To your health

Health care is not really that complicated. Right now, in this country, there's three kinds of health care, the kind before you get sick, the kind when you are sick, and the emergency my kid just flipped off his bike and his brains are leaking kind. There's also a HUGE army of people who support all of these folks, the thousands of nurses and technicians. Some of them are overworked and underpaid, some of them are well paid and have great working conditions. In all of these cases, they are ALL required by every society. From the mountainous jungles of Papua New Guinea to the urban jungles of Chicago and NY, everyone has moments (or loved ones who have moments) when they need the services of a well trained doctor.


As I understand it, the first kind requires a small army of people who can diagnose, read pictures, are compassionate and kind and have time for people, enjoy being exposed to colds, flus, and the chicken pox, and who don't mind popping boils or checking on hemorrhoids. This group used to include people who liked to birth babies, make house calls, and be there with the priest (or Rabbi) at the end of life, but not so much now a days. Now it's more about prescriptions and vaccinations, but the idea remains the same. In general, the costs from these visits is reasonably low, with the possible exception of some expensive lab tests which can run into the thousands.


The second kind require specialists but they ALSO have to be good with people. They deal with cancer, lupus, MS, CFS, CP, benign brain tumors, endocrine fuck ups, and a hundred thousand other chronic problems that people suffer from. They have long term relationships with their patients, like the first folks, but they are also only seen BECAUSE you are sick, like the 3rd folks. This coverage is typically much more expensive than your typical well check or pap smear; they perform more tests, and may offer new, cutting edge science to help with specific problems. Their role is to improve the quality of life of people, as well as save lives and detect illnesses. Nothing easy about this job, folks.

So then there's the 3rd kind, which is kind of like the 2nd kind, except these are the smarty pants who will fix your daddy's broken artery, who shave bones, mend burns, and play Lotto with nerve endings. Remember Lotto? Ok. So these folks really don't have to have the people skills of the first or second group. They work fast and furiously to save life or limb (or both), and have no time to connect to the patient as a whole person, it's all about the brains leaking out of the helmet, or controlling the stroke that is currently paralyzing that sweet old woman from down the block. They perform miracles, or try to, and are the front line of our critical care medical personnel. This part is UBER expensive, requiring every resource available, including ambulances (by air, land, and sea), surgeries, medicines, anesthetics, tests, pictures, etc.

How do other places figure out how to include 1) everyone who needs medical coverage (that'd be everyone) and 2) all the people in the first and third, and as many in the second group as humanely possible (do you eliminate the cancer specialists? the endocrine specialists? the dermatologists?) without breaking the bank? Evidently, France is the #1 country for health coverage (Bismark system) in terms of statistics, but the Nordic countries for customer satisfaction. Australia and Japan both scored well for survivor rates, and many Asian countries for combining a private/public system that stresses diet and exercise (gentle, like tai chi) as a method for dealing with stress, aging, and genetic propensity for disease. In Canada, there are abundant sport and leisure halls across the country, very low cost or free for residents. They generally include skating, swimming, and have gyms where people row, step, or walk/run according to their ability. They don't need a membership to an expensive YMCA or gym, they just need to walk or drive down the road. Kids are 30% leaner there, parents do more with sport on a regular basis (ok, a lot of this is hockey, I know, but still - they are getting out on the ice and mooooving!), and honestly, there is more FUN to be had within the family doing stuff than sitting around playing video games! They GET it!


It costs less to keep a healthier population healthy. Per capita, we spend way more than any other country in the world on health care (about US$17,000 per person per year), where as it's closer to US$6000 in Canada and US$4500 in Australia (possibly even less in France, where Viagra isn't covered because, as we heard, ze franchmen zey do not need zis!). And we still don't get it right! Have you known someone who went years without getting checked at the doctor (did they say outright that this is because of money? My friends won't say it outright, but a $20+ co-pay for every doctor visit sure adds up!), or kids who don't get mental health assistance, or parents who don't get marriage counseling etc etc etc. This is a long list, and we haven't even gotten to people who can't afford cancer treatment, who don't test their blood or take meds for diabetes or high blood pressure. It does come down to being the one who is responsible for your own health (and of the health of the people whom you love the most - parents, children, spouses, siblings etc.). If you choose to slack off every day, eat junk, and don't eat healthy foods (meaning foods that assist your body in being healthful), if you choose to eliminate organic from your grocery list because it's more expensive, realize that that choice may have very expensive consequences. Cancer is SO freaking expensive. But that's a far away bridge, hopefully one you don't have to cross ever, but god forbid, and worse, it happens to your son or daughter, you will have to live and die with those burdens.
There is no easy way to shift from a system that seeks only to get ahead and earn the holy dollar to one that respects the integrity of life of all Americans. Mistakes are going to be made. But basically there needs to be a card that says "this is me, and I am entitled to live here and be healthy". A beaurocracy already exists, Medicare and Medicaid already care for so many Americans. Tightening up this ship, and making this coverage available to every single American is not that far away - but it does depend on the heartfelt charity of our leaders, reverence for a high quality of life, and yeah, a little elbow grease from your average shlump. I will send out this prayer to your health, because you are alive, and you, just like me, have a body that requires fine tuning. Not being perfect relates to our physical and non-physical bodies. As hard as it will be to figure this out, there is almost nothing more important to the health and happiness, the potential productivity, future economy, and greatness, of this incredible nation than taking care of ourselves 100%.

What we don't know might just kill us.

This may not be popular (amongst whom - only a few friends read this, and I don't really think they would care) in general society, but I think the flu is a good thing. I think death is a good thing. I think it's GREAT to be alive, to live, to share, to make love and jump off waterfalls and relax in a hammock. I think it's amazing to birth babies and raise puppies and eat chocolate. I love that we get to do all this in a country where I can choose whether or not to vaccinate myself and my children (in conference w/my amazing husband, who just *might* be reading this). I love how much information there is out there, how many things people can do to make this a better world to be a part of, and how we can share or withdraw ourselves as our moods sway. But I also think it's ok to go back to being part of that BIGGER something, that spiritual only realm that some call god and others energy and even others call Nirvana. I am not afraid of death, and all the people I know who have died (most of whom were old) were not afraid to die. They, and I, are/am afraid of SUFFERING. Medicine was once the realm solely (no pun intended) of retroactive care - I hurt, how can I fix this. Dentistry, surgery, oncology, even mental health are all predominantly in the realm of retroactive health care. GP's are one of the lone surviving groups who can and do care for people proactively, but they are the dying breed. So much of allopatric medicine is focused on specialized (retroactive) care, that the GP can't earn much in comparison. It's the garbage man (I mean sanitation engineer) of the medical establishment - that if you can't cut neurosurgery or handle the emotional weight of oncology, oh go be a GP. Sad sad sad. Dying now means not having to pay bills, take pills, get cleaned up by some nursing staff, be a burden to your family, get Alzheimers, or wonder whether you will fall on this trip to the bathroom, or the next. It's sometimes a blessing when you are in chronic pain and your option is to be chronically doped. It can bring peace to your loved ones and offer solace to those in constant mental pain. Fear of this unknown place, death, is not real, not tangible, but frightening in that something is there, in the dark, a monster waiting for me, kind of way. Will it hurt? Will I like it after I get there? Will I be alone? If we don't know, we don't know. That doesn't make it a bad place. Losing people (me, my children, my husband and parents and siblings included) is ALWAYS sad and hard, but it's not always bad. Selective use of that awful badness of death for children, for those who are murdered by terrorists or crazy people, for those who would never have chosen that outcome, feels appropriate to me, but let's let people die who are done with this place. It's not the only place, in all likelihood, we just don't know.

How much green
can a green thumb green
if a green thumb
just ain't
green?


I spent the morning wiping O's nose, making soup, reading Olive Kitteridge. It wasn't the easiest read for me, and Orin was busy w/Legos. Come afternoon, regardless of the last 12 pages I have left to read, I decided to venture outside. Miraculously, his nose stopped dripping, we found the hedge clipper in the new back shed (duh, took me a while), and hopped to it. I hadn't gotten two bushes in, before the neighbor's lawn care professional showed up - possibly 19 years old - donned his mask, poured, walked, sprayed. I could smell it from across the street. So could Orin. Send him inside? Hope the wind blows? Resent? Leave a note? It was all so overwhelmingly disgusting to me that I sort of panicked and cut a little deep into the third bush.

Hard decisions are not normally a part of daily life. If we decide to get the chemo, it's not a big debate, usually. If we switch banks or buy a new window, it's not huge. Even the car buying grief I endured three years ago seems trivial next to the future health of my children, and their own progeny. Possibly prodigy. Not likely if we commit them to an earth filled with poison, worms who endure toxic spray multiple times per lifetime. We put up with the voles and moles, quite happily; they don't actually DO much beside tunnel and eat insects. What's not to like? Why do they need to inject poison to be rid of them? What are those people doing on their lawn that they can't have moles co-exist? There is only one old man, maybe beyond his 80's now. I am in disbelief.

It's not that I didn't know that my own neighbors were doing this all along - those bright yellow flags, undated, stick around for days and weeks after a spray. We can't walk the dog much for a few days. And I can really smell the stench of chemicals, like being back in the Greeley lab about a week before end of term. The flags are good - they let the unwary neighborhood traveler know not to get too close, especially those with canine companions. They let kids know that they shouldn't retrieve that football, just go play some tennis. They should be dated, they should be removed with some regularity. But it's better to have them than not. Except that they seriously raise my ire, bright spots of disgust in a world, currently, filled with scarlet maple leaves, scurrying squirrels, and clear blue skies. How to wreck a perfectly good afternoon? Watch that kid dump a bag full of nasties right in front of your lawn, in front of your preschooler, dribbling it into the street and onto your own lawn, while knowing that it is a truly unnecessary evil.

Vacating

I'm ready for a vacation. I know I just got home, haven't even finished the laundry! The car has lost 9 pounds of sand, the tent is finally dry, the towels are stacked; the camper is back in dry dock, the fridge and cupboards empty, the floor, well, the floor needs to be replaced (another story) but it's clean and everything has been tidied and dried and de-muddified. The trip to the Cape has come and gone, a beautiful trip, a sandy, muddy, cotton candy trip where the kids fished (and caught fish!), Jerry tanned (and burned), and mama read books, lots of good books!
It was a trip where we noticed the flowers,
rode bikes on dirt roads, and enjoyed the freedom of having vacated our lives - phones, jobs, bills, mail, all left 150 miles behind. I didn't think of writing, Rebecca didn't practice Hebrew, Orin left phonetics far behind. There were moments of hammock swinging for us all, finger smashes, bike crashes, jiffy popping, and lots of ice cream. SPF 85 became part of my vocabulary. We found starfish and many kinds of crabs, built/crusaded against/commandeered castles of sand, played games and waded through muddy rain shaped lakes. We ate wonderful food, met people who entertained and were so kind to us.

There were moments of angst, with 5 of us in the 114 sq foot trailer, but we came out of it having had a good time, and knowing ourselves and each other just that much better.

Cha cha cha changes!

I have been working on a written piece for about 9 years. It's big. Bigger than I am, most days. I keep trying to break it down, make it simpler, systematize the process to bring it into focus. It keeps growing, new characters who add life and color and depth keep popping into my head, out of my head (quite literally, and onto the pages before me). I can't even type-write this thing, it keeps morphing. It isn't ready to be born, obviously, and yet, the changes that it undergoes seem to be part of it's birth, part of the process of making it real.

When I was pregnant with Rebecca, even at the end of my pregnancy, even though I was HUGE, like apartment building huge, it still wasn't 'real'. We didn't HAVE a baby. There were kicks and pains, there was growth and change in my body, but the changes that have wrought the most significant scarring, that have left me shaken and disillusioned about who I was, let alone who I am, they were invisible at that time. And after she was born I was ... unreachable. I focused on her, from diaper to diaper. There were moments of loneliness, of disbelief, anger, frustration, of awe and there were moments I was right out of my mind with mama-lion hormones and insanity. But still it didn't FEEL real. I still felt like this was somehow NOW, not who I was for the rest of my life, Amen. There were moments when I would look at her, her sweaty curls plastered underneath a bucket hat, her fist tight around the handle of a sand shovel, or see the hummus smooshed all over her face and clothes and know, in my soul, that this was the most perfect creation I could ever imagine myself being a part of. But until recently, I don't think I'd matured into understanding that it IS for the rest of my life. I can't ever walk away from who she is, or where, or how. She is constantly with me, as is my little boikie. They are part of every breath, and that change is visceral. There is no going back. It makes the book look like playdough in an artists studio! But both are real to me, and this I take as a symbol of my own maturity. It's new to me (being the late bloomer that I am), but I hope to take it for a nice long ride.

How can I bring this writing into a place where I accept, unconditionally, it's nature. Where I understand that it will continue to change, as my children do, and I will not love it less for the pimples, mistakes, bad language, poor choice of friends, or bad co-ordination in the heat of the game? It's not real, it's not material, and yet...and yet it owns a place. It resides, it grows, it changes. Well, all deliberation on the topic aside, it is clear to me that (for me?) dealing with change is fucking hard.

Making it right

This is seriously what I think of when my mind wanders back to summer camp. Canoe races, lots of wooden buildings, bunks with foot lockers, dirt trails leading into secretive places, lakes with gleep. Camp Chingachgook (Gin-ga-cook) has all these (and more!). There are things going on there that are just awesome, and the kids come back year after year because they are so much fun. So why did I cry for half the journey home? I couldn't even say goodbye to her counselor, I was blubbering so hard. Well, I admit that I wish it were me, getting ready to swim 220yds, to prove my worth in front of my unknown peers, all of us shivering on the waterfront. I wish it were me, sleeping in my sleeping bag for the first time this summer, on a bunk with a new sheet (green and blue polka dots), a good book, and a weeny little book light. I wish it were me getting up at reveille, passing on polar bear swim, looking at that boy in canoeing. I do. I don't regret any of the years that have passed since I last graced summer camp, but I miss it. I miss being taken care of, being paid for, being part of a cabin, part of a unit that I wasn't responsible for. It's hard being a mom all the time. It's my job to constantly make things right. It's not always fun, or even entertaining, though occasionally it is some of each. But sometimes it's just driving back to the store to return a broken item, or clothing purchased one size too small. Occasionally it means leaving my nice spacious bed with my snuggly warm husband and sleeping in with the stuffed animals and random baby blankets that both my kids love to sleep with, and keeping half awake so I don't fall off the edge of the bed. Sometimes it's just drive - to this friend's house, to school for a forgotten book, to camp. To replace lost items. It's a labor of love from the first moment until you realize that it isn't happening anymore...not very often, anyway.

So I cried my way home from camp, letting Jerry drive, knowing there is no way to make this right. Letting them grow and fly - it's already right, it just hurts. I'd like to compare it to some kind of painful dentistry, or perhaps an appendectomy, but really there's nothing wrong, just hurting. She's in a beautiful place in the world, between childhood and teenhood, on a gorgeous lake, in a wonderful mountainous State Park. It really doesn't get much better. I guess it's already alright.

Old and new, again

Interesting thing, this facebook revolution. One old timer is going onto World Poker Tournament, some are having babies, families, life changing incidences that we sweep through in two words, rocking their universe, leaving grown men and women shaken and sweaty. A few die, already. Some I feel green meanies growing in my gut, they are living lives I envy and have achieved things I dream about. Others, well, not so much. I look at my little people, sleeping, windows open, and wonder where I'd be without them...Botswana, drinking red bush tea? India, eating curries and picking fruit from the trees in my yard? Lonely? Impressed with all I have achieved, or dismayed at all that I haven't. It's a fun way to kill a few quiet minutes...there are so few, why not really enjoy them!

In reconnecting to people from the past, I have come to appreciate so much more all that I have here, now. My friends, without whom I have no idea how I'd make it through each week. My husband, who has stuck by me think and thin, who was there for the birth of our children, next to me, touching me, connected. To my children, who have learned how to annoy me like no other beings on the planet, and who bring out such joy, pleasure in the moment, and searingly deep love. In an instant it can, it will, all be gone. But for this moment, I have depth of appreciation.

An old car, junk or parts or a home for rats, or sold, rebuilt, repainted, dents removed and retamed, it can sit idle after having driven dutifully for an eon of miles. Loved or not, it becomes part of a landscape of history, same as a dirty diaper or an empty soup can. It doesn't much matter how useful it was (diapers, nothing more useful to the mother of a baby!), or even how much it as loved (my old dolphin necklace is somewhere out there). It is a member of the heap. It is part of a historical clan and, memories not withstanding, it is part of the future, not the past or present. I found out on Facebook that a friend of mine's old car has finally bit the dust, a car I traveled in cross country, up and down the coasts, camping in Yosemite, and across the Mexico border for cases of Tequila.

Luka Benjamin was born the other day, a new old soul. He's part of this heap of today, though he is all about tomorrow - in a tomorrow he will be five, swinging the bat, begging for new cleats. In a tomorrow he will be 16, singing on the rooftop and emulating Kenneth Grahame's Frog. In a heartbeat of tomorrows he will find love, dance between trees, find cures or write interesting things or make beautiful sculpture. Right now he wakes long enough to find a nipple and fart. I found out he was born checking into Facebook.

And so it goes. Game scores, births, deaths. They're all on facebook, where old is new and new is old and it's just plain living to check in and say I'm still here, too.