growing

My son and daughter-in-law got married April 30th in Black Diamond, Washington. The young man in the photograph was the youngest in the house I rented. We had my two aunts: 81 and 86 years old, and my uncle, 85 years old. Me, my daughter, my two friends and their son. This young man and I took photographs. He taught me new things about my camera and on the last day ran a slide show from my laptop to the television. He helped all of us folks with technology and we really enjoyed having him there.

And I am delighted to hear that he told his parent that he wished we had one more day, all of us. Eight people in a household from Thursday to Monday and it went very well. Weddings always have some interesting glitches, but after putting off the wedding for two years due to covid, the bride and groom did not seem rattled by anything! My daughter-in-law is truly a delight.

Here is to the next generation, surviving this pandemic, sweeping up the pieces and growing, and thriving anyhow.

For the Ragtag Daily Prompt: children.

Covid-19: Good and Bad News

I am writing this on Christmas morning.

The good news is this: National Guard Empties Bedpans and Clips Toenails at Nursing Homes. “In Minnesota, an ambitious initiative is training hundreds of Guard members to become certified nursing assistants and relieve burned-out nursing home workers.” (1) Well, hooray, the National Guard is called out to help, because the nursing homes are out of staff and we aren’t supposed to abuse our elderly. I think this is AMAZING. And the National Guard may learn some things about work and the elderly too. Hoorah and Hooray!

The bad news is a snippet from New York State: Omicron is milder, BUT the exception may be children. (2) Child cases of Covid-19 are going up really fast and hospital admissions of children. ICU work is hard hard hard, but child and infant ICU is even harder. Blessings on the nurses who do this and the physicians too. When I did my pediatrics rotation way back in Richmond, VA, in a tertiary care hospital, I had children who were dying: one with a brain tumor, one with liver cancer, one with Wilm’s disease. Hard work. I chose Family Practice. I have still had pediatric patients die, including an 18 month old where I had taken care of mother through the pregnancy, but not terribly many. Even less in the last ten years since my average patient was about age 70. All of my kids in the last ten years were complicated: one with Down’s, another a leukemia survivor, others. Children can be very medically complicated. I had two adults who had survived infant heart surgery as well. They were set up with UW’s Adults who had Childhood Heart Surgery Clinic, though that is not the correct name. I am pretty happy to have that sort of back up only two hours away. They both had pretty awesome heart murmurs and that midline chest zipper scar. Ouch.

So, why post this on Christmas? If the cases are rising in children, maybe that will inspire some folks to get vaccinated or at least not yell at family who refuse to bring small children to an unvaccinated Christmas gathering. Judging by the posts on the doctor mom facebook group, there is quite a bit of family yelling going on. Stand down, folks, and respect other peoples’ boundaries.

The problem is, if enough children are sick, we run out of beds. And staff. “As of Thursday, there were 1,987 confirmed or suspected pediatric covid-19 patients hospitalized nationally, a 31 percent jump in 10 days, according to a Washington Post analysis.” (3)

Blessings.

1. https://www.nytimes.com/2021/12/22/health/covid-national-guard-nursing-homes.html?action=click&campaign_id=154&emc=edit_cb_20211223&instance_id=48593&module=RelatedLinks&nl=coronavirus-briefing&pgtype=Article®i_id=165651500&segment_id=77808&te=1&user_id=c97a1a8547f511fe3bd45b0806ed713c

2. https://www.nytimes.com/2021/11/23/us/covid-cases-children.html

3. https://www.washingtonpost.com/health/2021/12/24/omicron-children-hospitalizations-us/

Why care for addicts?

I posted this in November, 2015. I am reposting it.

_________________

Why care for addicts?

Children. If we do addiction medicine and help and treat addicts, we are helping children and their parents and our elderly patients’ children. We are helping families, and that is why I chose Family Practice as my specialty.

Stop thinking of addiction as the evil person who chooses to buy drugs instead of paying their bills. Instead, think of it as a disease where the drug takes over. Essentially, we have trouble with addicts because they lie about using drugs. But I think of it as the drug takes over: when the addict is out of control, the drug has control. The drug is not just lying to the doctor, the spouse, the parents, the family, the police: the drug is lying to the patient too.

The drug says: just a little. You feel so sick. You will feel so much better. Just a tiny bit and you can stop then. No one will know. You are smart. You can do it. You have control. You can just use a tiny bit, just today and then you can stop. They say they are helping you, but they aren’t. Look how horrible you feel! And you need to get the shopping done and you can’t because you are so sick…. just a little. I won’t hurt you. I am your best friend.

I think of drug and alcohol addiction as a loss of boundaries and a loss of control. I treat opiate overuse patients and I explain: you are here to be treated because you have lost your boundaries with this drug. Therefore it is my job to help you rebuild those boundaries. We both know that if the drug takes control, it will lie. So I have to do urine drug tests and hold you to your appointments and refuse to alter MY boundaries to help keep you safe. If the drug is taking over, I will have you come for more frequent visits. You have to keep your part of the contract: going to AA, to NA, to your treatment group, giving urine specimens. These things rebuild your internal boundaries. Meanwhile you and I and drug treatment are the external boundaries. If that fails, I will offer to help you go to inpatient treatment. Some people refuse and go back to the drug. I feel sad but I hope that they will have another chance. Some people die from the drug and are lost.

Addiction is a family illness. The loved one is controlled by the drug and lies. The family WANTS to believe their loved one and often the family “enables” by helping the loved one cover up the illness. Telling the boss that the loved one is sick, procuring them alcohol or giving them their pills, telling the children and the grandparents that everything is ok. Everything is NOT ok and the children are frightened. One parent behaves horribly when they are high or drunk and the other parent is anxious, distracted, stressed and denies the problem. Or BOTH are using and imagine if you are a child in that. Terror and confusion.

Children from addiction homes are more likely to be addicts themselves or marry addicts. They have grown up in confusing lonely dysfunction and exactly how are they supposed to learn to act “normally” or to heal themselves? The parents may have covered well enough that the community tells them how wonderful their father was or how charming their mother was at the funeral. What does the adult child say to that, if they have memories of terror and horror? The children learn to numb the feelings in order to survive the household and they learn to keep their mouths shut: it’s safer. It is very hard to unlearn as an adult.

I have people with opiate overuse syndrome who come to see me with their children. I have drawings by children that have a doctor and a nurse and the words “heroes” underneath and “thank you”. I  have had a young pregnant patient thank me for doing a urine drug screen as routine early in pregnancy. “My friend used meth the whole pregnancy and they never checked,” she said, “Now her baby is messed up.”

Addiction medicine is complicated because we think people should tell the truth. But it is a disease precisely because it’s the loss of control and loss of boundaries that cause the lying. We should be angry at the drug, not the person: love the person and help them change their behavior. We need to stop stigmatizing and demeaning addiction and help people. For them, for their families, for their children and for ourselves.

hold me

poem: hold me

hold me, Beloved

hold me
I long for you
to be reunited with you, Beloved

to return to you

it is the children who hold me

here

the children
my children, grown
the hope of grandchildren
the damaged children
the new and young children
the old children in adults
who are so sad

it is the children who hold me

here

sometimes I am so sad, Beloved
I long for you

I do and I don’t
long for you
to call me home
and hold me

I know
that you hold me, Beloved
every moment

even when I cannot feel your touch

I know, Beloved
you will call me home

and hold me
now and forever
in your infinite embrace

A house for our lives

I wonder why we don’t design houses for our lives.

A family house could have everything on the first floor, with a bedroom, wheelchair accessible, and a full bath. The stairs could have an entryway that can be closed off. Upstairs, a sitting room, a full bath, two bedrooms or three and a pocket kitchen. Laundry facilities need to be on the main floor, but they could be in a mud room/entry that is part of the entry to the stairs.

The basement, if there is one, could be for storage or for another apartment.

A couple could buy the house, raise kids in the whole thing, then downsize to the main floor, rent the upstairs, perhaps rent the basement.

My daughter and son want less stuff. Neither has the packrat gene from me and they want to be mobile and have cleaning be very easy and moving be easy. I feel guilty that I have a big house alone, but it is full of stuff that I am slowly decreasing. It has a daylight basement, but there is no bathroom down there nor kitchen and the laundry facilities are there. Also the plumbing is 4 inch across 2 foot concrete sections from the 1930s and runs under the slab poured inside the 1930s garage foundation. The garage is built to the neighbor’s line in back and five feet onto the lot in the middle of the block at the side, so I have two lots. If I take it down, I could not rebuild there because of codes. I think that to do the basement as an apartment I’d have to redo the plumbing first, which is daunting. Also renting is tricky. That is, getting someone out if it is not working can be a challenge.

Friends are looking for a four bedroom house. They have three children so that is what they need now. But the eldest is 14, so it will not be long at all until they need less house. I picture bedroom modules that can be detached.

Our town is very short on long term rentals because now people can make more with short term rentals to the tourists for the many festivals. This in turn is messing up the traffic and increasing accidents, because there are two two-lane roads into town. And a ferry. The people who work in the shops and restaurants are having to commute. People own a fifth house that they may visit only twice a year. It looks like it will get messier, though we may have another housing crash. Right now houses are going up.

My daughter has been designing her future tiny house for a while. The second entry is to a mud room with laundry facilities and a tile floor and a shower so that she can climb out of swimming or running or mountain biking or sailing gear and have a place to hang everything before she goes into the rest of the house. She will want to be able to clean herself and her gear.

My grandparents had a house on Topsail Island in North Carolina. There was an outdoor shower under part of the house, to wash the sand off before we were allowed upstairs. Then another hose to wash our feet once we were up on the deck. Sand and the smell of the ocean, all the time.

Friends have a four apartment building. They altered the two on the top floor to make one apartment. The lower two they rent, sometimes to family. There are four bedrooms on top and two in each apartment. They have a big kitchen and a pocket kitchen in the top section.

Some of my patients need tiny houses, a place alone, even though they also need social contact. I hate the big ostentatious show houses, especially the ones with the play room on a different floor, let’s relegate the children to a different part of the house. Then the elders can also be relegated.

I wish housing were more about need and practicality and less about money and status. And still, we are spoiled….

____________________________

written 8/2/2017

Songs to raise girls: Bessie the Drunkard’s own child

I am posting this from another site, originally posted November 2016. I am posting it because of a comment on a paper in my town about “homeless drug dealers”. It’s not the drug dealers that are homeless, it’s the addict. Ok, you can definitely have an addict dealer… But I worked hard to treat any kind of addiction, not only because of the patient, but also the family and especially the children. And every patient was a child once….

This is another temperance song that my mother taught me, learned from her father. Both of my mother’s grandfathers were Congregationalist Ministers in Iowa.

Out on the stormy night sadly I roam.
No one to love me, no dear pleasant home.
Dark is the night and the storm rages wild.
God pity Bessie, the drunkard’s own child.

Chorus:
Mother, O why did you leave me alone,
No one to love me, no dear pleasant home.
Dark is the night and the storm rages wild
God pity Bessie, the drunkard’s own child

We was so happy til father drinked rum.
Then all our trials and troubles begun.
Mother grew weary and wept every day.
Brother and I were too hungry to play.

Barefoot and hungry we wander all day
Looking for work, but “too small” they all say
On the damp ground to lay my head
Father’s a drunkard and Mother is dead.

Thus the two wandered, ’til one stormy night
Brother and sister both faded from sight
Then gazing at them, sadly I said
“Father’s a drunkard and Mother is dead.”

Cheerful, right? Again, I know the tune and only have the chorus memorized. My parents quit singing it in front of me so that I wouldn’t sing it at Show and Tell.

And small children shouldn’t hear this sort of thing, right? I don’t know. I learned an awful lot about the dark side of the world and danger from these songs. I found them helpful. I think they influenced me to be careful….

And think of the refugee children and children everywhere. This is still happening.

here: http://www.pdmusic.org/1800s/66fadamid.txt
and here: http://mudcat.org/thread.cfm?threadid=57166
The tune I learned is slightly different and darker than this: http://mudcat.org/@displaysong.cfm?SongID=6196
And some overlapping words with a different tune: https://www.youtube.com/watch?v=7ooDfYaH08E and https://www.youtube.com/watch?v=9KGiFkcxOus

The photograph is my maternal grandfather, F. Temple Burling, sitting on his grandfather’s lap. His grandfather was Morris Temple. My grandfather taught my mother this song and she taught me.

all blue

For the Ragtag Daily Prompt: chores.

I am not blue about chores. Not at all. I like chores. Being an independent stubborn woman, I don’t do them in the order or way that society currently seems to think we should do them. I do them in the order I think is important.

I was divorced in 2007, with a 14 year old and a 9 year old. My Ex promptly left town. He stayed in very close touch with the kids, calling about 5 out of 7 days, but did not see them for a year. I was working full time and had over night call.

My goal was that the kids would both know how to do lots of basic chores by the time they left home. Vacuum. Sweep. Clean the bathroom. Do laundry. Replace lightbulbs. Cook. Grocery shop. Plan a meal. Change a tire. Check the oil in each of our cars. We have a 1986 Honda Civic 5 speed, so include drive a clutch. Avoid debt and some basic money handling. Discuss insurance: car insurance, health insurance, others. I started turning over the responsibility for their own health care, dental, vision as well. I want them to know the family medical history and we discussed addictive substances and politics and justice. When my son was in college they asked for cell phones for Christmas. I asked them to research phones and a family plan and said, yes, I would do that. They did a great job bringing me the information. I wanted them to disagree with me as well. If they wanted to do something, they could argue their case and might convince me. I did not hire someone to do our household chores because running a household is work, honorable work, undervalued, and underappreciated. And expensive if you hire people to do all of it.

Both of my kids are much neater than me. Less packrat. At least, they are now… I think it’s a late expressing gene….

I took the photograph two days ago, on a walk in the evening. All blue.

water babies

For the Ragtag Daily Prompt: river.

Both of my kids are water babies, who love the water. The pictures are from 2005, my daughter and her cousin, loving the slip and slide. A home river and water. My daughter went on to seven years of synchronized swimming, four years of swim team and now is racing sailboats in college.

Slip and slide water joy
puddle joy

family fishing

For the Ragtag Daily Prompt: putrescent.

But it’s a family! Fishing! Our local five otter family, that I’ve seen before, pictures here and here. I can’t tell who is an adult and who is a child now, they are all pretty much the same size. They were swimming along and catching fish, heads tilted up to eat when they surfaced.

These are river otters, even though they are fishing in the Salish Sea. 

And why putrescent? Oh, they are delightful to watch, but they can leave some very putrescent gifts on the dock or in the boats….

speaking up 4

For the Ragtag Daily Prompt: sequelae. We don’t know what the sequelae to the Supreme Court vote is yet. But I am not going to stop speaking up and I hope more women speak up. And girls. So here are two experiences when I was a girl.

I start grade school in upstate New York. I am at the Northeast School. I don’t remember tons about it, except that it has ramps instead of stairs. I am failing to learn to read with phonics, which make no sense to me.

In first grade, I need to go to the bathroom. My teacher gives me a hall pass. This is not a kindergarten privilege.

Outside the girls’ bathroom are two boys. They are older than me. I don’t know them.

“You can’t go in unless you show us your underwear.”

I am wearing a dress. I stare at them.

“Show us your underwear.”

I go back around the corner and wait. Hoping they will leave. They don’t.

I need to go. I go and lift my skirt for a second, humiliation as they laugh. I hurry in to the bathroom.

I go back to the classroom.

I never go to the bathroom during class again. I am careful. I go before class starts and at lunch.

And I’ve never told anyone until now. And this was a grade school. How were the boys acculturated to behave this way already in grade school? And does this still go on? All the girls in my daughter’s school quit wearing skirts by second grade. Jeans only.

We move before fourth grade to another town.

The boundaries for the school districts change before sixth grade and I am bussed to a new grade school.

On the bus, a boy starts harassing me. I don’t know him.

“Show me your underwear.” he says. The other kids are watching.

I don’t answer, glare at him with scorn.

Each day he escalates.

“Show me your underwear.”

I pull a pair out of my bag the fourth day. “There. Now you’ve seen some.”

The other kids laugh, but it’s not enough. He keeps hassling me.

He starts reaching for my skirt from the seat in front of me.

I’ve had it. I play flute. But I also play piccolo.

The next day he starts up, “Show me your underwear.” He reaches towards my skirt from the seat in front. I have my hard piccolo case in both hands. I smash his hand as hard as I can, against the bus seat.

He screams and pulls his hand away, clutching it.

The bus driver looks in the mirror. He doesn’t slow down or stop.

The boy never bothers me again. And neither does anyone else on that bus.

____________________________________

I took the photograph when school started this year. This is our “city” bus. The Redhawks are our football team. I can’t think that football is good for us, but I thank the adults for this support for the high school students…..

Music gives me hope: this.