More Things I Forgot to Remember

During my medical training, attendings reminded us again and again to treat patients with dignity:  simple things, such as addressing them by title and last name, keeping them properly draped during physical examinations, sitting down at eye level when possible. The physical nature of the relationship between doctors and patients does not always bode well for that injunction:  there is no dignity in the rectal exam, or in dropping an NG tube, or in any of the many invasive things we do to patients during the acts of healing.  Nevertheless, there are certain things we can do that serve as reminders that our patients are adults, and that their bodies and minds deserve care with compassion and dignity.

So I had forgotten with my father.

“Dad, please eat the last few bites.”  I feed him.

“Dad, you need to take a shower.”  I undress him, I put him in the shower, I soap, I wipe, I dry, I redress him.

“Dad, time to brush your teeth.”  I put toothpaste on toothbrush, fill the cup, watch him brush.

“Dad, wash your hands.”  I give him soap, or hand sanitizer, and I watch to make sure he cleans his hands.

“Dad, please don’t use the stairs by yourself.”  I sleep on a makeshift bed, a human barricade on the staircase landing so that he cannot go downstairs in the middle of the night.

All these things that I think my father need to do, but that he refuses to do on a regular basis.  They are for his own good, right?  Why would he refuse to take care of personal hygiene, or to eat, or to get out of bed, or to do any number of other things that any reasonable human being does, as he did do for most of his life, but has stopped doing since Mom died?

My father is his own person, with his own reasons, making his own choices.  Who am I to try to force him on a course he doesn’t want to take? He wants to be with Mom, and as a thinking being, he is doing something about it.  And it’s about time I remembered the lessons of compassion and dignity.  No question it is a hard thing to watch my father dying, and to let him go on his own terms.  I choose to believe that is his gift to us:  that we are not his parents.

Conversation of the Month:

Me:  “Could you make sure after guests leave Mom and Dad’s house that you clean the                     toilets?  They were filthy after _____ stayed for 8 days back in May, and I had to                     clean them when I got here, 5 months after the fact.  Not fun.”

Brother:  “I did check the toilets, they were fine!”

Me:  “Did you flip the seats up and look underneath?”

Brother (in bewilderment):  “Why would I want to do that?”

In the Autumn of My Life

When white American men get angry and scared, they elect someone who is all they think they want to be.  He is white, he has gobs of money, he is a taker of women, money, property.  He is a racist, he is anti-intellectual, he is apparently amazingly potent — look at the much-younger beautiful-but-thick-as-a-brick wife, the many kids!  He would turn back the clock for all these angry and scared white men to a time when everyone knew where people of color belonged, where women belonged, where there were no such things as LGBT people (let alone rights for them), where Americans were home-grown and had a special relationship with God, where American military-industrial complex governed the world.

As a citizen, an immigrant, a woman, an intellectual, a believer in the rationality of science, a basically ethical human being, I am saddened by the election.  As a historian, I will take the long view, and I know America will survive this.  I don’t believe in American exceptionalism, but I do believe in American resilience.  I am happy to live in a state that did NOT vote him in, and I will do something I never really did before: pay attention to state’s rights.  As a doctor, I am glad that Colorado has become the 6th state to allow right-to-die measures for the terminally ill.  It was a sad election day, but with bright spots and hope intact for the future, for the next four years I will do my best to take care of my little corner of America.

In that little corner, I have other things to think about:


It’s not just any old knife:  I coveted this knife for the last two decades, and almost two years after Mom died, I brought her knife home.  Today I took it to Jim, my favorite knife sharpener.  He has been retired for years, but he sets up his tools every year during the summer outside one of our local grocery stores, and the rest of the year he sharpens knives and tools out of his garage.  Every time I bring in my other Mac knife (swiped from Mom years ago), he tells me how much he loves these Japanese knives.  Dad took care of Mom’s knives the old-fashioned way, with a whetstone.  This knife was Mom’s everyday/everything knife, and in the last few years, Dad stopped sharpening it for her, much the same way he stopped doing various things around the house for her.  Since her death, he has also stopped doing things for himself.

Dad is down to skin-and-bones now; he can barely get himself out of bed, he needs help bathing, he has a walker he hates to use but has to because he fell and broke his wrist.  Dad was a skinny kid and a skinny young man.  After he came to America, he finally developed a belly.  That belly would go up and down a bit and up again, and when it got too Pooh-like, Mom would put him on a diet.  For 50-something years, he had that belly, and he lost it all in the last year.  I help him bathe, and I am shocked by all he is now.  No fat, no muscle, just skin and bones.  He is so brittle.

I wait for Mom to take him home.

Letting Go, Again

I am very slow to acknowledge the end of a friendship.  I think I know what the other person is thinking or feeling, and of course I don’t know anything.  I attach different meanings to the silence, a very silly exercise in futility.  In my own life, I never say to someone, “I know how you feel,” because that phrase (along with “I will pray for you”) is both presumptuous and meaningless.  So why do I try to figure out why my friend is silent?

Martha and I met the first day of medical school over “Petunia,” our shared cadaver in gross anatomy lab.  She was older than the rest of us: she really had been at Woodstock, she had a daughter in grade school, and she was divorced.  She had done this and that, and finally ended up in medical school, determined to go into Ob/Gyn.  She was hard-working but not academically gifted, and spent part of the four years on probation.  But she did graduate, and we both ended up in New England for residency.

We bonded over Petunia and late-night study sessions and nasty attendings and nastier residents.  She was my best friend.  After medical school we managed to stay in touch through the occasional letters and emails, phone calls, and visits.  Then she stopped.  All my communications went unanswered for several years.  I did not know she had moved state again, that her email address had changed, that her phone number had changed.  But one day, she picked up her phone and actually answered the voice mail I had left awhile back wishing her a happy birthday.

We talked, and it was as though we picked up right where we left off.  She said she had been “very bad” about keeping in touch, and I did not push for a better explanation. Sometimes there just isn’t a better explanation, and if you don’t want a real answer, you shouldn’t ask.  But I confess I was hurt: she had managed to keep in touch with some of the other women in our medical school class, and in fact was renting a house with them for our class reunion.  Why was I not worthy?

She has stopped again.  It has been a year since I wrote to her, a year of silence.  I know where she is, I have her contact information.  I will be on a 2-week break near her neck of the woods, and I have been debating whether to try to get in touch with her.  Until today.  Today, my massage therapist (who is also a good friend and a very smart woman) told me something pretty simple: I cannot act based on how I think someone else will react.  Silence is just silence, but if I must have some sort of explanations, I should think about the nature of relationships and how people manage them: sometimes, the “I do not have the time” becomes “I cannot be bothered” becomes “I will not be bothered.”  The friendship is a burden and has been one for a long time, though I had been too obtuse to recognize it.  What I need to accept  is that I no longer serve any function in her life: she has others to love and care for, to love her and care for her.

I love The Parting Glass,  the traditional Irish farewell song.  So, in honor of what once was, I remember the best of times, and joy be with her always.

My Mom, the Pope, and Me

I have been reading the Pope’s encyclical letter Laudato si´: On Care for Our Common Home.  I am not Catholic (nor do I subscribe to any particular faith or religion), but this particular document is one for this age.  I have not read all of it.  It is slow going because in true historian fashion, I write margin notes as I read.  And as I read, I realize how very privileged I am:

45. In some places, rural and urban alike, the privatization of certain spaces has restricted people’s access to places of particular beauty. In others, “ecological” neighbourhoods have been created which are closed to outsiders in order to ensure an artificial tranquillity. Frequently, we find beautiful and carefully manicured green spaces in so-called “safer” areas of cities, but not in the more hidden areas where the disposable of society live.

We moved to a house next to a multi-use trail that runs along a natural creek.  The city owns much of the open space, and property owners observe an easement  along the creek itself.  It is a natural area, or as natural as is possible in middle of a small city.  A couple of months ago, I watched a hawk eat his meal on the roof of a not-quite-finished house in our very small subdivision.  Earlier in the winter, we followed a tail-less fox on our bikes: he ambled along looking like a rather large corgi from behind, and we were happy to note that he looked healthy.  I am delighted by the many dragonflies zooming through our neighborhood; I am hopeful that they (or even better, their larval stage) are doing their best to control the mosquitoes.

The real estate agents tout the wonderful location of our neighborhood, and it is indeed wonderful.  From a historic point of view, it is also a surprisingly diverse area.  Within a 1/2 square mile of our house are wood-framed 1890s to 1920s farm houses, minimal traditional 1930s and 1940s cottages, tiny brick post-war houses, expansive mid-century architect-designed ranches, less interesting 1970s and 1980s condominium complexes, and late 20th-century and early 21st-century post-modern homes.  Many of the houses verge on the decrepit, but gentrification marches on.  Even run-down shacks start at $300 thousand, and people are apparently quite happy to snap them up and turn them into their “open concept hardwood floors granite countertops stainless steel appliances minimum 3 bedrooms 2 bathroom large yard” dream home.

This is my neighborhood.  If I congratulate myself on being “green” because I can (and do) walk/bike everywhere, the Pope reminds me it is because I can choose to be green.  I have the economic wherewithal to choose to walk, to bike, to have expensive LED bulbs, to have high-efficiency plumbing and mechanics, to have solar panels, to have environmentally sustainable wood floors, to have a finished basement to escape the worst of the summer heat because I also choose not to have air conditioning.  And outside my door, I can enjoy a protected green space.  I use the trail everyday, and while I see the low-income apartment complex a couple hundred yards down the trail from my house, I also know its days are numbered.  The diversity that interests me on my walks is disappearing, and I am of course a contributor.  It is all very safe, very sanitized, very middle-class, and I am guilty of complaining that I still do not have the promised landscaping around my new house.  Luckily, I have the Holy Father and Mom (who would be appalled to know she had anything in common with a celibate white man who lives in a marble palace) to chastise me.  Who knew she would be the Pope’s enforcer in reminding me to be humble?

I sweep the (sustainable bamboo) floors everyday, and because I am compulsive, I do it on my hands and knees.  It is how Mom used to clean her floors, so it is how I do it.  It is actually quite efficient, and I can wipe down pretty much the entire house in about 20 minutes.  I hear Mom telling me not to be afraid of manual labor: “Do it right,” she says, “and no shirking.”  And she reminds me that our fortunes were built, quite literally, on the back of her grandfather, the day laborer who started the upward mobility of his family by hauling salt for a living.  I may have three degrees, but the floors still need to be cleaned.

I clean the floors, and most days I cry.  “Don’t cry,” Mom says.  “If you keep crying, Ah-ma is going to lecture me on how I didn’t raise you correctly to appreciate and understand the cycle of life.”  Remember your roots, remember your privileges, remember to be humble.

Wedding Industrial Complex

Not to be confused with the Military Industrial Complex, although one could be forgiven for confusing the two. For about a year, I have had a second row seat to the planning and implementation of the Wedding of the Century.  It has been fascinating in an appalling, watching-a-train-wreck sort of way.  I should not be surprised by anything I hear, yet I continue to be.

The Prelude:  The proposal in a boat, on a lake, with his-and-her families (sworn to super secrecy so as to be able to surprise the bride-to-be) gathered to watch on the shore.

The Ring:  OK, no snarkiness here.  It is a family heirloom.

Destination shower, destination bachelorette party, destination wedding.  And lest anyone balks at travelling the distance for just the ceremony, the beach barbecue the day before, and the swanky wedding reception and dinner with band and booze.

Eleven bridesmaids (and presumably eleven groomsmen), not counting the new-to-me entity of the “Junior Maid-of-Honour” (and yes, there is also a senior Maid-of-Honour).

The $3000 dress …  although I acknowledge that in this world of Say Yes to the Dress, it is probably a very low price for the Dress of the Century.  I still think the required alterations ($500) should be included in the cost of the dress.

The Veil, at $1500.  MOB showed me the picture, and I remarked astutely, “It’s a wedding veil.”   “It has hand-made lace,” she said.  I looked for it, and finally spotted the 6″ wide border of lace.  Well, of course it has hand-made lace, because why else would anyone pay $1500 for a few yards of netting?

The Wedding Planner.  I’m going to assume it was NOT her fault that the invitation to the destination bridal shower arrived two days before the event . . . .

The other (many) Invitations, including the announcement several months beforehand to prepare guests for the official wedding invitation.  I’ve never received one of those before, so I learned something new.

Someone cleverer than me said this, and perhaps it is as true as anything else:

The way we marry is who we are.  

Reuse Reduce Recycle Project

One of those silly online quizzes (you know, something along the line of what color dog were you in a previous life?) tells me I have a “philosophical mind.”  I think what that means is that for more than half my life, I have been wondering what is my purpose in life.  On the down swing of bipolar, my purpose is negative:  I am trying NOT to leave the world in worst shape than it is right now, on a grey maybe-it-will-rain August afternoon.

For the past six weeks or so, I have been on the R³ kick, although what I am actually doing is trying my damnedest to control my environment.  It began because I realized what I most wanted out of my new house is an empty house — but clearly that cannot be, because I need a bed, and clothes, and kitchen stuff, and bathroom stuff, and and and . . .  So the next best thing is to declutter.  We (this includes DH and The Teenager) have been giving away/throwing away at least one item a day, although we tend to count groups of items as one item (a set of towels, a group of figurines, that stack of technical papers from 20 years ago).  The surprise is how easy it has been.  The other surprise is that though we have reduced and recycled so much (well, we think it’s much), it is invisible.  The Teenager’s room is still cluttered, DH’s office looks about the same, I have way too many books and clothes and doodads, and we still have too much furniture.

So what is the Big Picture?

I moved to college with five boxes of belongings.  I moved to graduate school with eight boxes in my little Toyota Corolla (back when the Corolla truly was a compact car).  We now have five dining tables.  Does anyone need five dining tables?  In our defense, three of those tables function as desks, one is a sewing table, and one actually is a dining table.  But still . . .  Then I had a moment of clarity when I was reading an article about a man who bought a 700 square foot house, and immediately started making a list of “cannot live without” things.  As it turned out, there were even more items on the “cannot live without” list that he could in fact live without.

If my purpose is what I think it is, then it should not be easy.  When our neighbor moved out, she rented a dumpster, and managed to empty it twice with all the things she needed during her life in that house.  I am trying to avoid that last-ditch dumpster dump, but not sure if I will succeed.  So everyday, I continue to look at my belongings:  Why are you in my life?  How much “stuff” do I need to remind me of who I am?

Tula, who is pretty sure she does NOT need a ribbon

Tula, who is pretty sure she does NOT need a ribbon

Mountain Happiness

A few days ago, I watched one of Stanford University’s “Classes Without Quizzes,” programs offered during Reunion Weekends for alumni, sometimes by alumni.  Fred Luskin (Ph.D. 1999), director of the Stanford Forgiveness Project, gave a talk on “The Science of Happiness.”  Despite the title, the talk was short on science, but nevertheless was interesting and — dare I say it — useful.  An example Luskin gave:  you walk into a coffee bar, and instead of buying into the marketing message that happiness is in a perfect cup of coffee, you say to yourself, “Wow, how cool is it that I live in a country, in a city, in a neighborhood, where I can have my choice of 40 different types of coffee drinks!”

I thought about Fred Luskin’s message as I walked around Estes Park this morning, searching for a cup of latte.  As the 40 mph gusts nearly blew me over, I knew I was the crazy incognito woman (face mask! hood! double gloves!) wandering up and down the main drag, travel mug in hand.  Caffee Collage, closed Monday to Wednesday in the winter.  Kind Coffee, closed for remodelling until tomorrow.  Red Cup Paperie and Coffee Bar (home of delicious pastries, formerly Long’s Peak Coffee and Paper House, formerly MacDonald Papeterie when it was sort of associated with MacDonald Bookshop, which is still in business) had a hand-printed sign proclaiming December hours as open daily at 9 AM — but clearly not open today.  Finally, I pulled into Summitview Coffee, home of the Chicken Fried Latte® — but as the owner assured me, it’s just a goofy name for a blended drink and has nothing to do with chicken, fried or otherwise.  Happiness this morning: I got to be in Estes Park (Highway 34 is open, and weather be damned), and I had a choice of all these coffee places to patronize.  And not once did I feel thwarted.