • sun sensitivity (e.g., sunburn, skin rash, blistering or peeling skin)
  • sweating
  • tiredness
  • weight loss
  • muscle or joint aches or pains
  • Cough or hoarseness
  • sore throat
  • sneezing
  • ear congestion
  • dizziness
From my spouse's experience: 
  • Suppose you cannot get proper sleep, night after night (insomnia), so you always wake up tired.
  • Even when sleeping reasonably well, you're exhausted during the day.
  • You have no appetite and what you eat tastes different (awful).
  • You lose ~5 lbs every 10-14 days because you must force yourself to eat.
  • After eating anything, you're always bloated, have a stomach pain, suffer indigestion, and feel nauseous, often gagging during meals. 
  • After eating (and taking Esbriet®), you feel dizzy for a short time.
  • You alternate between diarrhea and constipation, the latter sometimes requiring extreme measures.
  • Your throat is always sore and you think you're coming down with a cold but it doesn't happen. 
  • You spend 1 hour in the sun and develop a sunburn and measles-like rash on exposed skin which lasts for weeks and requires stopping Esbriet® for a month, then going back on in increasing doses until the optimum dosage is reached.
    • The rash also means in future wearing long sleeves and a wide-brimmed hat (even in summer with temperature 30oC+) and lathering exposed skin with 50+ SPF lotion to walk outside and enjoy a sunny day.
  • You regularly suffer severe headaches. 
With these side effects eventually life becomes miserable. Do you 
  • Stay on Esbriet® because it extends your life?
  • Stop taking Esbriet® and opt for a better of quality of life though it may be shorter than if on the drug?
DOCTOR INPUT
In general, respirologists/pulmonologists review lung function tests, and, if they see lab measures like FCV haven't decreased, assume you will stay on the drug because it's helping. Indeed, they want you to stay on the drug, because opting for life is paramount in their world.

Severe side effects seem to mean almost nil to physicians, presumably because they've never experienced such hell. Also, as physicians, naturally they want to believe they can do some good, even if a disease is devastating and incurable. 

What doesn't happen is discussing the options and consequences (albeit uncertain), i.e., the reality of an incurable disease and what patients can expect, albeit based on population studies, which may or may nor apply to individual patients.

Often well meaning physicians assumes patients and their families want only hope and cannot deal with grim realities. Best to ignore them? 

To be fair, I'm unsure what physicians could say, given the uncertainties. As well, they know that some patients may grab onto something they say and it could come back to bite them. And some doctors may not want to unduly influence patients one way or the other. Mind you, in other circumstances, I've found that's often not true. And so it goes....

But physician reluctance to discuss realities gives patients precious little upon which to base life and death decisions, even if definitive outcomes  are unknown. Fortunately, I'm okay with reading the medical literature and research findings, but suspect many are not. 

Perhaps that's how it must be. As in life, after all is said and done, individuals are responsible for their own choices. But it would be nice to make informed choices based on a physician's knowledge and experience of your circumstances combined with what population studies show. 

BOTTOM LINE
How can patients with incurable diseases choose the best treatment option, even when one doesn't exist?  In our case, my spouse went off Esbriet®  for a month due to sun sensitivity adverse event (mandated by physician), then again later, due to other side effects that led to an unbearable quality of life. While off the drug, the symptoms lessened and many disappeared altogether.

He's back on Esbriet® now, opting for extending life and coping with drug's side effects. We'll see how it goes. Sadly, we have no real support nor wise advice when making decisions. We could join a support group and may do that in time. 

In closing, let me emphasize that there are far worse fates than developing IPF later in life. Overall, both I and my spouse feel pretty darn lucky, even with the latest side effects being a 'bummer', as we'd say in the 60s. Life is good, all things considered.

As always, comments are most welcome. Be aware that comments are moderated, but only to prevent spam.

FURTHER READING
Idiopathic pulmonary fibrosis: now a treatable disease and other highlights from the 2014 American Thoracic Society Annual Conference. CMAJ, May 27, 2014. 

Brett Ley B, Harold R. Collard HR, and Talmadge E. King, Jr TE. Clinical course and prediction of survival in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 2011;183( 4): 431-40.

King TE Jr, et al. A phase 3 trial of pirfenidone in patients with idiopathic pulmonary fibrosis. N Engl J Med. 2014 May 29;370(22):2083-92. Epub 2014 May 18.

My earlier blogs on IPF

Saturday, March 12, 2016

One love (Musings on Chelsea fans' blame game)

Updated 13 Mar. 2016
Chelsea FC exited the UEFA Champions League 9 March and among some fans the blame game is on, or rather, continues. Blame has been fan norm since Chelsea's play this year was shown to be far from the excellence it was in 2014-15 when we won the Premier League, indeed led from start to finish. 
Today (12 March) we exited the FA Cup and blame reached a fever pitch. I need to get this off my chest while fresh. Many, perhaps most, Chelsea fans will disagree but this is how I see it.

Please keep in mind that I grew to respect José Mourinho but eventually that eroded as I watched his poor decisions and eventual crass manipulation to preserve his reputation. 


WHO IS BLAMED

    • He was widely trashed after José Mourinho was fired and Emanalo spoke of "palpable discord" between José and the players and referred to José as 'the individual'. Emenalo haters, often longtime Chelsea fans, like to mention he has zero qualifications, coached a girl's club, and imply he has the job only because he's pal of Roman Abramovich, Chelsea's billionaire Russian owner since 2003.
    • Emenalo is blamed for not recruiting wisely. 
    • Some 'fair and balanced' fans use the Twitter hashtag #EmenaloOUT. Check it out with a Twitter search. Slightly less hateful than #RafaOut
  • Chelsea's Board of Directors, who presumably want the club to be winners but who many fans currently diss as incompetent. Fans didn't say this in earlier years when Chelsea won PL titles, and the UCL. Miraculously in space of one year, BOD are sh*t. 
    • Did José have no input into signings? Was he just a poodle to Emenalo and the Board's decisions? Hard to believe.
  • Specific Chelsea players, who it is claimed would not play for José and 'betrayed' him (José's own word). José played the blame game to protect his image as a great manager.
    • Chief culprits are players whose form dropped dramatically compared to last year, including
    • Diego Costa (20 PL goals 2014-15; 11 PL goals to date)
    • Eden Hazard (14 PL goals 2014-15; 0 PL goals to date)
  • Chelsea players in general (with one exception*), because they are deemed to lack club loyalty. You know the drill, score a goal and pound the club crest on your jersey. Indicates you are loyal to and devoted to your club. Pretty phony, given most players today are hired guns who play for several big businesses (clubs) over their careers.
    • *Exception is John Terry - Chelsea's Captain, Leader, Legend, who's been with the club from a young age, indeed more than half his life. When he taps the CFC crest, you know it means something.
WHO'S NOT BLAMED - José  Mourinho
Few longtime fans blame Mourinho who took Chelsea from PL winner to bottom of Premier League in 8 months and was fired after the club lost 9 of 16 PL games. José is the 'teflon manager', in same category as Jesus Christ or an infallible Pope to adoring fans. José rightly has huge deposits in fan's goodwill bank for his 3 PL wins.

The case for why José played a role in Chelsea's decline
(1) José's management style exhausts players after 2-3 years. Sooner rather than later millionaire players will say enough, I don't need this cynical manipulation. Players play for intrinsic reasons like love of the game and personal pride. Suspect the brighter among them resent José's mind games, see them for what they are, and naturally rebel.  

Takes a big personality to maintain control, keep the respect of players, adopt to changing circumstances, and develop youth. José Mourinho is an Alex Ferguson wannabee but his record shows he  lacks whatever it takes to manage a club for more than a few years. For interest:

(2) José prefers defense to freewheeling offenseJosé's preferred style of play tends to stifle creative players, especially midfielders used to pressing forward on the hunt for goals. For example, José couldn't let Juan Mata  - Chelsea's 2 time POTY  - be Juan Mata. Most fans grieved Mata's sale to Man United, but few criticized José for the loss. The magic of Mata-Hazard-Oscar was lost forever.

(3) José did not give Chelsea's young players (long list) a chance to shine, prove their worth. Why? Likely because to validate his genius as the 'special one', he needed wins now. Always playing the first squad, barring injuries, was the result. Even then, 'kids' seldom got a chance to play, gain top flight experience, prove their worth.  

(4) José was out of control, stressed and fearful for his reputation if the club lost a game, as shown by his treatment of Eva Carneiro and Jon Fearn. Only Eva had guts to call him on it, demand an apology

José quote: "I wasn't happy with my medical staff because even if you are a medical doctor or secretary on the bench you have to understand the game." Apparently, 
José winning takes precedence over giving medical help to a player who is on the pitch and asking for it.

At his core, José is a skilled manipulator who excels at obscuring his role in creating problems. He's an expert at the blame game. His main schtick is to blame referees and encourage fans to see the entire world as against us. As if Chelsea is so important that the entire Premier League - referees, referee association, FA -  would conspire to keep us down. Really?

He's done this act for years and it's worked well until senior management cottons on that there's dissension in the ranks and is forced to jettison him for the good of the club.

WHAT'S NOT BLAMED - Circumstance/Chance
Few Chelsea fans blame circumstance and chance. But Chelsea had many key players injured this year, including Gary Cahill, Diego Costa, Radamel Falcao, Eden Hazard, Nemanja Matić, Oscar, Loïc Rémy, John Terry, and Kurt Zouma.

Besides losing those players, injuries meant  that healthy substitutes were tossed into games lacking experience (because José gave them none to little) and key players like Willian often played exhausted. 

Players often lose form from year to year. Just a few of many:

  • Papiss Cisse, Newcastle United
  • Radamel Falcao, Man United
  • Wayne Rooney, Man United
  • Roberta Soldado, Tottenham Hotspurs
  • Fernando Torres, Chelsea
  • Thomas Vermaelen, Arsenal
Were all these players dogging it, out to get the manager fired? Or just struggling with circumstances that meant they lost their magic?

WHAT'S NOT BLAMED - Top players shun Chelsea
Many top players have not opted for Chelsea in recent years. Maybe they are happy where they are but maybe some are not keen to join Chelsea, even under genius manager José. 

BLAME GAME
In sports, as in life, some people prefer the blame game as opposed to examining themselves and those dear to them. To some fans, if something goes wrong, someone must be identified and blamed. The reasoning is as follows:

  • Those who I support are never responsible else I will be diminished as a savvy fan who knows it all.
  • When folks play the blame game, they often engage in irrational thinking to justify blaming others. 
    • For example, why in hell's name would Chelsea players want to sabotage the club and their reputations and future earnings by choosing to become losers - to say nothing of lowering their own feelings of self worth - all to cost José his job? Does not compute. 
If that were true, then following José's exit, form would miraculously reappear. It hasn't.

Also, the blame game crowd aren't satisfied with 'what players did was wrong.' Instead, players become lesser beings, unworthy of respect. It's personal and they are demonized as cretins who destroyed both 
José  and the fans' dreams of eternal Chelsea glory under José. 

BOTTOM LINE
What gets me most is Chelsea fans who put it all, or mostly all, down to lazy, pampered rich players betraying Gawd Almight, José.

Mourinho is a multi-millionaire who frequents Victoria Secrets fashion shows and GQ awards. With this lifestyle, he's interested in protecting his brand and earning power and expertly practices the blame game to do so. Any footie manager's decisions and actions are NOT infallible. 

To me, the players did NOT deliberately sabotage Chelsea. Which is not to say that José did not p*ss some of them off with cynical mind games and manipulation. Plus he creates unrelenting stress to perform perfectly, always. But to blame Chelsea's 2015-16 season on player sabotage is nuts. Players too want to protect their pride, brand and earning power. 

Sometimes bad things happen for complex, interrelated causes, not simplistic reasons like 'the players did it because beloved José could never be responsible.' Sort of akin to 'the dog ate my homework' vs admitting I, and my hero José, are responsible. 


Seems José's responsible for nothing when a club loses but gets credit for everything when it wins. 

Folks like simple explanations but simple seldom conforms to reality. 

Football clubs are big businesses where players are mere commodities to be bought and sold. To think of players as loyal souls who play their hearts out for a big business that they have no history with, that they know will dump them sooner or later, is deluded. Today most, indeed almost all, play for several clubs over a career.

In my view, several factors played a role to a varying extent in Chelsea's unprecedented fall from PL champs to mid-table ordinary in 2015-16. In particular: 


1. José Mourinho's management style, his tendency to manipulate players (always) and blame them for losing (once losing becomes the norm - otherwise he plays the role of I'll take the heat for the odd loss), and his failure to develop Chelsea's young players by giving them adequate game time. 

    • Is José to blame? Not really. He did what was best for José and no doubt what he thought was best for Chelsea. Was he a factor in the rapid decline? Had to be a major factor. He was 'the boss' running the club day-to-day, preparing and motivating the players, developing tactics.
 2. Circumstance/chance - injuries, loss of form by key players. Yes, poop happens.

3. Emanalo, Board of Directors and José too (because he must have had some say) in failing to recruit top players for key positions. 
Many top players are happy where they are and a body at rest tends to stay at rest unless a significant outside force acts on it (Newton's First Law of Motion). Chelsea is not a significant outside force. Chelsea club history with Roman in charge reeks of instability. The number of managers is the canary in the coal mine. Top players shun Chelsea for good reason. 
For Fun
Having spent 6 months bumming around Jamaica, I'm a reggae and Bob Marley fan. This ditty expresses how I feel about Chelsea. And by implication, what I think about Chelsea fans who diss the club and its players and feel the need to play the blame game. How about feeling the 'one love' for our club and players? Okay to love 
José too, but he's not the 'one love', my fellow fans.