Why I Started Blogging Again

...and why I stopped to begin with…

I’ve had a lot of people ask me why I stopped blogging a couple years ago.  Honestly, I didn’t think anyone was reading my blog, so I was really surprised that anyone missed it.

So anyway, why I stopped?  Let’s just get it out there to begin with:  The last 18 months have been the toughest, worst of my life.  And if you’ve read beyond the first page of this blog, you know that’s saying a lot.  

The deaths of my father, father-in-law and uncle,  loved ones battling addiction, depression, and suicide attempts, financial crisis related to the aforementioned, as well as a flood that left me without a kitchen for 5 months, incredibly strained family relations and finally the discovery of several pounds of tumors in my lady parts, necessitating their removal and a five-week recuperation.

Yeah, it sucked.

So here’s the thing: That kind of stuff is really hard to write about. Now I know what you're going to say: I pretty fearlessly blogged through Kiersten’s death and the aftermath…how could anything be harder than THAT? But that was a personal journey. That was all about my feelings and my thoughts and my experiences.  By contrast, while I was really profoundly affected by what has happened in the last 18 months or so, very little of it was actually about me. This has been about other people whose story wasn’t mine to tell.  Let’s combine that with a new job that I really, seriously didn’t think I would ever learn to do well, and the associated panic and angst that went with that and really, there’s not a lot left to write about that’s anywhere near safe. Even if I could collect my thoughts long enough to write.

And as I said elsewhere earlier this week, sometimes our voices need to go quiet for awhile so we can hear the rest of the world and figure out where we belong in it.

Are things perfect now?  No.  But they’re better.  And I have enough of a sense of myself on my own terms again that I can start to write. I’m loving my job and doing it well, I think. While the family situation hasn’t been idyllic, it’s at least stable for now. And I have a working kitchen!

And there’s so much interesting stuff to write about again, stuff that takes more than the 30 words or so that make up a Facebook entry. Politics are as nail-biting as anything I can remember in my lifetime, I’m really digging on a lot of changes in healthcare policy, and there’s some really juicy science that is the foundation of all that and it’s really fun to debate and talk about. I’m not as actively grieving as I was for those first couple years after we lost K, (so Dear Readers, you don’t have to worry about the constant emotional ambush). Mostly, I’m not just treading water anymore and there’s time to reflect and think about what I think about now.

I’ll try not to be as preachy as I’ve been this past week, but good gravy there was a lot of material to work with in so few days! :-)  And I’ll try to sprinkle in the occasional cooking post and silly story when they happen (because Christy wants more cooking posts). 

So here we go again.  Thanks for being here.

Out with the Old

I saw a thing on PBS the other day about “Gray Divorces” – people who have been married more than 20 years who decide to split up and get divorced. They give a lot of reasons why it happens and some things to do to keep it from happening. It hit home for me in a really current and personal way. I personally know three couples – friends for decades, all of them – who are in the process of divorcing.  It can be a bit unsettling to watch. In many ways, the long-term friendships we form as couple are as strong as any family bond, and watching those bonds unravel can cause really significant distress and grief for more than just the couple involved. I can't judge the people who choose to divorce -- if you don't see a way forward, sometimes the better way is out. But importantly for the rest of us, it does raise the question of “why stay together?” when so many around you are splitting apart. In a lot of cases, it seems that the stresses that push one marriage over the edge are so close to the ones the rest of us face in our own relationships.

Mr. and I have certainly teetered along that edge more than once.  Sometimes more than once a month.  Makes me question sometimes why we haven’t split up the way so many others have, especially when you look at the statistics on what usually breaks up a marriage and we pretty much have 8 of the top 10 in our wheelhouse. 

So it begs the question: what DOES make some couples stay together? 

I think the answer is super-simple, at its root:  They choose to. 

The implementation of that choice can be a more complicated matter, to be certain.

The secret to a good marriage is, at its core, simply choosing to put the relationship first: in cases when the needs of one partner tread on the needs of another, it’s a choice to talk, to compromise, to find a place where both parties can feel satisfied and nurtured. 

In short: it’s a matter of a lot of really, really fucking hard work.

But more importantly, it’s a matter of being really, really aware of who you are and liking that person enough to be fully present and a little vulnerable and willing to do a lot of communicating.  It’s about not shutting down or walking away when it gets hard (and it does…sometimes several times a day).  It’s about keeping your mind and body healthy.  Really healthy, inside and out.  It’s about putting yourself in the place of your partner and thinking about how he/she feels when things get tough.  All of these things require understanding ourselves and liking the person we come to understand.  It requires forgiving yourself for all the stupid shit you’ve done in the past and making the decision to let yourself do it differently from now on. 

Because if you hate yourself, guaranteed you won’t be able to love your partner.

I think a lot of us, as we head into our 50’s especially, are in a place where we are making a critical assessment about how we have lived our lives thus far, and many of us find that assessment wanting.  And I think that often times, we are trapped in the mode of “I live this way because I live this way and there’s not a lot I can do about it” until we become so suffocated by our own inertia that we feel like we have to blow the whole thing up and start over. 

I’m not sure it has to be like that.  

With some mindful introspection, each of us has it within us to find those things that, if we changed them, would boost that self-love score a lot.  And here’s a hint: if you’re looking outside yourself for the sources of your unhappiness and inertia, you’re probably not focusing in the right place.  Look inside:  how do you spend your free time? If most of it is in front of a screen, that might be a really good place to start making changes. How much do you reach out with loving intent to others? There are a bunch of studies (and I mean a BUNCH) that indicate that if we are conscientiously nice to other people -- like, way nicer than we have to be -- we feel happier and more satisfied with ourselves. How about the way you talk to yourself? Have you ever taken time to really forgive yourself for all the selfish crap you did as a 20-something? If we can make a determined effort to give some attention and affection to that most important relationship -- the one we have with ourselves -- it can’t help but strengthen each and every other relationship we have, including with our life partners.

This is not to say that liking yourself is enough.  If your partner is in active self-loathing over the long haul, or suffers from uncontrolled behavioral illness or is otherwise an abusive douchebag, then you can like yourself all you want and it’s not going to work. Get out before you get damaged. But assuming all that stuff isn’t true, the best way to stay married is, in my opinion, to spend some quality time nurturing and loving the person in the mirror.

Because you both deserve it.

"Why Not Me?"

I work in a large academic medical center, and many of my friends and colleagues are involved in research – specifically research into how to treat human diseases and conditions.

This week, the nation saw the success – and subsequent failure – of its first uterus transplant. I think we all felt sadness for the brave woman who underwent the procedure, as well as for her family and her doctors. It takes someone special to be the first, because being first at anything usually means failing.

And as is usually the case when a “first” is announced, the debate over the use of medical research money has resurfaced.  I have written about this before, back when the first face transplant was performed here in the US.  I am a great believer that experimental transplants – and medical research more generally – is as important to improving the quality of life as it is to extending the duration of it. And as I’ll explain below, I have a hidden agenda here.

I’ve run research centers before and have seen first-hand that it’s a difficult rubric, trying to determine who gets funded and for what research. I think sometimes, as Americans, we have this sense that every problem is solvable, if only we throw enough time and money at it. In medicine, I see daily that this simply isn’t the case. There is just some stuff we can’t solve yet, because it’s just too multi-faceted or we haven’t found the magic bean yet. Beyond that, making a decision about what is studied and what isn’t – and by extension, what projects receive funding for study and which ones don’t – takes some magical combination “How much?”, “How many?”, “What are the chances of success?”, “Is the scientific foundation in place to make a leap?” and perhaps most controversially, “Who cares?”

This last one is a toughie; no doubt about it. 

The Who Cares equation itself is multi-faceted: The list of stakeholders includes the researcher him/herself (who needs to feel so much passion for the problem that s/he is willing to get kicked in the shorts for years trying to solve it), the institution (which even in funded research provides a lot more support than most folks appreciate), industry (who needs to be able to commercialize the outcomes in the case of a drug or device, to justify the huge investment in development), and yes…the media and the American public.  I’d be a bald-faced liar if I told you there wasn’t a sexiness factor involved.

Last year, I gritted my teeth and smiled through everyone making a big stir over Ebola and the truly obscene amount of money spent by the government, pacifying a panicked and shockingly mis-informed legislature and public, to build multi-million-dollar Ebola containment units.  I gritted my teeth because the chances of an Ebola pandemic here are somewhat lower than our country being wiped out by an apocalyptic meteor shower, but an infectious disease unit and procedures that can contain an Ebola outbreak will be equally effective to contain a really horrific influenza outbreak, too, and we are totally due for one of those.  Sometimes, we take advantage of the sexy to fund the decidedly un-sexy.

So uterus transplants?  Right now, they totally rank on the Who Cares list. Totally sexy. And important to quality of life for some – so important that they’re willing to take the risk of death to fulfill their needs. Who am I to say what makes a life worth living and what risks are acceptable or unacceptable to another human? Believe me, the people who sign up for experimental transplants are absolutely aware of the overwhelming risk of failure and death and disfigurement.  I’ve sat on the IRBs and the ethics reviews for these.  I’ve seen first-hand the consent process. I’ve reviewed the psych testing procedures. If they and their doctors are willing to take those risks, then I’m not going to castigate them for it. 

If it makes you all feel better, here’s the bigger, harder and less sexy pay-off.  Every time we push the boundary in transplant, the attention to anti-rejection medications takes center-stage, too. The community gets a little closer to completing the break-throughs that will make all transplants safer and improve the quality of life for those who receive them. We are really close now – less than ten years away, by my reckoning.  (maybe I’ll explain the process in another post) And that?  That will not only improve lives – it’ll save them. 

If your condition, or the condition of a loved one, isn’t on the list of what’s sexy this year, this can feel so unfair. We all know someone who suffers from cancer, rheumatoid arthritis, Lupus, asthma, congenital heart failure, type one diabetes…the list is endless.  It’s hard not to say, “Why them?  Why not me?  Why not my brother/sister/friend/mother?” My answer is that it’s not so much “not you” as “not yet”.  But someday.  I know what doesn’t sound fair, and it isn’t. If they ever put me in charge of the universe I’m putting “alleviating human suffering” on the top of the list.  Pinky-promise.  In the meantime, I think we will all imperfectly do our best to make good decisions.

It's Not About the Nail

Depression, Powerlessness and Presidential Politics

Most of America is absolutely, positively flabbergasted that poor whites are voting for Donald Trump in record numbers. There have been a lot of articles written by people way smarter than me about why these folks seem to be voting against their own self-interest and frankly have been for quite awhile.

As I see it, working with poor white Americans is a lot like helping a friend who is suffering from depression.

I’m not sure if I’m at all unique in this regard, but I have a lot of friends and family members who suffer from depression in one form or another.  (There have been times that I’ve wondered if being around me in fact causes depression, but I’m trying hard not to dwell on that too much.)

Anyway, it’s part of my nature to be a problem-solver and so faced with people who suffer from depression, I have a tendency to jump into problem-solving mode:

“You know, sunlight is such a good stimulant for both serotonin and dopamine; you should try to get out in the fresh air and let it work its magic.”

“Well, if you turned off your phone at 10:00, you’d sleep better and that is BOUND to help.”

“Well, of COURSE you feel depressed; you’re looking at the worst side of every situation!”

There…don’t you feel better? 

No?

Yeah; it doesn’t work in person either.

So there’s this video that I pretty much have to watch every two weeks or so as a reminder; it’s called “It’s Not About the Nail”.  The link is here.  It’s only two minutes long, so if you want to go watch it, I’ll wait…

(If you’re anything like me, you were screaming “Oh for God’s sake, it’s about the $%&$^#* nail!!!” about 22 seconds into it.)

So here’s the point. Most people suffering from depression are absolutely aware of their condition. And they have been told…by therapists, friends, family members, the media, blogs, Facebook, etc. what they need to do to help them feel better. Knowing what to do isn’t really the problem. Having the presence and the will to do it is another matter.  And to get there, they need to feel supported.

The problem is that what they really, really need most is someone to simply acknowledge that they are suffering and don’t deserve to suffer. “Man; that totally sucks. I’m really sorry you are suffering.” That simple act right there makes them feel empowered and cared about and that can go a long way toward their having the courage to start the really hard work of alleviating their own suffering.

What does this have to do with presidential politics? Glad you asked.

White, poor Americans are suffering from their own depression. They have, for decades now, lost ground socially and economically against every other group in the nation. They feel powerless to help themselves get out of the hole they’re in. I mean, when was the last time you heard someone in Washington decry the “plight of the high school-educated white guy”. If you're a minority or a woman or an immigrant, then everybody acknowledges that they deck is stacked against you and there are programs and even if it doesn’t get better for you, at least everyone acknowledges that you're in a pickle.  But not if they’re white and poor. “White and poor?  Nope…don’t see much here for you.  Are you sure you’re not maybe Hispanic?  Because I can do something if you’re Hispanic.” It’s going to take a LOT of hard work and unpopular reforms to help this group, because the economic world, with its tech-based focus and cheap overseas consumer goods, has changed and left them behind.

And the messaging from everyone…Republicans, Democrats, the media…is that they brought it on themselves. That it’s their lot in life. Watch History Channel or TLC some time. What one group in America can we make entertainment fun about on a consistent basis? Poor whites. Honey BooBoo, Swamp People, Off the Grid, Hoarders…just watch. They’re all white. There’s all poor or working class. Most are southern. Let’s just cut to the chase and make a show called “The Have-Nots”.  We would never, and I mean NE-VER, see a show about poor blacks or Hispanics.  That would raise an outcry you could hear in the middle of the Indian Ocean somewhere.  But poor whites?  Fair game. And who is most likely to watch these shows? Other Have-Nots. Why? Because they can look at the folks on TV and say “Well, damn…at least I’m not them.”

Poor white Americans have been searching for decades for someone to stop telling them it's about the nail. 

For years, they turned to the Democrats.  The Democrats said “Well, manufacturing just isn’t where it’s at anymore; that’s reality. But here; let’s get you a better education and some better representation and take you outside in the sunshine and you know if you turned off your phone you’d sleep a lot better and that HAS to help…are you with me here?  You better get busy if you’re not going to slip farther behind.  You have to take advantage of what we’re giving you…and besides, you’re white.  I mean, it’s not like you have anything working against you…are you sure you’re not Muslim?  I can do something if you’re Muslim.” And the gap between the Haves and the Have-Nots got bigger because the world kept changing and the manufacturing jobs still weren’t there and the minimum wage still didn’t keep pace with inflation and eventually the Have-Nots got disillusioned with the Democrats.

Then they turned to the Republicans.  The Republicans said “Well, the reason you are in this pickle is because the Democrats stole all your money to create these social service programs for all those damn blacks and Hispanics and immigrants!  If you just vote them out of office, we can lower taxes and give the money to businesses who will hire you and you’ll be rich and fat like us in no time…by the way, the trash needs emptied. Oh, and you got a nail in your head there. Might wanna look into that.”  And the Have-Nots had even less and the Haves had even more.  A LOT more.  And there were MORE Have-Nots than ever before.

And now we are in another election season.  And there are a LOT of Have-Nots. And they look at our Congress and they see a lot of people who don’t seem to care much about them and haven’t in a long, long time.

Enter Donald Trump.

The Donald says, “Wow. Your head must really hurt. Of course it’s not about the nail.”

He says, “You poor bastards; you have gotten the rawest of raw deals here.  Because it’s not about the changing economy and it’s not about education and it’s not about what they’re doing with taxes and it’s not about income inequality.  It’s because the world has given all their attention to the blacks and the Hispanics and the immigrants and the Muslims and they just left you sitting there, didn’t they?  How dare they do that? Let’s make all those people go away, because they’re taking up all the attention and you’re not getting any. Tell you what? We’re going to make some new reality shows.  We’re going to call them ‘The Jigaboos’ and ‘The Mexican Rapists’ and ‘The Towelheads’ and our new reality shows will have electrical wire over top of a wall and you can watch people trying to climb over get electrocuted during Prime Time and you can look at all of those people on those new shows and say “Well damn…at least I’m not them.””  The Have-Nots looked up and said “See?  He gets us! See?  It’s really not our fault and we don’t have to do really hard work to make ourselves desirable.”

In that moment, the Haviest of the Haves became the hero of the Have-Nots.  And the rest of us were left scratching our heads.  How on EARTH could these people fall for this …this…BUFFOON? we all said.

All he had to do was say the magic words.  “It’s not about the nail.  There is no nail. It’s someone else’s fault that you’re in this pickle.”

The danger, of course, is that unlike working with individuals with depression, the working poor have not, by and large, been given a set of tools to get out of the pickle.  It’s all a fallacy. But Trump isn’t looking to solve problems; he’s looking to get elected.  He’s the ultimate sociopath in that regard. He will get elected on the platform of “You poor bastards” and then, because he has no actual policies, it’ll be business as usual. Or maybe worse.  He’ll combine bully pulpit politics with side-show theatrics and amuse himself for four or eight years and leave it for the next guy to clean up. He will abandon the people who are following him now, because he neither truly understands them nor does he truly want to.  They are a means to an end. The Haves and the Have-Nots will grow farther and farther apart, but it won’t matter to him, because he’ll be on to the next thing by then.  But this time, the Have-Nots will trust no one and nothing, because they have been betrayed at every turn.  And we may be well and thoroughly on our way to a civil war by that time.

Let’s hope it doesn’t happen.  Let’s hope that the majority of Americans see where this is leading and elect someone who can work in the best interest of the nation. I won't lie; I'm not hopeful.

But if it happens, there will need to be real changes.  It’s going to have to start with “Wow. Your head must really hurt.” But then it’s going to have to be followed up with a re-indexing of the minimum wage, some painful tax reforms, career-oriented education and perhaps just enough trade reform to break our addiction to cheap overseas crap, so we can remember how to make stuff here.  

Make no mistake; it’s about the nail. But first, it’s about really hearing the needs of the American working poor and giving them a sense that somebody really cares.  Because if not, we're going to see this played out over and over again in the years to come.