RERUN Brutal Discrimination: No Electric Wheel Chair For You, Audrey Peterson! Herein, only one more prime example of cold hearted mistreatment and related patient abuse at the Arizona State Hospital.

Americans with Disabilities Act of 1990

Full title	An Act to establish a clear and comprehensive prohibition of discrimination on the basis of disability

ORIGINALLY PUBLISHED IN JULY, 2012, THIS IS A FOURTH PUBLICATION OF THE DETAILS UNDERLYING THE ABOVE ISSUE. WHEREIN, A SEVERELY PHYSICALLY DISABLED PATIENT AT THE ARIZONA STATE HOSPITAL HAS BEEN DENIED HER FUNDAMENTAL RIGHT TO ACQUIRE CONTEMPORARY TECHNOLOGICAL DEVICES THAT WOULD GREATLY IMPROVE HER QUALITY OF LIFE IN THAT SPECIFIC CONTEXT. TECHNOLOGY THAT AS PER ESTABLISHED LAW, ALL AMERICANS HAVE ACCESS TO, IN KEEPING WITH A COMMON UNDERSTANDING OF HOW BENEFICIAL SUCH RESOURCES ARE TO THE WELL BEING OF ANYBODY AFFECTED BY PHYSICAL DISABILITY IN ANY CONTEXT- UNLESS, THAT IS, YOU HAPPEN TO BE AN AMERICAN UNDERGOING MENTAL  HEALTH "CARE" AT THE ARIZONA STATE HOSPITAL. AS ILLUSTRATED BELOW, THIS PATIENT'S PRIMARY ATTENDING PHYSICIAN, DR. RUBY RAMOS-ROXAS, WILLFULLY BLOCKED HER- A WOMAN WITH NO LOWER LEGS AND ONLY ONE ARM- RIGHTFUL ACCESS TO AN ELECTRONICALLY POWERED WHEELCHAIR, IN BRAZEN DEFIANCE OF THE FACT THAT SUCH A DEVICE HAD BEEN OFFERED TO THE PATIENT BY ONE OR MORE PUBLIC INTEREST RESOURCES DEDICATED TO PROVIDING SUCH PERSONS WITH TECHNOLOGY OF THIS KIND. TO DATE, I HAVE NO REASON TO BELIEVE THAT THIS SITUATION HAS CHANGED, AND NOW THAT HEIGHTENED ATTENTION IS BEING DIRECTED TO MY WRITING, I AM AGAIN GOING TO DO WHAT I CAN TO SEE THAT THIS ATROCIOUSLY INHUMANE ISSUE BE MEANINGFULLY ADDRESSED. 

ADDITIONALLY, EVEN IF THIS MATTER HAS BEEN ADDRESSED SOMETIME IN THE LAST 6 MONTHS, WHEREBY THE PATIENT IN QUESTION  HAS IN FACT BEEN GRANTED DIRECT ACCESS TO THIS TECHNOLOGY TO THE FULLEST EXTENT POSSIBLE AS PER THE APPLICABLE LAW,  I BELIEVE THAT IT IS ONLY BECAUSE OF MY HAVING REPORTED THE ISSUE IN THIS BLOG, WHICH HAS NOTHING TO DO- IN FACT- WITH THIS PARTICULAR PHYSICIAN'S UNLAWFUL VIOLATION OF THE PATIENT'S RIGHTS FOR A PERIOD OF AT LEAST 8 YEARS (PRIOR TO MY RECENT REPORTING OF THE ISSUE IN THIS BLOG). WHICH IS TO SAY THAT THIS MATTER WILL NOT BE RESOLVED UNTIL DR. RUBY RAMOS-ROXAS HAS BEEN HELD FULLY ACCOUNTABLE AS PER EACH AND EVERY APPLICABLE LAW, MEDICAL STANDARD, AND SO ON.

As per my knowing that this issue is in critical need of being meaningfully addressed, I am willing to state my express desire that Dr. Ruby Ramos-Roxas be stripped of her medical license, for never have I witnessed so graphically inhumane treatment of a medical patient; and in the context of so unconscionable an action, nothing short of such a penalty will protect Arizona's citizens as whole. As pointed out in other articles in this context, I have very real concern about the fact that some of ASH's senior psychiatric staff acquired training in foreign nations where human rights and the most basic precepts of America's democratic values are literally non-existent, and no one psychiatrist at ASH more falls under this concern then Dr. Ruby Ramos-Roxas, who came to America in the 1970s from her native nation of the Phillipines, which is where she was educated and originally received her medical license. While a number of possibilities may apply to this particular native Filipino's personal history, I feel safe in assuming that Ramos-Roxas emerged out of a distinctly brutal ruling class during the Marcos era and martial law (1965-1986), for only the wealthiest citizens of the Philippines have the requisite access and opportunity to acquire the level advanced education that she possesses as a medical doctor. She was both raised as well as educated in the Philippines, which as any reasonably informed person knows reflects a cultural setting where some of the most horrific abuses of human rights occurs, even today. And her actual dual defined surname, Ramos-Roxas, has direct connection to two former Filipino presidents (Manuel Roxas, 1946-4848; Fidel V. Ramos 1992–98- both of whom are now known to have overseen deeply corrupt administrations); suggesting, as such, that Dr. Ruby Ramos-Roxas  personal legacy stems from monarchial  government at best, or outright  dictatorship at worst. It is on this basis that I suspect she primarily relocated to the United States in order to avoid being faced with some or another form of dissent and civil unrest that may well have arisen due to her family's legacy, and other like challenges facing her in her own native society (she acquired her advanced degree and then ran away, in other words, rather than dedicating herself to reform on behalf of her countrymen, a pattern that is readily evident in virtually any nation sharing the horrific abuses of power that the Philippines is known for). And I will just say that, as an American, I am 100% on board with granting regulated entry to immigrants who have proven a critical need to escape regions of the world where they (such persons) cannot safely reside, or in relation to certain another like needs. But I am also aware that in many cases on the international front, many persons claiming the need to escape, as such, do so due to the fact that in their home nations, they were directly involved in past atrocities (as with Nazis who fled to Brazil in the 1940s). The Philippines as a country most definitely shares this specific historical characteristic, as illustrated in the 2008 documentary film, Beyond Conspiracy: 25 Years After the Aquino Assassination (produced By the Foundation for Worldwide People Power, Butch Nolasco director), and other like sources. With this example in mind, I suggest the distinct possibility that these aspects of recognized world history and related sociological factors have everything to do with grossly unethical conduct exercised by a majority of ASH's senior staff, including a majority of senior psychiatric staff, such as Dr. Ruby Ramos-Roxas, Dr. Pervaiz Akhter (Pakistan), Dr. Laxman Patel (India), and Dr. Sylvia Dy (Philippines).

BACKGROUND: For a period of no less than 8-9 years, the senior clinical staff at the Arizona State Hospital have denied a physically disabled woman with no lower legs and only one arm access to an electric wheel chair; this patient is also affected by serious mental illness, and disabled as such in that context, but her physical disability is not one that ASH staff have any right whatsoever to ignore, manipulate the status of, or otherwise engage in denying the patient access to technology specific to her physical disability.  Not only does this amount to an egregious restriction of this patient's fundamental rights in the broadest of senses, it is critical to realize, as well, that there on the ASH grounds, Ms. Peterson's very real lack of mobility virtually rules out her chance(s) to attend any variety of day to day activities at ASH, including in the context of critical psychotherapy and related occupational therapy activities, and so on.  I contend that this grossly inhumane case has everything to do with the fact that at ASH, foreign trained psychiatrists who come from some of the most corrupt third world nations in existence today have inordinate control over the lives and affairs of all ASH patients,  and through that control, subject ASH's seriously mentally ill and disabled and patients to blatantly unlawful standards of care and treatment that fly in the face of common understandings of American democracy and international human rights. 

In the context of the Americans With Disabilities Act, Audrey Peterson's rights as a person affected by severe physical disability supersede the authority of any one person or representative staff at ASH. Bottom line.

Call ASH today (602)244-1331 and demand that Audrey Peterson be granted her full rights as a human being. Or better yet, share your awareness of this story with these guys. And be sure to mention the Americans Disabilities Act.

 

U.S. Department of Justice
Civil Rights Division

950 Pennsylvania Avenue

Office of the Assistant Attorney General, Main

Washington, DC 20530

ACTING ASSISTANT ATTORNEY GENERAL

Jocelyn Samuels

Civil Rights Division (202) 514-4609

CENTRALLY INVOLVED ASH STAFF INCLUDE: DR. RUBY RAMOS-ROXAS, FORMER CHIEF MEDICAL OFFICER DR. STEVEN DINGLE, AND SENIOR SOCIAL SERVICES REPRESENTATIVES.

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Discussion

Americans with Disabilities Act of 1990

Full title	An Act to establish a clear and comprehensive prohibition of discrimination on the basis of disability

      
     So, here is a quick tale about one of the most horrifically disturbing things I experienced at the Arizona State Hospital (ASH), with added consideration that may very well relate to my sociological theories in this context. I had been hospitalized at ASH for maybe 2-3 weeks, when in early February, 2011, I met a very nice woman named Audrey Peterson, who has been wheelchair bound since losing both of her legs and one arm in a near fatal train accident just NW of Tucson, AZ, around 9-10 years ago. Audrey can be seen pretty regularly outside on the patient mall, struggling to push herself around in a mechanical wheelchair with her one only arm, often unable to keep the thing on the paved sections mall sidewalks, and in the worst case scenario, sprawled in the dirt when her chair capsizes. Without a doubt, in terms of how unkindly some people treat others, the denial of her being granted an electronic wheelchair is one of the saddest things I have ever witnessed in my entire life. And there it is, smack dab in the heart of a medical facility (!), of all places. I know that I'm not the only one who feels this issue exceeds my capacities as a moral being, but such is the reality at The Arizona State Hospital, where anyone of reasonable conscience will notice a one armed woman (that's it, the one limb out of four)laboring away in a mechanical wheelchair, literally inching her way up and down the 1/4 mile long outside mall area- which is only partially paved- while able bodied staff and patients virtually blow by her at a full walking pace as though the woman doesn't even exist. 

In this undeniably shocking context, and on the basis of the fact that Ms. Peterson's mobility has been willfully restricted in defiance of applicable state and federal law, I attest to the fact that Audrey Peterson has, and until I hear otherwise, is still being criminally denied reasonable access to the vast majority of therapeutic and recreational resources available to other patients at ASH, subject as such to gross humiliation that cuts to the core of her fundamental human right to dignity, comfort, and well being. Peterson's mobility has been willfully restricted in defiance of applicable state and federal law, and not only has her primary attending psychiatrist willfully engaged in creating this situation, I further contend that all licensed physicians share the required obligation to report any clear violations of federal law specific to health care, thus extending the implications of this issue to to all/any licensed medical staff aware of Audrey Peterson's very presence at ASH. Herein, just one more undeniably clear illustration of how grossly substandard the conditions at ASH are, across the board. 

                                                
SPECIFICS: 

     I  first met Audrey Peterson at one of the outdoor patio tables on the patient mall within 5-7 days of my early January, 2011, arrival to the civil section of The Arizona State Hospital. It was an astounding introduction, in no small part due the the sickeningly pitiful sight of a woman with only one arm and no lower legs in a wheelchair that requires two arms to operate (!). Audrey is a very polite, lucid, and reasonably rational patient, in my experience; and after basic niceties, we got around to asking each other somewhat inevitable questions regarding what led us to be hospitalized at ASH. As it turned out, we both had a history of depression and potentially lethal attempts at suicide. (I will just note that in this sense, Audrey and I were able to find solace in coming to know one another, and that is something I still appreciate today.) 
     Audrey went on to describe the fact that, in 2003, after drinking an excess of alcohol, she had purposefully lain her body down on top of a major railroad track on the outskirts of NW Tucson, where she fell into a deep sleep, following which a train had run over both of her legs and one of her arms. Any narrative possessing drama of this sort is bound to catch anyone's attention, and in this specific case, somewhat begs the question: 
     How in the heck anyone could possibly survive an accident of this magnitude. 
     And for this very reason, as we continued talking, it occurred to me that I actually recalled Audrey's story when it was reported in Tucson area newspapers. It only earned a short mention in that report, but it was there, the news that a person had been run over by a train, and yet somehow survived, and was at that that in critical care at a local Tucson hospital. As we talked that  day in 2011, my mind was drawn to the very day I read that shocking story; and when we did in fact meet in 2011, I was deeply moved by coming to meet this woman at the time, whose near death had very much caught my attention at the time it occurred (2003), both due to the drama of the tale, as well in the context of my own experiences specific to suicidal ideation and related behavioral characteristics. Profound in all terms, and one of my earliest experiences during my 13 full months of time as a patient at The Arizona State Hospital. 

       I recall thinking: "Oh my god... She survived something like that, this person, who had chosen death over life, only to find herself left permanently maimed, yet still alive…"

       I believe that it was in our initial conversation that I went on to ask Audrey Peterson how in the hell it could be that she didn't have an electric wheel chair, and she told me:
 "My doctor won't allow me to have one."
      I was so shocked to hear this addendum to her already tragic tale, that I found the claim audacious, and it is still somewhat beyond my sensibility and relative comprehension; it so shocked my sense of humanity at the time that I was initially unable to respond, in part because I simply could not believe what I was hearing. In order to clarify, I will just say that there are bound to be any number of goof-ball stories floating around a place like ASH (and I did hear my fair share of such), some of which are clearly far out of touch with reality (needless to say). So I initially took Audrey's statements with an inevitable grain of salt. But as I have already stated, she did not seem to display much in the way of deceitful character or any other like shortcoming, which left me perplexed, to say the least. But the bottom line at the time is as follows:
     No matter what the factual details happened to be in terms of her claim, "My doctor won't allow me to have one", I saw no reason at all for Audrey Peterson to be sitting there in front of me, with her one arm and no lower legs, in a mechanical wheelchair requiring two arms to operate,  
      I asked Audrey if she had, in her own right, ever looked into getting an electric wheel chair, and she told me while the topic had indeed come up in her flow of treatment at ASH to that point, she had never actively sought access to such technology, and that she wouldn't know where to go in that context, even if Dr. Ruby Ramos-Roxas was willing to allow her such a resource. This basic introduction to Audrey's predicament compelled me enough that I decided to see what I could come up with, despite whatever relative skepticism I had at the time. I saw nothing to lose, and knew that it might be a fairly easy task to identify resources willing to contribute to the matter, as it stood. I shared my intent with Audrey, including my knowledge of the fact that there are any number of resources in the public service arena dedicated to providing persons affected as Audrey is by severe physical disability.
      Under this initial air of perplexity, I also began asking patients and staff alike what they could tell me about Audrey Peterson's primary care physician, Dr. Ruby Ramos-Roxas (a native Filipino woman who acquired her medical training in an unaccredited college there, her home country), because I most definitely sensed that something very unusual was going on in this given situation; and I realized, as well, that if I were to come to the conclusion that there was any merit to the allegation of this doctor's brutality, I was going to have to look into addressing that aspect of the issue at some point in time. Such is my nature, and I know that I am not unique, at least not in the greater American environment. But at ASH, such nuances of recognized civility simply do exist, and as I later came to learn, clinical wrongdoing of this nature is imparted on ASH patients as a matter of standard practice.  

       I honestly had no grand visions of charitably saving the day for Audrey- it simply seemed to be the least I could do under the circumstances, given Audrey's obvious hardship, and the fact that I had more than an ample amount of free time; I mean, it's not as though ASH patients are steeped in therapy, and on average, I had anywhere from 5-7 hours of free waking time on any given day to pretty much do whatever I wanted, in context. I thus took this unsettling body of concern with me into the patient library, where I almost immediately came upon a public directory of resources for persons affected by disability in all contexts, and in that directory I came upon a section dedicated to the topic of wheel chairs. Within one hour I had drafted a straight forward cover letter (of inquiry) wherein I described the fact that I had a friend in the Arizona State Hospital who had a very real need for a electronic wheel chair, detailing Audrey's basic situation and the fact that she was limited to a mechanical wheelchair. As a matter of understanding patient confidentially and related hospital policy, I also made clear that I was not a doctor, and that I could have nothing more to do with the matter (beyond my initial letter of inquiry); and simply asked that anybody willing and able to help Audrey should feel free to to contact her treatment team there at the Hospital, including the name of Audrey's primary attending physician, Dr. Ruby Ramos-Roxas. I printed up copies of this simple one page inquiry and on April 8, 2011, mailed it to the following seven organizations:

          1) Arizona Community Foundation, Phoenix, AZ    

          2) Margaret T. Morris Foundation, Prescott, AZ           

          3) Disability Funding News, Silver Springs, MD  

          4) Arizona Department of Economic Security, Phoenix

          5) AZ Center for Disability Law, Phoenix     

          6) Friends of Disabled Adults and Children, Stone Mt. GA

          7) Mobility International, USA, Eugene, OR

Audrey's
Current                        A Powered Chair

Chair

       

     I fully explained to Audrey P. that I had put the letters into the mail, and  further explained to her that I was not going to be able to do anything beyond that, telling her to be sure and talk to her primary attending physician about it (Dr. Ruby Ramos-Roxas); I also expressed my relative confidence in the likelihood that her clinical treatment team would be hearing from one or another of the seven resources that I sent the letter to. Audrey, in turn, was clearly appreciative of my action, but I explained to her that the process had taken me less than 90 minutes of my time, and that the action should have been taken long before this. It was a very positive interaction at the time, and I knew that it boosted Audrey's spirit simply in the sense of friendship, as it did my own.   

       It was, indeed, a simple act of faith and decent courtesy. I recall being bothered by the attendant fact that somebody else hadn't already gone about dong this, chocking the situation up to the basic bizarreness ASH, which had already struck me in a small variety of ways. I had little idea, however, of how out of touch with reality the caregivers at ASH are, in fact, or of what I was getting into via this arguable simple act of kindness.  

      On April 22, 2011, I asked Audrey if there had been any developments, and she told me that her primary attending physician, Dr. Ruby Ramos-Roxas, was angry at her, for a reason that Audrey could not grasp; and angry at me, too, for "interfering" with Audrey's treatment. It was clear to me that the doctors behavior had confused and even frightened Audrey, and she literally apologized to me out of concern my own needs at the time. Needless to say, this shocked me (yet again), so I later asked a member of ASH staff about the matter, a person who I knew to be on Audrey's treatment team at ASH, and that person fully confirmed Audrey's slim and that person fully confirmed Audrey's claim, in all terms. 
     This staff person further informed me that several of the contacts I'd pursued had in fact been in direct contact with Dr. Ruby Ramos-Roxas in order to help Audrey P. acquire an electronic wheel chair of her own, but Dr. Ruby Ramos-Roxas had literally rdiscarded these good faith responses into the nearest trash can, stating to Audrey in the full presence of Audrey's entire treatment team, that my attempts to contact the involved resources on Audrey's behalf was in violation of hospital policy. ,  I attest to this conversation, and can and will identify the staff member when the time comes, as she had already agreed to cooperate with any investigations into this matter. This same staff person also informed me that Dr. Ruby Ramos-Roxas' position on the issue was that ASH had provided Audrey P. with two prosthetic legs and one prosthetic arm, and that if Audrey was not willing to take the initiative to learn how to use the prosthetic devices, she has no right to an electric wheel chair.

(personal journal note, late April, 2011):

          "Why not just take her mechanical wheelchair away while you are at it, Dr. Ruby Ramos-Roxas?!! We don't want Audrey getting away with anything, do we?" 

      It is common knowledge to most that psychiatric care and related treatment relies on sound, trust based  communication. For this reason, many people refer to the field of psychiatry as somewhat of an art, and I have come to wholeheartedly agree with that idea, because the fundamental elements of trust and reliability necessary to carry on a healthy psychiatric flow of treatment have definitely played a role in my own treatment. At ASH, however, it was apparent to me rather quickly that my primary attending psychiatrists(s) didn't give a rat's ass about whether I trusted them or not, because to most of the clinical staff at ASH, the relationship is purely about power, and the the psychiatric doctors wield a inordinate degree of authority that's only granted to them through their relatively  unusual positions at the Arizona State Hospital. Authority that I know for a fact that you will not find in medical facilities not protected by a grossly corrupt public health care system, operating as such under a shroud of criminal secrecy that ASH administrators willfully endorse as a matter of standard practice. In doing this, the doctors and administrators at ASH rely upon notions of patient privacy in order to maintain this secrecy, literally hiding behind the principles of the ADA and the Hospital Information Portability and Protection Act. But I know firsthand how graphically distorted this reliance is, and that it occurs in blatant defiance of the recognized purpose and intent of those Acts. 

As for Dr.. Ruby Ramos-Roxas, she has been practicing medicine for over 44 years, and as stated already, has been in the United States since the 1970s.  Given this extensive experience as a licensed physician, there is excuse or justification whatsoever for her willful denial of Audrey Peterson's lawful right to acquire an electric wheelchair. I contend that her misconduct in this case amounts to medical malpractice and outright criminality in the context of human rights. 

      Anybody familiar with the history of state operated mental hospitals knows how inhumane such facilities are known to be, this as per established history; as well as in terms of the fact that seriously mentally ill persons across the board are still today subject to gross discrimination and mistreatment. It is so common that many of my closest friends are able to admit the inevitable discomfort that arises when they are in direct contact with persons affected by mental illness; and in my own right, I am willing to admit that I too used to literally cross a major street if I were to spot a person ahead of me on the sidewalk who just so happened to be shouting at the sky, and so on. Ergo, it is no surprise to many Americans today that the conditions at ASH and other like facilities fall short of standard care and treatment. This definitely applies in terms of my own attempts in recent years to advocate on behalf of the ASH patent community, and many of the persons I now know and work with share this basic sentiment. 
I contend via my very real experiences at ASH, that such facilities are breeding grounds for abuse and related substandard care providers, for I witnessed and was subjected to it on a regular basis. Abuse and malpractice as a matter of standard practice. 

I further attest that it is terrifying to experience this sort of mistreatment, particularly if you are a person affected by childhood trauma and other like characteristics specific to the issue of mental and emotional instability, as I am. What's most shocking to me, even today, is knowing as I do that the senior ASH psychiatrists I interacted with, from the four primary attending psyche docs assigned to me during my 13 full months at ASH- Laxman Patel, Pervaiz Akhter, Lynn Lydon, Slvia Dy- to ASH's chief medical officer at the time, Dr. Stephen Dingle- posses little to no evident awareness of how grossly egregious their given misconduct is, in fact. 

     In this specific context, I contend the senior psychiatric clinicians at ASH are due serious oversight and related accountability as licensed medical doctors, public health care employees, and persons granted authority over persons affected my serious mental illness and disability. I know that I am risking my own sense of decency when I declare that at least some of these doctors reflect behavioral shortcomings that have everything to with where they come from, but in truth, I see little other option in terms of seeking a basic  understanding of how and why persons in these positions could be so radically out of touch with their obligations and responsibilities. I do in fact cite the lack of relationship with common human rights because even today, the nations of Pakistan (Akhter), the Philippines (Ramos-Roxas, Dy), and India (Laxman Patel- who is now ASH's chief medical officer) are known as being dismally effected by human rights abuse in all senses; and I cite a similar disconnect from common precepts of democracy on the basis of the fact that those same countries are anything but democratic. I attest to having been subjected to clear exhibitions of these dynamics- fundamental human rights abuses, rejections of applicable/required democratic protocol, at various points in my time at ASH, in a range of circumstances- and I can prove it.

  

Americans with Disabilities Act of 1990

Full title	An Act to establish a clear and comprehensive prohibition of discrimination on the basis of disability

       I don't know quite else to say about this horrific story. But I am of the opinion that any man or woman willing to deny Audrey Peterson the fullest comforts available to her as a physically disabled person is a criminal. As always, I will attest to the validity of my experiences in this case, in support of my current sentiments as they stand, and I do so in good faith, on behalf of each and every patient still being subjected these conditions there at ASH. 

And as stated, anybody who has spent much time at ASH has seen my friend Audrey Peterson trying to push herself with only her one arm, moving slower than cold maple syrup in her mechanical wheelchair,  while ASH staff as a group turn a blind eye to the issue. It as shocking a display of inhumane treatment as I have ever witnessed, and know that many of my readers would agree. Depravedly substandard medical-mental health care, and they are getting away with it every day. This is occurring at the expense of Arizona's taxpayers, and to the deep detriment of ASH's seriously mentally ill and disabled patients. 

IN CLOSING: Audrey Peterson's rights as a physically disabled human being supersede the authority of any one person at ASH, bottom line. So here again, a clear cause for you to get involved. Please visit my April 30, 2012 "Resources Ideas" article and consider how to take action today. I also encourage you to contact the Arizona State Hospital at (602) 244-1331 in order to advocate for Audrey Peterson at this time. Defy the Arizona Department of Health's willingness to ignore this matter, and speak out against any statement(s) to the effect that granting this woman a powered wheelchair is  against her welfare and interests as a patient there at ASH.

paoloreed@gmail.com