MPH Cupid

Heart and Blade

My name is Karel and I am an Internet dating failure.   Yes, I have met a few nice men on OK Cupid for the requisite coffees, drinks or dinners and “nice meeting you, good-bye.”  There of course have been the fascinating respondents who live in “New York, New York” but only write back at 2:00 AM and have no idea where the George Washington Bridge is.  The men who live in suburban apartments who had very lavish life styles and were very financially successful, but “lost everything in the divorce.”  (I don’t know which planet these men are from since, having been divorced myself, I happen to know first hand that wives definitely do not “get everything” as these men claim was their judicial fate.)   There was the very attractive somewhat familiar looking man who was wearing an Eddie Bauer shirt with the logo prominently displayed in every photo; nicely scanned from the catalogue.

My profile remains on OK C and I check in from time to time approximately once a month because though not an enthusiast, I am sort of academically interested in the process, maybe even a little bit hopeful.  And recently to refresh my memory, I checked in few times before writing this blog.

Of course I have heard the various urban legends of a cousin of a friend of someone’s sister-in-law who found true love, got married and had five children and lived happily ever after with a man she met on eHarmony. Or the neighbor of a woman in yoga class who is engaged to a man she met on Match.  There was even an article in the New York Times “Weddings” about two people who met on OK Cupid.  Read it, Believe it!  If it is in the New York Times it must be true.

Alas, I have not even come close to this experience, although I suppose it would help if I updated my profile from time to time (I went to St Petersburg, Russia two years ago.)  Maybe I need to add something really compelling like my broken ankle last winter with a photo of my scar.  Kind of makes me think of Ben Stiller’s Walter Mitty trying to get a wink on eHarmony, although I actually have been to the Himalayas and Iceland.

In spite of this failure to find true love on my computer, two years ago I met David and since then we have exchanged I am sure hundreds of emails, photos, ideas, feelings, thoughts, plans.  We have written sometimes several times in one day.  About year ago when I wanted to set up a meeting, he disappeared for over a month and I thought it was over.  I was pretty angry.  And there have been times when he has been angry and critical and seemingly very demanding.  But still we continue and in fact I just received an email from him this morning.  “Good morning,” he wrote.  “Thank you for your humble reply.  We have much work to do.”  David lives in Uganda and I live in New York.

David and I didn’t meet on a dating site.  We met on the Global Health Forum of LinkedIn when I posted my MPH thesis in 2011.  Over the two years we have been working together to establish Holistic Care for Mothers, a project of the Makindye Rotary and soon to be an independent not for profit registered with the Ugandan government.  I am more than academically interested; I am hopeful that we can make some positive change for women and girls.

This is not my only Internet relationship.   Early in my thesis process at New York Medical College, probably around 2008, I found the Birthing Kit Foundation and Dr. Joy O’Hazy.  Joy and I have written to each other over the years about the distribution and efficacy of birthing kits,, but also about her travel, her singing and dancing; her wisdom and experiences.  There are often long gaps in our correspondence, but I always feel a connection to her and every day I look at the beautiful appointment book she sent me last year with her photographs and poems.  It was Joy who was my contact to the Foundation that yielded the donation of birthing kits to Holistic Care for Mothers that David has distributed in rural Uganda.

I met Kirtiman Tumbahangphe in Nepal, the director of  MIRA, Mother and Infant Research Activities and after many emails and exchange of phone numbers, Kirti and I did meet in Hetauda where I visited several women’s projects out in the beautiful lush mountains of southern Nepal.  We talked about maternal mortality in Nepal and the very successful MIRA project using women’s empowerment, peer health education and community leadership.  Kirti and I even had dinner together at the Hotel Avocado and Orchid Resort where I stayed.  We said goodbye in the parking lot and he rode off on his motorcycle.

Diana Nabiruma is a health writer for the Ugandan newspaper The Observer.  I was researching health in Uganda when I found one her articles about violence against women and girls.  Thinking she might be interested in Holistic Care for Mothers I sent an email to the address in her by-line; an arrow shot into the cyber dark for sure, but she wrote back.  She was interested and interesting and funny and smart.  And, she interviewed David and Dr. Sarah Nkonge.  And….she did indeed write an article about maternal mortality in Uganda, about the Holistic Care for Mothers. The%20Observer%20-%20No%20more%20%E2%80%98labour%20suites%E2%80%99%20in%20banana%20plantation.html

And then there is Mike Cook who is one of the most amazing Internet contacts I have ever had.  I was thinking about how razor blades in birthing kits might be replaced with natural, local sustainable materials.  I thought about repurposing broken glass bottles; could blades be made from glass? So I searched “GLASS BLADES.”  And there was Mike Cook.  His website states, “Hi I am Mike Cook and I was born to be a flintknapper.”  Mike lives in Portland, Michigan and has a company called Art of Ishi He in fact makes blades from glass and stone, but not the kind of glass I was thinking of.  He uses natural volcanic glass, obsidian, flint, chert.  Take a look at his website and you will be totally astonished.  You can watch his videos about how he makes these blades.  For those of you who are not faint of heart, watch him shave with a blade he strikes off of a hunk of  obsidian  All I can say is “DON”T TRY THIS AT HOME.”  So I wrote to Mike.  Generous, thoughtful and expressing interest in birthing kits, Mike sent me a few of his blades.   I have them on my desk (although I have not used them on my legs,) and there is the possibility of natural blades to cut umbilical cords safely, cleanly, sustainably.  Thanks, Mike.

These are some of my Internet relationships.  I don’t think any of them will lead to a date for New Years Eve, dinner on Valentines Day, not even the cup of coffee or drink.  I have not found my one true love, but I have found passion.

As I, a la Joseph Campbell follow my (Internet) bliss, I think of a web perhaps not so different from our www in Walt Whitman’s “A Noiseless Patient Spider”:

A noiseless patient spider,

I mark’d where on a little promontory it stood isolated,

Mark’d how to explore the vacant vast surrounding,

It launch’d forth filament, filament, filament, out of itself,

Ever unreeling them, ever tirelessly speeding them.

And you O my soul where you stand,

Surrounded, detached, in measureless oceans of space,

Ceaselessly musing, venturing, throwing, seeking the spheres to connect them,

Till the bridge you will need be form’d, till the ductile anchor hold,

Till the gossamer thread you fling catch somewhere, O my soul.

Mobius: where time becomes a loop


Mobius tattoo

I have been thinking about Mobius Strips lately.   These tricky little mathematical shapes are described in Wikipedia as:


The Möbius strip or Möbius band (UK /ˈmɜrbiəs/ or US /ˈmoʊbiəs/; German: [ˈmøːbi̯ʊs]), also Mobius or Moebius, is a surface with only one side and only one boundary component. The Möbius strip has the mathematical property of being non-orientable. It can be realized as a ruled surface. It was discovered independently by the German mathematicians August Ferdinand Möbius and Johann Benedict Listing in 1858.


(Hmmmmm.  So it really could have been called “The Listing Strip” and then we all wouldn’t have to feel bad about not having umlauts on our keyboards.)


But a written description can’t possibly give you the full strip experience, so those of you who have never actually made one yourself, here is a video that will have you running for a piece of paper, tape and scissors (no, please don’t run with the scissors!)  so you can prove to yourself that there really is an object that has only one side…and dazzle others who may be uninitiated.


I first encountered this phenomenon, when I was in high school although Mobius Strips were not in any curriculum of my formal education at Earl L. Vandermeulen High School in Port Jefferson, New York.  No, it was when I was doing a little part time work for a famous sociologist, Dr. Benjamin Nelson, who at the time was on the faculty of the New York State University at Stony Brook.  My mother, Rose, worked for him in his home office as his secretary.  She was soon joined by her very dear friend Elsie in support of Dr. Nelson’s accounting, and over the years I, my sister Barbara, and my soul-siblings, twins Carol and Jim Winkler, who are Elsie’s children, all found ourselves in the Nelson home office, editing, organizing, filing, and having lunch with Dr. Nelson.  He was a fascinating person, professor, social science researcher, author and mentor.  I still clearly remember him telling me one day over dessert that there was blood in my tea which was pretty horrifying to my naïve self as he drew the longitudinal connection between my teabag and tyranny in developing countries. So, then there was an article he asked me to edit (by this time I might actually have been in college at Stony Brook,) for the Journal of  the American Psychiatric Association called ”The Onion and the Mobius Strip” (I am sure they had an umlaut.)  I have realized that there are limits to our searches on the Internet because although I have found many other journal articles and books by and about Dr. Nelson, I have yet to mine this one.  I do believe the article was about two conflicting models of personality studies, but it has been a pretty long time.  I, however, clearly remember looking up Mobius Strip in his (you won’t believe this but it is true) Encyclopedia Britannica.  (Just to give you a time reference on all of this Dr. Nelson died in 1977, in his sleep on a train in Italy.)


So why have I particularly had Mobius Strips on my mind?  It’s the US government shut down.  Here’s how that is going:


(If you want to read the most current details, here’s an article in Forbes )

In short, because the Democrats support President Obama’s Affordable Care Act, the Republicans are refusing to approve the United States budget which expired on September 30.  And the Democrats won’t negotiate. Since the budget isn’t approved, federal employees who are considered “non-essential” are out of work and some of them actually would be providing health care but can’t because the agencies they work for are shut down.  Here are a couple of examples from an article in the Washington Post


Health: The National Institutes of Health will stop accepting new patients for clinical research and stop answering hotline calls about medical questions. The Centers for Disease Control and Prevention will stop its seasonal flu program and have a “significantly reduced capacity to respond to outbreak investigations.”


Women, Infants, and Children: The Department of Agriculture will cut off support for the Women, Infants and Children program, which helps pregnant women and new moms buy healthy food and provides nutritional information and health care referrals. The program reaches some 9 million Americans. The USDA estimates most states have funds to continue their programs for “a week or so,” but they’ll “likely be unable to sustain operations for a longer period” — emergency funds may run out by the end of October.


So here’s the Mobius loop of the Affordable Care Act based on people needing health care looping back on itself to people needing health care while our government fights with itself.


I am aware of another more local Mobius Strip health loop.  Flu season is almost upon us and the New York State Department of Health has mandated that all health care providers receive the flu vaccine (or wear a mask in the presence of patients and other health providers.)  There are some health providers, the lowest paid who provide direct care but don’t have health benefits themselves from their employers.  Their employers will not pay for the vaccinations so they have to pay for the vaccine themselves.  If they can’t afford it they will be removed from their jobs and then they really won’t be able to afford the vaccinations and won’t be able to go back to work…well at least not until flu season is over.  And they may very well get sick and require the health care they can’t afford because they are out of work.  Dr.  Mobius, I presume.


And here is a more personal health Mobius.  A friend of mine works for a health care company.  She is required to work long days often into the evenings and on many weekends.  She has been very stressed and not feeling well and so has been seeing her doctor and a therapist who both have advised her to work shorter  (normal) hours and have some time for her health care, recreation and relaxation.  She however, can’t do this because of the requirements of her job.  And she often misses the therapy because she has to stay late at work, making her more stressed.  Here’s the Mobius one sided one edge shape: the health care company she works for is also her health insurance provider paying for her health care.  So, it’s a one-sided shape, the deterioration of her health is being caused and paid for by the same company!  Loop de loop.


None of this should be so complicated, convoluted and twisty.  In spite of all of this the health exchanges sites are so busy with people registering and buying affordable health care insurance that there were some crashes the first day.  There is a clear straight line between health care and the health and well being of individuals, communities, populations, the people of the United States.  The Affordable Care Act is a pretty simple straight line.


Getting back to the government shut down, a twist in the fabric of space where time becomes a loop.  It does seem that this isn’t quite a Mobius Strip, after all there are two sides, the Democrats and the Republicans.  But actually as the strip loops around, until these two sides get it together, there really is only one side to this situation:  everyone is losing.


If you need some cheering up after that, watch this and have a healthy, happy heart:


Whistling in the Dark: Truth, or What I did on my Summer Vacation


When I was 4 years old, by some quirk of a mail disorder, one of the greatest inspirations of my life turned up in the mailbox by my front door at 121 Greenwich Avenue in Roosevelt, New York.  I vaguely remember the brown paper wrapping and my mother opening the package.  It was a book filled with black and white pictures and some writing that in my 4 year old preliterate state was unintelligible to me.  I believe that the book was flipped through by the big people, my parents and two older sisters, and then was discarded in a pile of magazines where I discovered it and made it my own.  That was when I made my acquaintance with Joan of Arc.  Of course at the time I didn’t know her name was Joan of Arc since I couldn’t read, but most likely someone had mentioned that name and I must have mentally acquired it.  I know that I did acquire the book and I still have it; it is the screenplay for the 1948 movie Joan of Arc directed by Victor Fleming, starring Ingrid Bergman as Joan.  It became my personal visual story even though all of the left hand dialogue was just letters on a page, the pictures spoke to me.  First there was the cover, the only full color picture and the color is still glorious: blue background, a furling white flag with gold fleur de lis, her silver armor and her blue eyes and raspberry lips.  Yes, the lady, the beautiful lady in shining armor.  No woman I knew dressed like that, not my mother, or sisters or aunts or neighbors, certainly not Miss Frances on Ding Dong Schoolhouse. I loved this woman under the helmet holding a sword.  I had seen pictures of the Statue of Liberty and maybe they were related, the statue did have a crown and was holding a torch.  In Sunday School there were women like Jesus’s mother who dressed differently from a long time ago, but they didn’t look like the woman in armor.  She looked so proud, confident and powerful. Her blue eyes were like mine.

The pictures inside the book were more complicated, but even as a little girl I was aware enough of the symbolism of clothing to understand the progression of the story of Joan.  In the beginning she was dressed in simple dresses and looked sweet with her head covered what we would have called a babushka.  Then tunics and leggings.  (Of course I didn’t know these words.) She was shown talking to a lot of men.  And, praying a lot.  Then suddenly on the next page, there she was in armor on a horse surrounded by men.  Scary battle scenes. Bows and arrows.  I had been introduced to Robin Hood and his Merry Men so I knew about shooting arrows, but this looked more dangerous.  No one looked merry.  There was a picture of her on the ground with an arrow in here chest. Then Joan in her armor talking to a king; I knew he was a king by his crown and robes.  And then she was just dressed in black, simple black and really praying a lot and looking worried, crying.   I knew she was in trouble.  The last pages were the ones that I couldn’t stop looking at.  The armor was gone, the tunics and leggings were gone, even the simple black outfits.  She was all in white, wrapped in what seemed like a white sheet and they were chaining her to a post.  She was surrounded by logs and twigs.  Then the flames.  Her face on the final page, eyes closed, still beautiful, swathed in smoke.

Her clothing told a story.  So did her praying.  Toward the end she had reached out for a cross.  Some of this I understood as some kind of Sunday School story.  I wanted to ask my parents about this but something held me back.  Maybe I thought they would take the book away from me.  I didn’t know if they even knew I had it among my other story books, Babar and Alice in Wonderland and the Disney Classics.  There was something that resonated with Snow White eating the apple and falling, Alice running from the Queen, Babar’s mother shot by a hunter.  But somehow the last pages of all of those books ended with happiness, a reunion with loved ones, a return home.  Joan, my heroine, was alone in the smoke, with a sign on her head I could not at that time read or comprehend, like Jesus on the cross but with no Easter Sunday resurrection, bunny, colored eggs, new dresses and jelly beans.

At some point I showed the book to my sister Barbara, who was always the smart one in the family and 7 years older than me, and asked her why the story ended that way.  She told me that Joan had gotten into a lot of trouble with those men because she told the truth.

Getting in trouble for telling the truth has been very much in the headlines this summer.  There has been the trial and sentencing of Bradley Manning. There has been Anthony Weiner running for Mayor of New York City and his truth and lies and just down right too much visual information.  But my attention has been focused on Edward Snowden’s truth telling and the controversy of his legal right to tell these truths.  No one it seems, even the United States government in general or President Obama specifically has denied that what Snowden has declared is true, just that he shouldn’t be sharing these truths.  I have had many conversations with many people about this topic and the opinions have been as varied as the emails that have been read by the National Security Agency; meaning there are lots of different opinions even among people I know, ranging from Snowden being a spy who should be condemned to death, to him being a savior who is being martyred for his speaking the truth.  The political environment has become a shifting landscape of relationships between super powers and developing countries accepting or shunning him, inviting Snowden as a guest or demanding his personal criminal appearance.  Moscow might send him back home if we really really promise not to kill or torture him.  Sounds a little Joan of Arc-ish.  Saint or heretic?  Maybe like Joan only time will tell the good guys from the bad guys in this story of truth-telling.  And just as Joan wasn’t really the issue but was just the spokesperson for the big question, “who’s got the power, God or kings?” it’s really the same issue in the Snowden saga:  who’s got the power of information? Government or the people?

Repeat after me: Edward Snowden is not the story. The story is what he has revealed about the hidden wiring of our networked world. This insight seems to have escaped most of the world’s mainstream media, for reasons that escape me. The obvious explanations are: incorrigible ignorance; the imperative to personalise stories; or gullibility in swallowing US government spin, which brands Snowden as a spy rather than a whistleblower.

Was Joan of Arc a heretic or a saint?

Is Edward Snowden a whistleblower or a spy?

What about Bradley Manning, Sibel Edmonds, Coleen Rowley, Jesselyn Radack, Dr. Peter Rost?  Any number of whistleblowers at

All of this makes me wonder about all that medical information that is behind the firewalls of hospitals, medical centers, clinics and physician practices.  Of course patient privacy has to be protected, unless it is good public relations for the medical provider:  the successful heart transplant, the separation of conjoined twins, the new miracle drug.  Do an internet search and you can find dramatic accounts of life saving procedures.  Here’s one in the news today accompanied by photos of the patient, is wife and his child:

Life-saving: Matthew Green was the first person in the UK to receive a total

artificial heart implant and be able to go home thanks to a portable pump.

Read more:

But what happens when things go terribly wrong, which does of course happen.  Some stories do come out when family or patients speak up, if they can, if they have good lawyers.  But I wonder about what the internet hackers would find if instead of looking into national security they looked into national health care.  They probably would not find that our emails are being read or our phones are being tapped, but they would find that some patients got the wrong blood type in a transfusion, or the wrong dose of heparin was administered, or the wrong breast was removed, or someone was left in the hallway to the emergency department too long.  The New York Times article, More Treatment, More Mistakes, by Sanjay Gupta, MD in July 2012, states:

According to a 1999 report by the Institute of Medicine, as many as 98,000 Americans were dying every year because of medical mistakes. Today, exact figures are hard to come by because states don’t abide by the same reporting guidelines, and few cases gain as much attention as that of Rory Staunton, the 12-year-old boy who died of septic shock this spring after being sent home from a New York hospital. But a reasonable estimate is that medical mistakes now kill around 200,000 Americans every year. That would make them one of the leading causes of death in the United States.

Is there some national security that can prevent these deaths of 200,000 American citizens every year?  Can the NSA read all the medical records looking for medical errors that kill people rather than spending time reading everybody’s emails looking for terrorists?

What is important to know is that as cited in the article states don’t use the same reporting guidelines and that includes who knows about the mistakes including patients and their families, i.e., sometimes even if you get the wrong medication, or the wrong procedure, or some little inconsequential sponge is left inside your body you don’t have to be told about it.  Maybe it’s just better for you to not know. Just like if someone is reading your emails you don’t really have to know about it because maybe it’s just better if you don’t know about it.  Maybe this is keeping all of us safe.  Maybe not. 200,000 Americans die every year and we don’t know much about that, or who is protecting us, or how to protect ourselves.

But here’s something true about healthcare that is apparently not true in national security:  anyone in health care who knows that there is an error or risk to patient safety can talk about it without risking their own safety.  If you talk about what’s going on in health care as long as you don’t violate patient confidentiality, you don’t have to end up in the transit area of the Moscow airport or at the burning stake or in a military prison.  In New York State there is a specific law that protects health care employees from retaliation by their employers if they speak up about a medical error or any other untoward events.  It’s New York State Labor Law 741.  It explicitly states:

Retaliatory action prohibited. Notwithstanding any other provision

of law, no employer shall take retaliatory action against  any  employee

because the employee does any of the following:

(a) discloses or threatens to disclose to a supervisor, or to a public

body  an  activity, policy or practice of the employer or agent that the

employee,  in  good  faith,  reasonably  believes  constitutes  improper

quality of patient care; or

(b)  objects  to, or refuses to participate in any activity, policy or

practice of the employer or agent that  the  employee,  in  good  faith,

reasonably believes constitutes improper quality of patient care.

Whistleblowers in health care need not fear, they are protected by law.

So no hackers required. No one who works in health care can be penalized, forced to flee, ostracized, accused of being a witch, blasphemer or heretic, if they blow the whistle to inform a public body that there is a risk to safety, health and well-being.  They are protected.

Well, maybe.

Or, maybe not.

Brave Lyrics

by Sara Bareilles

You can be amazing
You can turn a phrase into a weapon or a drug
You can be the outcast
Or be the backlash of somebody’s lack of love
Or you can start speaking up
Nothing’s gonna hurt you the way that words do
And they settle ‘neath your skin
Kept on the inside and no sunlight
Sometimes a shadow wins
But I wonder what would happen if you

Say what you wanna say
And let the words fall out
Honestly I wanna see you be brave

With what you want to say
And let the words fall out
Honestly I wanna see you be brave

I just wanna see you
I just wanna see you
I just wanna see you
I wanna see you be brave

I just wanna see you
I just wanna see you
I just wanna see you
I wanna see you be brave

Everybody’s been there, everybody’s been stared down
By the enemy
Fallen for the fear and done some disappearing
Bow down to the mighty
Don’t run, stop holding your tongue
Maybe there’s a way out of the cage where you live
Maybe one of these days you can let the light in
Show me how big your brave is

Say what you wanna say
And let the words fall out
Honestly I wanna see you be brave

With what you want to say
And let the words fall out
Honestly I wanna see you be brave

Innocence, your history of silence
Won’t do you any good
Did you think it would?
Let your words be anything but empty
Why don’t you tell them the truth?

Say what you wanna say
And let the words fall out
Honestly I wanna see you be brave

With what you want to say
And let the words fall out
Honestly I wanna see you be brave

I just wanna see you
I just wanna see you
I just wanna see you
I wanna see you be brave

I just wanna see you
I just wanna see you
I just wanna see you
I wanna see you be brave

I just wanna see you
I just wanna see you
I just wanna see you
I wanna see you be brave

I just wanna see you
I just wanna see you
I just wanna see you.

The Write Stuff

The patient presented with multiple diagnoses:  Morbidly alcoholic with fits of anger, depression, anxiety, and insomnia.  His appearance was one of self-neglect with a disassociated affect.  But the doctor did not prescribe antidepressants, counseling or electroconvulsive shock therapy.  He placed a blank journal in front of the patient and positioned the pen on the page toward him.  “Write it down,” he said.  “A memory, a thought, a place.”  The patient was Nick Carraway.

Write something.  I do not mean for this to be an intimidating suggestion.  It makes no difference whether you write five paragraphs for a blog, a paper for a professional journal, or a poem for a reading group.  Just write.  What you write need not achieve perfection.  It need only add some small observation to your world.  Atul Gawande, MD. in his book Better: A Surgeon’s Notes on Performance  is writing about changing the world.  The doctor at the Perkins Sanitarium, in Baz Luhrmann’s The Great Gatsby, is telling Nick Carraway to write to change himself.  He tells Nick that it doesn’t matter if anyone else reads what he writes or if he burns it.  Just write.

Far be it from me to suggest that anyone who has a mental illness not receive necessary treatment, but there is something about the prescription of writing that is healing, that is life enhancing, that is empowering, that is both personally and publicly changing.

We all know the power of writing from the glyphs on the walls of the caves of Lascaux, to the Guttenberg printing press, to the emails and texts we now zap off and retrieve in nano seconds. John Snow’s essay On the Mode of Communication of Cholera in i849; Ignatz Semmelweis’s Etiology, Concept and Prophylaxis of Childbed Fever both had powerful, although delayed, effects on public health.  But what does writing do that changes the writer whether it is a blog, a poem, an essay, a professional paper, or The Great Gatsby?

First, there is the actual physical act of writing.  Nick starts out writing in the journal in cursive which Luhrmann conjures up as the words scrawling and draping across the screen.  In 3D, the curlicued letters actually float out to embrace the audience.

….scientists are discovering that learning cursive is an important tool for cognitive development, particularly in training the brain to learn “functional specialization,”[  that is capacity for optimal efficiency. In the case of learning cursive writing, the brain develops functional specialization that integrates both sensation, movement control, and thinking. Brain imaging studies reveal that multiple areas of brain become co-activated during learning of cursive writing of pseudo-letters, as opposed to typing or just visual practice. Other research highlights the hand’s unique relationship with the brain when it comes to composing thoughts and ideas. Virginia Berninger, a professor at the University of Washington, reported her study of children in grades two, four and six that revealed they wrote more words, faster, and expressed more ideas when writing essays by hand versus with a keyboard.

There is a whole field of research known as “haptics,” which includes the interactions of touch, hand movements, and brain function.  Cursive writing helps train the brain to integrate visual, and tactile information, and fine motor dexterity.   MEMORY MEDIC by William Klemm, D.V.M., Ph.D.       What Learning Cursive Does for Your Brain | Psychology Today.html

Then there is the whole right brain/left brain relationship in writing that connects the creative emotional side of ourselves with the sequential verbal side.  So here is what is going on in each side of our sophisticated bicameral brains that developed around 1,000 BC when a purely reactive brain was not capable of figuring out complicated stuff, and a meta consciousness was required:  thinking about thinking, desiring about desire, worrying about worries, wondering about wonder.  Julian Jaynes thought about these thoughts documented in his 1976 book The Origin of Consciousness in the Breakdown of the Bicameral Mind.

Here’s what each side of the brain does.


uses logic
detail oriented
facts rule
words and language
present and past
math and science
can comprehend
order/pattern perception
knows object name
reality based
forms strategies

“big picture” oriented
imagination rules
symbols and images
present and future
philosophy & religion
can “get it” (i.e. meaning)
spatial perception
knows object function
fantasy based
presents possibilities
risk taking

Writing gets the major highway system between the two sides of the brain, the corpus callosum, activated in fact, bringing a wholeness to our thoughts, our expression, our selves.  Fantasies, dreams, ideas, fears, beliefs, travel into verbal language, knowing, acknowledgement, comprehension.

So this is what happens when we write, and I can tell you it is happening to me right now.  There is a total engagement, there is a sense of being “together,”  there is what Mihaly Csikszentmihalyi calls FLOW in the book by that name, subtitled Steps Toward Enhancing the Quality of Life.  Enhancing the quality of life; isn’t that what we strive for in our personal health and public health?  (Don’t right brain panic over how to pronounce Mihaly Csikszentmihalyi .  It is actually quite simple if you don’t let all of those consonants throw you and your left brain just goes with the sequence.  First name: Me High.  Last name: Cheek Sent Me High.)  Flow is what happens when your left brain and right brain are working in complete participation with each other, when we are “lost” in experience, in creation, in process. Experiencing flow is a positive experience; in fact, some people refer to it as “optimal experience.” Flow doesn’t just happen for writers—athletes call it being “in the zone.” Artists, surgeons, dancers, and others also experience flow when they’re completely passionately focused on something they love.

So this is the fun part of being healthy, enhancing the quality of our lives, of choosing to go with the flow, of optimal experience.  There isn’t one single prescription.  It isn’t one size fits all.  There is no standard operating procedure.  Natalie Goldberg in her book on writing, Writing Down the Bones notes that journals should be big enough to write big, but William Carlos Williams, the poet who was also a pediatrician, often wrote his poems on his prescription pad.  How perfect, the prescription of a poem.

It’s all about you and doing what engages your self fully, right brain, left brain, body, soul, spirit.  Garden, bird watch, play music write music listen to music, paint, dance (actually no matter what else you do always dance,) practice yoga, solve mathematical equations, build something (I can actually get a little too engaged walking around Lowes,) heal someone, heal yourself.  And do write.  You can do it anyplace on anything at any time.  I have actually written various stories, essays, articles on the back of grocery store receipts and pay stubs.  If you feel the least bit inhibited about writing something, I recommend a book called Wreck This Journal.  If you write in this book you will never feel inhibited about writing again, in fact you might never feel inhibited about much of anything again.

“Write something,” prescribes Dr. Gawande, ”it need not achieve perfection.”

So back to Nick Carraway, (fresh faced and glowing after a nap on the couch and the accumulation of his typed pages,) and the final line of The Great Gatsby with my own edits, (and no apologies whatsoever to Mr. Fitzgerald, who would probably have loved to have been able to approve,) on this fine morning, May 27, 2013:

but that’s no matter–tomorrow we will run faster, stretch out our arms farther…and one fine morning–so we write on, boats against the current, born ceaselessly into the moment.”

 boats against the current


Some of you know that in addition to writing this blog, I write essays, professional articles, and short stories.  I wrote the following for my granddaughter and so it is titled For Sonoma at Bedtime, but it is also known as

The Mermaid and the Cowboy

Once upon a time, under the great blue green curls of the waves in the deepest most beautiful ocean, lived a mermaid with golden curls and eyes the color of the blue green waves.  With her beautiful blue iridescent tail she swam with the whales and played with the dolphins and raced with the seahorses.  She and her mermaid friends dreamed of love and adventures and flirted with the sailors on the passing ships.

Over time all of her friends fell in love with sailors and traded their beautiful iridescent tails for feet.   Ah the better to walk with on the piers and dance and love their sailors.  But the mermaid with the blue green eyes was determined to find love and keep her iridescent beauty and the power of her swimming.  So as her friends left one by one she was lonelier and lonelier but also bolder and bolder as she explored the ocean from the crests of the waves to the deepest darkest crannies of caves and she became acquainted with every living creature in the sea.

And so it happened that one night as she swam over the castle spires of a reef, a great storm blew in from some dark and violent place and the mermaid, caught in the winds of change and the rains of despair, was carried far from her home in the sea, to craggy coastlines, up muddy rivers to a sandy creek’s edge.  Covered with mud, scraped and bruised she lay on the sandy bank sleeping off the nightmare of the storm.

A cowboy, dusty and weary, walked his pony along the creek looking for an easy place to settle in for a quiet rest and to let the pony drink.   As they wandered down the bank, the cowboy was dazzled by a glimpse of iridescent blue at the edge of the water.  When he scooped into the sand he found beneath a layer of mud, golden curls and glistening scales and peachy, though scraped and bruised, arms and hands and shoulders and a face that slowly revealed, as her eyelids flickered open, the blue green of a sea he had only imagined.  And the mermaid, her vision a little blurred from the night of tears and fears, looked at the cowboy and was dazzled by the gold dust glistening in the sun that shone upon his face.

Though he was awkward, at the water’s edge the cowboy washed the mud off of the mermaid, and then bandaged her cuts and scrapes.  He made a pot of coffee on a little fire he built at the edge of the creek and took some biscuits and wild strawberry jam out of his saddlebag. The mermaid sipped the coffee and ate the biscuits with him and was warm and cozy, feelings she had never experienced in the deepness of the ocean.

For a month the mermaid and the cowboy lived on the sandy bank of the creek while her bruises and scrapes healed and his exhaustion faded.  She told him about the ocean and the creatures of the sea, the waves and the deep dark places in the underwater caves.  And he told her of the prairies and the forests, of snow and butterflies and falling leaves.  He took his guitar from his saddle and sang to her of moonlit nights and lost loves and little lambs found.  And the mermaid sang to him in the lulling voices of whales and the cadences of the dolphins and the soothing tones of the tides.  Some days the cowboy would ride off for a while on his pony and the mermaid would dip and swim and splash her tail in the creek as she grew stronger.  And once, just once, the cowboy joined her in the water and clumsily tried to swim by her side.  But he floundered, frightened by what seemed to him dark and scary beneath the surface of the water.  He sank and had to spit out the water that poured into his mouth.  And once, just once, the mermaid tried to sit on his pony and go for a ride, but her tail slipped and she fell into the grass.   She tried to maintain her dignity, but she was embarrassed and tearful.

So the days and nights passed and one morning after a night with a full moon, the cowboy and the mermaid simply said, “good-bye,” and she swam away down the creek, along the stream and into the river and out to the sea without once looking back.  And the cowboy climbed up onto his pony and rode away from the creek, across a field, through a forest and over some mountains and out onto the prairie, and he tried not to look back.

There were no calendars in the sea or on the prairie and so no one could guess how many days or months or years passed, but after many many full moons and snowfalls and campfires, the cowboy realized that he had left his heart on the sandy bank of that creek and it had been carried deep into the sea.  And after many many tides and migrations of whales and births of seahorses too many to count, the mermaid also realized that she had left her heart at the edge of that creek and it was far away somewhere on a dusty prairie.

And so the cowboy and his pony boarded a ferry, and then a boat and then a ship and they sailed around and around the world looking into the sea for a glimpse of iridescence and the blue green eyes of the mermaid he loved.  And the mermaid swam up rivers and into streams and creeks, and painfully wriggled into ponds and the shallowest of puddles on the prairie looking for a cowboy who was dusty and dazzling and who she loved more than anything.

It was a kind storm of graceful rains and fortunate strong winds that tipped the ship and beached the cowboy and his pony and that washed the mermaid out of the puddles and down the creeks and into the rivers, back to the sea where the whales and the dolphins and the seahorses conspired to carry her to a brilliant beach where she awoke in the cowboy’s arms.  In the moonlit nights of days that were on no calendar, on that beach at the edge of all oceans they sang together and danced.  And each fine morning a cowboy, holding the hand of his mermaid, swam in the blue green curls of the waves and each evening, a mermaid safe in the arms of her cowboy, sat proudly on the back of his pony as together they rode off into the sunset.

On the Bottom of a Paper Bag

I suppose I had noticed the names and dates at various times when I bought a deli sandwich or a cup of coffee or some totally evil pastry that came in one of those small paper bags.  A quick glance at the bottom of the bag at the name Maribel or Raymond or Mary, Lucita or Juan or sometimes a first initial and last name like L. Vu.  And a date. While I had noticed the names I hadn’t thought too much about them until I went to an exhibit at Mass MoCA with my friend Pat, after driving through the autumn New England countryside from Saratoga to North Adams.

Mass MoCA, the Massachusetts Museum of Contemporary Art, Mass MoCAis housed in an enormous old brick manufacturing building, with huge galleries, including room after room of Sol Lewitt’s wall drawings of bold strips of color and myriads of intersecting pencil lines.  The collection of paper bags by artist Mary Lum was part of an exhibit called The Workers that chronicled the connection of the people who operated the machines with the products and process, the banality and pride of manufacturing. The Mass MoCA blog states:  “Tinker Tailor Soldier Sailor features an assemblage of hand-torn paper bag fragments which the artist has been collecting for nearly two decades. Each of the pieces – torn from a multitude of bag bottoms — is stamped  with the name of the individual who made the bag or oversaw its production and quality on the assembly line.   A detail easy to miss, each name reminds us of the human element behind industrialized production and the objects we use on a daily basis.”  Mary Lum stated that the piece was about “the idea that a human being is taking responsibility for the acts of a machine, and the double purpose of being named, pride and quality control.”

(To read more about the exhibit: Mass MoCA The Workers May 29, 2011 to April 14, 2012

The exhibit was a reminder of how powerful our names are.  We sign checks, our tax returns, and all manner of legal documents that commit us, connect us, bind us and sometimes separate us.   We sign our names on little notes to loved ones, birthday wishes and post cards from faraway places; we sign our passports.  And for those of us in health care, our names verify notes in patient files, prescriptions, care plans.  When I was in the pre-op room before my ankle surgery on February 7, 2013, my surgeon, according to surgical protocols, initialed my right leg.  Tragic surgical errors of operating on the wrong person, at the wrong site, with the wrong procedure have resulted in the need for checklists of the process of identification and accountability to assure safety and quality of care.  On the website of the American Academy of Orthopedic Surgeons, the list is as follows:

Pre-operative verification process

  • Hospitals should identify the methodology of pre-procedure verification and site marking based on their own circumstances. Verification of the correct person, procedure and site should occur with the patient awake and aware, if possible:
  • At the time of surgery/procedure is scheduled.
  • At the time of pre-admission and testing
  • At the time of admission or entry into the facility.
  • Anytime the responsibility for care of the patient is transferred to another caregiver.
  • Before the patient leaves the preoperative area or enters the procedure/surgical room.

An article in the Chicago Sun Times noted that: “Even seemingly minor mistakes such as using an unapproved pen to mark the site, resulting in the ink being washed away before surgery, can open the door for a wrong-site error,” Joint Commission President Dr. Mark R. Chassin said.  Chicago Sun Times July 4, 2011

The surgical site can be marked with a line where the incision will be made, or with “yes,” with an X, or with the surgeon’s initials.  So my surgeon, Adam Becker, MD, of Englewood Orthopedics, marked my right leg with his initials, I am happy to say.  This might just be the protocol of Englewood Hospital, but to me it meant he was not only marking the site so there was no doubt about which ankle needed the incision, titanium plate and six screws, he was taking ownership of that ankle.  The procedure, the responsibility, the accountability and the quality of my ankle repair belonged to him.  I must say about a month after the surgery, after the massive wrappings and ace bandages which were transmogrified into a bright blue hard cast were all removed and the stitches came out and I was able to (finally!!!!) take a bath, I was a little sad to see the Sharpied AB on my skin float away into the warm water and bubbles.  My ankle was back to being my sole possession and responsibility although I will always appreciate Dr. Becker’s kindness, skill and his accountability.

Accountability is what it is all about in health care now linking the reduction in costs, with the increase in quality outcomes and patient satisfaction.  The triple mantra of right price, right place, right services, supports the structures of Accountable Care Organizations, under the Affordable Care Act.  Believe me, everyone out there providing health care wants to be an Accountable Care Organization because that’s where the government money is going.  Being Accountable is lucrative and the big health care providers and insurance companies are all grappling with the cost/quality/satisfaction matrix.  There’s a great website that brings together all of the research and expertise that accountability in health care is generating in policy and practice.  Important information for all of us care providers and patients.

And yet in this grand shift of corporate health accountability I think the change will be in the commitment of individuals to their own responsibility and pride in a job well done, of individual caring within a structure of accountability…kind of like people putting their names on paper bags.  Atul Gawande, MD, my second favorite surgeon, has focused on this in his Checklist Manifesto:  How to Get Things Right   In the environment of massive knowledge and expertise he maintains that true accountability and quality is in the commitment of each individual checking off their box on the check list.  I did this, I am responsible for this, I care about this, I am committed to the best of this, I check this off and put my name on it.  I own it.  This is my paper bag, my ankle, my responsibility and pride, my own name, my humanity.

At another museum, The Hirschhorn  on the Mall in Washington, DC, which I visited last  November with my friend Heller An and her daughter Karen, there was an exhibit of the work of Ai Weiwei, the brilliant Chinese artist, philosopher, political dissident  and human right activist.  There were his amazing Circle of Animals Zodiac Heads around the reflection pool, the back pack sculpture representing the 5385 students who died in the 2008 Sichuan earthquake, and the bold black on white statements like, “When was the last time you laughed?” And on one wall the testimony to each person’s accountability, rights, pride, commitment to quality, to their individual spirit and value, in health care and all care, caregiver or care recipient, individual human caring, kindness and virtue:

A name is the first and final marker of individual rights, one fixed part of the ever-changing human world.  A name is the most basic characteristic of our human rights:  no matter how poor or rich, all living people have a name, and it is endowed with good wishes, the expectant blessings of kindness, and virtue.   Ai Weiwei

lewitt and me

Karel Rose Amaranth

Beautiful to the Bone

The fine black line that diagonaled through the bright white shaft against the dark background was the reason we were looking at this picture.  It was cause for concern, for necessary interventions, for my fear.  And yet my attention was also drawn to the lower area of this study in black and white where delicate lines and sensual little spheres connected, designed like an intricate and elegant piece of jewelry.   These were the bones of my right ankle and foot.

I soon came to have a great appreciation for my ankles, the right one in particular.  I have of course enjoyed them and they have held me up in ever so many of my endeavors:  running on my pier out into the Hudson River; climbing along a precipice in the foothills of the Himalayas; standing in Proud Warrior; kicking away the blue and green and aqua of oceans and rivers and swimming pools; holding me steady as I bounced a baby (mine or anyone’s else’s I could get my hands on;)  dancing and leaping into a silly pirouette; rocking forward on a tennis serve, sloshing through the Mumbai Monsoon; supporting me as I sauté-ed and fried and roasted and peeled and mashed and whipped in my kitchen.

But I never learned to really appreciate my ankles until my right foot slipped from a wet stair onto a wet tiled floor and slid sharply (much too sharply) to the left on a wet San Diego morning.  Snap.  Alas, the ominous black diagonal line running through my lovely fibula poised above the delicate bones of my foot.  Despite the diagnosis, the picture of my ankle and foot was quite beautiful.  Perhaps if I ever decided to take online dating seriously I would post, instead of the requisite head shot, this foot shot with the caption, “Not just another pretty face.”

So while I have certainly enjoyed the structure and support of my bones, I haven’t really thought about them all that much, as is probably true of most of us.  Sure, I am pretty compulsive about getting my calcium; cheese is after all one of the great pleasures of life.  And then there is all of that low fat yogurt:  plain, Greek, frozen, and in smoothies.  Ice cream.  Zero Percent Over the Moon Milk (with Oreos, of course.)  Pizza with fresh mozzarella and anchovies.    I haven’t exactly indulged in all of these calcium rich foods for purely medicinal purposes.  I do also love all those green leafies: broccoli, Brussells sprouts (an odd early acquired taste during my childhood,)  spinach (preferably creamed. ) I have done exceedingly well on my bone density tests with very little advance study.

Now I think about my bones all the time; now that the thin black line has resulted in my right ankle being permanently adorned with some titanium.

I have also been thinking about why we don’t typically think too much about our bones.  In fact bones actually get kind of a bad rap.  Halloween: scary skeletons.  One annually adorns my front door kept company by the Jack O’Lanterns.  Pirate ships:  Skull and Cross Bones.  The dangling marionette of bones in a medical lab in a science fiction thriller.  Malicious King Richard found under a parking lot.  Creepy, but bones intact.  The pejorative terms:  bag of bones, bad to the bone,  bare bones and bone head.

I looked through a few magazines to do some research on the fashion value of bones.  More seemed age appropriate for me.  Here are the survey results of attention to body parts  beautiful as depicted in advertisements:

Skin:  18

Hair: 8

Eye lashes: 4

Lips:  3

Nails (fingers and toes):  2

Bones:  0 (except for a minor mention among heart, joints, muscles, digestive tract, immune system in an ad for Shiff vitamins.  Not very glamorous. )

Of course there were lots of ads for beautiful clothes, and shoes (I long to wear two matching shoes; high heels are yet a dream for the future…although mostly I would love to be wearing my tennis sneakers on the courts.)

Where would those clear unwrinkled skins, exotic eye lashes, lavish hair styles, luscious lips, and sassy finger and toe nails be without the beautiful bones holding everything up.

I was thinking that maybe to attain beautiful bones it just doesn’t take a lot of chemical research (certainly not like what it takes to have those exotic eye lashes.)

Here’s what the NIH has to say:

Get enough calcium and vitamin D in your diet at every age.

Be physically active.

Reduce hazards in your home that could increase your risk of falling and breaking bones.

Talk with your doctor about medicines you are taking that could weaken bones, like medicine for thyroid problems or arthritis. Also talk about ways to take medicines that are safe for bones. Discuss ways to protect bones while treating other problems.

Maintain a healthy weight. Being underweight raises the risk of fracture and bone loss.  (hmmmm here’s something those fashion models might need to know.)

Don’t smoke. Smoking can reduce bone mass and increase your risks for a broken bone.

Limit alcohol use. Heavy alcohol use reduces bone mass and increases your risk for broken bones.

Surgeon General’s Report on Bones

I thought it was interesting that it didn’t say anything about don’t do crazy stuff like skiing, playing tennis, skate boarding, bike riding,  bungie jumping, mountain climbing, running Marathons. Take it from me, done a lot of those things and never broke a bone.

Most of these recommendations are pretty easy for us here in the United States, but may be more difficult in developing countries.  In some countries dairy products are either expensive, difficult to acquire or in places like India and Nepal not a dietary desire.  When I was planning my trip to Nepal, I asked the Director at the US Embassy what he might like for me to bring him from home.  He didn’t hesitate for a nano second:  “Cheese.  Please bring me cheese. “ And it was true there was no cheese in Nepal.  There are other ways of getting calcium.  It is in those green leafy vegetables, nuts, herbs, soy and seeds (including, yes, Amaranth!!!!!)  But 4 cups a day of that zero fat milk will give you 100% vitamin D, 120% of your calcium, at only 360 calories.

So get your exercise, don’t smoke or drink too much, definitely don’t be underweight, be careful at home, and get your calcium and vitamin D.

But here is something a little tricky and it’s about the vitamin D.  Would you ever think that being out in the sun without sunscreen and eating sausages would be good for you.  Seems a little counter intuitive.  And yet one of the most important ways we get our vitamin D is why it is called the “sunshine vitamin.”   Yes, we get it from sunshine.  It’s also in some things we might find kind of odd:  Cod Liver Oil (ick!:) Fish (yum;) Fortified Cereals (think Cocoa Krispies;) Oysters (sexy;) Fortified Soy (meh!) Eggs (: ) Mushrooms (exotic;) Fortified Dairy (there’s that milk again:) and!!!!!! Salami, Ham, Sausage (get down and make yourself a good hoagie!)

As we know, sunshine is much maligned and for some good reasons like skin cancer.  But we do need some.  An editorial in the Indian Journal of Medical Research by Sarath Gopalan and Prema Ramachanandran (March, 2008) states:

Adequate exposure to sunlight can provide

sufficient vitamin D to children and adults. It is therefore

imperative that nutrition and health education to

improve exposure to sun gets due attention. These

efforts will also result in increase in physical activity

(play in schools and walks for adults) which will reduce

risk of overnutrition and associated risk of non

communicable diseases and improve muscle and bone


The article also notes that the preference for light skin in Indian and Asian cultures can keep people particularly women out of the sun, increasing the possibility of vitamin D deficiency.

If you want to read the whole (very interesting) article here’s the link:

So these are just some ideas about bone health.  Mostly, we all need to think about our bones more, love them, honor them, respect them.  I have been assured that my right ankle will once again be strong.  I will walk (without crutches,) swim, run, dance, balance, pick up and cradle babies, wrestle with my grandchildren.  I will climb mountains again.

And for this I have many people to thank:  My daughter Kierra who rescued me from Newark Airport and the hospital and nurtured, fed me and kept me smiling; my daughter Alex who will stay with me next week and get me off to my new job, I am sure with her typical sweetness; my grandchildren Nico and Sonoma who love me even in a cast; daughter Kristin who has cheered from the sidelines; Lauren who was able to make me laugh even when I was about to be wheeled into the hospital for surgery; Julie who kept me calm and brought me sushi the night before; Pat who is adopting me for (hopefully) almost the last of my days on crutches; Deb, Purna, Carol, Rochelle, Dan, Jon, Terry who have kept me company; Enrique who is always an Epic; and San Diego Steve who was there.

I am thankful to the health professionals at Englewood Medical Center and Englewood Orthopedics who are the finest and kindest I have ever known in any health facilities; Dr. Perlman who put me to sleep (and made sure I woke up;) and Dr. Adam Becker of Englewood Orthopedics who expertly put my lovely fibula back together (and called me “Princess” when I was wearing a shower cap, hospital gown and my glasses.  Sometimes it’s the little things that get us through.)

To all of the above, who have truly healed me, bones and soul, and to all of you, I raise a glass of Zero Percent Over the Moon Milk in a toast:

“To Our Beautiful Bones.”


Empty Chairs and Empty Tables

I have been looking forward to the release on Christmas Day of Les Miserables, the movie.  I loved the play and all those revivals of accumulated casts typically televised on PBS for fund raising events, with Colm Wilkinson in the lead.  For years I listened to the CD in my car, usually singing along, plaintively vocalizing the sad song of Fontine, or the righteous ballad of Javert, or belting out “Can you hear the people sing, singing the songs of angry men….,” harkening back to the passion of my old college Viet Nam War protests.

So on New Years night, I decided it was an auspicious moment to take myself to the movies and just allow myself to wallow in the music and the drama, the protests and love and tragedies, the Les Miz Experience.  I was in total swoony love with Hugh Jackman as Jean Valjean.  I was worried about Russell Crowe who looked terrified every time he had to sing.  Amanda Seyfried was a little annoying with her high pitched squeaky voice.  And Anne Hathaway sang her heartwrenching song in a performance that The New Yorker movie review noted she would probably parody herself in on Saturday Night Live.  But I overrode these little criticisms, and was completely engaged in the lavish sets and costumes and, of course, the music.  When Eddie Redmayne sang the beautiful “Empty Chairs and Empty Tables” I was totally entranced.

So entranced was I during his passionate rendition of the song Marius sings after his friends have died in the battle on the barricade, that I didn’t realize until the elderly man sitting next to me handed me a handkerchief (a real cloth handkerchief, not a tissue) that I was quietly sobbing.  For me, the singer was not an idealistic university student during the French Revolution, he was a little boy in an elementary school in Connecticut.  “There’s a grief that can’t be spoken, there’s a pain goes on and on, empty chairs and empty tables, now my friends are gone.”  Empty desks, empty cubbies, empty playground swings and empty monkey bars.

I have found during the past few weeks since December 14, 2012, that the grief has not been spoken; it is too tragic, too horrible and too frightening.   We had all talked ad infinitum about Super Storm Sandy, the deaths, destruction, unpreparedness, power outages, Global Warming, subways under water, boats in the streets.   But in various social settings, in conversations with friends or colleagues, I found no one wanted to bring up the deaths in Connecticut.  I talked to my daughters, desperate to assure them how much I loved them, wanting to be sure I could console them.  Our ritual “I love you”s at the end of every phone call, xoxoxo’s at the end of every email took on deeper meanings as I thought of the last goodbyes of so many parents and their children.  But most of my grief was silent, unspoken.

I wanted to call my friend and colleague Teri Covington, Director of the National Center for  Child Death Review.  We had worked together on the review of child deaths in Nevada, a public health initiative to analyze each death and the circumstances, to make recommendations, to prevent future deaths, to “Keeping Kids Alive” as the Center’s tag line reads.  But what was the analysis of these child deaths?  It was all too simple:  innocent children, a violently disturbed young man, semi automatic fire arms.

“Oh, my friends, my friends don’t ask me what your sacrifice was for.

Empty chairs and empty tables.”

I didn’t call.  I quietly grieved.

On the website,, sponsored by Elizabeth Kubler-Ross, the phrase Public Grief is used and explained.   It is that pervasive grief that impacts an entire population:  the aftermath of 9/11, the massacres in Rwanda, the killings at Columbine, the shootings and deaths in a movie theater in Colorado, Gabrielle Giffords shot and members of her staff and constituency dead.  Through the media or direct contact with those affected, we are all affected.  Public grief is like any other public health epidemic, it ravages our bodies and emotions, impacts on our abilities to function, disrupts sleep and eating, it causes literal heartbreak.  But there is no typical arc of a disease outbreak.   And, there is no vaccine to prevent the damage, or surgery to correct, or medicine to treat.  The outcomes are as varied as each individual’s fingerprints.  Some will be energized to enact changes in laws or policies.  Some will sink into deep depression.  Some will reach out to the victims with love and tokens and memorials.  Some will find an artistic expression.  Some will provide counseling; some will receive it.  Some will advocate for teachers and school personnel to have guns.  Some will seem unaffected and will suffer emotional pain in years to come.  Some will advocate for the mentally ill and the disabled so that these do not become labels of fear or mistrust.  Some will grieve and join together with others and heal.  Some will quietly privately grieve. The pain goes on and on in a myriad of ways.

But I wonder what is grief? One definition is:  grief is a profound emotional process with very real biological symptoms that can endure for months.  But there is disagreement as to whether or not it is a “disease.”  The argument continues in regard to grief’s inclusion in the 2013 DSM:

Is grief a disease? That is one of the crucial questions psychologists are asking as the American Psychiatric Association revamps its Diagnostic and Statistical Manual of Mental Disorders (DSM), used by millions of mental health professionals to diagnose patients, for a fifth edition due out in 2013.

A group of psychiatrists have spearheaded a movement to include ongoing grief as a disorder, to be labeled “complicated” or “prolonged grief.” Others have proposed, separately, that a mourner can be labeled clinically depressed only two weeks after the loss of a loved one. The problem with both potential changes is that more people’s grief will be diagnosed as abnormal or extreme, in a culture that already leads mourners to feel they need to just “get over it”. (

The psychiatrists and psychologists can argue on, but I don’t know, is grief a disease? An epidemic? A private emotional struggle?  I am not sure this research helped me at all to know what grief is, I only know how it feels.  But I do know what grief is not.  It is not despair.  It is not revenge.  It is not blame.  It is not a justification for violence.

I don’t know how it is that someone who suffered such a great loss could also give all of us a great gift.  It is as though the person with the most extreme pain is also the person able to provide a healing process for the rest of the population.  Robbie Parker, Emilie Parker’s father, was able to speak of grief, his grief, his family’s grief, the grief we all feel.  He spoke of his daughter’s beauty and generosity of spirit. He spoke of kindness, humility and compassion, and the inspiration for us to love each other.  He gave us a very public message from his own heart to help all of us begin to heal from our public grief and our own private broken hearts.  And as I think of his words I am reminded of a card I keep on my desk that says:

“…I swear I will not dishonor my soul with hatred, but offer myself humbly as a guardian of nature, as a healer of misery, as a messenger of wonder, as an architect of peace….”*

The chairs and tables will remain empty forever.  All we can do as we grieve is to try to be architects building a kinder, more compassionate, more loving world around them.

And to never forget to tell our children how much we love them.




*from a poem by Diane Ackerman; cards and posters produced by and available from Syracuse Cultural Workers, Box 6367, Syracuse, NY   13217



A Beautiful Day in the Neighborhood

“When I say it’s you I like, I’m talking about that part of you that knows that life is far more than anything you can ever see or hear or touch. That deep part of you that allows you to stand for those things without which humankind cannot survive. Love that conquers hate, peace that rises triumphant over war, and justice that proves more powerful than greed.”

It was not a beautiful day in the neighborhood.  The river swelled with rain, the high tide and the pull of the full moon which was obscured by the storm clouds. The wind blew houses apart, ripped out electrical wires, knocked down trees and set violent waves into motion.  On the streets of my little village, the storm left hundreds of people along the river and creek with water and mud in their basements, their living rooms, bedrooms and kitchens.  Some homes were missing entire walls. Docks were washed away.  Boats were in the streets and crushed into houses.  Without electricity the village was dark and people we had always welcomed as tourists became voyeurs to the devastation and some sadly came back under the cover of the darkness to take advantage of exposed boats and homes that still contained valuables.  We had a curfew in our little village.

As the days went on and communication was slowly restored we all became more and more aware of the assault on our larger neighborhood, other towns and villages where our family and friends live. Jersey City where two of my daughters live, Hoboken, the Jersey Shore with shocking pictures of homes washed out to sea and the roller coaster mangled and submerged.  Staten Island devastated; a woman walking around rubble where her house once was.  Battery Park under water and much of Manhattan at a standstill: a New York Moment became a long continuum of slow dark nights and days of daunting challenges of finding food, drinking water, housing and comfort.  There were deaths from falling trees, isolation, flooding.

Here in our little village we gathered last Thursday morning at the Village Hall for instructions, information and opportunities to help each other.  Our Mayor Chris Sanders said, “We didn’t lose anything of value; we lost stuff.  No one died.  We can replace the stuff but we can’t replace a life.”  “Life is far more than anything you can see or hear or touch.”  He didn’t say that, but it was the message in his message.

And the villagers joined together to help with the stuff.  Crews bulldozing the streets, neighbors helping neighbors pump water and clean sludge out of their homes, the Fire House serving as a temporary shelter.  I was fortunate.  I got to help just by doing something I love, cooking big pots of soup for people staying at the Fire House and the volunteers.  I also had the opportunity to just listen to some people who just needed to talk.   It was hard to listen knowing that I couldn’t fix anything that these women needed help with. I didn’t have answers, but I think there were people like Judy and Jackie and Helen and Sue who just needed someone to listen to their questions.  Like, “Can I ever go back to my house on the river?”  I thought of Atul Gawande’s book Better citing one of the five ways to change the world as listening.   I just tried to quiet myself down and truly listen.

There were all the public health issues of contaminated water and requirements of boiling drinking water, of wearing protective clothing in water that contained sewage and chemicals.  Concerns about food spoilage and gastrointestinal infections.   And the importance of safeguarding against stepping into water that had electrical wires concealed beneath the surface.  Although not too many homes in our village have garages I reminded people to not sit in a closed garage running their car to charge their cell phones.

In the midst of this I received an email from my daughter Kierra who had gotten information from my grandchildren’s Montessori School about what to tell kids about all the damage and devastation.  So often in the crisis and busyness of trying to cope and clean up and take care of and rebuild we forget that kids can’t understand what happened not just to them, but to others in the big neighborhood.  The email referenced a quote for parents, really any grown ups,to help children during a crisis in their own home, in the village, in the big neighborhood.

“When I was a boy and I would see scary things in the news, my mother would say to me, “Look for the helpers. You will always find people who are helping.”  Fred Rogers

Those of us who are of a certain age and our children remember watching Mr. Rogers’ Neighborhood which was on PBS for more than 30 years from 1968 to 2001.  It was in fact always a beautiful day in the neighborhood as Mr. Rogers slipped into his zip-up sweater and sneakers.  Although Mr. Rogers’ Neighborhood was a little cardboard town, he gave kids and all of us who watched the understanding of the big neighborhood and our responsibilities for each other.  He helped us all understand, “That deep part of you that allows you to stand for those things without which humankind cannot survive. Love that conquers hate, peace that rises triumphant over war, and justice that proves more powerful than greed.”   And helpers that put the neighborhood back together after a superstorm that devastated homes and businesses and people’s lives.

As I look at the newspapers and the TV reports, at the online pictures of the damage left by the violent winds and surging water, I keep looking for the helpers and I keep reminding everyone I know, big and little that there are always helpers.  I don’t mean this in any way to be flippant.  The damage is real in real neighborhoods, not the little 1960’s cardboard TV set.  Precious irreplaceable lives have been lost and it will take a long time and immeasurable resources to fix and repair and replace the stuff.   But the messages that Mr. Rogers left for us are real, too, and I believe that these messages help us as helpers and as those who need so very much to be helped.

The Marathoners ran to Staten Island with rakes and shovels and bottled water. My friend Linda Burnside in Winnipeg ran her own fund raising  “Run Anyway.”  On the news last night there was the report of a man from Texas who drove to Long Island with supplies and food.  There was a fund raising concert last Friday night with Sting and Springsteen and Christina Aguilera supporting the Red Cross.   Senator Kirsten Gillibrand and Congresswoman Nita Lowey came to our village.  The Salvation Army was here in Piermont, so were our DPW, Fire Fighters, Women’s Auxiliary, Police Force and our inspiring Mayor Chris Sanders.   The helpers are everywhere on this beautiful day in the neighborhood.  They are us.

(And by the way, “I have always wanted to have a neighbor just like you, I have always wanted to live in a neighborhood with you.”)

► 1:28

Fred Rogers > Quotes

“Anyone who does anything to help a child in his life is a hero to me. ”

“Love isn’t a state of perfect caring. It is an active noun like struggle. To love someone is to strive to accept that person exactly the way he or she is, right here and now.”

“If you could only sense how important you are to the lives of those you meet; how important you can be to the people you may never even dream of. There is something of yourself that you leave at every meeting with another person.”

“Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone.”

“Forgiveness is a strange thing. It can sometimes be easier to forgive our enemies than our friends. It can be hardest of all to forgive people we love. Like all of life’s important coping skills, the ability to forgive and the capacity to let go of resentments most likely take root very early in our lives.”

“When I was a boy and I would see scary things in the news, my mother would say to me, “Look for the helpers. You will always find people who are helping.”

“We live in a world in which we need to share responsibility. It’s easy to say “It’s not my child, not my community, not my world, not my problem.” Then there are those who see the need and respond. I consider those people my heroes.”

“You rarely have time for everything you want in this life, so you need to make choices. And hopefully your choices can come from a deep sense of who you are. ”

“Often when you think you’re at the end of something, you’re at the beginning of something else.”

“Mutual caring relationships require kindness and patience, tolerance, optimism, joy in the other’s achievements, confidence in oneself, and the ability to give without undue thought of gain.”

“Love and trust, in the space between what’s said and what’s heard in our life, can make all the difference in the world. ”

“The greatest gift you ever give is your honest self.”

“In times of stress, the best thing we can do for each other is to listen with our ears and our hearts and to be assured that our questions are just as important as our answers.”

“Whether we’re a preschooler or a young teen, a graduating college senior or a retired person, we human beings all want to know that we’re acceptable, that our being alive somehow makes a difference in the lives of others.”

“Who we are in the present includes who we were in the past.”

“I hope you’re proud of yourself for the times you’ve said “yes,” when all it meant was extra work for you and was seemingly helpful only to someone else.”

“The thing I remember best about successful people I’ve met all through the years is their obvious delight in what they’re doing and it seems to have very little to do with worldly success. They just love what they’re doing, and they love it in front of others.”

“We need to help people to discover the true meaning of love. Love is generally confused with dependence. Those of us who have grown in true love know that we can love only in proportion to our capacity for independence.”

“The child is in me still and sometimes not so still.”

“Discovering the truth about ourselves is a lifetime’s work, but it’s worth the effort.”

“It’s very dramatic when two people come together to work something out. It’s easy to take a gun and annihilate your opposition, but what is really exciting to me is to see people with differing views come together and finally respect each other.”

“The connections we make in the course of a life–maybe that’s what heaven is.”

“Little by little we human beings are confronted with situations that give us more and more clues that we are not perfect. ”

“It’s not the honors and the prizes and the fancy outsides of life which ultimately nourish our souls. It’s the knowing that we can be trusted, that we never have to fear the truth, that the bedrock of our very being is good stuff.”

“I’m proud of you for the times you came in second, or third, or fourth, but what you did was the best you have ever done”

“When we treat children’s play as seriously as it deserves, we are helping them feel the joy that’s to be found in the creative spirit. It’s the things we play with and the people who help us play that make a great difference in our lives.”

“In the external scheme of things, shining moments are as brief as the twinkling of an eye, yet such twinklings are what eternity is made of — moments when we human beings can say “I love you,” “I’m proud of you,” “I forgive you,” “I’m grateful for you.” That’s what eternity is made of: invisible imperishable good stuff.”

“At the center of the Universe is a loving heart that continues to beat and that wants the best for every person. Anything that we can do to help foster the intellect and spirit and emotional growth of our fellow human beings, that is our job. Those of us who have this particular vision us to continue against all odds. Life is for service.”

“Whatever we choose to imagine can be as private as we want it to be. Nobody knows what you’re thinking or feeling unless you share it.”

“The world needs a sense of worth, and it will achieve it only by its people feeling that they are worthwhile.”

“What’s been important in my understanding of myself and others is the fact that each one of us is so much more than any one thing. A sick child is much more than his or her sickness.
A person with a disability is much, much more than a handicap. A pediatrician is more than a medical doctor. You’re MUCH more than your job description or your age or your income or your output.”

“Peace means far more than the opposite of war.”

“Knowing that we can be loved exactly as we are gives us all the best opportunity for growing into the healthiest of people.”

“There is no normal life that is free of pain. It’s the very wrestling with our problems that can be the impetus for our growth.”

“There are three ways to ultimate success:
The first way is to be kind.
The second way is to be kind.
The third way is to be kind.”

“I don’t think anyone can grow unless he’s loved exactly as he is now, appreciated for what he is rather than what he will be.” “Try your best to make goodness attractive. That’s one of the toughest assignments you’ll ever be given.”

“How great it is when we come to know that times of disappointment can be followed by joy; that guilt over falling short of our ideals can be replaced by pride in doing all that we can; and that anger can be channeled into creative achievements… and into dreams that we can make come true.”

“A young apprentice applied to a master carpenter for a job. The older man asked him, “Do you know your trade?” “Yes, sir!” the young man replied proudly. “Have you ever made a mistake?” the older man inquired. “No, sir!” the young man answered, feeling certain he would get the job. “Then there’s no way I’m going to hire you,” said the master carpenter, “because when you make one, you won’t know how to fix it.”

“I believe that appreciation is a holy thing–that when we look for what’s best in a person we happen to be with at the moment, we’re doing what God does all the time. So in loving and appreciating our neighbor, we’re participating in something sacred.”

“There was a story going around about the Special Olympics. For the hundred-yard dash, there were nine contestants, all of them so-called physically or mentally disabled. All nine of them assembled at the starting line and, at the sound of the gun, they took off. But one little boy didn’t get very far. He stumbled and fell and hurt his knee and began to cry. The other eight children heard the boy crying. They slowed down, turned around, and ran back to him–every one of them ran back to him. The little boy got up, and he and the rest of the runners linked their arms together and joyfully walked to the finish line.
They all finished the race at the same time. and when they did, everyone in the stadium stood up and clapped and whistled and cheered for a long, long time. And you know why? Because deep down we know that what matters in this life is more than winning for ourselves. What really matters is helping others win, too, even if it means slowing down and changing our course now and then.”

“It’s really easy to fall into the trap of believing that what we do is more important than what we are. Of course, it’s the opposite that’s true: What we are ultimately determines what we do!”

“It’s a beautiful day in this neighborhood,
A beautiful day for a neighbor.
Would you be mine?
Could you be mine?…

It’s a neighborly day in this beauty wood,
A neighborly day for a beauty.
Would you be mine?
Could you be mine?…

I’ve always wanted to have a neighbor just like you.
I’ve always wanted to live in a neighborhood with you.

So, let’s make the most of this beautiful day.
Since we’re together we might as well say:
Would you be mine?
Could you be mine?
Won’t you be my neighbor?

Won’t you please,
Won’t you please?
Please won’t you be my neighbor?”

Healing: knit one, purl one, knit one, purl one

I have a scar on my right cheek.  It’s this little crescent shape that I have thought of  as a moon or a smile.  I have had it for as long as I can remember because it is from a sharp piece of metal on a doll stroller I got for Christmas when I was about a year and a half old.  (Yes, toys back then before the proliferation of plastics were made of materials like metal.)  I apparently fell and tumbled into the stroller and the little sharp edge near a wheel sliced into my cheek.  Apparently there was much crying, probably more my parents  than me.  My cheek bled, healed and formed my little moon-shaped scar.

I have a few other scars that I am fond of because they bring back memories of my past.  There is one on the inside of my left knee from a buckle on a flipper a friend, Jim Winkler, was wearing when we were swimming at West Meadow Beach and he kicked past me.  All I felt was a little stab and then the blood rose to the surface… my blood.  Fortunately this was Long Island Sound, not the warm Pacific so a shark feeding frenzy did not ensue.

I have a scar on my right knee from a biking accident a few years ago when I was riding from Piermont toward Nyack and hit some gravel.   I got home and realized I didn’t have a Band-aid  anywhere in my house.  I was sitting out in my yard sopping up the blood with towel when my neighbor Dan  (who you have met before in these blogs) came out of his house.  “Dan,” I said in a particularly plaintive voice, “do you happen to have a Band-aid.”  Actually he had quite the Band-aid.  The kind that is akin to the body wraps now used for battle wounds.  A tight plastic seal impregnated with antiseptic.  The wound is sealed up and mends like magic.  That knee boo boo makes me think of a warm beginning of summer day and a good neighbor.

I have a scar on the top of my right foot where a very fashionable shoe bored a hole in my skin while I was walking from meeting to meeting in New York City on a hot summer day.  (Hint always have a pair of flip flops or sneakers hidden somewhere in your briefcase for these dangerous situations.)  The bloody wound transformed into a lovely silvery oval that I think looks quite sparkly as it peeks through the lacings of elegant sandals.

And there is a quite newly acquired scar on the back of my left hand.  This summer as my friend Julie and I were launching her lovely little sail boat, a West Wight Potter, the boat glided too close to the dock.  In some deranged super hero moment I thought sticking my hand between the dock and the bow would prevent damage to both; of course it was my hand that was painfully sandwiched and immediately blew up like an inflated surgical glove and oozed scarlet.  Julie handily took control of the boat and I dashed up to the boat house and stole (yes, I did not pay for, I totally ripped off) a big bag of ice and buried my hand in it.  I have a pretty high pain threshold so as long as I don’t have to actually look at my own gushing blood and other physical damage, I can be quite functional.  I joined Julie on the boat, we navigated out of the Nyack Boat Club basin, past the moorings and channel markers and sailed the Hudson.  It was beautiful.  Really there is nothing like sailing, especially with a good friend.  From time to time I pulled my hand out of the bag of ice and over the next couple of hours the swelling decreased, my hand, somewhat blue, was in fact totally functional and the bleeding slowed and the blood began to congeal.  The scar now looks like a little butterfly, perhaps a Monarch gliding over the Hudson River enjoying the summer breezes before setting off for Mexico.

It’s kind of a miraculous thing the way our bodies heal.  Miraculous, mystical, magical.  And what is amazing is that this healing is real, it’s scientific, it’s physiological.  Look up healing on the internet and you will get a barrage of spiritual healing, healing stones, healing scriptures, sexual healing, healing your heart, healing hands, the one simple thing to do every morning to heal your prostate, aroma therapy healing, Kundalini healing.  Everybody’s into some kind of healing which is a good thing.   But I love the plain ordinary physical putting little pieces of your body back together healing.  Here’s the process, it’s about three steps of somewhat complicated bio chemistry.

!.  The inflammatory stage (like ouch!!!!) immediately after  the injury.  Clotting takes place to stop the blood loss and various factors are released into the cells to protect from infection.

2.  The proliferation stage.  This is more complicated because this is where the mending takes place.  Collagen starts to form, and new capillaries are produced.  The wound edges are pulled together and then the cells start reproducing to regrow the loss of flesh.  Amazing that they know how to do this.

3.  The remodeling stage.  Collagen fills in the gaps and a scar forms.  This is also known as cicatrisation….scar tissue is cicatrix which I have always thought is a pretty cool word.

I have been a knitter for a long time.  Friends and family have gotten scarves and sweaters.  A sweater vest with Reindeer.  Last year for Christmas I knit everyone in my family a scarf in their favorite color.  I love knitting because you can take this long yarn which really is pretty useless and turn it into something useful, something that will keep someone warm, something comforting.  And I like that repetitive knit, knit, knit, maybe a knit, purl, knit, purl seed stitch.  It’s meditative.  And I think it is like healing.

When I was about 15, I had a very intellectual boyfriend named Richard McDonough.  For my birthday he gave me a book of John Updike poems called Telephone Poles and Other Poems.   I had that book up until about 5 years ago when getting divorced, moving, packing and the various painful activities involved therein, many of my books including that little volume of poetry disappeared.  I think the birthday card that Richard gave me was still in the book.  Sad.  But of course the wonders of the internet are that one can track almost anything down.  No, not the exact book that was mine, but another copy.  I clicked on the “Buy With One Click” button on Amazon and a few days later there in my mail box was Telephone Poles, its worn cover like a dear old friend.  The price on the jacket flap is $4.00 and the back sports a photo of a very young John Updike on a beach.   As I perused the poems, “The Great Scarf of Birds,”  “Winter Ocean,” “Wash,” the words and syntax brought back feelings and memories of long, long ago, a time when I had far fewer scars for better or for worse.

I came across a poem I had always particularly loved, “Seven Stanzas at Easter.”  Updike writing of the Resurrection wrote:

If the cells’ dissolution did not reverse,

molecules reknit, the amino acids rekindle,

the Church will fall.

The healing miracle was very physical.  It was like knitting.

When I get hurt, I like to think of healing as my cells, my molecules, my amino acids miraculously knitting themselves together, cozy, homey and very domestic like a winter evening in front of a fireplace, making something physical, warm, comforting.

By Any Other Name: A Life Well Lived

The devastating epidemic that claimed the lives of 100,000,000 people globally and at least 600,000 in the United States caused the death of her young father, the family support and breadwinner when she was only 3 years old.  She was sent to live with her grandparents. Her sister died when she was about 5, from what was thought to be a heart condition, although diagnostics were limited then.  Children often died and the cause was a sad guess. The separation from her mother and two other sisters was emotionally difficult for her, but under the financial circumstances in the family and nationally, her mother knew it was her best opportunity.  Her grandparents had a small grocery store so no matter how limited their income was there was always nutritious food, for her, her family and the local community, her grandparents often taking a parrot, a zither, a paper IOU as payment from neighbors for their groceries.

She was told at some point in her adolescence that she might not be able to have children, and yet she married  and had three daughters.  She had a heart attack.  There was a diagnosis of breast cancer, a breast removed, chemotherapy.  A broken hip.  A thyroid condition.  Upper respiratory infections.  The long slow decline of Alzheimers.

My mother, Rose, died last week at the age of 96.  Despite the health and financial challenges, she thrived for most of those 96 years.  Last August my youngest daughter, Alex, and I visited her at the nursing home she lived in for about 5 years.  She was bright and happy to see us although at some point during the last few years I had realized that she might not really remember my name or which one of the daughters I was.  But she was all smiles and hugs that day, and she loved that we were there with her.  She particularly loved the granddaughters.  Once about 4 years ago, she was rushed to the hospital barely conscious.  My daughter Kierra and I met my sister in the emergency room and standing at her bedside we all believed that my mother was about to die.  Concerned that she might, even in that state, be thirsty, Kierra dripped some juice from a straw onto her lips.  She licked her lips and as the juice ran into her mouth she swallowed.  Her eyelids fluttered open and she smiled at Kierra.  “What are you all doing here, Sweetheart?” she asked.

Fortunate to have had her for so long and to have been able to spend her last two days of life with her, I am still grieving, but I also can’t help but wonder what it was that contributed to her long life.  My father died in 2001 at the age of 86 from a heart attack.  Most of my parents’ friends have died.

When I think about the generally accepted contributors to health, exercise, good nutrition, and keeping mentally active, I wonder how these affected my mother’s life.  She was always active gardening, cleaning, taking us kids to the beach, helping at the church, but she never went to a gym, never ran, never wore spandex.  Even at the beach she wasn’t a swimmer.  She and my father though would take walks around the neighborhood, holding hands.  And nutrition, well, she was an amazing cook and in the summer months was always gathering fresh fruits and veggies and then canning and freezing them to get us through the winter with those summer vitamins.  But, there was lots of meat (red and otherwise) in our diets:  Sunday roast beef, pork and dumplings and sauerkraut, fried chicken, bacon and eggs for breakfasts.  I remember that when I was in elementary school, the other little girls had these darling little sandwiches made of cream cheese, and peanut butter and jelly, maybe tuna salad, cute sandwiches with the crusts cut off.  I however, would remove from my lunch box, big hunks of homemade bread with a fried veal cutlet or slabs of leftover Sunday roast beef.  And by the way cutting off crust was considered totally wasteful and my parents subscribed to the philosophy that  eating “crusts makes you pretty.”  And of course there were not only the sandwiches… lunch box consistently contained a big slice of homemade lemon cake (with frosting) or apple strudel or a poppy seed pastry or chocolate chip cookies.  Well into my parents’ late 80’s, my mother was known as the “Cookie Lady” in their neighborhood because rather than giving kids’ candy bars for Halloween, she baked cookies that she and my father put in little baggies with ribbons to give out to the costumed callers.  They were renowned at their church for making literally hundreds of donuts (fried in hot oil of course!) for the Fastnacht celebrations every year the night before Ash Wednesday.  For all of this, neither of my parents were ever overweight, nor are or were any of their off-spring.

So exercise and nutrition in my mother’s life were not exactly by the public health book.  Keeping mentally active was.  When I was in high school, my mother, who was a very good student in high school but never went to (as if it would ever even have been thought of) college, became the assistant for a well-known sociologist in Stony Brook.  She took over his academic life as a gentle whirlwind, organizing his books, redeeming royalty checks that were long expired, editing his manuscripts, negotiating with publishers and handling all of his correspondence and travel plans.  Long after Dr. Nelson died in his sleep on a train in Italy, my mother continued to read academic articles and edited my sister’s doctoral dissertation and my masters thesis.  But that wasn’t all.  She sewed.  No, she didn’t just sew, she was the mastermind of three daughters’ and her own wardrobes.  Months before Easter Sunday, we would all make a pilgrimage to various fabric stores where we would study pattern books for the latest fashions, hunt through bolts and bolts of fabrics, and ferret out the best notions:  little fabric frogs, buttons, lacey trims.  And then over weeks my mother would work her magic with pins and those thin paper patterns and hours and hours at the sewing machine.  And those, long  “hold still!!!!” sessions of her pinning up the hems and adjusting waistlines, shoulder seams and zippers.  She knit us sweaters and scarves and  crocheted a dress for me that I still have.  She made millions of little craft items and baby sweaters and booties, and cloth dolls for church fairs.  When the grandchildren she adored came to visit she taught them how to make little Christmas mice, pot holders and seashell jewelry.  She always had the best craft supplies. My daughter Kristin loved those little Grandma mice.

So what else?  Certainly the literature supports the association of a long stable relationship with health.  Rose and Charlie were together in a loving mutually supportive marriage for almost 70 years.  My mother had a very strong network of family support, neighbors and church members:  a social support being a strong indicator of health.  My father worked for Grumman Aircraft and so we all had good healthcare benefits:  I actually remember as a child when my parents thought I might have polio, the doctor coming to our house with his little black bag.

And then there was my parents’ consumption of coffee, the health benefits now well documented.  From the Harvard Review: In 2011, researchers reported findings that coffee drinking is associated with a lower risk of depression among women, a lower risk of lethal prostate cancer among men, and a lower risk of stroke among men and women. Go back a little further, and you’ll come across reports of possible (it’s not a done deal) protective effects against everything from Parkinson’s disease to diabetes to some types of cancer

And this in the Daily Beast:  A new study suggests that drinking coffee significantly reduces our skin-cancer risk. There’s a raft of other research that’s piling up evidence that regular cups of joe—six-ounce servings packed with antioxidants, polyphenols, and other health-boosting chemicals—can prevent everything from diabetes to depression to cirrhosis of the liver to stroke. (Intracranial aneurysms, not so much.) Scared of superbugs? Pour yourself another cup.

My parents didn’t know any of this and perhaps all the coffee health benefits were outweighed by my mother’s yummy buttery pastries and cookies and cakes that went along with the caffeine and antioxidants, but I do believe that the two of them sharing coffee at breakfast, the mid morning coffee, coffee with lunch, the mid afternoon coffee break, coffee after dinner and the late evening coffee (usually accompanied by ice cream,) contributed to my mother’s long and happy life.  Maybe it was the conversations they had while they were drinking coffee or the plans they would make or the hand holding that went along with the coffee.

My mother was not a public health professional, she wasn’t a nurse or a doctor although I do truly believe that she saved my life several times when I was a child by making me yum yum, a combination of hot milk, honey and butter, in the middle of the night.  She wasn’t a great philanthropist with a foundation that put her name on some medical center building or library, and she wasn’t the author of any great books.  Her long loving life is however a testimony to a life well-lived and perhaps the greatest lesson we can learn about our own health and improving the quality of life in the world:  Love the people around you.  Be passionate about everything you do, especially those the small acts of kindness.  Make the world more beautiful in your own unique way.  Love children, grow roses, knit a scarf, bake cookies, smile at strangers, hold a hand, share a cup of coffee, change the world.

Rose’s Czech Peach Dumplings

This recipe makes 8 dumplings

In a glass measure, pour 1/2 cup milk. Add 2 large eggs and whisk together to blend.

In a large mixing bowl, measure 2 cups all purpose flour, 1 teaspoon baking powder and 1/4 teaspoon salt. Stir to mix. Make a well in the center of the dry ingredients and pour in the milk and egg mixture. Use a wooden spoon to mix well. Dough will begin to get stiff. If it is very sticky, add a little more flour. The dough should not be sticky, but should still be soft enough to roll into a sheet.

Divide the dough into 2 pieces. Roll out one piece at a time into a thin sheet and cut (with scissors) into 4 square pieces. Place a half of a peeled, pitted peach on each piece of dough, and add a small piece of butter, sprinkle with cinnamon and sugar.  Fold in the corners of the dough to cover the peach half.  Be sure the peach is sealed well in the dough. Repeat with the other piece of dough.  Sprinkle some flour on a clean surface. Set the peach dumplings on the flour and cover loosely with a clean kitchen towel. Bring a large covered pot of water to a boil.  When water is boiling hard, gently drop the dumplings into the pot. Put the cover on the pot. Set the timer for 20 minutes. Do not take the cover off the pot until the timer rings. Transfer each dumpling to a large dinner plate. Prepare to eat by cutting into small pieces. Pour melted butter over the dumpling. Sprinkle with more sugar and cinnamon. Eat. Enjoy!!!

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