Sunday, April 26, 2009

Choices at twilight time - Judge Jim Gray

A few years before my wonderful mother died, she first told me a story, and then followed it up with a strong request.

The story concerned my nephew, who had lived most of his life until the age of about 16 in the frequent company of his grandmother. But as time went along, his grandmother began to show the symptoms of Alzheimer’s, and that awful disease eventually took her away from us about five years later.

Some time after that, my nephew happened to mention to my mother that he only really remembered his grandmother during the time when she was afflicted with Alzheimer’s, and he did not really recall the good times before that. This affected my mother so much that she made me vow to her that when it appeared that she would be at the end of her life, I was not to allow any of her grandchildren to see her. She deeply wanted them only to remember her as she was, during the good times.

So when that time eventually came, we respected her wishes, and didn’t allow her grandchildren to see her.

This caused me to reflect upon my own experience. When I was about 12 years old my father took me to see one of his aunts who was in bed and dying of cancer. I had previously seen his aunt on several prior occasions, but the only visual memory I have of her to this day was that last visit, when she was weak, pale, and wasting away.

Obviously these are deeply personal matters. But personally, I think my mother was right. I want the lasting memories of me by my grandchildren to be of the good times. Think about it, because you might want the same thing, and want to make the same request my mother did.

Even treading further into private issues, I have personally decided that at the end of my life I wish to have the body I leave behind to be cremated. Therefore, I have pre-arranged and paid for this to be done with the Trident Society, and I carry a card in my wallet setting forth my chosen plan. It even includes an added provision that if I die more than 75 miles from my residence, the program will cause my body to be cremated wherever I left it, and the ashes returned to my family for disposal according to my wishes, which I have already made known to them.

Among other things, this course of action complies with my mother’s belief that “the land is for the living,” so the dead shouldn’t take up space. It also would have the additional benefit of relieving my surviving family and friends from the guilt of not going “often enough” to my gravesite to pay their respects. And it would also take away the situation of having withering and dead flowers on my grave, which I have always seen as sad and depressing. So for all of these reasons, I believe that cremation is the way to go.

And then there is the time that life is drawing to a close. My mother, based upon what she had seen and thought about, also made me promise her that no extraordinary measures would be taken to keep her heart beating, if by doing so she would lose her dignity and quality of life.

This evolved into her view that she didn’t want me to allow any tubes to be used to prolong her life under those conditions. And — bless her heart forever — at the end she was true to her convictions.

Without pressing the case too strongly, because these are some of the most personal things a person can discuss, it is important for all of us to think about and plan for all of these inevitabilities.

Not only is it not morbid to make these plans, it is actually being thoughtful and considerate of your surviving friends and family. Why? Because when the time comes, your loved ones will almost uniformly want to carry out your wishes.

So don’t increase their pain and grief by making them guess what your wishes are. Tell them — but not in your will, because by the time your will is read the decisions will have been made and the actions already taken. Instead, write them out in a “living will” (you can get the forms at stores like Staples), discuss them at the appropriate time with the right people, and even make some of the arrangements yourself. This really is an act of thoughtfulness and kindness.

Finally, I was talking with my wife and children recently about one of my wishes after I have left this earth. That wish is that the first time a good production of “Rigoletto,” “Carmen,” or “Les Miserables” comes to Southern California after my death, I want my estate to purchase good seats for anyone in my family who wants to attend, and also, either before or after the show, I want to host a nice meal at a good restaurant with some nice wine. Then maybe my family might have a good time, and drink a toast in memory of my life.

In response, my wife and others suggested that I should not wait. Instead I should purchase the tickets myself, and I should participate in the happy occasion right along with them. Why? Because life is for the living. They are right, and that is what I am going to do.

So that is my final thought to you in today’s column. Don’t wait until it’s too late. Be sure to make special plans to spend some of your remaining time on this earth enjoying nice occasions with your family and friends.

Because not only is the land for the living, so is life.




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JAMES P. GRAY is a retired judge of the Orange County Superior Court, the author of “Wearing the Robe – the Art and Responsibilities of Judging in Today’s Courts.” He can be contacted at JimPGray@sbcglobal.net or via his website at www.JudgeJimGray.com.

Sunday, April 19, 2009

The Canyon Acres story - by Judge Jim Gray

Last St. Patrick’s Day, while waiting at Promelis Market for my take-out order of corned beef and cabbage, I began making light conversation with a distinguished- looking man who was waiting for a similar order to take home to enjoy with his family, including several grandchildren. After expressing my jealousy that he had grandchildren and I didn’t, we began talking about other things.

It turns out that this man was Patrick Dirk, a name that was familiar to me, and he was soon discussing his involvement and commitment to an organization called Canyon Acres Children and Family Services. Surprisingly enough, even though I had sat as a judge on a juvenile court assignment for several years, I was not familiar with this group. So I asked him about it.

At this point, Dirk lit up with infectious enthusiasm. He told me that Canyon Acres is a private/public partnership composed of about 95 paid staff and 300 volunteers that work with the Orange County Health Care Agency, the probation department, and other parties to provide homes, care, treatment, and supportive services for abused, neglected, and emotionally troubled children and their families in Orange County.

What began in 1980 as a home for 12 young children has grown into a model child-welfare agency. It assists with foster care, adoptions, creating family connections, a daytime treatment center, “wraparound” services, mental health services, and in-home crisis services.

In doing this, they have found that their timely intervention both helps to keep children in their homes, and also reduces the chances that the children will later have to be placed into a higher level of care.

Sadly enough, many abused and neglected children in the child dependency system have family members and friends all around the country who are unaware of their plight. So Canyon Acres makes a concerted effort to find them.

Through a unique process of “high-tech” searching, these potential support systems are found and, if they are interested, introduced to the children. Then they are assisted through an “engagement process” to stimulate ongoing contacts and relationships. This action alone provides the children with a sense of stability, hope, guidance, and a brighter hope for the future.

Today most people who are involved with the court system realize that it is frequently in the best interest of the child, parents, and society in general to keep children in their homes as much as possible. So Canyon Acres coordinates the services of mentors, therapists, therapeutic behavior services coaches, and school teachers into a team to individualize a program for each child and family. That is what is known as Canyon Acres’ wraparound services, and they have gratifyingly large numbers of success stories to show for their efforts.

For example, Amanda had been in the foster care system since she was 3 years old, when she was removed from the home of her abusive father. Her mother was known to be on the streets, hooked on drugs, and prostituting herself, and the child welfare agency case workers had written off any further attempts for Amanda to live with her mother because they couldn’t find her.

Enter Canyon Acres’ wraparound services, which found the mother, assisted her in finding a six-month detox program, and then found a home for her that would assist her to reunify with Amanda. Then the team, along with the therapists, helped the mother to discover her own strengths and weaknesses, and helped her further to cultivate her ability to overcome the challenges connected with them.

In addition, the team discovered that Amanda liked to play the guitar, and encouraged and facilitated that interest. The team also assisted in the creation of a family photo album that helped to create in Amanda a much-needed sense of belonging. Over time, all of these efforts worked, and the Canyon Acres team helped a damaged mother and wounded daughter to reunite. Now Amanda is living back with her mother, going to school, and learning to play the guitar, and both of them have regained their health, self-confidence, and self-respect.

Canyon Acres also has a highly trained staff to provide, on a moment’s notice, some in-home intervention to help stabilize families in crisis, with the goal of preventing a child’s placement into Orangewood Children’s Home or psychiatric hospitalization. Orangewood is a fabulous institution, and people in our county have every right to be proud of it and its accomplishments. But the better result is not to have to use their services in the first place, if reasonably possible. And Canyon Acres often realizes that goal.

Then there is the treatment center itself. This is composed of a 4.6-acre ranch in Anaheim Hills, where severely emotionally disturbed children are brought for two to three hours after school, or all day during the summer, for specialized programs including recreational therapy, art, therapeutic horseback riding, and other mental health-based activities.

Mental health professionals have discovered that, among other things, where children will not originally open up to other people, they will often “confide” to a horse. So they have four horses on site, all of which have been privately donated. Canyon Acres specializes in dealing with hard-to-treat children, and it advertises itself as a “wonderful place for children to heal.” Well, based upon my good fortune to meet several of the key players in the Canyon Acres story, and also to take a tour of their ranch, I am here to tell you that they are right!

That was what inspired me to write this column, so that you could also be aware of this wonderful organization. And if you would like to learn more about what they do, please come to their Annual Blue Ribbon Gala, which will be on Saturday, May 16 at the Balboa Bay Club. Not only will you meet some of these marvelous, dedicated, and effective people, you will also be able to contribute your support to one of the most dynamically successful organizations I have ever encountered.

For more information, contact me at the e-mail address given below, or contact Canyon Acres directly at (714) 385-5272. These people are doing great work, and I know you will want to join me in giving them your full congratulations and support.



JAMES P. GRAY is a retired judge of the Orange County Superior Court, the author of Wearing the Robe – the Art and Responsibilities of Judging in Today’s Courts (Square One Press, 2008), and can be contacted at JimPGray@sbcglobal.net or via his website at www.JudgeJimGray.com.

Sunday, April 12, 2009

Lowering costs of health care - by Judge Jim Gray

I will get this fact out of the way at the beginning: My wife is a physical therapist, and she owns and manages her own physical therapy practice in the City of Orange. So maybe I have a bias.

Having said that, I want to call your attention to a change that should be made that will reduce the costs of effective health care and increase the general fairness of the health-care system. What is that change? Allow “direct access” for physical therapy in California.

What does that mean? Today patients who are covered by health insurance can go for evaluation and treatment to their chosen chiropractor, acupuncturist, marriage and family counselor, or psychologist and have those visits reimbursed by their health insurers without being first required to obtain a prescription from a physician. But to go to see a physical therapist, patients must first obtain that prescription. This, of course, requires patients to spend extra time and money before they can obtain their physical therapy.

How did this disparity occur? Probably, it has been perpetuated because the physical therapists simply have not had as strong a political lobby as the other health-care professions. But it originated in 1965, when then-State Attorney General Thomas Lynch issued an opinion that interpreted the Legislative intent of the Physical Therapy Practice Act to require access to a physical therapist only after a prescription from a physician. And this opinion was rendered even though it was and still is contrary to the protocol of Medicare and many managed health-care plans.

Currently, 44 states allow some form of direct access for the patients/consumers to physical therapists without a prescription. But California does not. That means that, on the average, the costs to patients in California are 123% higher than those in other states. And that hurts everybody, except the physicians.

In addition, the Wall Street Journal cited a study by Seattle’s Virginia Mason Medical Center that found that putting “physical therapy in front” when treating patients with back pain generally resulted in less time waiting for appointments, fewer MRIs, and a decrease in time lost from work for the patients.

Why do these positive results occur? Recently Consumer Reports published a survey of more than 14,000 patients that showed physical therapist and other “hands on” therapies outranked treatment by other medical specialists for back pain.

So, conservative physical therapy treatment not only is less invasive and less expensive, but often works better than other approaches.

To become licensed, physical therapists must graduate from a physical therapy program accredited through the Commission on Accreditation for Physical Therapy Education.

And, since January of 2003, only physical therapists who have obtained a master’s or doctor’s degree can even be considered for that accreditation.

Of course, if any health-care professionals determine that a patient has symptoms or conditions that are outside their field of expertise, they must refer the patient to the appropriate health-care professional.

But otherwise, just as in any other profession, the patient and consumer should be able to choose which health-care professional to see and trust for evaluation and treatment. And this is particularly true today, when the health-care industry is in such a crisis.

In an earlier column we discussed the benefits of allowing pharmacists to dispense to patients all non-addictive drugs except antibiotics without a prescription, and that not allowing this result affirmatively wasted the patients’ time and money.

The reasons are the same for physical therapists. Direct access would allow these educated and skilled health-care professionals to practice their profession and, along the way, would also reduce the costs and waiting time for treatment.

What can be done about this situation? At the moment, there is a bill that will be voted upon in the California Legislature in the next two weeks to provide direct and equal access for patients to physical therapy. It is Assembly Bill 721, and it merits your support. All it would take is for you to spend a few minutes to contact your representative in Sacramento and voice your support for this measure.

Direct access is a common-sense approach to health-care delivery that will save you time and bother, eliminate the burdens and costs of unnecessary visits to physicians, and often lead to quicker pain relief and recovery from injuries when you need them most. And along the way it will also provide for more basic fairness in the health-care field in general.

To me, that is a win-win situation for everybody. But it won’t be implemented without your help.



JAMES P. GRAY is a retired judge of the Orange County Superior Court. He be contacted at JimPGray@sbcglobal.net. www.judgejimgray.com

Saturday, April 11, 2009

WE TRIED A WAR LIKE THIS ONCE BEFORE - Mike Gray

 Dear family and friends,

Enclosed is a copy of an op-ed piece written by my friend Mike Gray that will appear tomorrow in the Washington Post. It is as incisive as anything I have seen, and deserves maximum distribution.

Please help us do so. This bus is moving, and Drug Probition's days of inflicting misery upon us and the rest of the world are numbered.

Good luck to us all.

Judge Jim

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THE WASHINGTON POST
Sun, 12 Apr 2009

Contact: letters@washpost.com
Website: http://www.washingtonpost.com/


WE TRIED A WAR LIKE THIS ONCE BEFORE

by Mike Gray

In 1932, Alphonse Capone, an influential businessman then living in Chicago, used to drive through the city in a caravan of armor-plated limos built to his specifications by General Motors.
Submachine-gun-toting associates led the motorcade and brought up the rear.
It is a measure of how thoroughly the mob mentality had permeated everyday life that this was considered normal.

Capone and his boys were agents of misguided policy. Ninety years ago, the United States tried to cure the national thirst for alcohol, and it led to an explosion of violence unlike anything we'd ever seen. Today, it's hard to ignore the echoes of Prohibition in the drug-related mayhem along our southern border. Over the past 15 months, there have been 7,200 drug-war deaths in Mexico alone, as the government there battles an army of killers that would scare the pants off Al Capone.

Now U.S. officials are warning that the vandals may be headed in this direction. Too late: They're already here. And they're in a good position to take over organized crime in this country as well.

After decades of trying to stem the influx of illegal narcotics into the United States, it's clear that the drug war, like Prohibition, has led us into a gruesome blind alley. Drugs are cheaper than ever before and you can buy them anywhere. As Mexico's cash-starved government struggles to keep up the good fight, the drug barons rake in more than enough to buy political protection and military power while still maintaining profit margins beyond imagining. And what's driving this desperate struggle may be the ubiquitous
weed:
Southwestern lawmen say that marijuana accounts for two-thirds of the cartels' income.

At last, the spectacular violence in Mexico has captured everybody's attention, and in an eerie replay of the end of alcohol prohibition, we may at last be witnessing the final act in the war on drugs.

One hint of a shifting wind came in February, when a state legislator from San Francisco introduced a bill to tax, regulate and legalize adult use of cannabis. This sort of grandstanding is always met with derision, and this was no exception. But then something strange
happened: California's chief tax collector said that the measure would bring in $1.3 billion a year and save another $1 billion on enforcement and incarceration. In a state facing an $18 billion deficit, suddenly nobody was laughing.

Four days later Arizona Attorney General Terry Goddard, who's no legalizer, said that he, too, thinks we should take another look at marijuana prohibition. "The most effective way to establish a virtual barrier against the criminal activities is to take the profit out of it," he told a U.S.
Senate subcommittee.

The next day, U.S. Attorney General Eric H. Holder Jr. announced a minor policy shift with enormous implications: The federal government would no longer go after groups that supply medical marijuana in the
13 states where it is legal. The Drug Enforcement Administration had been raiding dispensaries routinely, and dozens of patients and growers are behind bars today despite their legal status in California's eyes. Now that threat has vanished for those who comply with state law. For California, this amounts to de facto legalization.

At his recent cyberspace town hall meeting, President Obama fielded a question about whether legalizing marijuana would improve the economy. "No,"
he replied as the audience giggled. But that answer sheds no light on his actual thinking. Obama has already called the drug war an "utter failure."
And since he himself is an admitted ex-toker, it's hard to believe that he'd cancel some kid's college education over a crime he got away with.

Of course, resistance to marijuana legalization remains rock solid in Washington among those who can't face the failure of prohibition. But that has more to do with politics than science. The Department of Health and Human Services says that there are 32 million drug abusers in the country, but that includes 25 million marijuana smokers. If you strike them from the list, how do you justify spending $60 billion a year in this economy trying to stop 2 percent of the population from being self-destructive? It would be dramatically cheaper to follow the Swiss example: Provide treatment for all who want it, and supply the rest with pure drugs under medical supervision.

When we erected an artificial barrier between alcohol producers and consumers in 1920, we created a bonanza more lucrative than the Gold Rush.
The staggering profits from illegal booze gave mobsters the financial power to take over legitimate businesses and expand into casinos, loan sharking, labor racketeering and extortion. Thus we created the major crime syndicates
-- and the U.S. murder rate jumped tenfold.

Fortunately, the Roaring '20s were interrupted by the Crash of '29, and when the money ran out, the battle against booze was a luxury we could no longer afford. Prohibition was repealed in 1933, and over the next decade the U.S.
murder rate was cut in half.

Today it's back up where it was at the peak of Prohibition -- 10 per 100,000
-- a jump clearly connected to the war on drugs. And anyone who's watching what's going on south of the border can see that we're headed for an era of mayhem that would make Meyer Lansky and Frank Costello weak in the knees.

Profits from the Mexican drug trade are estimated at about $35 billion a year. And since the cartels spend half to two-thirds of their income on bribery, that would be around $20 billion going into the pockets of police officers, army generals, judges, prosecutors and politicians. Last fall, Mexico's attorney general announced that his former top drug enforcer, chief prosecutor Noe Ramirez Mandujano, was getting $450,000 a month under the table from the Sinaloa cartel.
The cartel can of course afford to be generous -- Sinaloa chief Joaquin Guzman recently made the Forbes List of Billionaires.

The depth of Guzman's penetration into the United States was revealed a few weeks ago, when the DEA proudly announced hundreds of arrests all over the country in a major operation against the "dangerously powerful" Sinaloa cartel. One jarring detail was the admission that Mexican cartels are now operating in 230 cities inside the United States.

This disaster has been slowly unfolding since the early 1980s, when Vice President George H.W. Bush shut down the Caribbean cocaine pipeline between Colombia and Miami. The Colombians switched to the land route and began hiring Mexicans to deliver the goods across the U.S. border. But when the Mexicans got a glimpse of the truckloads of cash headed south, they decided that they didn't need the Colombians at all. Today the Mexican cartels are full-service commercial organizations with their own suppliers, refineries and a distribution network that covers all of North America.

As we awaken to the threat spilling over our southern border, the reactions are predictable. In addition to walling off the border, Congress wants to send helicopters, military hardware and unmanned reconnaissance drones into the fray -- and it wants the Pentagon to train Mexican troops in counterinsurgency tactics.

Our anti-drug warriors have apparently learned nothing from the past two decades. A few years ago we trained several units of the Mexican army in counterinsurgency warfare. They studied their lessons, then promptly deserted to form the Zetas, a thoroughly professional narco hit squad for the Gulf cartel, which offered considerably better pay.
Over the past eight years, the Mexican army has had more than 100,000 deserters.

The president of Mexico rightly points out that U.S. policy is at the root of this nightmare. Not only did we invent the war on drugs, but we are the primary consumers.

The obvious solution is cutting the demand for drugs in the United States.
Clearly, it would be the death of the cartels if we could simply dry up the market. Unfortunately, every effort to do this has met with resounding failure. But now that the Roaring '00s have hit the Crash of '09, the money has vanished once again, and we can no longer ignore the collateral damage of Prohibition II.

Writing last month in the Wall Street Journal, three former Latin American presidents -- Fernando Henrique Cardoso of Brazil, Cesar Gaviria of Colombia and Ernesto Zedillo of Mexico -- declared the war on drugs a failure.
Responding to a situation they say is "urgent in light of the rising levels of violence and corruption," they are demanding a reexamination of U.S.-inspired drug policies.

Two weeks ago, a conservative former superior court judge in Orange County told the Los Angeles Times that legalization was the only answer, and of 4,400 readers who responded immediately, the Times reported that "a staggering 94 percent" agreed with him.

This is another pivotal moment in U.S. history, strangely resonant with 1933. The war on drugs has been a riveting drama: It has given us great television, filled our prisons and employed hundreds of thousands as guards, police, prosecutors and probation officers. But the party's over.

Here is a glimpse of what lies ahead if we fail to end our second attempt to control the personal habits of private citizens. Listen to Enrique Gomez Hurtado, a former high court judge from Colombia who still has shrapnel in his leg from a bomb sent to kill him by the infamous drug lord Pablo Escobar. In 1993, his country was a free-fire zone not unlike Mexico today, and Gomez issued this chilling -- and prescient -- warning to an international drug policy conference in Baltimore:

"The income of the drug barons is greater than the American defense budget.
With this financial power they can suborn the institutions of the State, and if the State resists . . . they can purchase the firepower to outgun it. We are threatened with a return to the Dark Ages."

Ending prohibition won't solve our drug problem. But it will save us from something far worse. And it will put drug addiction back in the hands of the medical profession, where it was being dealt with successfully -- until we called in the cops.


Mike Gray, the chairman of Common Sense for Drug Policy, is the author of "Drug Crazy: How We Got Into This Mess and How We Can Get Out."

www.judgejimgray.com

Monday, April 6, 2009

That’s the short and long of it - Judge Jim Gray

There is an old saying that being in a rut is like being in a grave without end. Of course, in some ways it is, simply and purely, beneficial to have a set routine. Why? Because it helps to conserve effort and also helps to get some things done efficiently.

But sometimes it is also productive to look around and be able, willing, and ready to change your routine.

Upon reflection, there really is no fast and hard way we should live our lives. Of course, there will always be a difference between wrong and right, and some guidelines will be written down inexorably in white and black (although that still leaves lots of things in our “gray area”).

But surprisingly enough, a change in our perspective will sometimes enable us to roll and rock around the clock with unimagined vigor.

So are you caught in a rut that tends to make you tired and sick of your daily life? Could you decrease your strain and stress, and at the same time increase your take and give?

Think about this, because I’ll bet you can quickly come up with some insights that will allow you to deal and wheel in your rejuvenated life like you have never dealt and whelt before.

One change that could re-invigorate your life would be to do something you have never even thought about doing before. For example, how about regularly going on hikes with your family? I use a guide titled “Best Easy Day Hikes” by Randy Vogel to make my selections here in Orange County, and my favorite is the 2.7-mile round-trip hike to Holy Jim Falls, which begins just off Live Oak Canyon Road. But there are lots of guide books to easy and fun hikes everywhere.

Or take a trip to somewhere really different that you have never even thought about going to. Why always be on the narrow and straight?

For example, expose yourself to a different world by going to a Bluegrass Festival. Google tells me that there will be festivals this year in Harlan, Ky., on June 25 to 27; Gettysburg, Penn., on May 14 to 17 and Aug. 20 to 23; and Luray, Va., on July 30 to Aug. 1. Or go to the National Storytelling Festival in Jonesborough, Tenn., on Oct. 2 through 4.

Go to one of these festivals, by crook or hook. They are just the balanced and fair things to help you take off the chain and ball of boredom, and reduce the tuck and nip of your mundane world.

The same approach to considering different options can also be used effectively in your business. It only makes sense and dollars. Because businesses can also have a tendency unthinkingly to use the same old forth and back, instead of using a balanced and fair consideration of different and new ideas. In fact this new open-minded approach could give your business a new easy and free path to more productivity. Some people may fight you nail and tooth along the way, but try to persist.

For example, how about considering the use of an alternative work schedule for your employees? For some companies, having employees work 10 hours per day for four days per week, instead of the traditional eight hours for five days per week, would increase productivity. And that change can often make your employees happier, while at the same time reducing overtime costs. So this could be a truly final and smart approach for your company, and just because “we have never done that before,” does not mean that it will not work.

Or what about employing a system of bonuses based upon increased net sales per month? As we see throughout the world, incentives matter, and often the way to find justice and truth in the workplace for employees and employers alike is to institute such a system of incentives. Most times it will work, and you will probably receive lots of appreciative ahs and oohs from your employees along the way. Spread the word clear and loud for everyone to be imaginative, because the list of possibilities is endless.

So that is the short and long of it. Rosencrantz does not always have to be mentioned before Guildenstern, or Mutt before Jeff, or sweet before sour. Instead, look right and left to see if you have fallen into a dried and cut rut in your personal or professional life. It’s not a question of evil and good.

In fact, you will find that many people have willingly come from far and near to adopt this true and tried approach to help them get past the halls of mirrors and smoke to find a more balanced and fair way to live in the now and here.

And you can too.



JAMES P. GRAY is a retired judge of the Orange County Superior Court. He can be contacted at JimPGray@sbcglobal.net or at www.JudgeJimGray.com.