In the spirit of Veritas…

Truth. Veritas.

The motto of Providence College, the only college/university in North America of the Dominican Friars.

The sound of wooden beads gently knocking together, hidden inside folds of long woolen-like brown robes as Friar/Teachers walked the campus, holding their notebooks and books for classes they were teaching. A gentle nod and sweet smile to students, from most.  Others would walk with head down, preferring to make no eye contact at all.

It was the first full year of girls on campus. Living in dorms once the bastion of boys in sport coats and ties, khaki pants and loafers.

And there we were – the girls – in our rather strange groups of three to a room – matched alphabetically, not in the fashion of today which usually means an extensive “similarity” questionnaire.  So, Sullivan, Taylor, Thomas we were. Two from Rhode Island, and one from Connecticut. Two from private school. One from public school in Pawtucket. We were all Christian, Roman Catholic – that was our similarity match.

Most of the rooms on the rest of the floor were taken by girls from Catholic Connecticut high schools. Me? A public school student from Pawtucket; having lived with an extended Portuguese family. First to go to college.

I started working a work-study job in the fundraising and public relations office.  Logging in donations and pledges in boxes of index cards. Always gravitating to the PR part of things.  It was easy to work at this job – sometime around 3pm I’d wander in after class, and leave in time for dinner at Raymond Hall, (named for Raymond Patriarca).

About six months into my freshman year I learned that my father had left the home and a divorce was imminent.  (It would take three years of courtroom trips – fighting for the sake of it – my father was not Portuguese, and always felt outnumbered by both numbers of people and the primary foreign language spoken in the house).

So, my circumstances were about to change. Dramatically.  The savings bonds that had dutifully been collected by buying them one a week from grammar school on, by my mother, were in jeopardy. They were paying for my college education, in addition to scholarships due to my excellent academic standing and testing.

The bonds had been put in my father’s name. That’s just the way we did things all those years ago. And in his anger and angst, he took them. He took all of them. I suddenly had no funds to pay a bill.

I became a homeless co-ed on the campus of this prestigious, expensive, Catholic college. And no one knew.

With a first semester paid for, I took another part-time work-study job. At a hospital two buses away, in East Providence, where I would go from 4pm to 9pm. Three days a week, right after my first job. I had just enough money to buy my meal ticket and books. Scholarships would pay for the next semester.

At Christmas, I stayed alone in my dorm room, with the lights off. We were supposed to vacate the dorms so they could be cleaned. But I had nowhere to vacate to. So I stayed in the dark, literally, and quietly, in case campus maintenance people came by. Jamming the door so it could not open. I had a hot plate and some cup-a-soup (never Ramen noodles) – and bread. The library was open during times the school was closed, so I spent most days there.  But nights were in darkness, less anyone find out that this homeless co-ed was living in a dorm room, in an empty building.

Summertime came soon. I found a living situation with four other people in a 2nd floor of a three tenement on Smith Street, a few blocks away. I got a job in some manufacturing company, in the kitchen, or at a check-out line, my memory is foggy on this. Buses back and forth.  I made enough to just pay my share of the rent.

As August came money ran out.  There was none to pay for tuition, or food, or clothes, or even buses. My scholarship would be in, in September, but how would I survive?  I went to the state’s “welfare office” and applied for help. But I had to sit in a large room, and as I looked around at the moms and babies I just got up and left. Surely I could find another way.

My favorite meal – my only meal most nights – was white River rice with butter and a generous sprinkling of some fake Parmesan cheese.  Occasionally I had frozen white fish for $1 a block – I wonder now – though I didn’t then – just what that was?  I would offer to cook for my roommates so I could eat a little of their food – I never told them why my shelf in the refrigerator had only a pound of butter on it and some bread.

At one point I took a bus to Maine and arrived on the steps of a house where I thought a nice boy I was dating lived. I must have gone by some sort of faith that drew me there, because I had never even checked his address. I arrived. I just stayed there. Somehow I knew that this family – with 6 children – could be my safe place for a few weeks.  To this day my love for the mom, and my dear nice boy who turned into a wonderful, heart-filled man, remain. The man from Maine and I went on to have 2 daughters each, with our spouses, and we both were divorced. We’ve always maintained our friendship – and sometimes more, and we talk to this day of our love for each other, a deeper love than any romance might involve.

I could go on. But the picture has been made.  The next three years were hand to mouth, as they say. The kindness of one Dominican who wore white robes, and not brown, must be mentioned. He was the brother of the president – he was Father Peterson’s brother, Father Peterson. The tall slim one.  Somehow he knew without words of my situation. And as the end of each year passed, he would remove some of the charges on my bill.

In my final months I was struck by a car leaving my hospital job going to the bus stop. I crushed my hip and pelvis and never completed my final days on campus – never walked the stage for graduation. But Father Peterson was there, helping always.

Ten years. That’s what it took to pay back my education. Probably as much interest as principle. But each payment was made with a thank-you to this small (at the time) soulful college that knew I needed help, and I didn’t fill out a form, or tell my story too completely, to anyone. I didn’t match the PC co-ed from Connecticut profile, whatsoever. Sometimes I think not knowing what to do about me was my salvation.

I had my pride. Big Portuguese pride. I would “make it”; of that I had no doubt. It is the same feeling I’ve had all my life. Through trials; ridiculous job situations; a divorce; money challenges. I would make it – because, well, what else would I do but make it? It was simply not an option not to.

I tell this story in my later years – not even my family has heard it. I tell it in the spirit of a liberal arts education, the kindness of men in robes with the sound of wooden rosary beads that comforted me on hot summer days, as I sat wondering if that dorm door would still be ajar when I got back to it, so I could  put my head down and wonder what my life would be like. I tell it to inspire others to look inward – first – rather than outward – for help. And never walk away without a plan to pay it back – even if it takes you a decade.

As PC says, “the search for truth is the basis for dialogue with others and critical engagement with the world”.  My story is far less than many people’s story of hardship. Far, far less. But it is my truth. And the core of who I am. It is my veritas, and in that spirit, I share it.

 

 

It’s been a year…

I was really getting into this blogging thing – and then 2018 happened.  On a completely personal level, many good things…on a business level, doing some of the best work I’ve ever done.

But on a political level, and on social media, where much of my work lives for clients and causes, the dichotomy of friend/foe, liberal/conservative, progressive/right-wing, and more, split my world in a variety of ways.  So, I stopped blogging. And watched. And listened. To everything, until some days my eyes and even brain physically hurt. Sure I commented profusely in mini-posts here and there, but no deep dives.

The glee has been tempered in my last 365 or so days. The easy smile has become a squinty-eyed, intense look; an effort to understand people and institutions, especially those I thought I knew best.

I’ve said – and been misunderstood about – that sometimes life is in need of a good shaking-up; a disruptor force. Be that being fired from a long-held job, a divorce, a dramatic change of circumstance.  An iconic company goes ‘poof’. The friend who held your life’s story in her mind inexplicably is gone – without warning. Or, be that a larger world shift.

There are disruptors all around us now. In our infinitesimally local world. And in the immeasurably larger world around us. We are in that disruptor time, and I hold hope that the virtual – and real – shaking around us will pour out a much better world – a kinder and gentler personhood for each of us. Where we seek first to listen, and then to speak. Where we regale in the diversity – of thought – and opinion – around us. And seek, once again, to understand one another – and to accept the very personal histories we each bring to the table of the lives we live – and those we interact with. Acceptance.

I’ve seen struggles to view diversity dissolve into a broad brush where we no longer see the individual, but only see a dissected collection of his/her most obvious parts. A generation with so little knowledge and respect for history – how do we know where we are going – if we do not know where we have been?

Hope is a Choice…

Can’t live without love?  Can’t live without hope!  I’ve heard it said that love is a choice we make (but never fully believed that). So, today, 20 days into 2019, I choose hope. I choose to live in it. To find my smile. To respond more with “this too shall pass”, or the familiar greeting of Aussies, “no worries”. And to hold firm to the words of President Jimmy Carter, who recently said, “I think in the past we have proven as a country that we can overcome any major challenge that presents itself. So I have confidence or faith in the future of America.”

 

Hope is a choice. Choose it.

With hope, we can – begin again.

Plasticity – Elasticity – and Amazing Resiliency!

In the time I’ve written this blog, 2 more names have surfaced in the tsunami of Hollywood sexual assault stories.  #MeToo on steroids now – all around us.  It is as if you are assumed guilty – until proven innocent. 

So many other hard things in the world – harassment – or bad things – descending upon us. How do we survive – those who do?  Press conferences – lawsuits – therapy? All tools to use to get a sense of vindication – or a way to shout ‘no more’ – but does all that do anything to heal – or are we “thrown helplessly like puppets” from one behavioral and emotional extreme to the other – perhaps with a few bucks in our pocket, if we’re lucky….perhaps with nothing but the experience festering into our soul.

Do we have a choice?  Are we blades of grass swinging this way and that, but always returning to a more or less ramrod straight position?  Or are we skinny twigs – ready to snap at the slightest insult?

If we’re blades of grass – how fortunate are we?  If we’re parents, what can we do to help our children?  We won’t always be there…protecting them, getting between them and harm in all the lonely places they must walk.

How do we teach resiliency?  How do we teach how to sway back and forth – take the time – and return to ramrod straight?  If we learn how to do this it will be a lifelong skill – a lifelong art – that will do them well. I believe years ago that we taught each other more deeply how to do that.  Have we lost that basic core? Maybe it starts with expecting that we will all be ok – there, there, it will.  And minute after minute – quite deliberately – quite mindfully – one day soon – it will be. We may be dented and damaged, or ever so more cautious – but we are back and strong and moving forward.

 

Here is an article that will help you be that resilient self – and will give you some resources to learn how to help others become that, too.

https://qz.com/1120865/to-be-resilient-start-by-avoiding-the-word-happiness/

Reprinted here:

Happiness isn’t a country.

You don’t get there and stay. It’s a fleeting space, a feeling that comes and goes, so focusing on being happy is just a distraction, according to some psychologists. Better to develop resilience, which is a characteristic that you can cultivate to improve the quality of your life in any circumstances.Resilience is essentially emotional elasticity, the ability to manage changes and difficulties. It’s the ability to deal with life’s vicissitudes with some grace, not being derailed by every failure, mistake, or shift in circumstances. The skill is worth learning, says psychologist Anna Rowley—who counsels executives at corporations like Microsoft on cultivating existential “mastery”—because emotional flexibility is exceptionally handy in our rapidly-changing world. Resilience provides you with a personal foundation of strength and sense of safety.

Rowley doesn’t talk about happiness at all. She argues that Americans are culturally obsessed with feeling good when, instead, we should be perfecting perception, our understanding of ourselves and the world around us. Rather than dealing with difficulties, Rowley says, people tend to “cope ugly.” We numb ourselves with food, drink, drugs, stuff, sex, or the internet, hoping not to feel anything at all if we can’t just feel happy.

Those efforts to hide from suffering are futile, Rowley says. We learn little from hiding. But by engaging with negative emotions, and learning to see they’re fleeting, we can get better at dealing generally. And every feeling or situation we manage wisely builds on our resilience skills. “Resilience is like a super coping mechanism,” Rowley told Quartz. “It protects against stress in any situation.”

Stretch, don’t bounce.

Coping sounds kind of dull compared to happiness but failing to do so can lead to depression. According to writer and clinical psychiatrist Peter Kramer, emotional resilience ensures mental health, and is the opposite of depression. “Depression is fragility, brittleness, lack of resilience, a failure to heal,” Kramer writes in his 2005 book Against Depression.

Developing resilience won’t bring happiness but it can help you avoid depression and teach you to heal yourself when you do suffer. Learning to deal will improve your quality of life, says Rowley, yet to get good at it demands facing and engaging the very thing we seek to avoid, most notably our own bad feelings.

According to the American Psychological Association, “Resilience…means ‘bouncing back’ from difficult experiences.” Rowley differs slightly on this. She argues that “bouncing back” is just an aspect of this skill and not the one that comes first. It would be better, she says, if we learned how to gently and continually stretch ourselves instead of bouncing around. “Rebounding is important but you can’t learn from experience if you hurry,” the psychologist argues.

“Rebound alone takes the personal accountability out of situations and leaves you with no locus of control. What we really need is emotional literacy, to be able to look at our actions and recognize the role of choice in events.”

You are not what you feel

The late Oliver Sacks, a neurologist and writer, spent half a century studying the minds of people with chronic brain diseases, patients who operated at neurological extremes—some operated super fast, some very slow, some were deeply depressed, others were manic, and some patients alternated between extreme states. In his last just-released book, The River of Consciousness, Sacks refers to resilience as the “middle ground” that gives people mental control and stability. Without it, he notes, patients are “thrown helplessly like puppets” from one behavioral and emotional extreme to the other.

Sacks’ patients suffered from neurological deficits that made it impossible for them to regulate themselves and develop resilience naturally. Most people, however, do have what it takes. If you’ve made it this far in life, you’ve already displayed amazing resilience, and Rowley says you can get better at it.

You don’t have a choice about getting sick or getting laid off from a job, say. But you do have a choice about how you respond to what happens emotionally, and the response will influence how far you fall, how fast you get back on your feet, and what you yield from your difficult experience. To practice responding appropriately, you must get to know yourself emotionally, says Rowley.

You do it by paying attention. Developing a habit of attentiveness is fundamental to building resilience. You can practice with a deceptively simple exercise that the psychologist uses herself and with clients: On the way to work, say, in your car, name three to five things you see, sense, and hear, Rowley suggests. For example, you see traffic is crawling, the sun is climbing in the sky, and that the car in from of you is blue. You sense a chill in the air, that your fingertips are cold against the steering wheel, and that the driver behind you is impatient as he inches closer to your bumper. You hear the hum of traffic on surrounding freeways, angry honking of horns, and the squawking of birds flying overhead.

Making simple mental lists like this might seem silly at first. Who cares about the birds? You’ve got important worries!

But Rowley says the lists teach you simple perceptual shifts from internal to external realities, and help you to see clearly in the moment. She practices the exercise herself as well, every day. When you practice moving between your inner self and the outer world, you stop being a prisoner to emotions and are able to simply note what is, explains Rowley. This helps you make better, fact-based decisions.

No one thing you do today will guarantee your flourishing in the future, warns Rowley. Developing the skill of resilience, however, means you don’t have to fear the failures, mistakes, and changes that lie ahead for all. The confidence that comes from knowing you can manage tough circumstances, makes difficult situations easier to handle, and that is certainly happy news.

Old enough to remember…

I wrote to the author of this hidden little piece, below, in today’s New York Times: “Thank you for sharing this – I think back to all the Sunday rides we took as a family – it was my mother who was the adventurer – spontaneously calling out – turn here! – to my dad, who just did whatever she told him to. And I giggled at the adventure – for no more cost than an ice cream if we found a place, or some french fries, maybe. Sometimes, summer tomatoes from a fruit and vegetable stand. No worries about the price of gas.

I was much too structured with my children – wish I had transferred the carefree spontaneity of my mom (but I suppose there’s still time)…

My treat on my birthday – which today is – is to spend most of the day with my all-too-grownup girls – I hope for giggles and memories – less worry and fret – less planning and structure – as our world’s concerns have descend upon them like a heavy cloak.  I can no longer protect – distract – cocoon them – with arts and crafts, or food, or entertainment. I suppose there were worldly concerns in my childhood, back on those dusty Sunday road trips – but I don’t remember what they were.

This world’s dark and ominous cloud needs aggressive bands of sunlight – people who can drag us out with inconsequential moments of wonder.

Maybe that’s my role now.  I’ve done far too much planning and prodding and pulling them along. So I’ll go back to the moments … some of which have already been forgotten.  “Do you remember that? When we went to Maine, just the three of us? When we went to the beach in our clothes because we didn’t bring suits?”  – “No, not really…” Sigh…

Maybe they are not “old enough” yet – to remember. Anyone near my age will know what I mean…

I encourage them to write, to journal, to blog, to keep boxes of memories…because one day something will come back to them…and they’ll giggle and pause – and maybe, when it is their time they will take their little ones spontaneously to Maine – or to the Cape – without a reservation, with no bags packed.  Or, they could go on a Sunday drive – and shout out, “turn here”!

Thanks to author Christina Baker Kline…

“At the steering wheel my father consults his large paper map, turning it this way and that, squinting at the small blue lines that squiggle through tiny Maine coastal towns. He’s heard that the author E.B. White’s house is somewhere around here, and he’s determined to find it.

My mother, next to him in the passenger seat of our rusty gold station wagon with my baby sister on her lap, raises her eyebrows at my other two sisters and me, free-ranging in the second row. It’s the early 70s, and seatbelts haven’t caught on yet. We gaze back at her, knowing that once Dad gets an idea into his head, it’s almost impossible to stop him. We range in age from 1 to 10 (I’m the oldest), and all of us are literally and figuratively along for the ride. Besides, we’re excited at the prospect of meeting this author we already feel we know. We’ve been lulled to sleep every night by the soft cadence of my dad’s Southern accent as he reads us stories about a wise spider and a hapless pig, a resourceful mouse and a mute swan.

Dad pulls off the road into the dusty parking lot of a country store with a lone gas pump, and gets out of the car. We hear him chatting with the attendant through the open window. “Sure is nice around here.”

The guy shrugs.

My sisters and I glance at each other. Rural Mainers tend to be stranger-wary and small-talk averse. But as usual, Dad doesn’t seem to notice. “You lived here long?”

“Ayuh.” Amazingly, before long, and with only a little coaxing, the attendant is telling Dad about his grandkids and his lobster boat and pointing off into the distance, giving him the intel he’s come for. “Mr. White lives right over that hill there. Privet hedge in front. Can’t miss it.”

Back on the road, my sister Cynthia ventures, “Isn’t it rude to show up on someone’s doorstep without asking?”

Dad grins and winks at us in the rear view mirror. “He’ll be flattered.”

We pull up to the farmhouse to find a courtly white-haired man trimming the hedge with a set of clippers. “It’s him!” Dad whispers. He rolls down his window and leans out. “Hello, good sir!” The man seems a little nonplussed. “I have a car full of young readers here who’d give anything to meet their favorite author. A word from you, and they’ll remember this moment for the rest of their lives.” What choice does the poor man have? Within a few minutes, the famously reclusive E.B. White is demonstrating to a cluster of little girls in bathing suits that when you crush pine needles between your fingers and hold it to your nose, the smell is as strong as patchouli. And Dad is right — we never will forget it.

The writer E.B. White passed along an appreciation for the scent of crushed pine needles to the author and her sisters when they arrived at his house unannounced in August 1973. Credit Courtesy of the Baker family.

My childhood was rife with moments like this. Dad was always going out on a limb, befriending people who didn’t necessarily seem to want new friends, trespassing on private property, pushing the boundaries of acceptable behavior in quest of adventure. His philosophy was that you don’t need money or plans, only a willingness to be present in the moment and to go where inspiration takes you. If you don’t, you’ll miss the entire point of being alive.

Raised dirt poor in rural Georgia by a mill worker mother and a father who often went to the bar rather than home after work, Dad learned early on that his quickest route up the social ladder was through charm and smarts. He got himself to college — the first in his family — on a football scholarship, then used seminary to springboard to a doctorate in a foreign land.

As a young academic in the ‘60s, he grew to reject traditional values and had scant respect for the social codes of privilege. At parties, he could often be found talking to the bartender or a 95-year-old Irish grandmother in the kitchen rather than the hosts. A Southerner through and through, even after moving to Maine, he was constitutionally incapable of walking down a street in New York without stopping to chat with doormen, bodega owners and homeless people. He never met a taxi driver whose story he didn’t want to know. Dad’s unorthodox and sometimes embarrassing friendliness got him, and us, into trouble now and then. Some people didn’t take kindly to probing questions. Others found his puppy-dog openness suspect or unsophisticated. But his innate, bottomless curiosity about the world also taught his four daughters to be open to new experiences and comfortable with improvisation. Even now, in his late 70s, he lives each day with a kind of purposeful recklessness, asking provocative questions and seeking new experiences in the belief that he can break through to something better, more meaningful, more satisfying.

Though my parents had little money, they took us on adventures all over the world. Driving through Scotland in a rainstorm, we pulled over to the side of the road and rode the wild ponies grazing by the fence. We coaxed a stray lamb over to our rented R.V. to feed it. One year my father switched houses, cars, teaching jobs, committees and pets with a professor in Melbourne, Australia, sight unseen. Another year our family of six flew to Crete without a plan; at the airport Dad bought a map and started asking random strangers, with the help of a woefully inadequate Greek phrase book: “What should we do?” “Where should we stay?”

This spontaneity meant that we missed flights, lost luggage, drove on perilous roads late at night, stayed in some cold-water hovels, and sometimes went hungry. But it also yielded beautiful surprises: an undiscovered beach, a fisherman’s hut with a breathtaking view, a hillside breakfast of goats’ milk yogurt and fresh honey that I still remember 35 years later. It led to his daughters’ sense of the world not as a huge frightening place but as a wonderland ripe for discovery.

The Maine farmhouse in Andrew Wyeth’s iconic painting “Christina’s World” was not yet a museum or even open to the public when my father got it into his head — soon after our ambush of E.B. White — to take a family field trip there. Following his usual routine, he pulled into the small village of Cushing and asked a local how to find the Olson house. When we arrived (no doubt trespassing), we picnicked in the field where the woman in the pink dress in the painting had lain. Looking up at that weathered gray house on the hill, and hearing the story of the woman with my name who spent her lifetime there, I was entranced. Years later, I drew on that experience to tell my own story of the painting in my new book.

There’s no doubt that my dad’s endless curiosity has shaped who I am. I often find myself — to my own kids’ embarrassment — chatting with strangers in lines, accepting spontaneous invitations, and seeking out-of-the-way adventures.

I think the most important thing I learned from my dad is that when you go out on a limb there’s a risk it will break, but you’ll get a whole new perspective on the world. And if you’re really lucky, it can feel like flying. ‘

Christina Baker Kline is the author, most recently, of the forthcoming novel “A Piece of the World.”

# # #

First….fix the harm we have done.

The opioid crisis.  It could have been predicted, after all.

Today you hear the smart young health advocates talk about setting up “pain clinics” as the “NEW” answer to the opioid crisis. You have already seen holistic wellness centers and alternative medicine practices cropping up on almost every corner.  But, let’s remember the ’70s.  When you had unlimited visits to chiropractors and physical therapists; when doctors could take their time to talk to you and treat you – when triple booking patients was not an industry best practice – but reserved for flu epidemics and such?  If you’re under 45 years old, you won’t have any idea about this – unless you are a medical history buff.  If you’re a physician you won’t even get this “old school” information taught to you in med school.  But this was before managed care – before big pharma, big health-insurance-business, big hospital-business, and big government regulation – when these things weren’t just tried here and there – they were a staple of medical care.

In the early ’80s a severe sciatica problem had me going dutifully to my chiropractor 3 times a week.  The most I did for pain outside of those visits was Tylenol and an ice blanket.  I was re-educated about how to not cross my legs at the knee, but instead at the ankle, when I sat for long periods of time; how I should get up and walk around about once an hour at work; and why carrying a heavy pocketbook and briefcase over one shoulder was no longer advisable.  I also learned about anti-inflammatory foods, and got advice on the proper exercise to do – and not to do.  It was a struggle, and it didn’t go away quickly, and there was one bout of a prescribed muscle relaxer for a few days – but, slowly, I learned the triggers and the treatments.

What would that treatment look like today?  What would the pill of choice be that I would be prescribed?  And how many would I get?  Would I get beyond 5 to 10 office visits to a chiropractor?  Would physical therapy be covered at all – and what would the wait time be to get in to see someone?  Would there be some counseling provided as to a good diet and proper exercise – and preventive techniques?

90% of pain clinics ceased to exist – yes, they were closing up shop, except for those serving the more well to do – out-of-pocket patient base. Other than that, compensation and reimbursements were drying up.  People were still in pain – and there was no miracle new drug that had been discovered.  Big-everything changed all that.  Managed-everything was faster, cheaper, and less holistic. And, today we find ourselves in an addiction and overdose epidemic of epic proportions.

I agree with this article, by Cindy Perlen, LCSW, and posted on KevinMD.com.

http://www.kevinmd.com/blog/2016/06/opioid-disaster-stop-criminalizing-doctors.html

Now that we are in this crisis – in 2016 – what are we talking about to deal with this opioid prescription crisis and a population increasingly in need of pain control? We’re talking about opening pain clinics, and encouraging (not paying for) people to seek alternative methods of dealing with pain – get a massage, go to an acupuncturist, utilize exercise.  Only if you really get hurt will it be paid for, and then, that treatment will also get restricted as to numbers of visits and/or costs.  We’re also talking about limiting pills doctors can give their patients.  We’re investigating doctors.  We’re criminalizing the medical system – and people who get hooked. Of course, there are real reasons to do some of that.  But in our rush to criminalize, to sanction, and to walk government right into the hallowed privacy of the doctor patient examining room, we have forgotten what got us there.  We have forgotten that we already know much about how to fix people in chronic pain.

For those who, because of their brain wiring, being prescribed opioids was the worst possible treatment. Now, they are on an addiction spiral, and we struggle to know what to do.  We have never seen a crisis like this.  Our drugs won’t take care of it.  Our prisons won’t.  Our mental hospitals won’t.  For now – it is our graveyards that are.

It is time we face this square on.  Pay for proper treatment of people in pain.  Open the pain clinics.  Pay for “alternative” care.  Re-educate the medical specialists who know so little about other ways to treat – other than pills and surgery. Stop the problem from continuing. And figure out how to clean up the mess that has been left behind.

Put the blame where it belongs.  We did this to ourselves.  I swear if you live long enough, you really do begin to see everything “old” become “new” again – functional exercise replacing use of complex equipment; simple, real foods replacing fast food grazing; custom-made anything replacing manufactured goods; “made in the USA” a better brand than the magic of manufacturing “made in China”, natural materials over plastics, organic over GMOs.  Eastern medicine looked at with new eyes, as Western medicine struggles to keep the healthy healthy, but has a pill for every ailment.

Don’t blame the doctors. Don’t blame the patients. Blame big pharma, big business, big medical-training, and big government…

Retraining and new curriculum for medical professionals. Healthcare for all might be the only answer – with a prevention and holistic focus – that’s two places to start.  Pay for proper treatment of people with pain.  Invest in prevention.  Help the addicted and the overdosing.  Sometimes it seems as though the plan is to wait until they all die away, and we can hit reset.  Sometimes it seems that we are on that road. We simply can’t do that. Nor can we fail to address that as we live longer, and are more active, people will have pain.  Intense pain.  Pain that we already know much about treating.  And we’re only offering half the treatments that are out there. Or will we only stoke the science machine to develop that next new pill?

Terror at Christmas

Christmas past…

Every Christmas I waited for one gift.  It would usually come a few days before Christmas, and it was never wrapped.  But I knew it was coming, when I heard my uncle bound up the stairs, rather than plod one step at a time. “Is she here?” he’d bellow.  I was always there. Where else would I have been?

As the only boy in his family, growing up with two sisters, one my mother, and a father who was more into gardening and puttering, than hunting or big physical exercise, I imagine he was thrilled when my mother was having a baby.  I imagine he was a little disappointed when it was a girl.

But quickly he figured that it made no difference at all.  And he would simply treat me like a boy.  So, gifts of clothing, of which there were very few, were often blue sweaters or orange and black gloves and brown boots bought in the boy’s department. As I said, he didn’t buy clothing very often.  What he did buy, though, was pretty spectacular.  Especially for an “only child” being raised like a princess (as a recall). Barbies!  Carriages!  Baby dolls!  All were plentiful. But they never came from my uncle.

No, when my uncle would come bounding up those stairs, I would just wait for it!  What magical toy would it be?  Lincoln Logs.  Those little plastic Indians and Soldiers in their war stances.  We’d play and make forts and have some big battles! Sets of tinker toys. And we’d build giant spaceship type structures. One time there were racing cars, complete with a curving roller coaster track.  There was the police car, all black and white and heavy, that you could rev up by running it back and forth and then letting it go and the red light would shine and the siren would shriek.  There was the police gear. And a badge I could wear. And we would play and run around the house. Never for very long, though. We’d start to play and then he’d run off to do some adult thing that he needed to do.

My mother would say “Sonny!” (what we always called my uncle) “Sonny! She’s a girrrllll!” But, I loved it all.  The gun shot caps.  Then he bought me real caps – the kind you stepped on and it sounded like pistol shots.  There was a science kit or two, and then, one day, there was a “pearl” handled silver gun.  It was big and heavy.  You could cock it back and it would snap out a loud POP.  I can still remember how it felt in my hand and how there were ridges on the inside of the hammer.  Better, yet, this gun went into a holster – a black holster that went around my waist.  Eventually I got a cowboy hat to go with it. And bullets on a cross strip.  And boots.  I was banned by my mother from playing outside dressed up like that because the neighbors might see.  So I played inside.  Lost in a world of Gunsmoke and Bonanza. Even Andy Griffith carried a gun!  And, for that matter, Ellie Mae Clampett from the Beverly Hillbillies prided herself on her shooting prowess.

As growing up will do to you, it changed things.  And the Christmas came when the boy-toy didn’t get such a gleeful response from me; and it stayed unopened.  “Hey, you didn’t open it… yet” he said, a few days in a row. Eventually the boy-toys stopped coming.  Eventually we didn’t play together anymore.

These memories are vivid this year; the same year my uncle passed away at 92.  I remember it because of how things have changed. And also for how they have not changed very much at all.

Christmas present…

Today, gun toys for young children are not cool.  But yet, they are on our shelves…waiting to be bought for little boys and little girls this Christmas.  The violent video games target the slightly older children, whose unformed minds bounce between fantasy and reality. This December begins with terror. Terror from San Bernardino – but living inside all of us today. When we’re shopping at a crowded mall.  Eating in a restaurant. Attending a concert.  Now, when we’re at work at a holiday party?

Gun control.  It seems an impossibility.  The little tweaks are purposeful, but in fact, all the guns we will ever need are already out there.  Guns are forever, but ammo degrades. It has a shelf life.  Ammunition is gun food. If we can starve the guns a bit, or change the way ammunition sales are regulated and controlled, perhaps we can change the way guns are used. As Marc Ambinder wrote in The Week in 2012, “Guns need food. Starve them”.  We can be distracted by all the focus on gun control – let us ask ourselves, what else can we do?

Here’s another thing we can do – we can ask to have these toys removed from our shelves. We can stop buying them. These are some of the gun type toys available for purchase on this one day in December in Rhode Island. They are at Benny’s, K-Mart, Toys ‘R Us, and Walmart stores.

The first store I visited was Toys R Us and while there were a few gun-like, nerf-type toys available, I didn’t see the more realistic looking, AK-47 types.  When asked, the department manager told me, “I haven’t seen them here in this store in about 10 years.  We stopped carrying them after Columbine.”

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Christmas Future…

What will be our Christmas future? What terror will hold us close?  How will we harden and adapt?  Is this our new normal?  I think about my children.  My grandchildren yet to be. I hope they can find the answers.  And we – the elders now – must stay engaged.  Let us bring our memories of our own childhood and see what we can do to our tenuous hold on happiness and peace in our loved ones’ future.  As Scrooge said at the final ghost appearance, “the shadows of the things that would have been, may be dispelled. They will be. I know they will!”  Let us pray there is truth in this tale.

 

I saw Jesus again today.

The first time had to be about five years ago.  He was walking slowly down a city sidewalk, parallel to the four lanes of traffic – he walked against the two lanes closest to him. So, the drivers could easily see his face as he walked.  You couldn’t overlook him or let him meld into the background, much as we often like to do when we’re disturbed by a person’s physical appearance. This man walks with his head slightly down, long, black, slightly wavy hair, parted in the middle.  Thick black eyebrows.  He is slim and tall.  He wears khaki cargo pants, the kind with lots of pockets and a little polyester so they have a bit of a swish to them as he takes his strides.  They fit close to his body, and hang low on his hips.  A black jacket hangs from his broad shoulders, past his thin waist. He did not walk on the main part of the sidewalk, but similar to the cars being driven in their thin lanes, he walked on the cement curb, one foot in front of the other.  He is barefoot.  The walk reminds me of that of a runway model and how they place the toe of one foot precisely behind the heel of the foot in front of it.  He didn’t totter.  Not at all.  Neither did he raise his hands out to the side to balance like a tightrope walker. He simply walked, in a steady, strong, slow cadence.  He walked with – grace. I remember thinking that the straight posture and balance came from something – dance classes? Fitness or core strengthening exercises? Gymnastics? Modeling, perhaps?  It was a trained walk.

Years before I had seen this man in my neighborhood. The neighborhood is not known for having homeless people walking about. Almost never. There was an occasional disheveled looking person walking to a bus shelter, carrying a white plastic bag, with little in it. You could tell by the way it hung from the wrist. I’d imagine toothpaste, toothbrush, maybe a bottle of water? Over the last few years there were just a few people with these white plastic bags. You knew only a fraction of their story by seeing them – the part of their deep, convoluted, complicated story – the part they could no longer hide.

This man stayed in the neighborhood season after season.  He would just appear one day. If the weather was cool he wore that long black coat – similar to an oilskin duster worn on a ranch – and work boots.  In warm weather he would walk without shoes. That’s when he took to walking toe to heel on the cement curb rather than the sidewalk.

One day my daughter said she thought he looked like Jesus – Jesus walking so gracefully, so quietly, with a presence that belied his obvious present lot in life.

There have been a few times when his eyes have met mine as I looked out from behind my steering wheel. And there was the unexpected meeting in the supermarket.  He was picking out a few pieces of fruit and I saw his eyes as he looked up at me with his head still bent downward. I was startled. Kind, deep, filled with “knowing” – and, somehow, familiar. I did not know him, yet the familiarity factor was there, and it startled as it commanded to be seen.  It wasn’t like the wild eyes of the deranged, but a kind and steady, sure look. A “don’t look over or around me” look. A look “at” me look.

I watched him walk through the fresh produce section, and maneuvering slowly around displays.  Grace.  An athlete’s grace.  A dancer’s grace.  Maybe an angel’s grace. This Jesus was food shopping.

It was then for several years that he was absent .  When I would see a person panhandling for donations at the end of an off ramp, I would often think of Jesus. Where had he gone?  Had it been time to move on?  Had he died?  Was he sick, in the hospital, or more likely, in prison? He would never have been standing at an off ramp. That I knew.

My daughter recently moved to the city over from mine.  This morning it was quiet in my kitchen as a text message came over my phone from her.  “I just saw Jesus! Walking near TGI Fridays – he’s down the highway. He’s making his way south!!” So, he was back, but had moved on a little further away from me.  It isn’t warm enough yet for him to walk barefoot.  Will he stay close by, or is he steadily moving south – a little late in the season for a RI snowbird migration. Do the nomadic homeless go south for the winter? Do they walk all the way to Florida?

Now my daughter will look for him, this Jesus walking.  A little more disheveled, and looking a little bit older. With the perfect posture and the dancer’s cadence.  Walking with grace.  Maybe she will see Jesus food shopping.  And he will look up at her with his deep kind eyes – eyes that held his life’s story behind them. Eyes that simply say, “I am here.”

“I am fearless now….”

“I am fearless now….”.

“I am fearless now….”

There are different kinds of memories. Events and happenings. Climactic moments. Hallmark days, such as a wedding, a funeral, a graduation. There are other memories that run deeper.  Memories of…scents…sounds…sight. Memories of emotion and feeling are perhaps the strongest.  The overwhelming moment when something happened inside of you; it changed the way you thought or felt about something. Like you could almost feel your brain morphing. The light bulb went on. The “aha” moment. The door shutting – for good this time – on a path of the past, a path that had been worn down and was going nowhere, and you struggled to get out of its rut, and now you can. These moments are, as they say, more ’emblazoned in our memories’ – because they go to our core – our heart and soul – they become more memorable because we were changed in that moment, that moment that we’ll always remember. We are different going forth.

This week the President gave an interview on radio which was somewhat controversial – but he stood rock solid, with a smile to his critics.  Something had changed in him.  A light bulb moment. An “aha” moment. A door shutting, or perhaps opening.  He put it simply when he said it: “I’m fearless now.” With that familiar jaunty full-faced smile we see more of these days.

This week I listened to a speech made by our new “fearless” President, this new Barack Obama.  And as he was expected to do, but no one could have truly anticipated, he gave a rousing one. But he went beyond rousing. He made a substantive one. He used high emotion, tragedy and deliverance to talk about issues that our country has yet to solve – poverty, poor educational systems, unfair housing, gun control, mass incarceration, jobs, racism, subtle prejudice – and he couched it all in the word “grace”.  Not “hope”, but “grace”.

And as natural as the gently waving program books in that church of 5,400 people – and in our homes and offices as we listened – our President began to sing. Low and deep he began. With the words, “Amazing grace. How sweet the sound…”.

I closed my eyes. I wanted to remember this day. Friday, June 26, 2015.  I wanted to emblazon its memory into my mind. I wanted it to change me. I wanted to call my children to gather and listen, but I was frozen watching this all transpire.  And as I thought of my children, grown and working now, I remembered Tuesday, January 20th, 2009.  My daughters were 20 and 22. Just coming of age in this adult world. We sat in the living room with snacks. Dip and chips, Guacamole, Nachos, and fruit. We wore our baseball caps of red, white and blue – one for each of us – with the word “HOPE” stitched right on them. And we watched our President take the oath of office. He delivered another speech that day – and it was a rousing great one, too.

I remember thinking back to another day – September 11th, 2001.  The day when hope died. When ‘future’ seemed grim and hard to imagine. My daughters were 12 and 14. I knew on that day as I watched them come home from school, that their lives had changed. Forever. 2001 began a time of war and fear in our country – faded only somewhat into the hope and change promised to us in 2009.  Things seemed so bright. There was hope again.

Six years we have walked this path with the first black president in our country’s history.  We have seen polarization and stagnation – and yes, we have seen change, and progress. Healthcare. Immigration. Employment. Yesterday we watched as same-sex marriage become the law of the land – and in a moment of glory and grace it became – just – “Marriage”.

We have watched our President age and turn grey. The memory of that promised hope has tinged grey, too.  But he has moved beyond hope. As legacy looms in his mind and for history, he has moved the conversation along and called upon ‘grace’.  He says he’s fearless now. He carries this new state of being with him, as he carries forth with a song from deep inside. He’s making new memories. With new words. Grace. Fearless. Legacy. He says he would have been a better president – today – than he was. Self-awareness is not lacking here.

But what can we learn? Have we learned that “hope and change” is not a plan? Do we need to conjure up some grace to lead ourselves along? And, if we can conjure up being fearless…think what we might do? Legacy looms closer at my age. The older-agers that 20 year olds grow weary of having around, are so important to moving hope and change along. The young-invincibles with a lifetime ahead of them, with things we need in this country – spark, energy, new ideas, and yes, hope.  But fear stalks the young. It limits them. It holds them back. Fear of speaking out. Of repercussions. Of loss of friends, colleagues, or opportunities. Of career short-circuiting. Of brass-ring missing.

But with the legacy years comes a sense of fearlessness. And that is power. Yes, it’s time to perfect the chocolate chip cookies – to be remembered forever for.  And to try for that hole in one.  But let’s not drift away too far. Together, wrapped in hope, wrapped by grace, together, think what memories we could make. Think what legacies there could be, not just for us as people, but for these United States.

Everything I needed to know about patient care I learned from my vet

My “Bella” is a long-haired, black-and-white “Tuxedo” rescue cat. Her veterinarian, Dr. Cathy Lund, opened an all-cat practice in 1998 in Providence, RI.  As her website states, she thought being an all-cat vet was just “purr-fect for her”.

I work on the fringes of healthcare, now, usually in promotions or marketing for a particular advocacy initiative or to raise funds for the cause du jour.  However, I spent over 25 years engrossed in healthcare – most of it in the marketing end of a large, national nonprofit.  Some of it as a communications professional for a small local hospital in an urban setting.

I spend a great deal of observation time these days looking at healthcare and its changes, improvements, and fragmentation bringing those professional perspectives to bear.  A year or so back I looked at these issues from the inside, when my daughter had a short and sudden illness.  But, a few times a year I look at it from the perspective of a cat.  A black and white perspective, you might say.  And each time I wonder, what lessons can be learned from the world of vet care to the world of human health care about a more patient-centric system.

First, I imagine how her medical record “notes” section might read:
“Bella is now in her 13th year, and is relatively healthy, though has struggled with mild obesity for most of her life. Her weight-loss attempts appear to have been exacerbated by a psychological need to overeat, perhaps as a coping mechanism resulting from post traumatic stress disorder of unknown origin, occurring early in life. Genetic traits are unknown, as Bella was taken in as a homeless stray at a few months of age. Our family accepted Bella into a home that had experienced a recent loss of two adult cats to old age.  Bella’s earliest days included gender confusion, as she was first thought to be male and referred to as Mason. She was also aware of early desires to take her to a shelter and adopt her out to another home. However, these additional early traumas soon resolved themselves, and Bella acclimated well into her forever family. “

Bella, which translates to “The Beautiful One,” aptly describes the prominent place she has taken in the family.
While Bella has not had any extraordinary illness, other than a mini-surgical procedure for a five-foot long piece of string down her esophagus and the extraction of several teeth, she is not an easy patient. Her unknown past, and suspicion of being feral, has meant a delicate handling. All eyes are on prevention. Preventive care has meant regular check-ups, shots, nail clipping, and blood work. It has also meant dealing with a progressively standoffish attitude, which has deepened with age into full-blown rage at invasive examinations and the sight of any other feline. Her “mental health problem” has exacerbated the provision of her medical care. Bella does not take well to invasive procedures, yet requires regular examinations of nails, teeth, and ears. Inoculations. Blood work. Cautionary procedures include full-length protective gloves for all medical staff. Mild sedation is recommended. Experimental prescription of valium proved to be ineffective and was halted.

Throughout her years of care, reminder postcards and e-mails are received when it’s time for a check-up. Appointments are made on the phone or by request over the website. You can even request an appointment on Facebook; there’s an app for that. Waiting time is less than a week [same day if there is a crisis, and phone calls returned within an hour, if needed].  Appointments are confirmed by e-mail, and again, a few days before the appointment, there will be another e-mail and a phone call, along with any special instructions, such as nothing to eat and drink after midnight. The day of the appointment there is no waiting, and because Bella is a mild-sedation patient, a first-in appointment is always available, so the distress of not eating or drinking since midnight is not too discomforting. When she is brought in, given her mild state of a building mental health crisis, she is talked to calmly and gently by staff. They pet her paw through the gate of her carrier and she is quickly taken in.

In an attempt to take care of her quickly, due to her sedation, one can only envision the Mario Andretti racing team pit crew being called to her tableside. They swoop down and, in quick order, in less than half an hour, the care is done. Using sedation on an older cat is a concern that grows with age, so the quicker, the better. Their specialists have come together, each taken his/her turn – nails, teeth, ears, shots, blood work, a little shaving here and there, and good to go. Recovery is almost immediate as the sedation wears off. With a groggy “hisssss”, we know all is well.

There are follow-up instructions and education at the front desk. A quick checkout and then the next appointment is set. There is the constant reassurance, explanations, and calm demeanor. There is even a pat on the back for me, when I’ve needed it. We are good to go.  Within a few hours of being home, City Kitty will call to see how Bella is doing and if I, her caretaker, have any questions. They refer to her by name and speak in an unhurried manner. Later that afternoon I will get an email. It asks us to submit a review: how did we do, and are there any suggestions? A few days later, there is another call. How is Bella? We’re thinking of her. Here is the result of her tests. Guess what? She is at her ideal weight! May she live long and well, and just call us with anything.

I am often struck by the quality of the “kitty care” provided to Bella – and what we could learn from it that might be applied to “health care” provided to humans.

Slow down might be a start. Look the family and the patient in the eye. Call the patient by name. Speak as if you genuinely care, because I assume you do. Don’t be afraid to touch the patient, or put your arm around a family member or caretaker. Repeat instructions. Ask if there are questions. Ask again. Provide information. And, educate and follow up, in several ways, by e-mail and again on the phone. Have a website that has a picture of the patient and their information, too, so they can see their records.

Keep good records. Have a resource link that is tailored for different types of patients and conditions. Tell us about who works there – not just their medical credentials, but a little bit of the personal, too – and perhaps show us their photo. Include a way on your website, or by e-mail or on social media, for us to ask you to call us, or to make an appointment.

Bella’s birthday is in February. She will be 14. She will receive a birthday postcard from City Kitty – and an email greeting, too – just as she has every year.

As published in the June 8th issue of ConvergenceRI

http://newsletter.convergenceri.com/stories/Everything-I-needed-to-know-about-patient-care-I-learned-from-my-vet,158