True

Be true to yourself. Even if it takes your whole life.

In one of his books Obama said your actions must reflect your thoughts and feelings.  In The Audacity of Hope, he discusses his inner conflict. Should he take public transportation, opening a door to encounters with everyday people? Or accept flight on a private jet along with a financial boost to  his campaign ? What if your sense of self was irreparably corrupted?  Say someone who’s all powerful  committed actions that permanently made you a bad person. Would you then reaffirm this self identity by abusing yourself?

Today, my patient I’ll call Nadia said that for each pound she’s overweight, she’ll assign and write about one stressful life event. She’ll then address each item in turn. She proposed a big bonfire at the end to get rid of them all…I suggested she publish her work instead. (The delusions of a lonely blogger).

In The Family That Preys, Tyler Perry writes in  a minor character who wants to start his own business even though his best friend, wife, and multiple bankers try to pound his dreams and ego into the floorboard. His “blindness” to the “truths” around him lead to….his own business. According to Hollywood expert Emily June Hanson, Tyler Perry was abused by 3 different people.  He seems to be searching for his self identity by playing multiple roles in his own movies….movies which portray right and wrong in bright lights.

Emily and Andy had to rank order the severity of 13 crimes in their sociology class at the University of Washington…crimes including murder, rape, suicide, embezzelment, treason and adultery. Our instructors in med school would have never assigned such an  exercise. If they did, I’m absolutely sure, the class would have protested strenuously. I know this because a simple deviation from the multiple choice test format created an uprising. (We’re  training to be doctors, not writers!). 

My friend, Tom, started off as an accountant in his father’s business. His inner voice suggested an entirely different path. When he followed his own instincts, his family disowned him but he  earned a long, gratifying career of his own. As a psychoanalyst, he now helps others discern their true images from the mutilated distorted collages that cruelty previously cemented  onto their canvasses.

“That was true,” I said to myself   today when I hit the pickleball fast, just over the net, and far into my opponents backhand yet within the boundaries. Can you believe, I posted this whole long blog just so I could immortalize that shot? The blog has nothing to do with the fact that my mother is  partying  in South Beach for Halloween.

Connections

Rabbi Fine said that David Eagleman explores what it means to be human in his book “SUM” with vignettes about the afterlife. The first vignette recalls that Dr. Frankenstein’s monster went out of control because he badly wanted a relationship and things weren’t going well.

My yoga instructor gave me a candy flagged with “relaxing with friends is the best way to unwind after a long day.”  And the NYT reported that the researchers who found that obese friends increase risk of obesity are now finding that the opposite is true. Hhmmm hanging out with healthy types could be good for your health. (makes me think about Jim Hammond and Iris…)

Anyway….I got lucky Friday night. Three friends came over even though decaf tea and watered down (scoreless) Scrabble were the only draws.  We had the best time just talking.  But I kind of dreaded Sunday night.  In one my my excessively good moods, I had the idea of inviting 2 families with young kids who I thought would enjoy meeting. LITTLE KIDS….What was I thinking???  But for once, I was right. The husbands were talking so intently , I had to practically drag them to the table for lasagna. The wives, both former clarinetists, did hit it off and Lauren and Summer  entertained the 6 and 7 year old and the 7 year old did a beautiful job with the darling one year old.  I had fun at my own dinner party for once.

Best of all, Emily very considerately took the dog to the dog park and shopping during the party and then stopped me from piano to talk to me.  With Andy at her side looking adoringly, she informed me that she plans to exercise when she’s pregnant and she’ll attend an ice cream social for the business school (NOT IN THAT ORDER). She also says she’s going for straight A’s her 2nd quarter at UW. (I had to blurt out that Peter Orzag singled out UW in today’s NYT because of its Medicaid driven  budget cuts:  26% this year and next. But adversity worse than that can be overcome. )  Emily and Andy are so happy and I’m confident and motivated- I’m confident they’ll have a successful quarter.

What does it mean to be buman?  Maybe it’s our  yearning to weave connections  with generations past and future  and our computers….ooops I mean our  family and friends. 

Shambles or perfection?

The Arctic ice is melting quickly.  Slow moving dark  waves creep ominously through large gaps between ice fragments in waters that used to be strictly contained by  solid ice. Next year’s ice will be even more fragile due to the heat absorbed by the black water.  How successful will humanity prove when starvation and water shortages are exacerbated by the catastrophic flooding and crop upheavals that could result?  What if the gulfstream turns the British Isles to ice?  Am I joining  legions of insane predicting that the end is near?  Or falling victim to a culture that awards undue credit to miserable pessimists?

“Our mission is not to see what lies dimly in the future but to do what lies clearly at hand.”

Annie found her way into my office today. I last saw her 2 years ago when she used her given name, “Fang” and spoke almost no English. She has long black hair, a girlish face and figure, and wears a spirited jacket over distressed jeans, polka dot socks and high heels.   She could easily pass for 20 even though she’s 35.  “I just want a check up. Nothing’s wrong,” she chirps. She has a thick Chinese accent but otherwiese surprisingly good English.  “How’s Samuel?” I ask about her husband after admiring photos of her 18 month old son.  She turns away from her i phone for the first time and faces the wall.  “Not well,” she chokes out. “Terrible. He passed away. “  I gasped.  I had never met her husband but had spoken to him several times.  Years ago, he meticulously arranged care for his Japanese wife by phone.  Then more recently he translated by phone for his younger Chinese wife. A successful Jewish American, he travelled for work and seemed to have an affinity for far eastern women and languages.

“What happened to him?”

“He had depression. He hurt himself.”  Luckily, Annie was seeing a Chinese speaking counselor and was thankfully looking forward to things like her son’s education.  Aside from trying to speak English with her son “since Samuel’s gone,” she seemed to be making good decisions.  I had another patient waiting as I drew her blood and finished her review of systems: “…and do you ever feel unsafe?”

“Oh yes,” she understood very clearly. “That’s why I want to move. A man in my neighborhood helped me feel better after Samuel died but he’s not a good person.  He knows where I live. He knows where my son goes to school. “  She had requested I test her for everything possible  during her exam. 

Later, a young French woman, Francoise,  said she wanted to drive straight through crowded downtown Bellevue streets without moving her steering wheel to end her own life. She stopped herself because her 3 young children were sitting in the back. Her children save her life every day as they’re the only reason she’s gotten out of bed for the past 3 months.  If only Samuel’s baby son  had the same power to  pull Samuel up.  Samuel spent 5 months of his brief time with his son in his pajamas in bed.

The privilege of trying to assist my patients sure saves me. I had to put the NYT editorial page aside quickly to get to work and I didn’t think about melting ice once all day. Because I’m in family practice,  I was able to diagnose Francoise’s bipolar type 2 with major depression during her baby’s vaccine appointment. It was gratifying to see Annie enjoying a cascade of photos of her  beautiful little boy knowing that I”ll follow up with her next week to make sure she has no sexually transmitted diseases and that Eastside Domestic Violence is helping  her escape an unsafe environment.

Samuel made a big mistake. But to avoid falling into his abyss, maybe we should stick to Hollywood gossip shows and Pets 101,  focus on  tasks at hand and try not to dwell on the overwhelming urgencies that  Paul Krugman and Thomas Friedman convincingly present.

Or we could always create a utopian piece of fiction. Found a good movie set in a happy  future: The Fourth Element.  And someone made a book recomendation: Stroke of Insight where a left brain stroke helped a neuroscientist achieve  the same goal:  Less analysis and more imagination.

Letting go

“You’re going to have to let us age,” my 72 year old mother-in-law directed me. Ouch. What a way to start a one week adventure in Guadalajara and Nueva Vallarta. Luckily, she went on to try yoga for the first time, conduct a cooking demonstration and go out late at night after early morning walks on the beach. She also reached new heights in expressing anger when she disagreed with my mother and my scrablle rules.

My own mother kept tugging us into the future. Mexican and Chinese husbands would be an asset…except marriage is such an outdated idea. And she correctly saw beauty in everything-the bus trip from Guadalajara was more beautiful and safer than a trip from Phoenix to San Diego. The coastline in Puerto Vallarta reminded her of the Amalfi coast in Italy. The pools overlooking the Pacific Ocean looked even more inviting than her pool at the beach. She could identify a lot of the palm trees and sea birds. We especially loved the frigrates which sat still on a large sculpture in PV. Also, the grand pedestrian boulevards in Guadalajara were lined with imposing buildings hundreds of years old. Fruit trees had plenty of breathing room in open air courtyards. Iris and I used well worn tricks in furtive scrabble games so as not to bother Carol. I forget which Mexican magic she attributed it to but my mother’s radiation burns healed quicker than expected.

How about letting Carol and Iris be ageless. That’s what I’d prefer for myself.  But letting kids go into adults is a great idea. Lauren will major in English and SHE will get her book published. Emily will major in business and figure where to go from there. I still want to help Summer study for the SATs …we’ll see if she lets me. We gave them our credit card last night and after hours in the mall, Lauren, Emily, Summer and their bag handler, Andy, returned with 6 large bags of new clothes and shoes for me from Bellevue Square. Their style is my casual and party style and Grandma and the Air Force provided my preferred work style. Lucky for me to have this guidance.

Eric and I biked  to HBs today where we met HB s parents Lilah(?) and Shel and enjoyed SeaFair for the first time. HB found the pilot’s frequency on his radio gadget (CB?) and we could hear the lead pilot. He actually hummed to keep 4-6 jets in tight formation, said “pull”  to coordinate their climb and calmly directed “smoke on” and “smoke off” during their 200 mph stunts over Lake Washington.  Focused practice that utilizes your talents makes the nearly impossible look easy. Summer runs like she’s competing for state in daily track and cross country practices.“Look out",” the lead pilot said amiably as 4 jets aimed straight at HB’s deck. “And up,” as they veered upwards at the last minute.  Lynelle could float a stunning painting or photo into existence as a child. But every single day she strives for photos that soar higher. “Hello down there,” the lead pilot greeted hundreds of land and water locked people beneath him. It felt like a  part of each of us  flew with them as all six pilots  rocketed straight up in formation and on hearing “delta break” showered out in their own directions.

Lauren’s book…

She printed 2 copies that Iris, Summer, Lynelle, and get this, RAFI fought over during our recent 1 week vacation at Iris’ 4 star hotel. It’s marvelous and she’s sending query letters to agents now. If anyone has questions on FALLING IN LOVE, they’ll need to read her book. It’s also a great illustration of how a teenager can calmly and competently deal with depression, disappointment, and friends trying to go the wrong way. Yahoo says “how was your day?” is an unpopular question with teens. This book helped me get to know my wonderful daughter better than all our past question and answer sessions combined.

She just needs a title!!! Lynelle has been elected. Lynelle, help!!!

Channeling health and happiness

Johannah can beat me in pickleball even though I’ve played longer, I try harder and she’s EIGHTY years old. The only reason I’m better than 73 year old Lillian is because she took 6 weeks off to perfect her eyes through cataract surgery.  Today, the 3 of us enjoyed coffee overlooking a huge water aerobics class. Lillian’s lumpectomy, and 5 years of tamoxifen (cheaper and less side effects than the aromatase inhibitors) are history that ended in 2007. Johannah’s daughter suffered a divorce right after having a baby and Johannah gave up her career as a nurse to raise her granddaughter- way more fun than the original kids-she loved staying home and being a PTA grandma.

My first patient today is about 45 years old with 6 kids. He just got done riding his Harley Davidson to Reno to meet his brother who biked from Colorado.  His work will take him to Korea, Japan, China, Taiwan and India this summer. “Exactly what do you do at Microsoft these days?” I had to ask. He exercises enough to largely avoid my office.   “I’m in charge of Access and EXEL” I demanded more detail before he finally admitted “Vice president…has a nice ring to it doesn’t it?”

My second patient has landed back at her parents at the age of 31 after completing her MBA. Her boyfriend, in exactly the same boat lives with his parents. The parents do NOT permit sleep overs. But all is not lost. The boyfriend plans to hike the Pacific Crest Trail and the two enjoyed the world cup and visited friends in S. Africa this year.

Then I had 2 boys with the same name…. A 6 month old who  held perfectly still when I checked his ears  (and wiggled constantly before and after ) and a 20 year old whose pot/cigarettes/alcohol didn’t even cause a ripple in his family due to a severely bipolar brother and a sister just recovering from addiction to cocaine/pot/alcohol/cigarettes/ADD medications ANG bulemia for good measure.  The youngest child in that family is overweight but the sweetest best adjusted kid ever. The parents cope amazingly well. The right combination of optimism, seeing that things could be worse, and steering their adult kids back into society. I actually think they’ll fully succeed.

That’s it- just 4 patients today. Aren’t you lucky?  Then Levi ran next to my bike to Crossroads and on to other errands.  He stays on the narrow sidewalks avoiding cars without a leash.

I missed breakfast and had a little salmon, 1 TBS yoghurt and some cornbread for lunch and had an excessively good mood all day.I think it’s meant to add to the positive energy Emily, Andy, and Summer are giving to Iris while they stay with her during her recovery from radiation.  She’s going to drink more water and coke and find the perfect balance of rest and activity so she has the strength to meet me and Lauren in Mexico Saturday.  

Channeling health and happiness

Johannah can beat me in pickleball even though I’ve played longer, I try harder and she’s EIGHTY years old. The only reason I’m better than 73 year old Lillian is because she took 6 weeks off to perfect her eyes through cataract surgery.  Today, the 3 of us enjoyed coffee overlooking a huge water aerobics class. Lillian’s lumpectomy, and 5 years of tamoxifen (cheaper and less side effects than the aromatase inhibitors) are history that ended in 2007. Johannah’s daughter suffered a divorce right after having a baby and Johannah gave up her career as a nurse to raise her granddaughter- way more fun than the original kids-she loved staying home and being a PTA grandma.

My first patient today is about 45 years old with 6 kids. He just got done riding his Harley Davidson to Reno to meet his brother who biked from Colorado.  His work will take him to Korea, Japan, China, Taiwan and India this summer. “Exactly what do you do at Microsoft these days?” I had to ask. He exercises enough to largely avoid my office.   “I’m in charge of Access and EXEL” I demanded more detail before he finally admitted “Vice president…has a nice ring to it doesn’t it?”

My second patient has landed back at her parents at the age of 31 after completing her MBA. Her boyfriend, in exactly the same boat lives with his parents. The parents do NOT permit sleep overs. But all is not lost. The boyfriend plans to hike the Pacific Crest Trail and the two enjoyed the world cup and visited friends in S. Africa this year.

Then I had 2 boys with the same name…. A 6 month old who  held perfectly still when I checked his ears  (and wiggled constantly before and after ) and a 20 year old whose pot/cigarettes/alcohol didn’t even cause a ripple in his family due to a severely bipolar brother and a sister just recovering from addiction to cocaine/pot/alcohol/cigarettes/ADD medications ANG bulemia for good measure.  The youngest child in that family is overweight but the sweetest best adjusted kid ever. The parents cope amazingly well. The right combination of optimism, seeing that things could be worse, and steering their adult kids back into society. I actually think they’ll fully succeed.

That’s it- just 4 patients today. Aren’t you lucky?  Then Levi ran next to my bike to Crossroads and on to other errands.  He stays on the narrow sidewalks avoiding cars without a leash.

I missed breakfast and had a little salmon, 1 TBS yoghurt and some cornbread for lunch and had an excessively good mood all day.I think it’s meant to add to the positive energy Emily, Andy, and Summer are giving to Iris while they stay with her during her recovery from radiation.  She’s going to drink more water and coke and find the perfect balance of rest and activity so she has the strength to meet me and Lauren in Mexico Saturday.