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?"

"Guess."

"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.

No Golden Ticket Here

So when my son Nicholas was about 3 and a half, he finally began to notice that not everyone looked the same. In fact some of the differences were meant to call attention to if you asked his opinion.

His cousins are mixed race and so he suddenly noticed his best bud Cole was a different shade one day and said, 'Cole's brown." "Yes he is, just like his Mommy and Daddy," I said. pause. "Aunt Gegea is not brown(my sister, Genea). "Well what color is she?" "Grey." (Lucky Uncle Carry is the color of warm mocha.)

So began the slide for me into the perpetual parental embarrassment of having an articulate child. Nick's younger brother was 18 months old and both were seated side by side in a giant shopping cart at the local Petsmart. "Look at the bird!" "Look it's a ssssssssssssssnake!" "Mom that guy only has ONE ARM!"

Cue complete and utter silence in said store, except for the crickets chirping out their beleagured version of the Ave Maria before being eaten by the store iguana. "Sweetheart shhhh, we don't want to hurt anyone's feelings." "BUT MOM WHERE IS HIS ARM?"

"SSSSHHHHHHHH please lets use our quiet voices and I will tell you."

"okay....." So I began,"Nick sometimes people are born with only one arm or leg, or some times they lose an arm or a leg in an accident."

"WE HAVE TO HELP HIM FIND IT!"

"Hush and listen, he looks very healthy, he works here with the kitty cats and see he is able to carry big bags of food and help people. God makes everybody different."

So from then on there were multiple situations each week where Nick would notice something different and we would review the ways in which people are different from one another and I would wind up each and every conversation with my best rosy comment that, "God makes everybody different!"

Six months later the day began as any other, I loaded up the minivan with the boys and drove to meet another mama at a local bagel store. I parked by the store and helped Nick out of his car seat and onto the curb next to the car where he could wait while I did the same for Henry. Suddenly, in full voice Nick bellows, "MOM, LOOK AT THAT GUY!"

(Cue sounds of internal maternal sirens on continuous loop)
"HE'S TINY!"
Panic stricken I pulled Henry out of the car and turned to see a man about 3 feet tall at most, a little person.

"Nicholas shhhh, remember we don't want to hurt anyone's feelings."

The man smiled at the boys and continued waiting for someone in front of the bagel store. "Nick smiled back and pokes Henry in the arm and says,"HE LOOKS JUST LIKE AN OOMPA LOOMPA."

And then my precious now four year old turned and looked at me as the little person wisely chose to move farther away from our family,"I guess that's just how God made him, huh?"

Indeed.

Friday, May 6, 2011

Drugged

I forgot to give the boys their ADHD medication before school yesterday morning. By the time I realized my error they were at school and Bob and I were at work and I had to let it go. In the big scheme of things this seems like no big deal, and to some out there I know there is a wonder as to why I would ever want to medicate my sons.

Here's the truth of it-I don't want to medicate them-I never have and I resisted for almost two years although my son's pediatrician from birth looked at me when Nick was 4 and said-"we probably ought to talk about ADHD." When I finally relented after he almost failed first grade I took both boys in and told Dr. Elliott I was ready he looked at me and then at the two tornados dismantling his exam room and said blithely,"so, can I go ahead and write two or do you want to wait?" I waited.

I also wandered through multiple trials and therapies with Nick to find medication that would help him manage his own behavior and be successful in school. He spent almost the entire year of Kindergarten at a separate table by afternoon because every other kid in the class was exhausted by him. As time has gone by we have had to adjust, readjust, stop, start over, revamp and reevaluate his treatment. The onset of puberty appears to have been similar to throwing a can of gasoline on a forest fire and his ADHD has erupted again to the point that there have been many moments I have cried and felt like all the work we did together, he and I, was for nothing.

But we have perservered. His school is working with us to develop some modifications to help him succeed, his current medications are working, and he is responding to our behavioral interventions at home. At the heart of it all he is a beautiful, loving, funny, articulate fellow and all I want as his mother is for the rest of the world to get to see who he really is behind the mask of ADHD.

Henry also takes medication for ADHD, but unlike his brother his has always been simple to manage with a low dose of medication. He is enjoying success at school, makes friends easily, is well liked by his teachers, self motivated to do his homework, etc. Without his medication though he is like a squirrel on speed, and if he and his brother are together it is like watching a couple of feral cats in a dryer running a marathon. They exponentially expand to fill all air space within 500 feet of them and within moments I find myself contemplating how long it is until bedtime, and when is it ok to start drinking heavily.

Because I am a nurse I have been fortunate enough to know how to advocate for my children with physicians, how to understand terminology, dosing, when to tell the doctors-NO. This is a long road and I believe Nick will need some medication throughout his life to help him manage his ADHD. Henry I am not sure-he may be one of the few who grow into adulthood and with a combination of behavioral interventions and maturity he may not need medication every day.

Some families have to worry about diabetes and cancer, my family tree is riddled with mental illness and addiction-addiction that was very often self medicating to deal with mental illness. I am honest with the boys, I do not forcibly shove medicine down their throats, and both boys are able to tell the difference in themselves when they miss a dose. I don't like that they are on medicines that can cause serious side effects, but I know for sure that life without the medications is miserable for them and everyone around them.

It's easy to be an armchair parent and say,"I would never allow my child..." But as with everything else in life until you have walked the road yourself do everyone around you a favor and be quiet. I see children and parents everyday coming in for treatment at my hospital-children with visible disfigurements and the pallor of professional patients. Often children who are chronically ill can become very demanding and entitled because they are so used to being the center of attention. I won't judge their parents though-because I can't imagine what it is like to constantly face the specter of death with a little one and try to be an effective disciplined parent. I imagine there are days where they are just holding on to make it to bedtime themselves.

I would never tell the mother of a child with diabetes not to use insulin or monitor her child's blood sugar, I won't tell someone to ignore asthma and pretend their child doesn't need an inhaler. Don't judge me for putting my child on medications for their emotional, physical, and and educational wellbeing.

Ask questions, absolutely. But don't judge me-I have two tender boys that deserve a chance to shine and they are going to get it with all my love, all my support, and whatever else they need to make it down the road-including medication.

Thursday, May 5, 2011

Turning

It should come as no surprise that the headline I read this week that most disheartened me came from a Fox Network affiliate in Houston. Next to The National Enquirer, and Weekly World News one can always count on Fox newscasts for thinking that strains credulity.

"Is TV too gay?" This is the question posed by a newscaster (African American and female) to her guest, American Family Association (only if it is a white, Christian, two parent, heterosexual family) leader, Bryan Fischer. There was no attempt at evenhandedness, no attempt to present more than one side of this issue or have a real conversation about what time slot is most appropriate for a show with many adult themed elements. The gay activist interviewed appeared stunned to even be listening to the drivel and simply said,"I don't know why this conversation is being held."

The heart of the matter cannot possibly be,"Is TV too gay?" For members of the AFA-any amount of gay is too gay, any amount of unmarried coupling is too much, any amount of non Chrisitan religious views is too much.

Fischer contends that constant exposure to all that is gay is creating an atmosphere of temptation. Uh, no. I agree that too much of anything is too much: chocolate, porn, alcohol are all fine examples. But saying TV is too gay takes us in to the realm where there are too many female focused programs on TV, too many  black folks on TV, too many fat people, too many short people...

I have watched way too many episodes of Law and Order over the years...I have a little obsessive streak when it comes to Sam Watterston, and yet, I have never committed a crime, become a police officer, evaded arrest, prosecuted a criminal, or learned to play the"Duhn Duhn" sound at the beginning of each new scene in my day. I enjoy watching Glee every week but I still can't sing, can barely dance, and certainly don't intend to get knocked up by a member of the football team while having a slushie thrown in my face.

Here's what I think about TV and exposure to things that are different. It's good.

Being exposed to people with different beliefs helps every single one of us learn about the wider world, develop a sense of compassion and empathy for those that are different, and become engaged in things that are happening beyond our doorstep.

When I was little I didn't know anyone with Down's Syndrome until middle school and even then those students were put in a separate room so all I had to go on was the fact that a) they looked odd and b) they were a little slow. Then in college I saw a program called "Life Goes On" with a main character who had high functioning Down's Syndrome and while it certainly didn't expose me to everything about the condition it did help me understand that people with Down's are first and foremost people, and their wants and dreams are very much like my own.

When I was a child my mother took me to the symphony, ballet, and museums. The arts were important just for art's sake, but as I grew older I realized not everyone had parents who took them to see a Broadway musical or a Picasso exhibit. I met people who had never been to a zoo or seen the ocean firsthand. For all the complaining we do about the sorry state of the media-the reality is television is a window to a wider world for many people who live in rural communities, for those who do not have access or the finances to enjoy the arts in person, and yes for some people to understand that gay people are just that...gay. They love and lose, succeed and fail. They cannot all dance or craft a fancy outfit out of a ziploc bag and strategically placed bandana. All gay women are not golfers, bodybuilders, or k.d. lang afficionados.

There are still many parts of our country where the population is not very integrated religiously or ethnically. Some Americans may never have the opportunity to experience a Seder meal or see the inside of a mosque without PBS or the History Channel. There are lots of people who grow up without ever having a black or latino friend-but most can identify that black and latino families have similar struggles to their own.

No matter what your religious or moral beliefs are -seeing the other side of the coin and becoming educated about another persons life can do nothing but strengthen you for your own life journey-even if it happens at 8 p.m. Eastern/7 p.m. Central.

Tuesday, May 3, 2011

The real Queen Mother

My first real memory of the woman I would come to call Mom Cormie is of a vibrant fortysomething redhead with Union Jack knickers sitting on a piano in pub on the grounds of the Texas Folklife Festival. She was elegant and bawdy at the same time, naughty and ladylike, and always a good hostess. Her daughter was on her way to becoming my dearest lifelong friend and had invited me to the Festival. An annual event for her family Denise was neither shocked nor embarrassed by her mother's pub behavior and introduced me after the crowd finished a rowdy version of another traditional British pub song.

My own home life was neither elegant or ladylike-I couldn't begin to imagine my own mother on top of a piano, much less singing and showing off her undergarments. I was instantly enamored, more than a little jealous, and I knew I wanted more. Years passed and Denise and I grew into women, married, divorced, widowed, degreed, employed women. Mom Cormie became a teacher and earned a Master's Degree and then she taught scads of third graders. She taught for the love of education, never for a test, and she taught more with her approach and care than any book could ever demonstrate.

It was a cruel blow when her diagnosis came, at the time I hadn't really heard of Parkinson's disease and had no way of knowing how the horrible specter of the illness would come to so profoundly effect my life. With her diagnosis came the slow unraveling of her teaching career, her ability to write, speak, walk, her very independence.

She remained throughout every indignity, every inch an English lady. Committed to trying a new treatment, medication, operation-committed to being a mother, wife, grandmother, aunt, and honorary mum to the collection of misfits her kids brought home in need of mothering. She exemplified grace under fire through it all and when the unthinkable happened and her beloved was diagnosed with ALS, she dug deeper and found more strength to be the companion he needed in those last terrible days.

She is a shadow of the woman I met 30 years ago, unable to stand or care for herself any longer. She has lost her vanity in the last couple of years-a change that has been harder to accept for those around her than most anything else. Despite all the nastiness of Parkinson's throughout the years, one could always count on her being impeccably turned out, hair styled, jewelry coordinated with clothes and shoes. It seems the worst affront that her"lady"ness has finally been taken.

This Mother's day there is a lengthy list of things I have learned from the honorary mothers in my life: but the list starts with Mom Cormie. She was there when I became a woman myself and eventually a wife and mother. She was there when I buried my own mother and subsequently my husband. She demonstrated by her daily willingness to get up and face the world what it meant to be a woman, a lady, a mother and I learned from her what grace under pressure looks like, right down to the Union Jack knickers.

Monday, May 2, 2011

Blinded

"An eye for an eye makes the whole world blind." Mahatma Gandhi

The news this morning has brought tears of joy to many, feelings of victory and satisfaction, a sense of completion. Yet for me I wonder if a death so long anticipated really brings anything to a close, or rather opens a wound in our human family even deeper.

It's hard to attribute human qualities to a man so demonized in our media and culture. The attacks of 9/11are the defining historical moment for so many in my generation. Too young to be truly involved in the national debate over Vietnam the Trade Center's destruction left an indelible mark on all Americans and even the most peace loving were left wanting retribution, justice, and the ability to make it all make sense and have a purpose.

Does the death of Bin Laden serve that purpose or give an America immersed in war throughout the Middle East any real sense of justice or vindication? How does the assassination of one lead to the ability for another to rest easy?

The world is no different this morning because he is dead. In the initial days there will be many who claim victory, even a moral one for the U.S. and there will be many who try to take his place or create terror in his name as a martyr.

U.S. soldiers will be more at risk this month because a new cycle of revenge will begin and the cycle of violence will continue unbroken. There was a time where I believed war was never justified. I had the hippie naivete to think that reason and compromise could result in solutions.

I no longer believe in that simplistic a world or in simple solutions to terrorism here and abroad. I understand that war and indeed violence is sometimes the only way to communicate with evil-but I also know that every time we lower ourselves as human beings to violence our own souls are wounded-our own humanity stained.

Osama Bin Laden was no innocent. By all accounts he was evil incarnate-pursued within by demons that intensified his hatred for the modern world, modern Islam, modern diplomacy. He used money and fear to finance hate and he was a success in a region of the world that is polarized by faith, money, oil, and relationships with Western powers. He preyed on the weakest and least educated and their fears of being overrun by white Christian oppressors and he succeeded because these hapless souls had little else to place their hope in-What futures? What professions? What stability?

The most radicalized individuals with the least to look forward to in their lives. While we Americans have been mired in economic doubt and uncertainty, al-Qaeda forces continue living day to day, hand to mouth. There are no fears of an inability to retire, fears over the stock market or dismantling of Medicare. No worries for the budget cuts of teachers. Nonsense and rubbish. Survival is the concern of these who have come to be known as enemy number one.

So where do we go from here? The violence won't come to an end-there will always be another tyrant to take his place. There is always a "bad guy" to subdue and we like to be the "good guy." But when do we stop being avenging angels on the side of all that is good and become forces looking for vengeance at any cost.

It's too simple to divide the world into right and wrong, good and evil. All of humanity has the potential for evil and when we allow those among us whose purposes are truly evil to determine our own behavior we lower ourselves into the filth with them-and no one comes out the "winner."

I don't have any profound answer. I don't feel better because he is dead-but I certainly won't mourn his death. His death won't satisfy my questions or grief for those lost on 9/11 or in all the days since in the name of justice.

We remain at war today, with one less enemy and a little less of our own soul untouched by violence. I pray for answers, I pray for peace.