Wednesday, September 21, 2011

Troy Davis

After a brief delay by the U.S. Supreme Court, convicted murderer, Troy Davis was killed by the state of Georgia just an hour ago. I woke up after falling asleep knowing about the stay of execution, yet knowing his death was almost a forgone conclusion. He has been awaiting completion of his sentence for 22 years through a vast number of appeals and stays of execution. Members of his family and the family of slain policeman Mark McPhail were present for his death, and a media observer stated that the McPhail family, "seemed to get some satisfaction," from the death of Davis.

I don't doubt they are satisfied that this miserable chapter in their lives and their continuing grief is closed. Open forever will be the wound of losing a beloved man, and despite their vocal pronouncements that they are,"100 percent sure," of Davis' guilt and responsibility in the death of their loved one, they will live with the myriad of questions that government sanctioned murder brings to bear on all of us. For his part, Davis never wavered in his denial of wrongdoing, and in his final moments he offered God's blessing on those prison officials responsible for his impending death by lethal injection.

We are a country of contradiction on the value of human life. My faith and my practice as a member of the Catholic Church have led me to the a very firm conviction that capital punishment is morally and ethically wrong, and fatally flawed and the current Pope was one of many world leaders who denounced the planned murder of Davis and asked for clemency. Most tellingly for me were the denouncements by conservative Georgia politicians, the former director of the FBI, Archbishop Desmond Tutu, and Former President Jimmy Carter. I don't agree with many of the churches stances on social issues, but I do admire the consistency of valuing all human life.

There will be many advocates for the death penalty who will trot out the concept of justice based on "an eye for an eye," but with that notion comes the archaic belief we live in a world that is not colored in shades of gray. Justice in the U.S. is not applied in a just manner, even the most conservative political persons will acknowledge that human error has been responsible for false convictions, and in many cases wrongful deaths in the case of convicted persons being murdered and then being exonerated post mortem by physical evidence. Since 1973, 173 men have been released from death row with the discovery of evidence and the advent of DNA technology.

There is a large body of research performed by all manner of learned individuals, both politically liberal and conservative, that has consistently determined that the death penalty is not a deterrent for violent crime, that it is not applied consistently with regard to victims and their accused offenders race or ethnic background, and that economically it is a money pit of epic proportions. Estimates by news organizations and advocacy groups on both sides of the issues have determined that it costs well over 4 times as much to commit government sanctioned murder, than to house an individual for over 40 years at the maximum level of security.

On a purely emotional level I cannot imagine the heartbreak of losing a loved one to a violent crime, and on that gut level I can well imagine wanting, wishing, and longing for the death of the perpetrator. That is exactly why members of a murdered persons family are not serving on the jury-objectivity is lost, no matter how devoted one is to the cause of truth, human nature overrides the desire for truth and justice on so many every day matters in life, how could we not expect it to be a lost cause in matters of death.

Capital Punishment is a complex, convoluted, and misapplied concept because of the very fact that human beings are in charge of it and if we truly believe that having a society that protects and values life is important then we have to value the lives of the guilty as well as the innocent. Why? Because one day it could be you or I that stand falsely accused and facing death-and no one, executioner, judge or jury member, should bear the emotional cost of government sanctioned murder in the name of justice.

Tuesday, July 26, 2011

Hitler, Beck- separated at birth?

GLENN BECK, on his radio show, likening the camp on the Norwegian island of Utoya to the Hitler Youth
 I heard this quote this morning and read it online and all I can say is, what the hell are you talking about?
Let's break it down. "There was a shooting at a political camp," No, Mr Beck there was a shooting at a Youth Camp sponsored by a Norwegian political party. The camp was focused on developing leadership skills, teaching grassroots political activism, and offering inspiration and encouragement to young people about their country and it's continued promise and potential. Sounds a lot like a Young Republicans or Young Democrats conference, Rock the Vote meeting, or summer camp for political geeks.
"Which sounds a little like Hitler Youth." No, Mr. Beck the Hitler Youth organization was compulsory, it's only purpose was to prepare German boys for military service and German girls for motherhood. Children were forced to attend meetings until late in the evening and the meetings were so stressful, many children suffered academically and physically with teachers complaining of poor attendance at school due to late night meetings and drills.
"Or, whatever." Mr. Beck if you are going to throw out the name of Hitler either come prepared to have a real conversation or be quiet. I realize this is a foreign concept to you but give it a whirl, or whatever.
"I mean, who does a camp for kids that's all about politics." The camp is actually not all about politics. Like most summer camps it's about swimming, soccer, smooching the cute girl from the town across the river and playing guitar around a camp fire. There were political speakers on a variety of topics and there were discussion groups on everything from politics to Norwegian history. Here in the U.S. the American Legion, political parties, the Masons, churches, and state governments all sponsor youth summer activities to teach young people about how they can impact their society. All of these camps have a particular political or ideological bent, and no one compares them to Hitler.
"Disturbing." No Mr. Beck, the camp itself is not disturbing. What's disturbing about this absurd and appalling commentary from you is how it continues to show how ill informed you are, and how you seemingly do not care to get all the facts before you open your mouth and slander a nation of people in mourning.
Right now, the people of Norway are dealing with an emotional tragedy and facing the harsh reality that people with beliefs like the admitted gunman seek haven inside the borders of their tolerant Nordic country. The actual comparison to Hitler might have actually been appropriate if it had been made as a comparison to the gunman, Anders Breivik, who views himself as a Christian fundamentalist set upon affirming the need to destroy Muslim culture and acceptance of Muslim's into "white society." In his manifesto of hatred Breivik mentioned a variety of anti Islamic bloggers as his heroes and I imagine he and Hitler would have had a lot in common, including a maniacal myopia regarding their importance to the rest of the world.
Not unlike Mr. Beck himself.

Monday, July 18, 2011

Love, loyalty, and wizarding

*SPOILER ALERT-if you have not yet read Harry Potter and The Deathly Hallows-do not read this post

Before Nicholas and Henry were born I had already begun reading the Harry Potter series and with each new book I revelled in the joy of getting lost in another world. As my babies became boys we got in the habit of listening to the books on CD in the car or at bedtime. Soon one or both of them would be pointing a stick at the other in the backyard and yelling "You great prat!" As time has passed they have practiced their Unforgivable Curses, hunted for just the right stick/wand, longed for their own Quidditch pitch, and, of course, the sword of Godric Gryffindor.

So by the time the opening of the final movie began on Friday I was feeling overwhelmed by "THE END." I gasped when I saw the Quidditch fields ablaze, I wept when Harry finally got to see into Severus Snapes heart via the Pensieve, and I delighted in watching Maggie Smith and the other professors defend Hogwarts to the death. The movie was not exactly like the book, but every moment of it did service to the words in print and to the character J.K. Rowling so lovingly brought to vivid life page after page.

Now here I am days later still pondering Mr. Potter and what his story means to me and mine. When the movie finished we ate supper, all four of us talking at once about our favorite parts, characters, lines. The boys were in heaven dissecting the movie and were even willing to listen and hear what Bob and I had to say about Professor Snape's terrible choice of Voldemort in his early wizarding life and how that one choice, ruined every possible moment of joy he could have had in life. Harry Potter is more than a book to me and mine, because his story transcends wizardry and Death Eaters for real life.

The boys identified with Harry missing parents he didn't remember, and as they have gotten older, they identify with not quite fitting in with the Muggles around them. How I wish there were a Hogwarts summer camp they could go geek out at! Beyond the joy of friendships and learning Harry, Ron, and Hermione made mistakes-sometimes big ones, and learned to ask for help and forgiveness. They learned that loving people means acknowledging their flaws and loving them regardless (brash Sirius, common senseless Hagrid).

They learned that being brave doesn't mean not being scared whether that was riding a hippogrif, dealing with ginormous spiders, facing the school bully, or swallowing potion and becoming Bellatrix. They cheered for the little guy (Dobby, Flitwick) and how even wizards could be cruel to other species (centaurs, Giants, dragons)

They learned to value the eccentric (dear sweet Luna) and the awkward (heroic Neville), to value smarts (Ginny) over money or fame (Professor Slughorn) and to recognize that all people, no matter how difficult you may find them to interact with, have their own life story unfolding-and it is sometimes a heart breaker (Snape). Most importantly they learned the value of being loyal, not just to oneself or friends, but to your beliefs and they learned that there are worse things than dying and that those we love change us forever, and remain with us forever. Not unlike a truly magical book.

Thursday, July 14, 2011

Bachmann Blues

It's funny now that at 42, I see the world through my children's eyes and see how much progress we have made in terms of women being capable of being a part of most any profession. As a little girl in the 1970's, the idea of a "lady" doctor or "lady" policeman was still a rare thing, and a female soldier or firefighter, forget about it. When Geraldine Ferraro was nominated for Vice President on Walter Mondale's ticket it seemed like a gimick to get the attention of voters, not an effort to actually have a gender balanced alliance in the White House.

I marvel at the fact that my kids live in a culture that has women professionals of every kind, a female Secretary of State and a mixed race President-but I admit to having a sense of dread as the new presidential election looms ahead of our country. Not the,"Oh dear Lord, please not another campaign ad," dread, but rather the,"there are two female presidential candidates and both make me embarrassed to be a woman," kind of dread.

There really isn't much I could add to the discussion on Sarah Palin at this point-I think time has proven over and over again that she is all hat and no cattle. She is the Dr. Phil of presidential politics, full of folksy witticisms and "common sense talk" and her nonsense plays to the crowds she chooses to address. Mind you, that's all she's actually done since the last election, talk to people who want to drink from her Kool Aid stand. She has never been part of any substantive discussions on issues of importance to American voters where anyone present might disagree with her.

Michelle Bachmann on the other hand appears poised to steal Palin's thunder despite her persistant inability to pronounce common words or speak competently about American history. It's not about her being conservative. Honest to goodness. I would be more than happy to see a competent, articulate, conservative female run for President. I could listen to her debate our current President and be willing to acknowledge her strengths, despite my left leaning tendencies. But for the life of me, I cannot bear the thought that we are going to be forced to wade through the muck of another presidential race that involves the incessant correction of facts, mispronounciations, and disclaimers that will come with a Bachmann candidacy.

It is as if some part of the conservative nominating base has determined that the only way Americans will vote for a woman is if she looks like she fell out of a PTA meeting at the local Talbots. She is white, trim, always immaculately dressed, and her hair is a helmet of perfection. She is the Stepford wife candidate and what disheartens me most is that, she appears to get all of her political ideas spoonfed to her, and when she does pop off with some little gem of her own-it's usually factually incorrect.

In just the last month she has incorrectly named John Quincy Adams as one of the authors of the Declaration of Independence, signed a pledge that glamourizes the family life of slavery, and announced her pride at being a part owner of her husband's Christian therapy clinic which espouses the concepts of "praying the Gay away" and converting homosexuals via prayer.

I do not like all of the decisions President Obama makes, I haven't liked all the decisions any president I did or did not vote for has made in my last 20 odd years of voting. I don't actually think I have to like Mr. Obama in order to respect his ability to govern our country. I respect President Obama because he has shown a healthy respect for the process he is part of, while acknowledging it's glaring deficiencies. He is intelligent, learned, compassionate, and articulate. He also readily acknoweldges that he is not an expert on every subject facing our country-but he will find the right people for the job.

I believe our country deserves to trust that the office of the President will be held by someone who believes in the importance of the office, but takes the reins with humility, a desire to serve, and the willingness to learn. We cannot afford to elect or even waste time listening to someone so arrogant that she would argue the validity of her Adams misstatement with the press or proclaim her pride in being a part of a "medical" clinic that accepts taxpayers dollars, while providing treatment that is grossly negligent.

I believe our country has moved far enough down the road of gender equality to have qualified candidates, both male and female, we don't need another Palin, and she may claim her individuality, but the fact is, Michele Bachmann is nothing new. She is ignorant, arrogant, and disposable and no President of the United States can afford those three character traits, no matter how good they look in a red dress and heels.

Saturday, July 2, 2011

Independence from Beck

"I'm so sick and tired of being in the system. I'm not going to play the game anymore." Glenn Beck, signing off from his Fox News program on Friday, July 1, 2011.
Oh, please. Would that we could all actually believe he is actually going to sit down and shut up.
No, no he is taking his crazy train to his own Web TV channel, eponymously named, GBTV, which sounds a little too much like a sexually transmitted disease for my liking, but perhaps that is the point. Glenn Beck, or at least his manufactured, not ready for prime time persona is as virulent as a case of the clap. Worse still, it will be a daily two hour extravaganza of hyperconservative half baked nonsense...almost makes me want to go back to dial up Internet service.
Here's my real problem with Glenn Beck, Sarah Palin, Michele Bachmann, and others like them who claim to represent "the average frustrated God fearing American." They don't know American history, they don't fact check their own comments, and they don't understand that even the most average American would really like their elected officials to be better than average.
I am not a economics whiz, yet I think the person running the Treasury should be and I think the Secretary of State ought to have a little background and hands on experience in foreign relations and diplomacy. What the hell, let's go crazy and make sure that the people planning and leading troops into battle, actually have experience doing that while we're at it.

I do not want a folksy every person who knows half of the Declaration of Independence and is muddy on the details regarding the founding fathers (Michele Bachmann) to represent me and my country to the rest of the world. As it is, America lags behind every other developed country in educating our children and the current crop of politicos making news simply adds to the chain of evidence.

Glenn Beck revels in creating drama, even manufacturing it on occasion. He delights in pointing out the foolishness of liberals and Democrats but forgets that he is playing with a double edged sword. Once you tread down the path of name calling and vitriol it is impossible to come back to the land of sane, reasonable debate. Moderates have stopped even trying to reason with Beck for that very reason.

There have been conservative talk show pundits before and they managed to keep the highway of conversation flowing in both directions, intelligently and with respect for all parties involved. William F. Buckley was witty and irascible. He wasn't necessarily likable, but he knew his facts and he didn't pick a fight with someone if he didn't know what the hell he was talking about-whether you agreed with him or not you were likely to get a well thought out argument.

And that is exactly my point-this is supposed to be a democracy and part of the democratic process is, or should be, well reasoned, rational debate. Year after year our country becomes more diverse in every possible way and with that diversity comes an increasing number of divergent views-again, that's the way it should be. Part of the health of our growing democracy should be based on the kind of free and open debate we are able to have as Americans.

Free of vitriol, open to the exchange of ideas that are different from our own, and debated in a manner that does service to the men and women who founded an imperfect democracy.

"Democracy must be something more than two wolves and a sheep voting on what to have for dinner." James Bovard

Happy Independence from Inflammatory Argumentative Nonsense Day!

Friday, July 1, 2011

And Medication for All?

At a time where justice seems to becoming more myth than reality I have been following the proceedings related to Jared Loughner, the young man accused of shooting Congresswoman Gabrielle Giffords and 18 others. He has been diagnosed with schizophrenia and in May the courts decided he was not competent to stand trial for the 49 counts against him, including the deaths of 6 people. He was transferred with little fanfare to a federal facility in Springfield, Missouri in June and since the 21st has been receiving psychotrophic medications against his will.

His attorney's argued that the federal facility did not provide enough evidence or reasons for medicating Loughner and that he should not be forced to continue the medications without a judge's approval.  Wednesday, Federal Judge, Larry Burns ruled in favor of the doctors treating Loughner,"I have no reason to disagree with the doctors here," Burns said. "They labor in this vineyard every day."  Amen brother, amen.

I admit to being conflicted about how we care for a man in Loughner's condition. I am too well aware of how limited mental health services are in the U.S. and how easy it is for someone with a severe mental illness to spiral out of control when they are off of medication. I know also, how these medications can impact a person's daily life and the plethora of symptoms the medications cause while treating the voices, tics, visions, and panoply of misery that is schizophrenia.

Long before my nursing degree I worked with adults with mental illness who were on parole for the Texas Department of Corrections, the vast majority also had a substance abuse problem due to their years of self medication to cope with the aforementioned mental illness. My job in a nutshell was to act as their guide back into the land of people who take care of themselves outside of an institution. How to ride the bus, buy groceries, take medication on time, go to AA, and meet with your parole officer were all part of our lessons, as well as reminders like, "Have you bathed this week?" and "No, you cannot wear that shirt again unless you go to the laundromat."

I did home visits to check up on their self care at everywhere from seedy motels, homeless shelters, the Salvation Army, boarding houses, group homes, and occasionally squallid apartments that would make sex offenders hope for death. I went with my clients to their parole appointments, to apply for social security benefits, and to get blood pressure medicine or teeth pulled. What I learned every single day in that job was that no matter how shitty I thought my life was...I had nothing to complain about.

The few clients I had who still had family members actively engaged in their lives were either ill themselves or looking to "borrow" money from them. Most reported their family members were dead, or simply did not want anything to do with them any more. Their families were fed up, tired, emotionally and/or financially exhausted and when the clients ended up in the pen, that was it.

The bulk of the individuals I worked with ended up in jail because they were accidental criminals. A prime example was a lovely gentleman named Wilbert, he was in his mid sixties, had been diagnosed with schizophrenia for all of his adult life and lived with his mama on the north side of Fort Worth, quietly tending her tomatoes, going to church with mama twice a week, and
staying away from alcohol and drugs.

Then his mama died, and Wilbert inherited her home. Not too long after he stopped taking his medicine and the neighborhood crack dealer offered up friendship as well as crack cocaine to calm his new buddy's voices and lickety split Wilbert had a new best friend. Fast forward six months and Wilbert's house was now the neighborhood crack den and when the police arrived everyone was smart enough to get out except... Wilbert.

By the time I met him, Wilbert had served three years in prison for dealing crack cocaine even though he could not tie his own shoelaces, manage his medications, ride the bus independently, or smoke a cigarette without setting the couch on fire. Quite the criminal mastermind.

Wilbert was fairly mellow when he took his medications, when he didn't he became very paranoid and hid from the world. He was never violent. Many of the people I worked with could become very violent when they became paranoid or heard voices and for my part I had no trouble imagining feeling pretty violent myself if I heard someone repeatedly calling me names or singing nursery rhymes, or thought I could hear my dead baby crying all night.

There was a constant pendulum swinging in the lives of the people I worked with between medication and non medication and sometimes over medication. They clients I worked with had limited education, less than limited insight, and getting them engaged in the process of finding just the right dose of medication was a battle punctuated by frustration on their part as well as that of their psychiatrist.

Day in and day out I saw that even though these people were legally adults they were not capable of making healthy choices for themselves on a consistent basis and while that was certainly their choice the consequences were shared by the entire community around them. No antipsychotic medication for some of these people meant public drunkeness, robbery, violence, and further costs to everyone for medical care and legal interventions. How does a community balance freedom from medical intervention with the need to provide a safe healthy community for the rest of its' citizens?

Jared Loughner is mentally ill, and absolutely no one denies it. Neither the prosecution nor the defense has debated his need for care or debated his inability to stand trial for his devastating actions. Rather the debate is about how much medication and what kind of evaluation is thorough enough before medications are forcibly administered to an incompetent adult.

Loughner's attorneys have stated that the physicians at the federal facility medicated him without a full and proper evaluation and that he is being overmedicated against his will. Here's the kicker though-how do you evaluate a man you have only just met, who has reacted violently to his own attorneys and family members and can't or won't assist in his own care? At some point, push has to come to shove, and prescriptions are written. So much of working with these patients is based on observation before and after medication and developing a plan of care that results in optimal health and behavior.

What would be the best possible outcome for this whole sorry mess is if our elected officials, people who vote and love those with mental illness, and budget bureaucrats would come together and realize that there will be more mass shootings and forced medications, suicide attempts and psychotic episodes, jail time and institutionalizations if we do not stop treating mental illness like the common cold.

Major mental illness does not blow in and stay for a week or two of misery. Major mental illness is not "the blues" or "feeling down." Major mental illness effects every single part of a person's life and therefore it effects every single person they come in contact with, every member of their family, workplace, school and it must be managed daily just like diabetes and hypertension. People with major mental illness deserve and require daily support to maintain their health, to stay on the proper dosage of medications, and to prevent harm to not only themselves, but to their communities. That harm isn't just physical, it's financial, legal, and emotional and the cost in dollars and cents is astronomical.

Case management works, there are multiple examples of ACT (Assertive Community Treatment) teams that work providing daily medication monitoring and support for people. The only problem is that these programs work so well people are able to hold down jobs and manage large portions of their lives independently-so they no longer qualify for the services that helped them get better. Surprise, surprise months later many are off medication, hospitalized, or in jail because they no longer had the support they needed to stay well and the cycle begins again. Except this time they have to recuperate or rehabilitate to a lower level of functioning because their brain has been even further impaired by mental illness.

Case management is expensive-but far less costly in money and human lives than this repeated roller coaster of mental health devastation. Time and again we are presented with an opportunity to change business as usual. When will enough be enough?

Read more:,8599,2080687,00.html#ixzz1QnBakmAz

Judge: Loughner Can Be Forcibly Medicated

Saturday, June 25, 2011

Call me Corny

Last night New York became only the sixth state in the U.S. to legalize marriage between same gender couples. The Empire State Building was lit up with rainbow colors, crowds took to the street to sing and celebrate throughout Manhattan and the five boroughs and according to the New York Times, Marriage licenses could be granted in late July, barring any attempts to block the new law.

Throughout the week there have been opponents and proponents of the law all over television throughout the U.S. and commentators have been abuzz on the web. Friday morning I watched a three minute segment from Keith Olbermann and was overwhelmed by the way he just cut to the heart of the matter.
"[Gay marriage] won't destroy the democracy; it doesn't destroy the family; it strengthens the institution of marriage and its principal premise of fidelity; and it increases the number of people living in stable and loving homes. ... This is, corny as it seems, not about politics or religion or power or lobbying. It is about love. In a time of impermanence and fly-by-night relationships these people over here want the same chance at permanence and happiness that is already yours. They don’t want to deny you yours. They don’t want to take anything away from you. They want what you want: a chance to be a little less alone in the world. And your acceptance of their love turns out to be your own expression of love to your fellow human beings."
It's true that in 2011, the idea of love and marriage has become a bit corny yet here I am newly remarried myself and tearful at the thought that some of my dearest friends might someday be able to wed as well, for better or worse. There is a lot to be cynical about if a person just goes about life with everyday sort of expectations. Greenhouse gas, violence and war throughout the Middle East, Africa, and almost everywhere else, AIDS, poverty, illiteracy, and the rise of celebrityhood as a proper profession, are all good examples. Yet, there are perhaps 10 good reasons for hope to replace each and every negative image and idea you can come up with, including Paris Hilton.

Most days I care for an assortment of adult patients with cancer. Many are older and simply interested in comfort, some are younger than I and hope for remission and the chance to dance with little girls at their grown up weddings, or see young boys become men themselves. Those that are most hopeful are usually the least self motivated of the patients I meet-motivated by their abiding love for others, rather than fear or selfishness for one more moment of their life. Their life is no longer about them, but about those they love.

To be sure they are enduring often brutal treatment for their health, but they are inspired by the love they give and receive. The kind of love that is exponential and grows stronger with each exchange. I remain grateful I have that kind of love in my life, from my children, my family and family of friends, and yes, my husband. That kind of love allows me to wake up and go forth to work in an emotionally draining and physically taxing job and come home to a messy house and hungry children, stinky turtles and shedding dog. To sleep at night, worry about bills and taxes, contemplate graduate school and professional writing, and what mark I might leave on the world.

CNN Sports Anchor Nick Charles died today at age 64 after a two year battle with bladder cancer. In one of his last interviews with Dr. Sanjay Gupta I was struck not by his gaunt appearance or loss of his trademark curly locks, but by his continued optimism and his committment to living a life based on looking forward and remaining positive in the face of terminal illness. "I wake up every morning expecting it to be a good day." Corny? Maybe, but living a life based on love and optimism is what really allows the world to keep moving forward.

Tonight I toast the people of New York who choose to be hopeful about the state of the world and the institution of marriage, despite all the negative and nasty the world can dish out. I'm grateful to be loved, grateful for the lump in my throat when I hold a new baby, hear a love song, hold my child close. Grateful to be one of the corny, sentimental fools who keep Hallmark in business. I know I'm not alone.

Wednesday, June 8, 2011

Weiner on the Grill

In what can only be described as some type of self fulfilling prophecy related to childhood name calling Representative Anthony Weiner finally confessed what everyone else in America has known for days... that he was showing off his little weiner to the world via his Twitter account.


Sad to say, this almost makes Arnold look classy. Especially when Rep. Weiner inferred that he had not been unfaithful to his wife by sending pictures of his privates to other women. Presumedly this is because he did it before they were married (only engaged) and he never actually met these other women. It was simply a consensual exchange of lurid material to get himself and the other unknown woman some sort of sexual healing of a kind most people who behave like this manage to get in the shower or with a Playboy while their mother is standing outside the bathroom door wondering why little Johnny is suddenly so interested in personal hygeine.

Here's just a couple of quick facts for the Representative:
1. If you are sending pictures of your genitalia to anyone other than your spouse or significant other-it is in fact, inappropriate.
2.If you are in fact stupid enough to take pictures of your genitalia and send them to women other than the previously mentioned spouse, perhaps you should send them from a phone, not download them to your Twitter feed.
3.Thank you so very much for bringing such a lovely tenor to dinnertime conversations around the country between flustered parents and curious preteens and teens. You just can't imagine how delightful it is to discuss why a man might want to send photos of his erection to strangers and how this same man might be qualified to hold public office.

Good times.

Honestly, whatever happened to discrete dalliances? Is it too much to ask in this multitasking tech savvy world that if people are going to cheat on one another that they do it without involving all the rest of us? I do not want to see your crotch or listen to your repeated and increasingly stupifying rationale for sending said pictures out into the known universe.

I do not want to know what you or your wife think about your behavior, I simply do not care. It's your mess, clean it up, wallow in it, whatever, but please leave the rest of us out of it.

I imagine when reelection time comes the people of New York will have more to say about the issue. They are a forgiving lot, but frankly even this may be pushing the boundaries of good taste. Time was you could count on politicians to have a lover on the side, but you could also count on the discretion and inpenetrable wall of denial as well. Representative Weiner seems to have missed those pivotal conversations in his orientation to political office and instead is clinging to the belief that the more details the American public receives about his indiscrete behavior, the more likely we are to understand it and absolve him of any wrong doing.

Here's the thing. There are many marriages that recover from infidelity and indiscretion, many well known political ones in point of fact. It really isn't anyone's business how or why a couple chooses to muddle through a mess, even one of their own making. What is the business of the American people, and in particular, the voters of New York State, is what kind of judgement their elected officials display day in and day out and in this particular instance Representative Weiner has displayed the poorest, most self serving type of judgement of all by arrogantly presuming that his behavior is no big deal.

It is a big deal when someone that voters elect to make decisions for them cannot exhibit enough self control in his own personal behavior to keep vulgar pictures of himself from being seen by complete strangers. It is a big deal when the same elected official fabricates and attempts to blame others for this same lack of self control and poor judgement.

Most importantly it is a very big deal when a man who must negotiate decisions that effect those who put him office and their day to day lives chooses to lie repeatedly to avoid accountability for his boorish behavior and then expect the media and his constituents to excuse and ignore it.

Representative Weiner would do well to excuse himself from the political dialogue in New York and look for a new job. Maybe he could get a hot dog cart and manage to profit off his ill chosen behavior and moniker.

Sunday, June 5, 2011

Cymotrichous and Other Powerful Words

Couldn't have even spelled it on my hand, but the lovely Sukanya Roy, age 14 and a seasoned academic competitor nailed it and won the Scripps National Spelling Bee.

The word itself means having wavy hair and the Miss Roy actually recognized the word which is a feat in and of itself. Most 14 year old girls in the U.S. are obsessively texting and deleting unnecessary vowels and consonants in a faux effort at cleverness. More and more our society is opting out of full length conversations in person, by phone, by mail and I worry the loss of so many lovely words.

Cymotrichous is one that I made all the way to 42 without ever hearing in conversation and yet I have known many people with cymotrichous hair, and even mine can get a little cymotrichous when it is longer and I go to sleep with it damp.

For many years now I have made it my habit to compliment the boys on their use of a new word,"Nice vocabulary there buddy." So much so now that they will prompt me,"Nice one, huh mom?"

I love using words to paint a picture both verbally and in writing and I dread the loss of real conversation to all of it's abbreviated forms. To be sure I love the internet and facebook, and email, but I also love the heft of a book in my hand, the feel of stationary under my pen, the joy of a 50 point word in Scrabble.

Beyond the spelling bee this week I have seen or heard 3 or 4 news stories regarding words coming under fire as in the "F" word (faggot) and the "R" word (retard). The new PSA with Jane Lynch and her lovely young costar from Glee who happens to be a person with Down's Syndrome is short and to the point-and really takes your breath away when you hear the streak of vulgar names in quick succession.

My mother would have preferred I used the word F*ck at the dinner table than to have ever heard the word "Ni**er" cross my lips. Having been raised in Northern California she was horrified by the lingering racism in Texas and reinforced that there is no time ever to use such a hateful word. As I became a parent there are words I reinforce with the kids that "we" do not use, ever.

Yet, there seem to be few parents like me at my son's middle school because this week the "G" word  crept into my house and knocked me down in the kitchen. "That is soooooooo gay," I heard from the livingroom. "Pardon me?" "Oh mom, you know what I mean." "Yes, I know exactly what you mean, you mean it's stupid and I'd like you to go call one of the many gay people we know and love and tell them you think they're stupid." (Heavy sigh) "I got it mom."

So I'd like to offer a solution to both of my concerns. In order to air out the Thesaurus and the treasure trove of words within it and correct the use of inappropriate pejorative put downs I am now going to require anyone around me to give me 5 other words to replace their offensive one...should the offensive party in question be an adult who refuses, I will offer up five suggestions.

For example, "That is" "No, no I think you mean witless, doltish, inane, imbecilic, or idiotic."

Just doing my part to change (adjust, advance, correct) the world.

Saturday, May 28, 2011

Courage and the Elementary School Play

Well after months of preparation Henry's elementary school production is now a moment for the history books. The "Mousical" was staged three times, once for the littler ones, yesterday afternoon for the 3rd-5th graders and last night for all of the obnoxious parents, grandparents, siblings, and neighbors. In what I can only describe as a true stroke of genius the mastermind of the event, Mr. Scheuer, raised the house lights and said to the audience,"Let's just get it out of the way-this is your turn to wave at your kids and let them wave at you."

So we all got a little goofy and then the play began. As far as I'm concerned it could have been Hamlet at the Globe for all the sincerity the kids and their teachers poured into the production. This being his last year in the school I found myself becoming very emotional watching these "big kids" perform, sweating in felt mouse ears under the hot lights, trying not to fidget or play with their tails. The performance was not perfect-but it was exquisite in its imperfections. There were missed lines, stumbled over words, North Carolina British accents that came and went with the imaginary tide, and an errant double decker bus.

It was simply divine.

I told Henry after the play that I was so proud of him, not because of his performance, which was delightful, but because of his courage. This week he had a hard time going to sleep on two nights and fretted over the possibility of forgetting his lines or missing his cues. On the nights where he climbed into our bed Bob and I reinforced to him that everyone gets nervous before a performance. Actors on Broadway, surgeons in the O.R., me before I start a new patient in the clinic. Those nerves are a part of life and so many people miss out on life because they are too scared to get on their own stage.

I told Henry I was proud of his performance, but that his courage was what I admired most, because I knew he was scared to get up there at 11 years old in front of the whole school wearing mouse ears and a British policeman's cap, but he did it anyway. And that kind of courage makes all the difference between a life well lived and a life of "what if?"

When Henry's father died I was 31 and a college drop out who hadn't managed to drop back in. I was scared, sad, angry, overwhelmed and grief stricken, but I knew then that this was my only chance to go back to school and become a nurse. So I reapplied and come August I was sitting in the front row of Anatomy and Physiology.

Over and over again people told me,"I just don't know how you do it." "You're amazing." Frankly, it was a huge source of annoyance to me, because I didn't think I had a choice. In retrospect I can see that what they admired wasn't me going back to school or becoming a nurse or caring for the boys. They admired my courage in the face of what seemed unimaginable to bear. They admired the fact that I was still getting up in the morning and for many I think that alone would have been enough for me to accomplish.

I look back now on days where I am tired or the boys are being miserable little beasts and I think how far we've come, literally and figuratively, and I'm grateful for the grace to keeping getting up on the stage of life, alone or as an ensemble cast of characters. I don't want to miss my chance to steal the show.

Tuesday, May 24, 2011

Earning and Learning What Our Culture Values

New list out on this morning shares the ten top earning college degrees and the ten lowest paying degrees.

Highest Earning Majors

Lowest-Earning Majors

I was stunned to see that 8 of the top 10 are Engineering degrees, not shocked though that all of the top ten require a heavy dose of Math and Science.
To be sure, we need engineers and I know that the work they do is invaluable for every facet of life, so I don't have any problem with them being well compensated for their work. What disheartened me most is the second list. The 10 lowest earning college degrees. There is nothing shocking here either-I know how poorly people in these professions are paid, but I can't ignore it and I can't stop thinking about the constant message the low wages and often rotten working conditions of these professions sends out to students pursuing their educations and to the world in general about what our culture values most and what it values least.
The Washington Post in relating this same information actually had the nerve to refer to some of these majors as "Fluffy." Pardon me? I dare any electrical engineer to go on a home visit with one of my social worker friends and remove a battered, lice ridden child from drug addled, abusive parents. It is with a true sense of pride that I see how many young men and women continue to pursue professional life as social workers, knowing that when they graduate they will have to pursue a 2-3 year graduate degree and will still earn less than a first year computer programmer.
I am not even asking for people in the humanities to earn the same as engineers, but can't we at least make sure that people who go to college and earn a degree and work for a living in their profession actually be paid a wage that does not require them to work two or even three jobs to sustain a family? Forget the nonsense of competing for bigger houses or cars. I mean just being able to raise a couple kids, a dog, pay for karate lessons, and save for retirement.
Our society is dependent on the variety of professions that spring from math and science, but it is also dependent on the humanities, fine arts, and helping professions of all kinds. The world needs art of every kind to inspire everyone from engineers to physicians and we should be happy to pay for it. Every child should get to experience art firsthand and more importantly, try their hand at it themselves with an art teacher or artist.
Our society needs to have advocates for those most vulnerable and they should be compensated well for the emotional and physical work they do day in and day out. Social workers reach every kind of person in every stage of life and without them millions of children with disabilities, aging adults, people with mental illness, and every other kind person in need would go without the support they need to be successful. Two individual examples from my own little corner of the world, Mr. Scheuer and Mrs. Mountz.
Over the weekend and for the last 6 weeks the kids at Henry's elementary school have been preparing to star in an original musical production. There have been myriad rehearsals, set buildings, and costumes to prep and the two adults most responsible for all of this are an inherently goofy and inspiring music teacher who wrote the play and the score, and the school art teacher who helped Henry create his own Andy Warhol portrait. Saturday I watched Mr.Scheuer herd 50 elementary age kids through a rehearsal and direct parent helpers without once losing his temper. When one student was obnoxiously noisy while others were performing he called attention to the quiet ones without shaming the noisier and got the quiet he was looking for at no expense to anyone's pride.
In truth, Henry joined chorus this year on the sheer exuberance of Mr. Scheuer alone. He can't sing like Placido, and will very likely never sing for any kind of recording, but Mr. Scheuer has reinforced and rewarded Henry based on his participation all year along. In fact one afternoon I got home and Henry proudly announced that he had gotten Skittles from Mr. Scheuer during rehearsal that morning. When I asked why he said, "Cause I'm so enthusiastic!"
Every child deserves to have a teacher like Mr. Scheuer and be exposed to the way music can make you feel physically and emotionally, the way music moves you body and soul is a gift worth without price. As for the art teacher Mrs. Mountz, to say she is dedicated is simply an understatement. She has collected boxes and managed to keep a swirling group of parents and volunteer middle schoolers on task and painting and building for the better part of 8 hours Saturday. By showtime tomorrow the Kindergartners will see a working version of Big Ben and a rolling double decker bus. (I myself helped put the cockroaches in the villains kitchen.) Like Mr. Scheuer she makes progress with unruly kids by reaffirming their positives and she manages to keep a sense of humor when all that stands between her and sanity is a cadre of hormonal fifth graders and a sea of tempera paint.
Neither one of these teachers is going to get a financial reward for all their efforts-money doesn't motivate their work-the work and their love of art and children motivates them to devote almost every moment of their free time to productions like this, a production I know will be remembered fondly by every child included in the adventure. When Henry auditioned and got a call back he ultimately got the role he coveted most, police chief. But since the play is set in London he is Constable Wiggins and since the play is about a lost mouse, he is in fact, a mouse police captain. In Henry's mind this was, in fact, a major casting coup, "Mom, I get two costumes! I'm a MOUSE and a POLICEMAN!"

When Henry talks about school he says 5th grade is his favorite year ever and I know in large part it is do to the extra effort of two artists who know their real value no matter what price our culture places on them. As a nurse I get compensated with a living wage, yes, I could earn more, but what I earn is enough because I love what I do, I am rewarded emotionally, professionally, and in so many other ways by the work I do and I know the work I do is valued by our culture at large. Professionals who share the joy of learning, the arts, speak for the least of these, entertain, help others find their voice, and tend to the spiritual health of their communities should be lauded and compensated like their work means something.

Because without it all the well engineered inventions in the world will be meaningless if the culture surrounding them does not inspire creativity, celebrates all kinds of gifts, and is willing to pay the price.

Read more:,29569,2073703,00.html#ixzz1NHB0KOBS

Friday, May 20, 2011

Peace, Antisemitism, and a Palestinian State

Today Israeli Prime Minister Benjamin Netanyahu will be meeting with President Obama at the White House. The timing is awkward given that yesterday President Obama laid out his vision for the Middle East and North Africa, including returning boundaries in the contentious Israeli/Palestinian border back to there 1967 locations. Kind of like telling your mother in law you never intend to bear grandchildren for her and then having a cookout the next day.

To say that this is a hot potato diplomacy wise is an epic understatement. Realistically, making any suggestions as to where the lines are drawn in the Israeli/Palestinian land disputes is akin to political and social suicide. Someone at some point will brand Obama as an antisemite and then the fur will fly and once again any reasoned conversation will give way to extremist nonsense that benefits no one, most especially the people who populate the coveted real estate.

Much like the abortion debate in the U.S. it seems impossible to have a reasoned, thoughful conversation on the topic of the Israeli/Palestinian conflict. Dating back to before many in the dialogue today were even born the debate is rife with feelings of betrayal and anger-much of it directed at groups of individuals who had nothing to do with the centuries old conflict. The debate has become a pivotal issue for politicians seeking backing and more important, money from PACs and private donors with deep pockets and deep ties to Israel.

I don't pretend to be an expert on Arab-Israeli politics. But I do know that for my entire life there has never been a moment of true rest for that part of the world. There is no one my age living in that part of the world that knows what it would be like to live without the specter of violence overhanging every walk to school, to a mosque, to sit Shiva for a lost relative. Every day suicide bombers, gunfire, bloackades, threats, streetfights, discrimination, food shortages, mandatory evacuations or evictions.

A life where by age 5 you have seen a bloodied body in the street and been told over and over again that you are worth more or less than another child who is of the opposite persuasion-when really, all you are is a child stuck in the no man's land of conflict that adults have created and perpetuated.

Therein lies the problem for both Israelis and Pa;estinians-no one alive in either group has any idea what peace and quiet look like and no one is willing to believe that committing faith and energy to a true peaceful resolution of the confict is really worth it. for years I struggled with trying to build healthy relationships with people-I was stuck behaving the way I always behaved in my intimate relationships with family-crazy alcoholic family nuts. I sought out crzy, broken birds to be in relationship with, because even though it was misery-it was a misery I knew how to live with-not an unknown quantity to be reckoned with or learned.

In simple terms that is the crux of the conflict between Israel and Palestine-no one has any idea what it would be like to simply stop fighting over neighborhoods and boundary lines and simply let one another live. The very thought of putting down their arms and simply sharing power is too threatening to even consider and so anone who suggests Israel relent is antisemitic and any one who suggests Palestinians share leadership with Israelis is branded anti Islamic.


The children born this morning to Palestinian and Israeli mothers deserve the opportunity to play in the street without dodging bullets, have safe homes not dictated by arbitrary politics, worship with their grandparents without fear of retribution. And the only way that true lasting peace can come between Israel and Palestine is if the leaders of other nations can speak to the need for compromise without being branded Anti Semitic. Name calling gets no one anywhere, and thousands of years of violent history should be proof enough for anyone.

Tuesday, May 17, 2011

Addiction Apologists

By the the time I post this most everyone in the world will know that Arnie couldn't keep it in his pants and fathered a child outside of his marriage. Probably not the only straw on Maria's back, but I'm guessing it probably lit the match as far as her decision to separate from him formally.

For his part, Mr. Schwarzenegger has been appropriately contrite and apologetic in the press, no looking for redemption or offering explanation as to his shitheel behavior. This doesn't make it any nicer, but in contrast to some of the other celebrity divorces of late it is certainly an improvement. Now for something completely different.

Meet Jesse James, tattoo afficionado, chopper creator, loser ex husband of Academy Award winning actress Sandra Bullock. "I cheated on my wife. Guess what millions of men do that." Indeed they do, but most at least have the good grace to appear contrite and keep their mouths shut. They do not go on to write a tell all book detailing their conquests or describing in detail their preferences and the fact that good old Sandy isn't quite as wild in the sack as say the newer tattoed broad he is currently bedding.

Is it too much to ask to just, SHUT UP.

I do not care that you had a miserable childhood, get in line.

I do not care that you have an addicition. In fact-shut up about your addiction and recovery. You are the reason people and lawmakers do not believe in funding treatment for addiction. If you were truly in recovery you would be making amends to your former wife, your children and your friends. You would not be airing out every bit of dirty laundry, sexual prowess, and history of trysts to the world and making a profit off of it.

There are hundreds of millions of people in recovery and they have worked and continue to work to stay sane, sober, and healthy. They do not seek the limelight, they seek real life, unimpaired by their addiction (s) and you sir are not in recovery and the only steps you are working are the ones that lead further down the path of no return. I believe sexual addiction is a real problem, and I believe recovery is possible for anyone. I do not believe for a moment that Jesse James is in recovery and I am tired of him and others of his ilk bastardizing the process of healing with their moronic, self serving myopia.

At the heart of it all addiction is the most devastating form of selfishness and self absorption. It takes years to retrain and refocus a brain, body and spirit to living life differently. Not 6 months, a new girlfriend and a fresh tattoo. So Jesse take a moment, go to a meeting, get a new sponsor, and SHUT UP.

Monday, May 16, 2011

Making Peace

My favorite patient died on May 1st. I discovered this on Saturday night about 4 a.m. after I finished writing he and his sweet wife a little note to say hello. I went to look up his address and had the wind knocked out of me by the word deceased on his facepage.

He was 83 years old and had been diagnosed with a form of lung cancer over the winter. He had a short course of treatment, lost his hair, lost a little weight, otherwise he did ok. At the end of his treatment though his doctors recommend he do 25 radiation treatments "Just to be sure." He wasn't happy about it. He didn't want to do it, but at 83 he was used to the doctors knowing what they were talking about and so he resigned himself to doing the treatments.

But he also looked to me and the other nurses who cared for him to confirm that he should do it. Now, I sit here feeling like a traitor to him and his precious wife. I feel like I gave him the company line, when what I should have said was, "Well you are 83 years old and you have had chemo and if you don't want to do the radiation just tell them no and make peace with your decision."

But I didn't. I said something like,"Well if the doctors think this will give you the best chance at survival you should go ahead and do it." So, his life ended on a ventilator, in an Intensive Care Unit, with pneumonitis and pneumonia likely brought on at least in part by the damn radiation treatments and here I sit, complicit in the crime.

No, I didn't kill him-but did I do enough to make sure he knew the decision was his and not the doctor's? Not his wife's Not his cancer's or his grandchildren's or his priest's. The decision to endure radiation treatments should not have been accompanied by the external pressure of his healthcare providers-we should have given him all the details, respected his choices, and let him go home for 6 months, a year, or a decade.

But we didn't, he got pushed by all of us into radiation, and now he's dead.

The day I accepted by original hospice nursing position I was working an overnight shift in a San Antonio ICU and the patient was an 80 year old man who had been "found down" in his nursing home, and got "brought back" before anyone checked to see if he had a DNR. As luck would have it, he did. But by the time anyone saw it the poor SOB had been shocked, intubated, and was now spending his last miserable freaking days on a ventilator being continuously dialyzed, and that night every time I suctioned secretions from his lungs I chanted to myself, "This is why I am going to hospice, this is why I am going to hospice...."

And I did. I worked in Hospice for close to three years with adults and children and it was rewarding and challenging and I loved it-but between remarriage and two deaths at home on hospice I had begun to feel like everyday was "Take your sickle to work day" and I needed a change. So I came back to the medical and surgical side of things and there isn't a day that goes by where I do not find myself torn between telling people what they want to hear, what they need to hear, and what I can responsibly tell them as a part of their healthcare team.

This time I didn't do it right and now I am left with my grief, my conscience, and the hope that I will do better next time. The next time you are a patient remember that the people prescribing and providing your care are human too and therefore your care is inherently flawed. 

Clinically he should have had the radiation treatments, but realistically, an 83 year old man with a 50% survival rate after chemotherapy should have been allowed to go home and read the paper and flirt with his wife. Next time I hope I err more on the side of flirtation than radiation.

Saturday, May 14, 2011

Custody and Cancer

This week a woman in North Carolina was told that she has to relinquish custody of her children to her ex husband who lives in Chicago, IL. The woman in question has been the primary caregiver for the children since birth and she is also a cancer patient.

By all accounts the marriage was a miserable affair. Evidentally affair is the operative word in this case as both parties had sexual relationships outside of their marriage, there are also allegations of physical and emotional abuse and both parents spent a night in jail after a fight turned physical.

So let's skip that part of the story. They both kind of suck, and clearly, as is the case in many marriages ending in divorce, they are not quite done shitting on each other yet. Unfortunately their two offspring are in the way and being used as pawns in the 21st century game of custodial chess.

The reality here is that these kids are facing a lot of misery-but maybe not any more or less than if their parents had stayed together in a miserable marriage. There are unfortunately millions of children like them here in the U.S. being shuttled between homes and parents and used as bait in everything from financial to psychological negotiations. I have a wee little girl asleep in my house this weekend who is one of them, and we don't pretend to be a perfect family either.

What terrifies me about the judge's ruling in this case is the fact that a parent with a diagnosed illness has been given a shelf life and an expiration date for parenting. The judge in this case heeded testimony from a forensic psychologist that stated children in these situations do better with more contact with the "non-ill" parent. While I don't doubt that the judge and psychologist could be very well intentioned. I don't believe they thought about the precedent being set by removing children from a parent due to their medical diagnoses.

There are certainly cases where an ill parent cannot successfully or safely parent a child-but by all descriptions, this is not that kind of case. This is a case where a patient has been classified as Stage IV by her oncologist and now the court system has determined that means she is actively dying. But she's not.
She does have metastatic breast cancer and it is in her bones. In all likelihood she will die as a result of breast cancer. But when she will die is anybody's guess. Because of the research and treatments available she is likely to survive 5 or 10 years, quite possibly more and there is no oncologist who will tell you she is dying.

She is living with cancer. Just like parents who are living with heart disease, diabetes, bipolar disorder, Multiple Sclerosis, Parkinson's Disease, and HIV. Custody matters should be based on the parenting ability of the parents in questions-not their medical diagnoses. In her decision Judge Nancy Gordon stated that, "Children want a normal childhood, and it is not normal with an ill parent."

Normal for whom? Is it idyllic? No, but real life very often isn't. Children deserve the opportunity to be raised with loving committed parents. Those parents can be of either gender, any race, ethnicity, religion, or sexual orientation, and they can have a chronic medical condition that does not hamper their ability to love and nurture another human soul. In many cases it may very accentuate their ability to do so.

There is a balance of course, and I am not suggesting children should spend their every waking moment cleaning up vomit after Dad's chemotherapy treatment. But I do know that my own sons learned a lot about caring for others from helping their grandfather when he was unable to do something because of his Parkinson's disease, or walking with their Great Grandmother to and from the sanctuary at church when she needed a little more supervision because of her dementia.

In retrospect some of their funniest memories are of the way Grandpa terrorized people at the hardware store on his scooter, and the way we had to move the salt away from Great Grandma because she would vigorously cover the same plate of food with it three times due to her forgetfulness. The boys were part of the family journey. Grandpa didn't just disappear one day. He died at home, and they held his hands before and after, and they grieved his loss with all of us.

The judge in this case is forgetting that children live in the real world, not in a Disney movie. The real world has flawed parents with crappy marriages, and sometimes those parents get sick. But that doesn't mean they stop being a family and shame on anyone who tells a child they have to lose their mother twice. First, to a court decision that ignores the flawed uniqueness of every family. Second to a disease that doesn't discriminate against anyone-including judges or parents.

Friday, May 13, 2011

The Men I Hope I'm Raising

I have a patient in the clinic right now that is only 33 and is fighting her 2nd round of metastatic disease related to a gosh awful syndrome that effects her family tree. The syndrome places her at high risk for developing soft tissue cancers and so this young woman has experienced a lot of illness and grief in a short life, watching multiple family members fight and die miserable cancer related deaths.

She never planned to marry. She was pragmatic about it and figured, it simply wasn't fair to anyone to put them through all of that misery when in all likelihood she would die and leave them alone again anyway. So she made a life and career for herself and she did some online dating with no intentions of tying the knot.

Enter Mr. Wonderful. He is the same age as her, fell deeply, madly in love with her, and asked her to marry him for five years. She finally relented, they married and three months later she was diagnosed with breast cancer.

Because of her genetic stew the cancers she is prone to are not "polite, sorry to interrupt your life, there is a little spot on your breast" cancers. No, there is nothing polite, tidy, or forgiving about her cancers. They roar into a body that was healthy one day, and riddled with disease the next. In fact she was treated for and in remission from breast cancer in January of this year and six weeks later she had a new metastatic pancreatic tumor.

I met her the very first day she came for treatment in March for this new virulent cancer that was already causing pain along her spinal column and painting spots on her liver. Tearful, frightened, overwhelmed. She looked at me grief-stricken and said, "Is there really any chance this is gonna work?"

I offered her reassurance, a chaplain visit, other nurses visited, her doctor visited. But more than all of that her husband sat beside her and whispered in her ear tenderly, "I'm right here baby, right here."

There are moments as a nurse that simply take your breath away. Too private for you to be privy to and yet you are there and part of the inner sanctum of marriages and families. I try to be what my patients need me to be on any given day: funny, thoughful, prayerful, quiet, listening, distracting. With every visit what they may need from me is different and just as I take their vital signs I also take a reading of their emotions and figure out how to navigate as their nurse in that moment.

In the months since her treatment began I have come to know them well and she has struggled. Her treatments have made her physically and emotionally ill but she has made a turn towards a little respite and I am grateful that she and her Mr. Wonderful will be able to spend a week at the beach pretending to be thirtysomethings in love and not squezzing in romance between chemo appointments.

What continues to stop me in my tracks every time I see them though isn't her resolve or charm, it's her husband. He is easygoing, devoted, and passionately in love with his wife. He loves her bald, pudgy from steroids, tearful, drunk on sedatives. He loves her with the level of commitment that most marriages need years to develop. I care for older patients and see the wisdom of 40 years of peaks and valleys in the way they battle cancer-but in younger patients I never see that, I see impatience and hurried hopefulness usually as a mask for terror.

I've never seen a man who loves his wife the way Mr. Wonderful does-never. I know my darling loves me and will be with me through thick and thin. Thankfully he hasn't had the opportunity to stand by me through this kind of crisis. I know a lot of devoted husbands and I know they will step up to the plate and be the partner their wife needs and deserves if they are needed.

But Mr. Wonderful is different-he is a tangible example to me that hope remains for a generation of young men that the media considers less concerned with the real world and more interested in technology, less concerned with personal relationships than personal status. He's the kind of man I hope I'm raising.

Dorothy Parvaz update

Revolution isn't free

Once upon a time I was a journalism major. I dropped out of college soon after being chosen to be the editor of my college newspaper-when I did return to college I got a degree in nursing but I still relish the news and newswriting. I like being well informed, and as my oldest and dearest friend Denise says, "I am the they in 'they say'."

I torture my children with NPR on a daily basis and love to peek at news sites during my work day. I am not a snob about my information either-I freely admit to enjoying celebrity nonsense as well as the more important world news. The media in the United States gets a lot of grief for being too invasive, too exploitive, too liberal. On any given day most anything published could be accused of at least one if not all of these complaints. But that really isn't the whole story.

Journalists in the United States enjoy unparalleled access to what becomes our news in real time and most of us take it for granted. We assume that if something important happens we'll find out about it at the top of the hour. There won't be a coup or conviction without us getting the full scoop. For many people in the world though that kind of access is not a standard, but the exception.

The Committee to Protect Journalists website keeps a running tally of press freedoms and restrictions around the world and posts information online regarding journalists jailed, tortured, or killed in pursuit of the news. At the end of 2010 the CPJ was able to confirm 145 journalists worldwide that were being held based on their attempts to cover the news. Almost 50 percent were in Iran and China, and given this springs historic events I am sure the number of imprisoned journalists in the Middle East is now much higher.

This year alone in less than 5 months, 16 journalists have been killed and their deaths have been directly attributed to their work. More startling is that since 1992 when the CPJ was formed and began keeping track of its' own-861 journalists have been killed worldwide. 861. Many no one ever heard of, no one ever read their stories.

Currently Dorothy Parvaz, a reporter for Al Jazeera, is being held without any communication in Iran. Parvaz holds dual citizenship in Iran and the U.S. and has traveled many times between the US and Middle East to provide an insiders view on the politics and culture of the Middle East. Parvaz had traveled to Syria where she was able to use her Iranian passport for entry to the country. Once her identity and her dual citizenship were discovered Syrian officials accused her of not telling them she was a journalist and shipped her to Iran, where she has been inexplicably kept without any communication since April 29th.

Iran has absolutely no reason to hold her, other than not liking nosy, opinionated broads, and I feel quite sure Parvaz is both. But Iran and Syria, and other countries ruled by leaders who continue to cling to autocratic and dictatorial rule, are threatened by the very existance of the media, much less  the free and open flow of information that Westerners take for granted.

Here's the truth though, the days of hiding in plain sight while you beat and bludgeon your citizens into submission are coming to an end. The evolution of the media and the innovations provided by technology have all but sounded the death knell for those who would hide their evil behind a cloak of protection for their countrymen.

The Middle East has erupted with a cacophony of tweets and blog posts from the epicenter of the chaos and it is at once both terrifying and thrilling for the soul. I can imagine the palpable feelings of joy and fear intermingling in the crowds and like the rest of the world I have watched in awe as these people have shown unflinching bravery in the face of knowing they would be beaten, jailed, even killed for demanding the right to choose their own way.

Those brave souls found out about the corruption within their own countries the old fashioned way. They read the paper, or heard the news from journalists within their own countries who were brave enough to root out the information without the Freedom of Information Act or the Bill of Rights. The very least we can do is make sure the men and women who continue to spread the word and shine a light in the deepest of chasms are safe from harm.

Becausee if we don't protect the rights of journalists around the world and demand the release of our unlawfully imprisoned US journalists, we may not have anyone around to tell the world about the next revolution, and we'll have no one to blame but ourselves.

Wednesday, May 11, 2011

Who Really Loses When States Stop Funding Planned Parenthood?

I drove home yesterday after a long day on my feet caring for a variety of patients with cancer. The last patient of the day is 23 and was diagnosed with a virulent form of cervical cancer related to a Human Pappilloma Virus (HPV) infection just six weeks ago. She was initially diagnosed by her nurse practitioner at a Planned Parenthood and came to my hospital for surgery and chemotherapy. She has a more than 75% chance of survival and although she will never bear children of her own, she will live to adopt, be an aunt, finish college, get married and get on with her life. Her journey to my chemo chair was heavy on my mind as I listened to All Things Considered on NPR and heard the story I have linked to below.

Then this morning I saw on CNN that the courts have said Indiana can restrict funding to Planned Parenthood so I guess that makes it official. If you are poor and uninsured in Indiana, you can also plan on not having access to contraception, an affordable pap smear or a mammogram. Good times.

Every few months, and certainly every election cycle, the far right anti abortion advocates sprout up like weeds and begin to spew half truths and out right falsehoods about Planned Parenthood. Elected officials who want to remain elected then begin their difficult tap dance of being "pro woman, but not pro choice." and in the end once again, it is the poor and uninsured that bear the burden of electoral politics. Planned Parenthood is not an abortion factory. In fact only 12% of all people served by Planned Parenthood in the last 12 months sought an abortion. Of all the health care related services provided by Planned Parenthood only 3% are related to abortion, and those services are not federally funded.

That is in sharp contrast to the estimated 600,000 unplanned pregnancies prevented by the contraception provided by Planned Parenthood. In fact with their educational efforts, clinics, and outreach in developing countries Planned Parenthood serves over 5 million people annually. No, they are not all teenagers trying to get condoms, in fact, only about 20% of Planned Parenthood's clients are less than age 20.

Do not misunderstand me, I do not believe 13 year old's should be able to have an abortion on a street corner or have access to condoms in the lunchroom-"juice box or prophylactic?" But I do think it is time to stop making the entire reproductive health conversation about abortion. Frankly, if we have the conversation like reasonable adults, abortion will be the smallest part of the equation when all is said and done.

We can't afford to demonize an entire organization for providing services that are LEGAL. I don't like abortion, and I would prefer no one ever needed one. But I live here, in reality, where women are raped by family members, diagnosed with cancer during their first trimester, and discover Tay Sachs in their genetic stew after becoming pregnant. Sometimes, abortion is a valid choice and it is a LEGAL choice.

I have two biological children, the first was the result of a lot of love, and a failure of our contraceptives. I do not regret him for a moment-but when I became pregnant I was 28, in a loving relationship, employed, insured, and healthy. I had options that many women can't even imagine. I am now parenting that child through the teenage years and having conversations that make my insides squirm.

But again, I am having those conversation now, and offering information now, so that I do not have to be a shoulder to cry on later. My sons will both have the Gardasil vaccine, not because I want them to go out and bed every woman in the county, but because I do not want them or the partner they do eventually have a physical, sexual relationship with to be at risk for HPV.

What makes me angriest is that when "pro-life" organizations rally against Planned Parenthood they are not rallying for the lives of women-they are rallying for the fetuses women could potentially carry, not the living human beings seeking health care. Last year 1 million women got their pap smears at a Planned Parenthood. The bulk paid on a sliding scale and would not have gone to another doctor due to cost. These women deserve to continue getting care that is focused on their needs and those of their families.

Pro life should mean more than anti abortion. Being pro life should mean advocating for safe health care for people in all stages of life. Instead of having the same arguments over funding and Planned Parenthood elected officials should focus on the lives of their constituents, and making it possible for them to have healthy productive lives that fulfill the American dream.

Tuesday, May 10, 2011

Aging Without Grace

I have a patient who weights about 80 pounds soaking wet and tops out at about 4 foot 9. She is beyond petite, but her personality appears to be where she compensates for her diminutive stature. She is to put it mildly, a pistol.

Actually she falls more into the category of cranky old battle axe-but for whatever reason I have fallen for her and her cranky pants demeanor.

She is bald and slightly stooped and resembles the actress, Margaret Hamilton, who played the Wicked Witch in the film version of The Wizard of Oz. Her husband is about 6'5 and weighs at least 250 and is without question the most henpecked SOB on the face of the earth. From the moment she sits down until the moment she stands to leave after her chemotherapy she does not draw breath. She instead produces a constant stream of bitching and complaining about everything from the dinner menu to her children, the weather and the economy.

I, being the obnoxious sort, have now developed a relationship with her that allows me to interupt her perpetual bitching with, "For the love of everything M, stop fussing, you needed to breath." Pause.
"Oh, Patti...cackle cackle cackle."

There are other patients who will see her coming and actually pull the curtains around their area for fear of having to listen to her bird dog her husband all day, and some who will ask to move. When she is in rare form she will ask everyone around her what kind of cancer they have, where it started, if they have a colostomy, and so on. I have actually interrupted her treatise on bowel movement management more than once to save a patient who was looking green at the gills.

The first time I had her as a patient she was with me for four hours and at the end I said, "Mrs. M what kind of work did you do before you retired?"


"I bet you were a lawyer," I said.

"Oh no dearie, I don't like to argue with people."

Silence throughout the clinic followed by an eruption of belly laughing from every patient and family member within 50 feet of her.

She glared.

She pouted.

Finally, I stopped laughing, wiped my eyes and said, "M, you are lucky it isn't storming because you would have been a lightning rod with that whopper you just told."

She grinned. Her husband to his credit spent the entire time behind his newspaper, for fear of her seeing his smile I'm sure.

Turns out she was a fifth grade teacher. I cringe at the thought of her tending to one of my kids. I can only imagine her teaching style would be brusque and uncompromising to a fault. As petite as she is-she completely fills the room with the force of her personality, no doubt a vestige from her days of being a tiny woman in a man's world.

She is a pill to be sure, but I find her transparent nosiness and irritability somewhat charming. I appreciate the fact that she does not want to be the, "sweet little old lady with cancer." She intends to be a complete and total pain in the ass-and most often she succeeds.

She continues to care for her husband and remind him about his doctor appointments and medications, plan their meals and grocery list, and set times for them to perform their yard work together. "If I don't get him out there early he'll keel over in the sun honey and I'll play hell dragging him in the garage to recover."

There is a deeply ingrained cultural myth about aging women, mothers and grandmothers that is I suppose meant to be a compliment or at least it was, but in today's world the constraints of being the doting grandmother would be too restrictive to a generation of women who worked outside the home earning their own salaries, and no longer define themselves based on their relationship with or without a man.

She is more a caricature than I think she realizes, and if she had been born fifty years later she might not have developed such a coarse way of dealing with the world. The reality is however, that she is a remarkably spry 80 year old woman with cancer playing the cards life has dealt her with spirit and determination and an unwavering belief in herself.

What's not to like about that?

Monday, May 9, 2011

Women, Nonsense, and Hillary

So I don't know if any of you heard, but the U.S. finally offed Bin Laden last week, but by Thursday the web was abuzz with discussion of the now infamous Situation Room photo with President Obama looking stoic and presidential and Secretary of State Clinton looking concerned and with her hand in front of her mouth.

Was she worried? Upset? Scared? Feeling Maternal? Confused by her ovaries in some other way?

Oy vey. Enough already. The woman had her hand in front of her face-that's it. She was not crying hysterically, clutching prayer beads, or holding hands and singing Kum Ba Yah with her neighbor at the table.

Why does every reaction by a woman in a position of leadership provoke concern or questioning by the media? It's 2011 and yet if a woman is in command she not only needs to perform her duties better than a male counterpart but she needs to look and behave like a man while she's doing it. And woe betide the woman who expresses emotion about a difficult decision:she'll be labeled as "dramatic" or worse yet, "tenderhearted." Then of course if she doesn't react enough, she's a bitch.

It's the age old double standard. President Obama gets flack for being emotionless, but the same behavior from a woman would mean she's able to put aside her feminine qualities. Really? Is that what it takes for a woman to be in charge in 2011?

I am biased obviously, because I am female. But here is the raw truth of it, I have had male and female managers, and I have been a manager myself. Through every part of my professional life over the last 8 years I believe my gender, my experiences as a mother, and my experiences running a family have made me better at what I do, more capable, more creative, and more determined to find the best outcome.

Women are still perhaps more in touch with their emotional selves, and that isn't a leadership deficit, it's an asset. Being able to fairly assess your colleagues based on not only their professional skills, but also based on their emotional intelligence makes for a healthier work place. To be fair I have also had male leaders who were more emotionally in tune and provided better management than any of their female counterparts in the same organization.

It's about leadership skills-not gender-and again, it's 2011.

I think what may have annoyed me most about the whole debate is the fact that Mrs. Clinton had to wade into the fray and state she thought it was a symptom of her spring allergies...Really? So it's ok to have the sniffles, but not cover your mouth in shock at a display of violence and the end of an era for our country?

I do not want leaders at work or the leaders of our country making decisions and reacting to them with only the analytical part of themselves. I want the whole enchilada-I want leaders who are engaging both their heads and hearts in their decision making. I want leaders who reflect upon their decisions and what the consequences of them are for the people on the other end of the bomb, raid, or embargo.

I want leaders who recognize that decisions have ramifications that can't be analyzed in a completely clinical way-there is a human cost to every endeavor and leadership that doesn't acknowledge that fact is at its best, ignorant, at its worst, incompetent.