A Meme, A Meme, I Found a Meme! ~ by Jay

Found at Dawn's place.

And I quote: Play along! Tag yourselves! Memes are good for you!

1. What bill do you hate paying the most?

The VISA bill. It's just so huge and yet made up of all those tiny little things that didn't seem to cost that much at the time...

2. Where was the last place you had a romantic dinner?

A world-class restaurant we recently discovered in our own backyard, and where we went spontaneously on a Tuesday when Eve was invited for dinner at a friend's before orchestra practice.

3. If you’re married or in a committed relationship, how long has it been?

Together 28 years, married 25.

4. How many people do you cook for? Or does someone cook for you? Or are you the Carry-Out Queen? Do you sit down for dinner?

Sam does most of the cooking these days for the three of us. We sit down to dinner together at least four nights most weeks. Some carry-out - less than there used to be.

5. What do you really want to be doing right now?

Sleeping.

6. How many colleges did you attend?

One.

7. Got any advanced degrees?

An MD.

8. How long have you been in your current job?

8 months.

9. Do you have a “career,” or are you just paying the rent while you do more interesting things in your off time?

Career.

10. IRA, 401(k), private pension, government pension, private savings, or cross your fingers?

401(k) equivalent, private savings, fingers.

11. Children? Grandchildren? Nieces & nephews?

One daughter. Two nieces. Oldest is 12, so no next generation yet.

13. Name one big mistake you’ve made in the past ten years.

Adopting one of our dogs.

14. You will live to be 95. On your deathbed, you will experience a moment of perfect clarity, complete with total recall of your entire life. The current you can ask the 95-year-old you one question. What will it be? Be careful; what you do with your answer has the potential to change the future. And yeah, you can ask who’s going to win the Derby in 2023 if you want to, although personally I think that shows a lack of imagination and ambition.

I am enjoying my life too much to ask. I hate spoilers.

15. What are your thoughts on gas prices?

I am privileged enough to think that gas prices should be higher - high enough to encourage actual innovation and to generate enough tax to fund public transit - but I also acknowledge that this would be incredibly regressive since affordable and functional public transit does not now exist. So I'm confused.

16. First thought when the alarm went off this morning?

No alarm. Even on on-call weekends, I don't set an alarm.

17. Last thought before going to sleep last night?

So not sharing that :-).

18. Do you miss being a child?

No.

19. What errand/chore do you despise?

Cleaning up after the dog.

20. Get up early or sleep in?

Early but only if I go to bed early, and it's too late for that.

21. Have you found real love yet?

Yes. More than once, actually :-).

22. Favorite lunch meat?

Turkey breast.

23. Vacation: who goes with you, or do you fly solo?

Mostly we all go. Sometimes I go alone with Sam, sometimes with Eve - at least for a weekend.

24. Do you think marriage is an outdated ritual?

Only if you're getting married to fulfill someone else's expectations.

25. Of all the people you’ve ever met, which one would you most like to face over the dinner table for the rest of your life?

Sam.

26. How old is your current car? How old was the last one when you got rid of it?

Our van is a 2002; Sam's Scion is a 2004. The last one we got rid of was the Explorer that was replaced by the Scion, and that was a 1993 car.

27. Ever use a fire extinguisher for its intended purpose?

Once, and I'd prefer not to repeat the experience.

28. Somewhere in the world you’ve never been and would like to go?

Israel (and Scandinavia, and Australia, and Spain, and South America...)

29. At this point in your life would you rather start a new career or a new relationship?

Do I have to choose? I just did start a new career. I'd do that again before I'd leave Sam.

30. How old do you admit to being?

49, which is my age.

43. Do you have a go to person?

Sam, but I also have backups.

44. Are you where you want to be in life?

Yes, actually, I am. What a gift.

45. What about you do you think has changed the most?

I am more deliberate and mindful than I used to be.

46. Looking back at high school, were they the best years of your life?

No. And I liked high school, but no.

47. Are there times you still feel like a kid?

If by "kid", you mean "college student", then yes. Younger than that? No.

48. Did you ever own troll dolls?

No. See up there where it says 49?

49. How old were you when you first read Flowers in the Attic?

Started it when I was 19 and hated it and never finished it.

50. Where were you when Kennedy died?

With my mother at a club meeting full of Republicans (she's a Democrat). I know this because she told me.

51. Where were you when the Challenger exploded?

In the clinic where I did my fourth-year geriatrics rotation.

52. Do you remember seeing any of the moon shots on television?

Oh, yes. That first one in particular.

53. (For Americans) What’s the first presidential election you remember?

Nixon/McGovern, 1972.

54. (For Americans) What did you do that was special for the Bicentennial?

I was sick in bed with the worst ear infection I've ever had - ruptured my eardrum the Sunday night of that weekend. Was just reminded recently (and had completely forgotten) that John, who I was dating at the time, had pneumonia that weekend. I don't know what we had planned, but we didn't do a thing except take antibiotics.

55. Did you have a pager?

Yes.

56. Where was the hang out spot when you were a teenager?

Pine Ridge Park.

57. Were you the type of kid you would want your children to hang out with?

Sure, but Eve would have found me totally boring and weird. It would be fine with me, but not with her.

Conversations With My Daughter ~ by Jay

Please go upstairs, take the clothing off your floor and put it in the laundry so Daddy can do the wash.

But I need to finish my homework.

Please pick up the floor first.

But homework is more important.

You'll have time for both.

Homework is for school, so I can learn and get smarter and have a good career and a family. The floor will do none of that.

As an adult, you'll spend a lot more time picking things up off the floor than you will spend doing multiplication. Trust me on that.

Conversations with Patients ~ by Jay

So you're telling me I should do something different.

I don't think there's a "should" in there. I wanted to explain what the options are for treating your pain. I hear you telling me that you're concerned about taking more medication because you will be sleepier, and I understand that. We can increase the dose, but we don't have to.

Do I have to decide tonight?

Not at all. You can think about it, and talk with your wife.

And then you'll decide.

Well, I'll be happy to talk to you again, but it's not my decision. It's up to you. I'm not driving this bus. I'm sitting up front with the map, and I can tell you what will happen if we turn right, or if we turn left, but I'm not driving.

I'm not driving. I 'm where I usually sit - in the back.

Then who's driving?

I don't know. You're the one up front. You tell me.

Conversations With my Daughter ~ by Jay

Teenagers are all thinking about sex.

Well, not all of them, but a lot of them.

Did you used to be like that?

Sometimes. Most teenagers and adults think about sex at least some of the time.

Well, not any more.

What do you mean?

You and Daddy are too old.

Oh, no, we're not.

You mean you still have sex?

Yes. We're grownups and we love each other, and we like to have sex.

When was the last time? Like, before I was born?

No, sweetie, quite a bit more recently than that.

When is the next time going to be?

Transition ~ by Jay

Funny, the things you notice and the things that sneak up on you.
Eve has grown more than an inch since she started school in the fall. She now wears a woman's size 6 shoes, and has jumped two sizes in jeans and shirts. I'm waiting to buy her a bathing suit for fear it won't fit when she starts camp in June. I can see subtle changes in her shape that tell me other, more significant shifts are not too far away.

She understands more sophisticated humor and has started to write her own songs on the piano. She is fascinated and repelled by the idea of sex; she asks questions and then winces or groans at the answers. All of this I've seen and expected. It's fourth grade. It's time. It's no surprise.

But today I realized that she was calling me "Mom" instead of "Mommy". I don't know when that started; I didn't notice. She's still going back and forth with both of us - sometimes we're still Mommy and Daddy, and sometimes we're Mom or Dad. When she's in a rush, it's still one word - Mommydaddy. I'm not distressed by the early signs of puberty, but I am undone by the idea that someday, I won't be Mommy any more.

I wonder how long I have before I become "MoTHER".

Why I Am A Reconstructionist ~ by Jay

Because when we ask rabbi candidates if they will officiate at same-sex weddings, they all say "yes", some with a quizzical tone, as if to say "you had to ask"?

The Annals Of Things That Shouldn't Have To Be Done ~ by Jay

But, given the world we live in, it's a good thing someone did it, anyway.

Hospitals will have to allow same-sex partners to visit patients. The President says so.

President Obama mandated Thursday that nearly all hospitals extend visitation rights to the partners of gay men and lesbians and respect patients' choices about who may make critical health-care decisions for them, perhaps the most significant step so far in his efforts to expand the rights of gay Americans.

Oh, but that last sentence needs to be fixed. Try this:

....a significant step forward in the effort to protect the rights of those who are ill when they are at their most vulnerable.

There, that's better. Now we acknowledge the real impact of this change, and we eliminate that "expand the rights..." bullshit, which implies that gay people don't have the same rights that straight people do. Rights are something we all have, by definition. Currently, hospitals are far too likely to deny people their right of self-determination if they have the misfortune to fall ill while a) gay or b) not married for some other reason.

So we're not expanding rights. We're requiring publicly-funded institutions to recognize and act on existing rights. We're insisting that doctors and nurses and hospital administrators act in their patients' best interests.

What a radical idea.

From Across the Pond ~ by Jay

You almost certainly know this already, but in case you've been living under the proverbial rock for the last 12 years, I'll mention it: J K Rowling was a single mother, living on welfare, when she started writing the Harry Potter books. Now, of course, she's unimaginably wealthy (apparently the British tabloids generally refer to her as "Rowlinginit") and married - but she has not forgotten her origins any more than Harry could forget about James and Lily.

In Britain as in the US, conservative politicians seem to think that single mothers represent a moral crisis, and they they can resolve this crisis by denying those families basic services. Rowling disagrees,* and explains why she is not "a natural Tory voter". The Tories are offering a tax bonus of 150 pounds to low-income married couples. Sure, it's not much money, but (they say) "it's not the money, it's the message". Rowling skewers that one:

Nobody who has ever experienced the reality of poverty could say “it’s not the money, it’s the message”. When your flat has been broken into, and you cannot afford a locksmith, it is the money. When you are two pence short of a tin of baked beans, and your child is hungry, it is the money. When you find yourself contemplating shoplifting to get nappies, it is the money. If Mr Cameron’s only practical advice to women living in poverty, the sole carers of their children, is “get married, and we’ll give you £150”, he reveals himself to be completely ignorant of their true situation.

How many prospective husbands did I ever meet, when I was the single mother of a baby, unable to work, stuck inside my flat, night after night, with barely enough money for life’s necessities? Should I have proposed to the youth who broke in through my kitchen window at 3am? Half a billion pounds, to send a message — would it not be more cost-effective, more personal, to send all the lower-income married people flowers?

I am not, of course, in J K Rowlings' financial bracket. Far, far from it. I am, however, privileged enough to benefit directly from the tax advantages introduced by the Republican party in the 1980s and continued since then. And yet I have never voted Republican and never will - and, as Rowling says, they keep reminding me why.

____

*The piece is worth reading; the comments, not so much.

Never Say Never ~ by Jay

I swore I'd never prescribe for my family. My father used to, and I always thought it was wrong. I wasn't going to follow his lead.

Broke that rule the day Sam got sick on a cross-country flight. Eve was four months old. We landed after five torturous hours and he had a 103 fever and a raging sinusitis. Honoring my principles would have meant taking a cranky, jetlagged baby into an urgent care clinic, and waiting for some unspecified amount of time to see a doc who would have prescribed whatever antibiotic I insisted on anyway. We skipped the middleman and I called in the scrip. The world did not cease turning on its axis and the Ethics Gods did not strike me down.

Sam, of course, is an adult, and I am an internist. We are doctors for adults. Eve is a child. I don't provide medical care for children. I don't prescribe for Eve.

Of course, the first time Eve had strep throat it was a Sunday afternoon. She was three. She came and lay down on the kitchen floor, huddled at my feet, so hot I could feel her fever through my shoes. I looked in her throat, saw the white spots, felt the swollen, tender lymph nodes in her neck. I again considered the urgent care waiting room - and instead I called the NP who was Eve's PCP at the time, and a good friend of mine. I described what I was seeing and reported the temp - 103.5, that time - and Betty said "where do you want me to call in the scrip?". So OK, I didn't take Eve to be seen - but it wasn't my name on the prescription. I hadn't actually provided the medical care.

Betty moved away two years ago. The last time Sam took Eve to be seen in Betty's old practice, Eve came home and said "Daddy and I don't like those doctors". Mommy's not crazy about the approach they take, either, but Mommy hasn't had time to get Eve established with a new practice. Bad Mommy.

Yesterday Eve woke up with a fever. She went to bed with a fever, too, despite regular doses of Tylenol and ibuprofen all day. Even more tellingly, she went to bed voluntarily a full 90 minutes before her usual bedtime, after sleeping for much of the afternoon. This morning she was still sick, so I looked in her throat - no spots. Sam stayed home again and I went to work. In the middle of the day Eve started to complain about a worsening sore throat and pain in her ears.

I debated with myself, but I stuck my otoscope in my purse before I left the office, and when I got home, I had office hours, just like my father used to. Sure enough, there were the swollen tonsils with white patches, and two bright red eardrums. My very tired, uncomfortable child looked at me and said "do I HAVE to go to the doctor, Mommy? I just want to stay here". I thought about that urgent care waiting room, and the tendency of most local docs to use expensive, broad-spectrum antibiotics when all she needs is five days of amoxicillin - and I picked up the phone and called in the scrip.

I guess I owe my father an apology. I have a feeling that wherever he is, he's smiling at me, shaking his head, saying "It's OK - but never say never, Jay".

Disruption ~ by Jay

Dawn isn't talking about the family that sent their son back to Russia. Because she's smart, sensible and articulate (in short, she's Dawn), she's made more sense in a three-paragraph post about why she can't talk than most people have in long, vituperative screeds.

A friend of mine who adopted her daughter from Ethiopia says that adoption always starts with a tragedy. Sometimes it's the tragedy of lack of money or family resources that keeps a woman from parenting her child (like Dawn's daughter Madison and my Eve); sometimes it's the tragedy of parents dying, like my friend's daughter from Ethiopia, and sometimes it's the tragedy and crime of children who are stolen from their parents.

All adoptions start with tragedy, but few end with tragedy, and that's what happened here. You can find any number of sites on the Internet to read about how evil and wicked and horrible the adoptive family is, and how egomaniacal and selfish and exploitative adoptive parents are in general. I'm not going to recapitulate those arguments. I don't know the Hansens. I do know a family who chose to place their son, also adopted from Russia, after struggling to manage his rage and violence for three years. They sought help from pediatricians and psychologists and psychiatrists, but had no support from their agency and no access to professionals with skill and experience in post-adoption issues.

I won't vilify the parents I know, or the Hansens. Dawn is right - this isn't about adoption alone; it also happens in biological families. When it happens in adoptive families, though, I will lay at least some blame at the doorstep of the adoption agencies. Our own disruptions were far less tragic - Rose and Jesse went back to parents who wanted them. They had two loving families available. That was tragedy to us, but not to the babies. Even so, those disruptions happened because the agency didn't take appropriate responsibility for their behavior toward first mothers. They minimized the impact of the trauma on all members of the triad and offered no resources to any of us after the papers were signed and the checks had cleared.

So many people have such scathing words to say about the Hansens; it must be easy for them to do so, to use their anger and scorn to distance themselves from this unspeakable act. To say "I would never do that". And maybe there are mothers and fathers who walk away from children without a second thought, without guilt and fear and panic and regret. Maybe they exist, but I don't know any. I only know parents - biological and adoptive - who live every day wondering about the fate of the child they lost, and who surrendered that child because they saw no other choice. I only know parents who want to be good parents, and who are betrayed by the very institutions that are supposed to help them achieve that goal.

Torry Hansen will not get the chance to parent another child. If this were just about her, then we wouldn't need to do anything else to make sure it never happens again. Unfortunately, it's not just about her, and we do need to do something - a great many somethings - to make sure this never happens again, starting with reforming the international adoption process, providing resources to support parents both in the US and in other countries, and holding adoption agencies accountable to all the families they serve.

This Made Me Cry ~ by Jay

In a good way.

If you don't read Lesbian Dad, well, you should. And what better place to start than with this photo-essay about a day LD spent with her father and her son?

It was the last picture that got me. I bet it'll get you, too.

Happy ~ by Jay

The sun is shining, and the weather is cool and breezy; a good day to open the windows and get fresh air in the house. We have nothing scheduled this weekend - no meetings, no visitors, no birthday parties, no deadlines.

Sam and I are slowly working on the last piece of the renovation/redecoration project, which is clearing out the room we've used as a dumping ground (er, storage area) so we can reclaim it as a sewing/craft room. The Yankees will be on at 3:00 and I bought a nice new iPod dock/clock radio so I can listen to the game on my phone while I sort and fold laundry, and the do the crossword puzzle. Dishes are done, kitchen is clean, even the dining room table is fairly clear.

Eve has a friend over for a sleepover; at the moment they're out on bikes somewhere in the neighborhood. They have water bottles and fruit, so they're set for a while.

I didn't bring any work home, and I'm not on call. I'm expecting to spend some time on the phone catching up with an old friend later today or tomorrow. There's nothing I have to do at all. The weekend will be quiet and restful, and on Monday I will return to a job I dearly love.

Happy.

Love Thy Neighbor ~ by Jay

I've been distracted all day.

It started with a text from Sam in the middle of my morning meeting. Never a dull moment, he said. And then Bob across the street just found a body in his back yard.

The nurse who was talking stopped because it was clear I wasn't paying attention. I called Sam, who knew nothing more than what he'd already told me - Bob had looked out his bedroom window, seen something in the backyard, and gotten close enough to realize it was a body. The police and crime scene techs were there. He was about to take Eve to the JCC (it's spring break) and go to work.

It's a challenge to go back to a meeting after that.

Midafternoon, Sam texted me again to tell me that he'd gotten home and heard the rest of the story: the body was Al, who lived next door to Bob, and who shot himself last night.

Al wasn't a friend, but he was was someone we knew - someone who noticed and worried when our door was open in the middle of the day, and who smiled and waved at Eve when she rode her bike, and commented on how nice the yard looked when it was raked and mowed. Al was also a man who lived a difficult life - he didn't seem to have a job; he had some obvious physical problems; he frequently spent hours sitting in his car, sometimes on the phone and sometimes just asleep. I wondered if he had a problem with alcohol but I never got close enough to find out.

Never got close enough. I held myself apart, kept my distance, didn't reach out.

Or I held my boundaries, took care of myself and managed my internal resources so I could maintain my balance.

I'd like to look at it that way - that I was taking care of myself, not failing to take care of someone else. Rationally, I know that I can't take care of everyone. I know that in my daily work I stay in relationship with people who are deeply troubled, and I also know that I consciously and deliberately avoid those relationships outside of work. Sometimes I think that I choose my work so that I can soothe my conscience by saying "but I'm not avoiding friendships with people because I judge them; I just use up all my tolerance for that at work". Or, in other words, I gave at the office.

It's much easier for me to hold my boundaries at work. I will go out of my way for friends and family more than I will for patients. I enter into my work relationships fully and sincerely, but I do have a professional persona and some degree of professional distance (not detachment, I hope).

Pirkei Avot teaches us that ours is not to complete the task; neither may we refuse to participate. Rabbi Hillel teaches us to love our neighbor and says all the rest is commentary. My own experience teaches me that I have limits, and that I need to respect and honor those limits for my own well-being. And I know that I can't rescue everybody; that I can't, really, rescue anybody; that we all need to rescue ourselves, and sometimes a friend can lend a hand.

I wish Al had found a friend, even though I know it couldn't have been - and didn't have to be - me.

What We Have Here Is a Failure To Communicate ~ by Jay

In case you can't read the caption, he says to her "Yes, I hired you to work half days. A half a day is twelve hours - what's the problem?"