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. ‘

First….fix the harm we have done.

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

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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.

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I saw Jesus again today.

little-boy-walks-road-curb-sepia-high-definition-video-fps-sec-please-look-another-footages-my-train-arrival-account-45180160-1The 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….”

th-2There 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…”.

Amazing-GraceI 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.

getPartI 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.

520976963_295x166But 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

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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”.

DrLundI 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.

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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.

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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

We are every one of those 50 shades of grey…

Yes, I’ve seen the movie and bought and read all the books. I am 50 Shades of Grey literate. I watched the live debut in London yesterday afternoon, on the internet, complete with the red carpet walk, and interviews with the producer and the writer who said she never dreamed she would be at a debut of a movie made from her books.

I thought the movie would not live up to the books, such as they are.  Regardless of the success, or not, of the movie, the success of the books cannot be denied – if you judge success on books sold and money made.  100 million women anticipated to have read it.  The formula these days seems to be in writing trilogies and in something that lends itself well to images, blogs, and social media – to hype the hype.  50 Shades has all of this.  The book – as in any book – brings images to mind. Images that are as private as the image of each of us reading the book – in our easy chairs, in bed, late at night, on our computers, or ipads, hidden in our offices, or even reading on our cell phones, if we didn’t want to have the book in the house.

As the movie has come closer to opening, we hear a variety of words – anticipatory giggles, “when are you going”, “are you going with your husband”, “…with your boyfriend”, or “with the girls”?  We hear angry words, mainly from women.  Women talking about violence towards women, disrespect, abuse, and challenging each other to boycott the movie on behalf of the cause of feminism.  Or we hear psychologists talk about the damage it will cause to young girls.  We hear little from men.  They say it’s a chick flick. And they don’t know what it’s about.

The Valentine’s Day opening was moved to the 13th, so ladies could go with their lady friends and still have their date nights on the 14th.  Would couples attend together?  Would there be giggles?  Shifting in one’s seat?  Sighs of mutual acknowledgement? Nods to each other when we leave the theater?  Rushes to our cars?  Would we post our thoughts on Facebook? Or would we be as quiet as we were in the private time when we read the book?  Alone with our thoughts.  With our ponderings. With a smattering of confusion.1423712148300The theater was filled.  Mainly women, but a few with male dates, too.  We began with quiet applause, as if we had all been waiting a very long time in our lives.  Popcorn at the ready, we snuggle down.  Women in sweat pants and comfy clothes, no dress-up needed. There is humor in this film.  Mainly it is comedic timing and natural instinct by Dakota Johnson.  Jamie Dornan does not meet our expectations of Mr. Grey as neatly.  How could any actor meet what each of us had imagined and created in our own minds?  A little too slim.  Curling up of the upper lip makes him always appear as about to giggle. Shoulders not broad enough. Though his hands are striking, and brought about an audible gasp from the audience as he clasped a table edge.

In my opinion, the movie is not about BDSM or violence against women.  Or degradation. Or disrespect.  It simply isn’t about any of that.  It is about the fantasy.  The fantasy of what women – mainly older women – might think about – sometimes.  Maybe it’s even an offering of a fantastical thought, should the woman have run fresh out of them. The exploitations that may roll around in one’s mind, while the reality of acting upon any of it would equal the chagrin of a couple watching mid-core porn in a hotel room. Really, honey? But we might think about it. We might.

So, just what is the appeal of all of this experimental sex?  What were the sexiest moments?  Were they the riding crop, or were they by the piano listening to him play a haunting melody?  Were they the necktie around her wrists, or were they taking her up on an air glider, a day completely planned by him, from beginning to end?

bill-clinton-monica-lewinsky-affair-ftrAs I sit writing this I am listening to some “national expert” talking about the grave damage this movie will do to young girls….and I think about Bill Clinton and his declaration of “I did not have sex with that woman”.  I think about how oral sex replaced intercourse by definition for young girls in an instant.  And how a “goodnight, I had a nice time” with a kiss, became lost to the acceptable act of quick oral sex.  One sided, I would add.  How has HPV been spread exponentially?  By young people – men & women – believing an STD could not be spread this way. Because this is not sex.  The president said so.  Talk to young women today.  The sexual act, for many of them, is about their performance with their man.  Not about receiving pleasure, or sexual skill of their partner.  It is yet another giving act – much like making dinner, and doing the laundry. And if the money equation is tipped on the male’s side, even more.

50 Shades of Grey is fantasy.  Speaking as a feminist, I believe men probably don’t get it (nor will they take the time to read or watch), so we need to tell them how we are feeling about it.  It is not the black and white of sexual pleasure.  It is the grey of our lives, of our minds, of our exhaustion.  It is the grey of our feelings – of what might be, or could have been.  It is a lifetime of fairy princesses and handsome princes, with broken promises for our lives, watched when we were very young. To be followed next by Donna Reed and Lucy and Laura & Dick Van Dyke. We have the ‘right’ to equal pay and our careers.  Yet our “before” lives and responsibilities remain largely intact, too; just with more stacked upon it, very little removed or replaced. Many of us do all of this while also being the sandwiched caretakers of our aging parents. And still we hear we aren’t doing enough and that we need to “lean in” and do more. Be more.

1246217_1373593008227_fullThe fantasy is freedom. It is putting our shoulders down and not worrying about what is for dinner or the buying and cooking of it, or where we will go if we go out (pick the restaurant, arrange for the babysitter, get the concert tickets, call the friends).  It’s not worrying about buying our own car, or servicing it. Or paying all the bills.  It’s not even thinking about what we will wear.  It’s about looking good, being fit, being healthy, being taken care of. It is a fantasy of release.

But as the books and the movies are clear to reveal, the control in this fantasy is always the woman’s.  She realizes it herself, half way through. Nothing is done to her she has not consented to, or actually asked for.  Her inquisitiveness did take her a little too far, but sometimes that happens with a safe situation and a mind free to wander.

This movie is not for the young, and certainly not for tweens.  Much damage has already been done by an ex-President, and what we watch on our televisions every day. Sex mixed with violence is power.  Not sex.  50 Shades of Grey is none of those things.  It is mature content, for a mature life.  It is a gentle, ‘what if’. It is not a blonde princess spinning on the ice singing about her true love. It is, however, fodder for conversation between couples about that private part of their lives.

765d00dde9d4099d_reese-on-setThe fact that this movie is about to enjoy success at a time when the popular movies are showing some of our more famous female actresses at their worst – no makeup, abused, beaten, raped, going through physical challenges, etc. is an interesting coincidence.  This time, we seem to want another fantasy. In the yin and yang of life, this time we want to be the woman offered an easier life, love, and consensually great sex (and of course we want control).  But sometimes we also want to be seen as the woman who has been torn to the ground and has risen again, scathed and damaged, but alive, and the wiser for it, too. A survivor.

We are a complicated hot mess. We are not black and white.  We’ve earned every one of those fifty shades of grey.

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“We” are not amused…

It is almost a knee jerk reaction.  I hear a politician tell us “I need you to…” or “I will be asking for this in my budget…” and I’ve already had a gut reaction to the start of the sentence, such that I really don’t hear what comes after that.  I imagine myself on that podium, saying that sentence.  And I realize that the word I would be so hard for me to utter.  In writing, yes, I can use it.  But in speaking?  To a group?  No, I just sticks in my throat.  But why?

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Linguistically, there is the use of the royal “we”.  First, made famous by Queen Victoria when a vulgar joke was told in her presence. When she replied, “we are not amused”, she “clearly intended to speak on behalf of the other ladies whom she knew were equally offended.” Later, used by royalty to note the collective body of a politically organized nation – most commonly used as a term of separation – them and those – we and they – the intelligentsia and the peasants.

The use of pronouns such as I and we are called functional words.  When used by politicians, the choice can mean the difference between claiming authority and creating community.

There are even studies done about one’s mental state and the use of these functional words.  More people who are suffering from depression use I as opposed to we or they.  Kind of fascinating.

Having spent almost an entire career in the world of nonprofits, I learned quickly that the use of we was, indeed, to build community. And not at all spoken like the “royal we”.  What seemed so odd, at first, became rote.  “We hope you will…we ask you…we thank you.”  Sometimes I felt almost like turning around to see who else was standing there with me.  Never the bolder use of I.  Never as though the individual, the staff member, even existed, except as a title of function, certainly not a separate person. What mattered was the greater good, the cause.

I would like you to donate a major gift towards research.” Imagine! “I would like you to?”  “We need you to donate a major gift towards research.”  OK, but who is the we?  The we is you – and me – and collectively, all of us.

So, staff were in the background, writing the words, designing the photo opp, poised with conductor’s baton, or wind up key, if you will.  It was an adjustment – to deny one’s self – personality – personae – to become invisible.  But soon I came to understand the benefit of this group-being. So, for 20 years I was on behalf of and quite content in that role.  It was deemed to be a best practice of success for a nonprofit.

Today, the role of staff in a nonprofit is quite different.  Today the staff member is often front and center.  Someone whose life has never been touched by the disease du jour is speaking at a podium about the tragedies of some type of cancer they’ve never had.  Often, the volunteers or ‘survivors’ are right there, and willing to speak, but they are not invited to do so.  It is the staff member’s job now.  One they may truly love and be dedicated to.  But one with distance built all around it. Between community – and cause.

All this goes through my mind when I hear the word I spoken by an elected official, over and over again.  What is the purpose?  It must be to reinforce one’s role of power, surely not to build a sense of community – not to sing kumbaya with the people at all.

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http://www.youtube.com/watch?v=vo9AH4vG2wA

I think about the organization I worked for and how the tagline, or slogan, it used, changed over the years, reflecting part of this new word order. “We’re fighting for your life.”  Outwardly focused. Inclusive. Involving. Engaging.  “I’M not fighting for your life.  YOU are not fighting…WE are fighting.”  Kumbaya. Exponential engagement!

Today, that slogan has morphed to several others, with degrees of warm and fuzzy. “Learn and Live”  (don’t listen to me and you’ll find out for yourself);  “Your Life is in Your Hands” (it’s up to you, do what you want, you know what you need to do)’ and, today, “Life is Why”. (we’re tired of giving you all the reasons why – you should know why by now).

We have made today’s politicians into caricatures of themselves.  The media has done that.  And we expect it now.  We tweet about the color of the Governor’s jacket and how her hair looked on any one day.  Our obsessiveness would lead one to believe that we have relegated them to use the “royal we”, yet we have created a new level beyond that. Today politicians ask us to do things, to support things, in first person.  I need you to do this.  There is leadership in that, and a sense of authority, but I suggest there is no sense of community or coalition building.

If I were the speech writer I would reserve the authoritarian use of “I” for select moments of crisis.  Rather, I would bring back the royal we, the friendlier we.  For, “it’s all in our backyard”, isn’t it?  It’s not your backyard, or my backyard, it’s ours.  How might we all better respond if we brought back the use of the plural personal pronoun?  Just as your mother saved the use of your middle name for “those times” when obedience meant right now, and no discussion, politicians might command a more communal sense of engagement with the use of we, forgoing the assertive first person singular pronoun for crisis and woe, for that time when “we are not amused”.

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50 years ago it was Kitty Genovese who couldn’t breathe…

As the tragedy of the death of Eric Garner and the call for action and justice, has played out nightly with demonstrations coast to coast, and cries of “Black Matters” and “I Can’t Breathe” have entered into our cocktail chatter and business conversations, I can’t get the thought of Kitty Genovese out of my mind.

Do you remember Kitty? 

Kitty was a 28 year old woman. She worked as a waitress. One night, around 2am, she was murdered – stabbed and raped – right outside of her own apartment – by a 29 year old man who said he simply went looking for a woman to kill “because they didn’t fight back”, he later revealed. Kitty fought. She screamed. It was a loud, disruptive incident. Yet – no one called or came to help Kitty. Over 37 people later said that they were aware she was being attacked. They had heard her screaming for help.  Each person believed someone else was doing something. Calling for help. Rushing to her aid.  Yet, no one did.

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The social psychological phenomenon became known as the “bystander effect”, and, Kitty had her immortality, in the study of the “Genovese syndrome”, which continues to this day in colleges all across the country.  Literally, books have been written about Kitty – and the syndrome that bears her name.

While a student at Providence College, I studied social psychology.  I became rather fascinated by the development of group consciousness, group mentality, and “diffusion of responsibility”, and the “bystander effect”.  How could it be that one or two people would have more probability, individually, of helping someone than a group would?  How does the instinct to act become dissipated when they see themselves as members of a group?

We see this demonstrated with Kitty, yes.  We also see this on our college campuses when we talk about rape and sexual assault.  Often, the worst take place in fraternities or at parties, where society’s boundaries morph to the new society of the moment.  Where actions one person would never think about, much less act on, become the group’s behavior, and the individual becomes but one cog in the wheel that has been set in motion, with its own outlying concepts of right and wrong, its own shady sense of rules. As but one cell of the whole, the power to pull away is exponentially difficult.

The collective brain often rules.

The study of this has led to some good things.  It only took 25 years or so for CPR training groups to realize that there was a fatal flaw in step #1 – “call for help”.  How many of us were first taught to shout at the downed person, “are you all right” and then to shout out into the air or the group gathered, “call 911”!   Groups that were forever tweaking their CPR compressions, breaths, etc, heard about this, studied it and realized it was true that sometimes no one called for help – each thinking another member of this newly identified group had done so.  New instructions were written that when you called for help you should specifically select one or two people – looking at them directly and address them with a powerful order.  “You! Get help – Call 911 – now!”  What did this do?  It charged the specific person with a specific action.  The burden to do something – to move – was extremely powerful – and effective.  Some others in the group may act, too, but assuring that one person carried the full weight of that charge is now known to be crucial in a successful “chain of survival”.

How can this study – these concepts – help us better understand what happened to Eric Gardner – and offer critical retraining to our police officers?

We know his name.

Daniel Pantaleo. He is the police officer who put Eric Gardner in a fatal choke hold. But do you know who Justin Damico is? He’s one of the other officers. There were four others, too. There were also four EMTs/paramedics.  All told there were 10 “first responders” engaged with Eric that day.  And a score of others watching. The five police officers were given immunity to testify about the choke hold actions of Daniel Pantaleo.  The EMTs were suspended for their lack of lifesaving efforts at the scene, though they were later put back into duty.

Yes, Daniel Pantaleo was the officer who performed the fatal choke hold.  But there were four other officers there in that heap on top of Eric.  Did anyone say, “hey, back off a little, I think you’re killing this guy?”  Was that even a whisper? Or did the “diffusion of responsibility” have a powerful effect to have five officers believing that their actions were justified – there was no individual cry-out because there was no individual any longer – just ‘one of the five’.  Add onto this the layer of Eric being black. Add on to this the layer of poverty – all of this was happening in a poor section of the community.

What questions and answers can the study of group phenomena bring to retraining? Another group has used this information to help stop wrong side surgeries. Collective conscious thinking has been responsible for operating room errors when there was an assumption that the surgeon was cutting into the right appendage of his or her patient – even in the face of serious doubt or question.  It is a strong phenomena that makes an individual, maybe someone low on the hierarchy in the room, frozen from questioning, from saying, “wait, let’s check this again”. It is hoped that by retraining, and allowing all members of the group to have equal voice, this can change. To be effective, there must be a real promise of no repercussion, even if the person is incorrect, and all members of the group must believe that, to be so empowered.

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Did those officers, did Justin, and the four others, and David – approach Eric – with individual decisions that they were going to make this day one Eric would never forget – they were going to take this guy into custody – and if he resisted, they were going to kill him.  Right there, on the street, in front of groups of people, and while being film?

The overlay of race and poverty.

Did race – and bigotry – and fear – and poverty overlay these dynamics making the situation beyond salvation? Of course.  Exponentially so. So, yes, we need to do our cultural education and racial education, and our retraining.  We need to also restore the power of the individual to question tactics, protocols, and moments when common sense has gone haywire. Shoot to kill? Arming our police force like they were at war? Match our law enforcement to the diversity of the community? Teach individual responsibility and empowerment?

“I can’t breathe!”

There were lots of people around Eric.  Lots of people cried out.  But the most important ones who could have stopped it – the officers, themselves – didn’t hear.  They were bonded by a powerful magnet creating one new entity, made even stronger by fear. Each, by their silence to the others, reinforced the actions – the holds, the knee into the back, the smashing of Eric’s face into the cement – the fatal choke hold growing tighter and tighter.  They could no longer see with their own eyes, or hear their own thoughts – and they certainly did not the 11 cries from Eric – “I can’t breathe! – I can’t breathe! – I can’t breathe! – I can’t breathe! – I can’t breathe! – I can’t breathe! – I can’t breathe! – I can’t breathe! – I can’t breathe! – I can’t breathe! – I can’t breathe!