Thursday, June 27, 2013

Shift Differential


Brian asked me to put up some info on shift differential pay.

Some links:

Federal Regulations
United States Code
Society for Human Resource Management
NCBI Abstract on Shift Work Disorder 
Abstract: Accident risk as a function of hour at work
Abstract:  Shift work and health: current problems and preventive actions
Abstract:  The impact of overtime and long working hours on occupational injuries and illness 

Abstract:  Shift work and health--a critical review of the literature on working hours.

From a source on physicians frequent demand for working night shifts:
The problems of rotating shifts stem mainly from working in opposition to the body's normal circadian rhythms. The major circadian rhythm involved is the sleep/wake cycle. Social isolation of those who must work while others sleep is also a major problem. There are many biological and social problems associated with rotating shifts. Physical problems include an incidence of peptic ulcer disease eight times that of the normal population. Cardiovascular mortality has also been noted to be increased among shift workers. One author estimates that the risk of working rotating shifts approaches that of smoking one pack of cigarettes per day.  Other physical problems include chronic fatigue, excessive sleepiness, and difficulty sleeping. Part of the social toll on those who must work rotating shifts is reflected in an increased divorce rate. Shift workers are also known to have higher rates of substance abuse and depression. Shift workers are much more likely to view their jobs as extremely stressful. Accidents are increased as a result of working shifts.  (ACEP, Circadian Rhythms and Shift Work)
From CDC Report:

The average number of hours worked annually by workers in the United States has increased steadily over the past several decades and currently surpasses that of Japan and most of Western Europe. The influence of overtime and extended work shifts on worker health and safety, as well as on worker errors, is gaining increased attention from the scientific community, labor representatives, and industry. U.S. hours of service limits have been regulated for the transportation sector for many years. In recent years, a number of states have been considering legislation to limit mandatory overtime for health care workers. The volume of legislative activity seen nationwide indicates a heightened level of societal concern and the timeliness of the issue.  (CDC: Overtime and Extended Work Shifts: Recent Findings on Illnesses, Injuries and Health Behaviors)
 

Wednesday, June 26, 2013

Confidence


Harrison Ford discusses building confidence with Anne Heche...




Saturday, June 22, 2013

Lewis Carroll: The Garden of Live Flowers


'I should see the garden far better,' said Alice to herself, 'if I could get to the top of that hill: and here's a path that leads straight to it—at least, no, it doesn't do that—' (after going a few yards along the path, and turning several sharp corners), 'but I suppose it will at last. But how curiously it twists! It's more like a corkscrew than a path! Well, THIS turn goes to the hill, I suppose—no, it doesn't! This goes straight back to the house! Well then, I'll try it the other way.'

And so she did: wandering up and down, and trying turn after turn, but always coming back to the house, do what she would. Indeed, once, when she turned a corner rather more quickly than usual, she ran against it before she could stop herself.

'It's no use talking about it,' Alice said, looking up at the house and pretending it was arguing with her. 'I'm NOT going in again yet. I know I should have to get through the Looking-glass again—back into the old room—and there'd be an end of all my adventures!'

So, resolutely turning her back upon the house, she set out once more down the path, determined to keep straight on till she got to the hill. For a few minutes all went on well, and she was just saying, 'I really SHALL do it this time—' when the path gave a sudden twist and shook itself (as she described it afterwards), and the next moment she found herself actually walking in at the door.

'Oh, it's too bad!' she cried. 'I never saw such a house for getting in the way! Never!'

However, there was the hill full in sight, so there was nothing to be done but start again. This time she came upon a large flower-bed, with a border of daisies, and a willow-tree growing in the middle.

'O Tiger-lily,' said Alice, addressing herself to one that was waving gracefully about in the wind, 'I WISH you could talk!'

'We CAN talk,' said the Tiger-lily: 'when there's anybody worth talking to.'

Alice was so astonished that she could not speak for a minute: it quite seemed to take her breath away. At length, as the Tiger-lily only went on waving about, she spoke again, in a timid voice—almost in a whisper. 'And can ALL the flowers talk?'

'As well as YOU can,' said the Tiger-lily. 'And a great deal louder.'

'It isn't manners for us to begin, you know,' said the Rose, 'and I really was wondering when you'd speak! Said I to myself, "Her face has got SOME sense in it, though it's not a clever one!" Still, you're the right colour, and that goes a long way.'

'I don't care about the colour,' the Tiger-lily remarked. 'If only her petals curled up a little more, she'd be all right.'

Alice didn't like being criticised, so she began asking questions. 'Aren't you sometimes frightened at being planted out here, with nobody to take care of you?'

'There's the tree in the middle,' said the Rose: 'what else is it good for?'

'But what could it do, if any danger came?' Alice asked.

'It says "Bough-wough!"' cried a Daisy: 'that's why its branches are called boughs!'

'Didn't you know THAT?' cried another Daisy, and here they all began shouting together, till the air seemed quite full of little shrill voices. 'Silence, every one of you!' cried the Tiger-lily, waving itself passionately from side to side, and trembling with excitement. 'They know I can't get at them!' it panted, bending its quivering head towards Alice, 'or they wouldn't dare to do it!'

'Never mind!' Alice said in a soothing tone, and stooping down to the daisies, who were just beginning again, she whispered, 'If you don't hold your tongues, I'll pick you!'

There was silence in a moment, and several of the pink daisies turned white.
'That's right!' said the Tiger-lily. 'The daisies are worst of all. When one speaks, they all begin together, and it's enough to make one wither to hear the way they go on!'

'How is it you can all talk so nicely?' Alice said, hoping to get it into a better temper by a compliment. 'I've been in many gardens before, but none of the flowers could talk.'

'Put your hand down, and feel the ground,' said the Tiger-lily. 'Then you'll know why.'

Alice did so. 'It's very hard,' she said, 'but I don't see what that has to do with it.'

'In most gardens,' the Tiger-lily said, 'they make the beds too soft—so that the flowers are always asleep.'

This sounded a very good reason, and Alice was quite pleased to know it. 'I never thought of that before!' she said.

'It's MY opinion that you never think AT ALL,' the Rose said in a rather severe tone.

'I never saw anybody that looked stupider,' a Violet said, so suddenly, that Alice quite jumped; for it hadn't spoken before.

'Hold YOUR tongue!' cried the Tiger-lily. 'As if YOU ever saw anybody! You keep your head under the leaves, and snore away there, till you know no more what's going on in the world, than if you were a bud!'

'Are there any more people in the garden besides me?' Alice said, not choosing to notice the Rose's last remark.

'There's one other flower in the garden that can move about like you,' said the Rose. 'I wonder how you do it—' ('You're always wondering,' said the Tiger-lily), 'but she's more bushy than you are.'

'Is she like me?' Alice asked eagerly, for the thought crossed her mind, 'There's another little girl in the garden, somewhere!'

'Well, she has the same awkward shape as you,' the Rose said, 'but she's redder—and her petals are shorter, I think.'

'Her petals are done up close, almost like a dahlia,' the Tiger-lily interrupted: 'not tumbled about anyhow, like yours.'

'But that's not YOUR fault,' the Rose added kindly: 'you're beginning to fade, you know—and then one can't help one's petals getting a little untidy.'

Alice didn't like this idea at all: so, to change the subject, she asked 'Does she ever come out here?'

'I daresay you'll see her soon,' said the Rose. 'She's one of the thorny kind.'

'Where does she wear the thorns?' Alice asked with some curiosity.

'Why all round her head, of course,' the Rose replied. 'I was wondering YOU hadn't got some too. I thought it was the regular rule.'

'She's coming!' cried the Larkspur. 'I hear her footstep, thump, thump, thump, along the gravel-walk!'

Alice looked round eagerly, and found that it was the Red Queen. 'She's grown a good deal!' was her first remark. She had indeed: when Alice first found her in the ashes, she had been only three inches high—and here she was, half a head taller than Alice herself!

'It's the fresh air that does it,' said the Rose: 'wonderfully fine air it is, out here.'

'I think I'll go and meet her,' said Alice, for, though the flowers were interesting enough, she felt that it would be far grander to have a talk with a real Queen.
'You can't possibly do that,' said the Rose: 'I should advise you to walk the other way.'

This sounded nonsense to Alice, so she said nothing, but set off at once towards the Red Queen. To her surprise, she lost sight of her in a moment, and found herself walking in at the front-door again.

A little provoked, she drew back, and after looking everywhere for the queen (whom she spied out at last, a long way off), she thought she would try the plan, this time, of walking in the opposite direction.

It succeeded beautifully. She had not been walking a minute before she found herself face to face with the Red Queen, and full in sight of the hill she had been so long aiming at.


'Where do you come from?' said the Red Queen. 'And where are you going? Look up, speak nicely, and don't twiddle your fingers all the time.'

Alice attended to all these directions, and explained, as well as she could, that she had lost her way.

'I don't know what you mean by YOUR way,' said the Queen: 'all the ways about here belong to ME—but why did you come out here at all?' she added in a kinder tone. 'Curtsey while you're thinking what to say, it saves time.'

Alice wondered a little at this, but she was too much in awe of the Queen to disbelieve it. 'I'll try it when I go home,' she thought to herself, 'the next time I'm a little late for dinner.'

'It's time for you to answer now,' the Queen said, looking at her watch: 'open your mouth a LITTLE wider when you speak, and always say "your Majesty."'

'I only wanted to see what the garden was like, your Majesty—'

'That's right,' said the Queen, patting her on the head, which Alice didn't like at all, 'though, when you say "garden,"—I'VE seen gardens, compared with which this would be a wilderness.'

Alice didn't dare to argue the point, but went on: '—and I thought I'd try and find my way to the top of that hill—'

'When you say "hill,"' the Queen interrupted, 'I could show you hills, in comparison with which you'd call that a valley.'

'No, I shouldn't,' said Alice, surprised into contradicting her at last: 'a hill CAN'T be a valley, you know. That would be nonsense—'

The Red Queen shook her head, 'You may call it "nonsense" if you like,' she said, 'but I'VE heard nonsense, compared with which that would be as sensible as a dictionary!'

Alice curtseyed again, as she was afraid from the Queen's tone that she was a LITTLE offended: and they walked on in silence till they got to the top of the little hill.

For some minutes Alice stood without speaking, looking out in all directions over the country—and a most curious country it was. There were a number of tiny little brooks running straight across it from side to side, and the ground between was divided up into squares by a number of little green hedges, that reached from brook to brook.


'I declare it's marked out just like a large chessboard!' Alice said at last. 'There ought to be some men moving about somewhere—and so there are!' She added in a tone of delight, and her heart began to beat quick with excitement as she went on. 'It's a great huge game of chess that's being played—all over the world—if this IS the world at all, you know. Oh, what fun it is! How I WISH I was one of them! I wouldn't mind being a Pawn, if only I might join—though of course I should LIKE to be a Queen, best.'

She glanced rather shyly at the real Queen as she said this, but her companion only smiled pleasantly, and said, 'That's easily managed. You can be the White Queen's Pawn, if you like, as Lily's too young to play; and you're in the Second Square to begin with: when you get to the Eighth Square you'll be a Queen—'

Just at this moment, somehow or other, they began to run.


Alice never could quite make out, in thinking it over afterwards, how it was that they began: all she remembers is, that they were running hand in hand, and the Queen went so fast that it was all she could do to keep up with her: and still the Queen kept crying 'Faster! Faster!' but Alice felt she COULD NOT go faster, though she had not breath left to say so.

The most curious part of the thing was, that the trees and the other things round them never changed their places at all: however fast they went, they never seemed to pass anything. 'I wonder if all the things move along with us?' thought poor puzzled Alice. And the Queen seemed to guess her thoughts, for she cried, 'Faster! Don't try to talk!'

Not that Alice had any idea of doing THAT. She felt as if she would never be able to talk again, she was getting so much out of breath: and still the Queen cried 'Faster! Faster!' and dragged her along. 'Are we nearly there?' Alice managed to pant out at last.

'Nearly there!' the Queen repeated. 'Why, we passed it ten minutes ago! Faster!' And they ran on for a time in silence, with the wind whistling in Alice's ears, and almost blowing her hair off her head, she fancied.

'Now! Now!' cried the Queen. 'Faster! Faster!' And they went so fast that at last they seemed to skim through the air, hardly touching the ground with their feet, till suddenly, just as Alice was getting quite exhausted, they stopped, and she found herself sitting on the ground, breathless and giddy.

The Queen propped her up against a tree, and said kindly, 'You may rest a little now.'

Alice looked round her in great surprise. 'Why, I do believe we've been under this tree the whole time! Everything's just as it was!'

'Of course it is,' said the Queen, 'what would you have it?'

'Well, in OUR country,' said Alice, still panting a little, 'you'd generally get to somewhere else—if you ran very fast for a long time, as we've been doing.'

'A slow sort of country!' said the Queen. 'Now, HERE, you see, it takes all the running YOU can do, to keep in the same place. If you want to get somewhere else, you must run at least twice as fast as that!'

'I'd rather not try, please!' said Alice. 'I'm quite content to stay here—only I AM so hot and thirsty!'

'I know what YOU'D like!' the Queen said good-naturedly, taking a little box out of her pocket. 'Have a biscuit?'

Alice thought it would not be civil to say 'No,' though it wasn't at all what she wanted. So she took it, and ate it as well as she could: and it was VERY dry; and she thought she had never been so nearly choked in all her life.

'While you're refreshing yourself,' said the Queen, 'I'll just take the measurements.' And she took a ribbon out of her pocket, marked in inches, and began measuring the ground, and sticking little pegs in here and there.

'At the end of two yards,' she said, putting in a peg to mark the distance, 'I shall give you your directions—have another biscuit?'

'No, thank you,' said Alice: 'one's QUITE enough!'

'Thirst quenched, I hope?' said the Queen.

Alice did not know what to say to this, but luckily the Queen did not wait for an answer, but went on. 'At the end of THREE yards I shall repeat them—for fear of your forgetting them. At the end of FOUR, I shall say good-bye. And at the end of FIVE, I shall go!'

She had got all the pegs put in by this time, and Alice looked on with great interest as she returned to the tree, and then began slowly walking down the row.

At the two-yard peg she faced round, and said, 'A pawn goes two squares in its first move, you know. So you'll go VERY quickly through the Third Square—by railway, I should think—and you'll find yourself in the Fourth Square in no time. Well, THAT square belongs to Tweedledum and Tweedledee—the Fifth is mostly water—the Sixth belongs to Humpty Dumpty—But you make no remark?'

'I—I didn't know I had to make one—just then,' Alice faltered out.

'You SHOULD have said, "It's extremely kind of you to tell me all this"—however, we'll suppose it said—the Seventh Square is all forest—however, one of the Knights will show you the way—and in the Eighth Square we shall be Queens together, and it's all feasting and fun!' Alice got up and curtseyed, and sat down again.

At the next peg the Queen turned again, and this time she said, 'Speak in French when you can't think of the English for a thing—turn out your toes as you walk—and remember who you are!' She did not wait for Alice to curtsey this time, but walked on quickly to the next peg, where she turned for a moment to say 'good-bye,' and then hurried on to the last.

How it happened, Alice never knew, but exactly as she came to the last peg, she was gone. Whether she vanished into the air, or whether she ran quickly into the wood ('and she CAN run very fast!' thought Alice), there was no way of guessing, but she was gone, and Alice began to remember that she was a Pawn, and that it would soon be time for her to move.

Lewis Carroll: Alice meets Humpty Dumpty

Humpty Dumpty sat on a wall


HOWEVER, the egg only got larger and larger, and more and more human: when she had come within a few yards of it, she saw that it had eyes and a nose and mouth; and, when she had come close to it, she saw clearly that it was HUMPTY DUMPTY himself. 'It can't be anybody else!' she said to herself. 'I'm as certain of it, as if his name were written all over his face!'

It might have been written a hundred times, easily, on that enormous face. Humpty Dumpty was sitting, with his legs crossed like a Turk, on the top of a high wall — such a narrow one that Alice quite wondered how he could keep his balance — and, as his eyes were steadily fixed in the opposite direction, and he didn't take the least notice of her, she thought he must be a stuffed figure, after all.

'And how exactly like an egg he is!' she said aloud, standing with her hands ready to catch him, for she was every moment expecting him to fall.

'It's very provoking,' Humpty Dumpty said after a long silence, looking away from Alice as he spoke, 'to be called an egg — very!

'I said you looked like an egg, Sir,' Alice gently explained. 'And some eggs are very pretty, you know,' she added, hoping to turn her remark into a sort of compliment.

'Some people,' said Humpty Dumpty, looking away from her as usual, 'have no more sense than a baby!'

Alice didn't know what to say to this: it wasn't at all like conversation, she thought, as he never said anything to her; in fact, his last remark was evidently addressed to a tree — so she stood and softly repeated to herself:
'Humpty Dumpty sat on a wall:
Humpty Dumpty had a great fall.
All the King's horses and all the King's men
Couldn't put Humpty Dumpty in his place again.
'
'That last line is much too long for the poetry,' she added, almost out loud, forgetting that Humpty Dumpty would hear her.

'Don't stand chattering to yourself like that,' Humpty Dumpty said, looking at her for the first time, 'but tell me your name and your business.'

'My name is Alice, but —'

'It's a stupid name enough!' Humpty Dumpty interrupted impatiently. 'What does it mean?'

'Must a name mean something?' Alice asked doubtfully.

'Of course it must,' Humpty Dumpty said with a short laugh: 'my name means the shape I am — and a good handsome shape it is, too. With a name like yours, you might be any shape, almost.'

'Why do you sit out here all alone?' said Alice, not wishing to begin an argument.

'Why, because there's nobody with me!' cried Humpty Dumpty. 'Did you think I didn't know the answer to that? Ask another.'

'Don't you think you'd be safer down on the ground?' Alice went on, not with any idea of making another riddle, but simply in her good-natured anxiety for the queer creature. 'That wall is so very narrow!'

'What tremendously easy riddles you ask!' Humpty Dumpty growled out. 'Of course I don't think so! Why, if ever I did fall off — which there's no chance of — but if I did —' Here he pursed up his lips, and looked so solemn and grand that Alice could hardly help laughing. 'If I did fall,' he went on, 'the King has promised me — ah, you may turn pale, if you like! You didn't think I was going to say that, did you? The King has promised me — with his very own mouth — to — to —'

'To send all his horses and all his men,' Alice interrupted, rather unwisely.

'Now I declare that's too bad!' Humpty Dumpty cried, breaking into a sudden passion. 'You've been listening at doors — and behind trees — and down chimneys — or you couldn't have known it!'

'I haven't indeed!' Alice said very gently. 'It's in a book.'

'Ah, well! They may write such things in a book,' Humpty Dumpty said in a calmer tone. 'That's what you call a History of England, that is. Now, take a good look at me! I'm one that has spoken to a King, I am: mayhap you'll never see such another: and, to show you I'm not proud, you may shake hands with me!' And he grinned almost from ear to ear, as he leant forwards (and as nearly as possible fell off the wall in doing so) and offered Alice his hand. She watched him a little anxiously as she took it. 'If he smiled much more the ends of his mouth might meet behind,' she thought: 'And then I don't know what would happen to his head! I'm afraid it would come off!'

'Yes, all his horses and all his men,' Humpty Dumpty went on. 'They'd pick me up again in a minute, they would! However, this conversation is going on a little too fast: let's go back to the last remark but one.'

'I'm afraid I can't quite remember it,' Alice said, very politely.

'In that case we start afresh,' said Humpty Dumpty, 'and it's my turn to choose a subject —' ('He talks about it just as if it was a game!' thought Alice.) 'So here's a question for you. How old did you say you were?'

Alice made a short calculation, and said 'Seven years and six months.'

'Wrong!' Humpty Dumpty exclaimed triumphantly. 'You never said a word like it!'

'I thought you meant "How old are you?"' Alice explained.

'If I'd meant that, I'd have said it,' said Humpty Dumpty.

Alice didn't want to begin another argument, so she said nothing.

'Seven years and six months!' Humpty Dumpty repeated thoughtfully. 'An uncomfortable sort of age. Now if you'd asked my advice, I'd have said "Leave off at seven" — but it's too late now.'

'I never ask advice about growing,' Alice said indignantly.

'Too proud?' the other enquired.

Alice felt even more indignant at this suggestion. 'I mean,' she said, 'that one can't help growing older.'

'One can't, perhaps,' said Humpty Dumpty; 'but two can. With proper assistance, you might have left off at seven.'

'What a beautiful belt you've got on!' Alice suddenly remarked. (They had had quite enough of the subject of age, she thought: and, if they really were to take turns in choosing subjects, it was her turn now.) 'At least,' she corrected herself on second thoughts, 'a beautiful cravat, I should have said — no, a belt, I mean — I beg your pardon!' she added in dismay, for Humpty Dumpty looked thoroughly offended, and she began to wish she hadn't chosen that subject. 'If only I knew,' she thought to herself, 'which was neck and which was waist!'

Evidently Humpty Dumpty was very angry, though he said nothing for a minute or two. When he did speak again, it was in a deep growl.

'It is a — mostprovoking — thing,' he said at last, 'when a person doesn't know a cravat from a belt!'

'I know it's very ignorant of me,' Alice said, in so humble a tone that Humpty Dumpty relented.

'It's a cravat, child, and a beautiful one, as you say. It's a present from the White King and Queen. There now!'

'Is it really?' said Alice, quite pleased to find that she had chosen a good subject after all.

'They gave it me,' Humpty Dumpty continued thoughtfully as he crossed one knee over the other and clasped his hands round it, 'they gave it me — for an un-birthday present.'

'I beg your pardon?' Alice said with a puzzled air.

'I'm not offended,' said Humpty Dumpty.

'I mean, what is an un-birthday present?'

'A present given when it isn't your birthday, of course.'

Alice considered a little. 'I like birthday presents best,' she said at last.

'You don't know what you're talking about!' cried Humpty Dumpty. 'How many days are there in a year?'

'Three hundred and sixty-five,' said Alice.

'And how many birthdays have you?'

'One.'

'And if you take one from three hundred and sixty-five what remains?'

'Three hundred and sixty-four, of course.'

Humpty Dumpty looked doubtful. 'I'd rather see that done on paper,' he said.

Alice couldn't help smiling as she took out her memorandum book, and worked the sum for him:
365
    1
----
364
----
Humpty Dumpty took the book and looked at it carefully. 'That seems to be done right —' he began.

'You're holding it upside down!' Alice interrupted.

'To be sure I was!' Humpty Dumpty said gaily as she turned it round for him. 'I thought it looked a little queer. As I was saying, that seems to be done right — though I haven't time to look it over thoroughly just now — and that shows that there are three hundred and sixty-four days when you might get un-birthday presents —'

'Certainly,' said Alice.

'And only one for birthday presents, you know. There's glory for you!'

'I don't know what you mean by "glory",' Alice said.

Humpty Dumpty smiled contemptuously. 'Of course you don't — till I tell you. I meant "there's a nice knock-down argument for you!"'

'But "glory" doesn't mean "a nice knock-down argument",' Alice objected.

'When I use a word,' Humpty Dumpty said, in rather a scornful tone, 'it means just what I choose it to mean — neither more nor less.'

'The question is,' said Alice, 'whether you can make words mean so many different things.'

'The question is,' said Humpty Dumpty, 'which is to be master — that's all.'

Alice was too much puzzled to say anything; so after a minute Humpty Dumpty began again. 'They've a temper, some of them — particularly verbs: they're the proudest — adjectives you can do anything with, but not verbs — however, I can manage the whole lot of them! Impenetrability! That's what I say!'

'Would you tell me please,' said Alice, 'what that means?'

'Now you talk like a reasonable child,' said Humpty Dumpty, looking very much pleased. 'I meant by "impenetrability" that we've had enough of that subject, and it would be just as well if you'd mention what you mean to do next, as I suppose you don't mean to stop here all the rest of your life.'

'That's a great deal to make one word mean,' Alice said in a thoughtful tone.

'When I make a word do a lot of work like that,' said Humpty Dumpty, 'I always pay it extra.'

'Oh!' said Alice. She was too much puzzled to make any other remark.

'Ah, you should see 'em come round me of a Saturday night,' Humpty Dumpty went on, wagging his head gravely from side to side, 'for to get their wages, you know.'  (Alice didn't venture to ask what he paid them with; and so you see I can't tell you.)

'You seem very clever at explaining words, Sir,' said Alice. 'Would you kindly tell me the meaning of the poem called "Jabberwocky"?'

'Let's hear it,' said Humpty Dumpty. 'I can explain all the poems that ever were invented — and a good many that haven't been invented just yet.'

This sounded very hopeful, so Alice repeated the first verse:
''Twas brillig, and the slithy toves
   Did gyre and gimble in the wabe:
All mimsy were the borogoves,
   And the mome raths outgrabe.
'
'That's enough to begin with,' Humpty Dumpty interrupted: 'there are plenty of hard words there. "Brillig" means four o'clock in the afternoon — the time when you begin broiling things for dinner.'

'That'll do very well,' said Alice: 'and "slithy"?'

'Well, "slithy" means "lithe and slimy". "Lithe" is the same as "active". You see it's like a portmanteau — there are two meanings packed up into one word.'

'I see it now,' Alice remarked thoughtfully: 'and what are "toves"?'

'Well, "toves" are something like badgers — they're something like lizards — and they're something like corkscrews.'

'They must be very curious-looking creatures.'

'They are that,' said Humpty Dumpty; 'also they make their nests under sun-dials — also they live on cheese.'

'And what's to "gyre" and to "gimble"?'

'To "gyre" is to go round and round like a gyroscope. To "gimble" is to make holes like a gimlet.'

'And "the wabe" is the grass-plot round a sun-dial, I suppose?' said Alice, surprised at her own ingenuity.

'Of course it is. It's called "wabe" you know, because it goes a long way before it, and a long way behind it —'

'And a long way beyond it on each side,' Alice added.

'Exactly so. Well then, "mimsy" is "flimsy and miserable" (there's another portmanteau for you). And a "borogove" is a thin shabby-looking bird with its feathers sticking out all round — something like a live mop.'

'And then "mome raths"?' said Alice. 'I'm afraid I'm giving you a great deal of trouble.'

'Well, a "rath" is a sort of green pig: but "mome" I'm not certain about. I think it's short for "from home" — meaning that they'd lost their way, you know.'

'And what does "outgrabe" mean?'

'Well, "outgribing" is something between bellowing and whistling, with a kind of sneeze in the middle: however, you'll hear it done, maybe — down in the wood yonder — and, when you've once heard it, you'll be quite content. Who's been repeating all that hard stuff to you?'

'I read it in a book,' said Alice. 'But I had some poetry repeated to me much easier than that, by — Tweedledee, I think.'

'As to poetry, you know,' said Humpty Dumpty, stretching out one of his great hands, 'I can repeat poetry as well as other folk, if it comes to that —'

'Oh, it needn't come to that!' Alice hastily said, hoping to keep him from beginning.

'The piece I'm going to repeat,' he went on without noticing her remark, 'was written entirely for your amusement.'

Alice felt that in that case she really ought to listen to it; so she sat down, and said 'Thank you' rather sadly,
'In winter, when the fields are white,
I sing this song for your delight —
only I don't sing it,' he added, as an explanation.

'I see you don't,' said Alice.

'If you can see whether I'm singing or not, you've sharper eyes than most,' Humpty Dumpty remarked severely. Alice was silent.
'In spring, when woods are getting green,
I'll try and tell you what I mean:
'Thank you very much,' said Alice.
'In summer, when the days are long,
Perhaps you'll understand the song:
In autumn, when the leaves are brown,
Take pen and ink, and write it down.'

'I will, if I can remember it so long,' said Alice.

'You needn't go on making remarks like that,' Humpty Dumpty said: 'they're not sensible, and they put me out.'
'I sent a message to the fish:
I told them "This is what I wish."
The little fishes of the sea,
They sent an answer back to me.
The little fishes' answer was
"We cannot do it, Sir, because —"'
'I'm afraid I don't quite understand,' said Alice.

'It gets easier further on,' Humpty Dumpty replied.
'I sent to them again to say
"It will be better to obey."
The fishes answered, with a grin,
"Why, what a temper you are in!"
I told them once, I told them twice:
They would not listen to advice.
I took a kettle large and new,
Fit for the deed I had to do.
My heart went hop, my heart went thump:
I filled the kettle at the pump.
Then some one came to me and said
"The little fishes are in bed."
I said to him, I said it plain,
"Then you must wake them up again."
I said it very loud and clear:
I went and shouted in his ear.'
Humpty Dumpty raised his voice almost to a scream as he repeated this verse, and Alice thought with a shudder, 'I wouldn't have been the messenger for anything!'

'But he was very stiff and proud:
He said, "You needn't shout so loud!"
And he was very proud and stiff:
He said "I'd go and wake them, if —"
I took a corkscrew from the shelf:
I went to wake them up myself.
And when I found the door was locked,
I pulled and pushed and kicked and knocked.
And when I found the door was shut,
I tried to turn the handle, but—'
There was a long pause.

'Is that all?' Alice timidly asked.

'That's all,' said Humpty Dumpty. 'Good-bye.'

This was rather sudden, Alice thought: but, after such a very strong hint that she ought to be going, she felt that it would hardly be civil to stay. So she got up, and held out her hand. 'Good-bye, till we meet again!' she said as cheerfully as she could.

'I shouldn't know you again if we did meet,' Humpty Dumpty replied in a discontented tone, giving her one of his fingers to shake: 'you're so exactly like other people.'

'The face is what one goes by, generally,' Alice remarked in a thoughtful tone.

'That's just what I complain of,' said Humpty Dumpty. 'Your face is the same as everybody has — the two eyes, so —' (marking their places in the air with his thumb) 'nose in the middle, mouth under. It's always the same. Now if you had the two eyes on the same side of the nose, for instance — or the mouth at the top — that would be some help.'

'It wouldn't look nice,' Alice objected. But Humpty Dumpty only shut his eyes, and said 'Wait till you've tried.'

Alice waited a minute to see if he would speak again, but, as he never opened his eyes or took any further notice of her, she said 'Good-bye!' once more, and, getting no answer to this, she quietly walked away: but she couldn't help saying to herself, as she went, 'of all the unsatisfactory —' (she repeated this aloud, as it was a great comfort to have such a long word to say) 'of all the unsatisfactory people I ever met —' She never finished the sentence, for at this moment a heavy crash shook the forest from end to end.

Friday, June 21, 2013

Coronary Artery Bypass Grafting

CABG procedure in progress

CABG is a medical acronym that stands for Coronary Artery Bypass Grafting

I have been reviewing my blog posts, and realized that there is a big hole in my blog entries, starting about October 2011 and going forward for about a year.  Sorta like the big hole in my chest that appeared just about that time.

One of the excuses I offer for my lapse is that I had a timeout for a heart attack and bypass surgery.  In medical parlance, they refer to it as "myocardial infarction".  To me it was just plain ol hurtin.

I had the acute heart attack episode in September 2011.  I came home from work that day feeling rather tired, so I tried to lay down and take a nap.  But I had a persistent sharp chest pain, and was having difficulty breathing while laying down.  I had little inkling of just what was developing inside my body, but since laying down proved too uncomfortable, I went to the family room to sit in the big cushy recliner and watch TV.

I live with my mom, but she had been gone on an extended shopping trip since that morning, so I was home alone.  I got more uncomfortable as time went on, but still had no suspicion that I was experiencing a heart attack.


Finally my mom came home late in the afternoon.  She had been experiencing frustrations of her own, with shopping crowds, road construction, her car running out of gas, preparing a meal for a Relief Society assignment for some families in the ward, and a host of other annoyances and inconveniences.   She started telling all about it, while she put Papa Murphy's pizzas into the oven.  She had been planning to fix casserole for the other families, but ran short of time and decided to do quick Take 'N' Bake pizzas instead.


I sat on the couch, immersed in a haze of pain, not paying much attention to her recounting of the challenges of her day.  When the first batch of pizzas were cooked, she left to deliver them, after putting in some to bake for us.

By the time she returned, the pain had increased to an alarming level, though during earlier episodes with health problems I have endured much higher pain levels.   I just didn't understand what was happening.

We sat down together to eat pepperoni pizza, and I was thinking I might feel a little better after I ate something.  So I had a couple of slices of pizza.

After we had dinner, I returned to the recliner.  Eating dinner didn't help.  I got to hurting so bad, I felt like I just wanted to go off to bed, and sleep it off.  But I got in some kind of surreal argument with my mom as I attempted to head off, and finally confessed to her just how awful I was feeling.  She wouldn't let me just go to bed, but insisted that I needed some emergency medical attention, and it turns out she was right.

Dammit, she's ALWAYS right!  Why do I even bother to argue?

Anyway I donned my footwear and she drove me to the hospital emergency room at Utah Valley Regional Medical Center.  I was unhappy to be heading there for yet another hospital adventure, but it hurt me so bad, I didn't argue.

Checking in at the ER

When we arrived, the ER attendant quickly wheeled me in to an exam room, and the doctors and nurses began their probing and prodding and inquisition.  One hitch that I encounter with every doctor visit these days is how I should answer their question about pain.

Numeric Pain Rating Scale

Medical people all ask the same question to evaluate patients experiencing pain.  "On a scale of 1 to 10, how would you rate your pain level, with zero being no pain, and ten being the worst pain imaginable."

Okay, that's clear enough to understand.  My problem is, how to frame my response, because I have in the past experienced a nightmarish raving screaming in pain, such intolerable pain that I was more than willing to die right then to have it stop, bouts of pain that would rise to a crescendo, until finally it would cause me to pass out.  So I can imagine quite a lot.  My past experience kinda tends to make the pain rating scale irrelevant.

The compromise I have arrived at for such situations, which have been all too frequent lately, is generally to report a pain rating level of 7.  I know from experience that this is the level medical professionals consider to justify some kind of medication as intervention for pain relief.

They finally gave me a big shot of morphine, and immediately I was breathing much easier.  Pain drugs are so wonderful!

As they worked on me in the ER, my mom had phoned my sister Cindy, and she came right away with her husband Carl to the hospital.  That was another routine that had become far too routine, but Carl and his son administered a priesthood blessing, which is always a comfort to me in times of distress.

Quite some time passed.  Then the ER doctor made an extended presentation of what they knew so far.  He explained that test results were somewhat ambiguous, indications from blood testing were that I'd had a significant myocardial infarction, but the chest x-rays also indicated some pericarditus.


During a heart attack, heart muscle cells die and release certain proteins into the bloodstream.  The blood tests showed this, but there were other possible explanations for my symptoms.

After some medical deliberation, the doctors brought in the heart specialist.  He recommended that they perform a coronary angiogram, which helps them map blood circulation to the heart,  and allows them to perform angioplasty, and to emplace a coronary stent where they judge it is warranted, to help open blocked arteries.

Soon they wheeled me into the pre-op room, where they prepared me for the catheterization lab.  The guy that was prepping me injected me with something, and I don't remember anything after that for what seemed like a long blackness.

I don't know exactly what they saw in the cath lab, but next thing I knew, I was back in pre-op being prepped for the CABG operation.

Those moments are pretty fuzzy to recollect.  I heard people saying things around me, but they seemed to be very far away, and it was much too difficult to respond.  What I remember mostly is people offering reassurance and encouragement, but I wasn't sure why.  I still didn't realize what was happening.

After that I remember going into the operating room, transferring from the gurney onto a narrow table, laying on my back.  All kinds of people bustling around in surgical gowns with gloves.  Then someone put a mask on my face, and told me to start taking some deep breaths.  That's the last awareness I had for what seemed like a long time.

Apparently, while I was unconscious, the doctors had decided that the angiogram results indicated that there were too many severe arterial blocks to correct with angioplasty and stents.  Facing the possibility of my immanent demise, my mom gave the go-ahead for the doctors to perform the CABG surgery.  The cardiac surgeon apparently told my mom it was lucky for me that she brought me into the ER, instead of letting me just go to bed as I had wanted, because I would not have survived the night with the current condition of my heart.

Heart during CABG procedure
The surgery involved cutting a long incision down the center of my chest.  Apparently then they saw apart the ribs, and use an instrument called a rib-spreader to force apart the rib cage and expose the chest cavity and the still-active heart.

The surgical team

The CABG procedure apparently employs quite a team of doctors and nurses gathered around the exposed heart.  Before they put me under the anesthetic, I noticed a pretty big crowd of people were in the OR.  Everyone is wearing a surgical mask, so even if I knew anyone, I would probably not have recognized them.  I guess some of them mighta just been curious spectators, or even space aliens just dropping in for a visit from another planet, I honestly dunno.

Heart-lung machine

To get the CABG started, the heart is prepared for attachment of the cardio-pulmonary bypass machine, which during the surgical bypass procedure, replaces the normal functioning of the patient's heart and lungs, hopefully temporarily.  Plastic tubes carry blood from the heart to the machine and back.  While passing through the machine, transported by mechanical pump, the blood is oxygenated and returned to the body.

At this point the surgeon administers a cardioplegic agent, which paralyzes the heart muscle and stops the heart from beating, just as in death.   The patient is effectively being kept alive by temporary artificial cardiovascular perfusion.

Prior to the opening of the chest cavity, another team is involved in harvesting veins from the leg or arm to use to bypass blocked coronary arteries.  In my case, the blood vessels to be used in bypass grafts were extracted from my right leg, typically using the "great saphenous vein".  Apparently they utilized some type of endoscopic technique - I'm not certain, but there is no incision scar on my leg.



During the procedure, the cardiac surgeon performed seven bypass grafts on my heart.  That seems like an unusually high number to me - I've heard of double, triple, quadruple bypasses before, but I never heard of seven.  I guess they had plenty of grafting material, so why not go for it?   Maybe I'm just lucky to still be alive.  They don't even seem to have a term in medical jargon for a seven-artery bypass.

So the surgery took about 8 hours of the surgical team working on me.   Obviously they went to a great deal of trouble in my behalf.  My heart was not beating for much of that time, which is difficult for me to imagine.  Perhaps it is fortunate for me that I don't remember any part of it.  But in any case, they performed the CABG, got my heart beating once again, and closed up that huge gaping incision in my chest.

Shocking the heart to stimulate heartbeat
Next thing I knew, I was waking up some time in the afternoon of the following day, in the  cardiac intensive care unit at the hospital, there was a big incision wound sutured down my chest, wires and tubes trailing out of it, with attachments to all manner of devices that I could not really see.  I could hear them, though - beeping and ringing and vacuuming me right on cue, as if to reassure the attendants that I was still alive.

Actually the first shock to me was to realize that I WAS STILL ALIVE!  I think I had prepared myself for dying, but being kept alive hooked to a bunch of machines, seemed like much more than I was ready to accept.

I recall very little about the first few days.  One memory of the attendant assisting me to sit up in the bed.  With help, I swung my legs out of the bed, and just about the time my feet were touching the floor, everything suddenly went black again.  I heard someone saying something like, "He's passing out!", and don't remember what happened after that.  I guess I woke up a bit later.

I was several days in the cardiac intensive care, then they moved me to a bigger room somewhere else in the hospital, I don't really know where.  During that period, I got physical therapy from a whole cadre of people, I don't remember much about.  They encouraged me to stand up, and eventually to walk around the ward, it you could call it walking.  I was also coached about breathing exercises by the cardiologist and a host of others I don't remember too well.

They seemed to have a lot of interest in my capacity for continued breathing.
Apparently that is one factor they encounter lots of complications with in cardiac care.  They gave me a little plastic gadget for measuring my breathing capacity, and I was supposed to exercise with it regularly.  I did the breathing exercises, but I could never tell that it made all that much difference.



A number of people visited while I was there, many of whom I don't recall.  Several notable visits including Dr. Kennedy, my family doctor.   Two ladies from Ability First, where I had been working.  My cousin Randy.  People from my ward.  Several of my sisters.  And of course, my mom.

One of the grossest things in all of this nightmare experience - at least, that I was conscious for - was when I was getting ready to check out from UVRMC.  The whole time I was there, I had a number of "things" attached to me, among other pleasantries, several big plastic tubes trailing out of my chest leading off to some kind of suction pumps.  I guess the object was to remove any excess blood that accumulated in my body's various cavities as a result of the surgical wounds.


When the time came, they just yanked them out, rather unceremoniously, from my perspective.  It was quite horrifying to me, watching these big plastic tubes come slithering out of my body.  I was afraid I would come apart at the seams or something, and all my guts come spilling out across the bed.  Over the next few months I had the uneasy feeling that if I sneezed too hard, or happened to be too roughly jostled, my chest would open up and everything would gush out on the floor.  To make it worse, medical authorities routinely warn those who have had their chest surgically opened to be careful about heavy lifting and reaching overhead. 


Of course the biggest relief of all was having that damned Foley catheter removed.  It never is comfortable to have that thing jammed up one of the most sensitive parts of the body.  I was not capable of urinating by myself for a while, so I guess it was necessary.  But what tortuous hospital appliance could be more undignified, I cannot imagine. 

So after my time in the hospital, they got tired of me, and sent me across the street to a rehab place.   They delivered me in an ambulance, to ride across the street.  How exciting.   I was at the rehab and nursing care center for several fairly uneventful months before they finally sent me home.

Several other issues related to the CABG procedure have come to my attention since I had the surgery.  I believe they are of general interest to anyone involved in such an operation.


My older brother had an artificial heart valve implanted in a similar procedure, and he expressed concern about one of the side-effects popularly referred to as "pump-head", or in medical parlance, postperfusion syndrome.  The syndrome is rather controversial, and is provisionally characterized by a wide array of neurological deficits that are manifested following surgery that involves perfusion.  Medical authorities theorize the syndrome may be caused by tiny debris and air bubbles (microemboli) that enter the brain via the action of the heart-lung bypass machine.  Scientific research has returned contradictory findings.

Am I any more stupid than I was before the surgery?  I don't really know.  There is no objective method for me to assess my own cognitive functions, other than those that use those very functions.  I have no way to distinguish between neurological defits resulting from my strokes and other medical issues and the CABG surgery.   It becomes a sort of recursive question, one that seems to be of much particular interest to no one but myself.
Another standing question from the CABG procedure relates to how the surgery affects people, particularly in ways other than the most obvious.  A number of scientific studies indicate that postop outcomes directly affect many quality-of-life issues.


One of the relative measures of success for post-CABG is referred to as "graft patency".  It expresses coronary circulation in grafted veins, as a percentage of optimum.  CABG veins go through the same occlusion processes that the original arteries are subject to, and the general projection estimates an average of five years of life from the grafted veins.  Then it is expected that CABG recipients who have survived that long will undergo another CABG procedure to replace the old grafts.


In further medical episodes that have been staged in more recent times, I have experienced chest pains and breathing difficulty, with lots of rather disturbing irregular heartbeats.  There have been doctor visits to all kinds of specialists, and not a few trips to the ER.

Most recently I consulted with a cardiologist, and though the outcome of the session was as unsatisfying to me as most other doctor visits, among other things he recommended that I have a cardiac stress test.


He prescribed for me to start taking a very commonly used diuretic, Lasix or generic furosemide, even though I protested that I had tried diuretics before, and the side-effects for me were intolerable.  The good doctor seemed not to hear me.  After trying the drug for one day, and spending most of the subsequent night in the bathroom, I decline to take any more of the stuff.

The cardiologist had also prescribed an additional drug which I never obtained, since the pharmacist informed me, when I requested the prescription, medical insurance would not cover the cost of that drug, therefore decided I really didn't need the drug that the doctor had prescribed all that much.  Another instance of health insurance informing my need for health care.  The last time such a thing happened, I was scheduled by my doctor to get a cardiac stress test, and the insurance company declined to authorize it, because they decided I didn't need it.  By coincidence, the very next day after the test had been scheduled, I had the heart attack. 

I submitted myself to the stress test this time, admittedly without much joy, and went back to the cardiologist a few days later to hear the interpretation of the results.


The only really interesting thing was the nuclear reagent Thallium, which they carried into the room enclosed in a small lead-lined flask.  Then they injected the stuff into ME!  I guess I was glowing in the dark for a while.  It was an amusing picture to imagine, anyway.



Subsequent meeting with the cardiologist was a rather interesting session, more informative than most doctor visits prove to be, perhaps because the cardiologist was accompanied by some kind of apparent doctor-in-training, who listened to his narrative and took copious notes.  The doctor addressed many of his observations to her, but I listened intently.  I did not internalize all of his characterization of the test results, but caught several references that seemed important.

He mentioned one metric they call "ejection fraction", and indicated that mine is less than 40%, which I understand is not good news for me.


He used the term "congestive heart failure" in the particular context of the problems I have been having with edema in my feet, more pronounced in the right foot.  He categorized the edema as "grade 4" in severity, which is the most severe.  He offered the rather obvious observation that circulatory impairment was naturally more pronounced in my right leg, because surgeons had removed a portion of the right saphenous vein in the CABG procedure for graft material.  None of the other doctors prior had ever suggested such an obvious and clear reason for the right leg swelling.  Believe me, I had asked plenty.

He said he was not anxious for me to have another coronary angiogram, even though I was continuing to experience severe chest pain.  I expressed my reluctance also, but perhaps for reasons somewhat different than his.

Anyway, the immediate outcome was that he prescribed a proton pump inhibitor, on the off chance that my chest pain was just a bad case of heartburn manifesting itself.  I've been taking it twice a day, and cannot discern any significant effect, particularly in the incidence of chest pain and irregular heart rhythm.  He scheduled a follow-up for a month later.  We'll see what future developments will follow.

Next instalment:  Everybody Dies

Thursday, June 20, 2013

Obedience



Some have the mistaken idea that the commandments of God constrict freedom and personal growth.  Not so.  God gives commandments for our benefit. They are loving instructions for our happiness and for our physical and spiritual well-being.


Jesus counselled his disciples to be obedient:
And why call ye me, Lord, Lord, and do not the things which I say?  (Luke 6:46)
If ye love me, keep my commandments. (John 14:15)
If ye keep my commandments, ye shall abide in my love; even as I have kept my Father's commandments, and abide in his love. (John 15:10)
Joseph Smith taught about obedience:
There is a law, irrevocably decreed in heaven before the foundations of this world, upon which all blessings are predicated—and when we obtain any blessing from God, it is by obedience to that law upon which it is predicated. (Doctrine and Covenants 130:20-21)


In a recent conference address, President Monson taught:
A knowledge of truth and the answers to our greatest questions come to us as we are obedient to the commandments of God. (President Thomas S. Monson, Obedience Brings Blessings)


President Uchtdorf counsels to be aware of the beautiful blessings that blossom and grow out of obedience:
Let us not walk the path of discipleship with our eyes on the ground, thinking only of the tasks and obligations before us. Let us not walk unaware of the beauty of the glorious earthly and spiritual landscapes that surround us.
The “what” and “how” of obedience mark the way and keep us on the right path. The “why” of obedience sanctifies our actions, transforming the mundane into the majestic. It magnifies our small acts of obedience into holy acts of consecration. (President Dieter F. Uchtdorf, Forget Me Not)

This illustration of the cycle of obedience models the result of observing the commandments of God.   Obedience brings blessings to us, which makes us happier and motivates further obedience.


Despite the popular confusion of this idea, there has never been the slightest ambiguity.  Obedience is always positive.  God has never commanded us to disobey any of his commandments.


Cecil B. DeMille, producer of the epic The Ten Commandments, dramatizing the life of Moses the Lawgiver, spoke at a BYU commencement in 1957.  He made these observations:
We are too inclined to think of law as something merely restrictive—something hemming us in.  We sometimes think of law as the opposite of liberty.  But that is a false conception. That is not the way that God’s inspired prophets and lawgivers looked upon the law. Law has a twofold purpose.  It is meant to govern and it is also meant to educate...
 ...We cannot break the Ten Commandments.  We can only break ourselves against them—or else, by keeping them, rise through them to the fullness of freedom under God.  God means us to be free. With divine daring, He gave us the power of choice.  (Cecil B. DeMille, BYU Commencement Address)

Jesus taught his disciples, "If ye love me, keep my commandments."(John 14:15)
During the Last Supper, Jesus Christ taught His disciples how they could show their love for Him.


We manifest our love for the Lord by keeping His commandments.

Monday, June 17, 2013

Divine Love


In the February 2003 Ensign, Elder Russel M. Nelson presents an exposition on "Divine Love".

In the article, Elder Nelson explains the nature of divine love, a frequently misunderstood and mistakenly characterized idea.  "While divine love can be called perfect, infinite, enduring, and universal, it cannot correctly be characterized as unconditional."

  He offers unambiguous scriptural references to conditional promises that the Lord has offered through time.   The nature of divine conditional love is expressed in specific language that characterizes such scriptures.
It is equally evident that certain blessings come from a loving Lord only if required conditions are met. Examples include:
If thou wilt walk in my ways, to keep my statutes and my commandments, … then I will lengthen thy days. (1 Kings 3:14)
If thou wilt walk in my statutes, and execute my judgments, and keep all my commandments … ; then will I perform my word with thee.” (1 Kings 6:12)
“I, the Lord, am bound when ye do what I say; but when ye do not what I say, ye have no promise.” (Doctrine and Covenants 82:10)
“When we obtain any blessing from God, it is by obedience to that law upon which it is predicated.” (Doctrine and Covenants 130:21)
“Unto every kingdom is given a law; and unto every law there are certain bounds also and conditions.” (Doctrine and Covenants 88:38)
Elder Nelson explains, "Understanding that divine love and blessings are not truly “unconditional” can defend us against common fallacies..."
“Since God’s love is unconditional, He will love me regardless …”; or 
“Since ‘God is love,’  He will love me unconditionally, regardless …”
These are popular ideas today, but they are as mistaken as the false teachings of Nehor in the Book of Mormon, 
...he also testified unto the people that all mankind should be saved at the last day, and that they need not fear nor tremble, but that they might lift up their heads and rejoice; for the Lord had created all men, and had also redeemed all men; and, in the end, all men should have eternal life. (Alma 1:4)
Does this mean that Jesus has no love for unbelievers and sinners?  No, it means that the Lord gives us our agency, and we choose the extent to which we receive the Lord's blessings.

Elder Nelson quotes from Brigham Young:
“Every blessing the Lord proffers to his people is on conditions. These conditions are: ‘Obey my law, keep my commandments, walk in my ordinances, observe my statutes, love mercy, … keep yourselves pure in the law, and then you are entitled to these blessings, and not until then.’” (Discourses of Brigham Young, sel. John A. Widtsoe (1954), 454)
Jesus asked us to love one another as He has loved us.  The pure love of Christ is granted to all who seek and qualify for it.   Such love requires our obedience to the conditions and laws upon which it is based.