It was one of those weeks. First listening to Mayor Swearengin extol downtown revitalization from my seat behind a pillar at the Grand. Later, behind a palm tree watching Gov. Schwarzenegger hype the advent in years (and billions of dollars) ahead of high-speed rail in Fresno.

Somehow it seemed kind of normal that a guy standing next to me at the Amtrak station was trying to snag the Governator's attention by hoisting a soft-covered book bearing Schwarzenegger's name, titled, "The Encyclopedia of Bodybuilding."

Which brings me to a Feb. 2 Wall Street Journal story headlined, "California Growth Zigs, Zags." Basically, coastal areas are rebounding modestly from the economic roller-derby, but places like the Central Valley aren't. Housing prices are up 15% in San Francisco, but still down 11% in the Valley. Silicon Valley is hiring, and the onetime home-grown Pelco in Clovis is laying off staff. Venture capital is heading to the coast, steering clear of inland, the story suggested.

Access to good health care, education on prevention and wise lifestyle choices -- these all factor into making a community a desirable place in which to live and invest. Each year, the California Department of Public Health publishes a health status profile for each of the state's 58 counties.

The data lag by a few years but here's how Fresno County ranked in 2009 on some indicators:

• Chlamydia -- 58th, worst in the state (and 54th in gonorrhea)
• Persons under 18 living in poverty -- 57th
• Stroke -- 56th (and 54th in diabetes)
• Low birth-weight infants -- 54th (51st in African-American infant mortality, and 53rd in births to mothers ages 15-19))

Fresno County ranks in the 40s in a lot of other status indicators, none of them good. And with the economic skid, the outlook for an uptick in future reporting isn't a good bet.

As the region's safety-net provider, Community Medical Centers is well-versed in a lot of these harsh realities. As the region's largest provider employer, with a $1 billion budget, it also could be a positive transformer of the region's future.

As the Journal story noted: "The continuing decline inland could drag down the state's overall recovery and lead to greater inequality between residents. That has national repercussions, since the state's $1.8 trillion economy is often viewed as an economic bellwether."

No way I could see Fresno Mayor Ashley Swearengin as she delivered a 30+minute  "State of Downtown" pledge to several hundred people Jan. 26.

That's because the old PG&E building, restored and renamed "The Grand," wasn't designed as a viewer-friendly venue. So, sitting behind a pillar, I got to concentrate on her message. And she certainly does know the lingo of redevelopment and understands 10-pounds of regulations make a dandy paperweight but do nothing more than tax and regulate innovation to death.

And I sure hope she and other electeds and bureaucrats make good on simplifying a path for this 10-year downtown renewal she envisions.

But in chats with colleagues afterwards, I was transported to the early 1990s when Community Regional Medical Center was being born. I was a Fresno Bee reporter, and Fresno Street was so narrow that if cars parked on the street, other drivers had to plan how they would get past them.

Eventually, the roads were widened. A 58-acre campus was developed. There was demolition and an infusion of, so far, nearly half-a-billion dollars in new buildings and services by Community.

Still, in 2010, as one of my colleagues noted, when 4,000 Community Regional employees look for a place for breakfast or lunch, there is but a handful within walking distance -- and some encourage a risky crossing of  busy Tulare Street without traffic signal control.

The mayor made a number of good points. Forty thousand people come downtown to work. But few of them dally here after hours. There's 1.5 million square feet of vacant commercial office space. I work near where two coffee shops have died in the last three years.

So, there's a reason I often pack a lunch from home. There are reasons why I was a regular at Beiden Field when the Fresno Grizzlies played there, but not so much at the nifty downtown stadium. There's a parking garage near the stadium being propped up by beams wedged into the street. When you drive by Selland Arena, the electronic marquee is still advertising concerts that occurred last December.

I wish the mayor good luck in wooing me and others to shop and stay longer in downtown. She said she faced a "big, hairy audacious mission." An understatement. But at least she's not talking about putting a lake somewhere. Even though Community Medical Centers is sometimes overlooked/taken for granted by the business community, despite being the region's largest private employer, with a huge presence and historical commitment to downtown Fresno, we're comfortable tackling big, hairy audacious challenges. We've got lots of skin in the game already.

I've seen a lot of dirt pushed around in my nine years with Community Medical Centers, and in the years prior while covering health care for the Fresno Bee.

But there was something electric on Jan. 14, when earth movers and levelers, a street sweeper and even the oddly timed honey wagon went to work on Terry's House at Fresno and R streets.

The idea of establishing a residence for families of those being treated at Community Regional's burn and trauma centers really rested a hand on my shoulder, making palpable what so many thousands of caregivers do for those suddenly in desperate need.

Many families and friends build their days around hospitalized loved ones. Food, a shower, doing laundry, getting kids to school, taking the dog to the vet -- oh, and my aunt/son/niece/cousin are still in critical condition, on the bubble between life and ....

Terry's House, which should open later this year, will provide another bridge to a hopeful future for many, allaying some of the stresses and easing access to loved ones.

I've seen iron beams locked together, bulldozers toyed with by novice groundbreakers and gold-painted shovels shaking more dust into the Valley air.

But watching the dirt roil this day as the sun tried to etch a path through the Tule fog, well, something mighty wonderful was unfolding.

For more information and ways to help fund the future for Terry's House, go to http://www.communitymedical.org/terryshouse.htm

Nice little slam piece the other day in the Washington Post. David Ignatius decried creeping "Californiazation of America -- the growing tendency of our political system to make promises in social spending programs that it isn't prepared to pay for with tax increases."

The graffiti are on the wall, and numbers are in billions. A much-needed national health care reform will impose burdensome costs on California at a time when it is spinning into a seemingly endless chasm of deficits and cuts in jobs and services.

Ignatius pulls no punches regarding the villains in California: "A Democratic Party in hock to public-employee unions and a Republican Party in love with tax cuts."

Many of the tragic human consequences wind up in California hospital emergency rooms, with severe illnesses that could have been treated at a earlier stage had the patients had access to doctors, insurance and/or preventative education.

Simple solutions have indeed gone away. As the Modesto Bee reported, a woman with chronic obstructive pulmonary disease has seen her share of costs jump, under the medically indigent services program, from co-pays of $5 for doctor visits and $3 for medications to $300 to $575 a month as Stanislaus County cut back its budget.

And in another sad episode of dysfunction, the Los Angeles Times reported that a computer glitch in the California Department of Public Health prevented low-income people from filling their birth control prescriptions.

"The U.S. economy survived the trauma of 2009, thanks to good policy and good luck," Ignatius wrote. Still, 2010 begins with California -- if it were a country, it would have the world's eighth largest economy -- anchoring itself for Third World status.