Tag Archives: children

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The happiest day of his life

When I was a preteen, I got my first Spiderman comic book. I was enthralled. A hero who had powers, but had a grandmother, responsibilities, made mistakes, felt guilt and confusion. I wanted this, not the princess crap. I did not want a prince to ride in and carry me off. I did not and don’t trust princes. The wedding being the happiest day of a woman’s life: what the hell? Is it the happiest day of the man’s life? If not why not? It’s important to the woman to be married to her love but not the man?

And anyhow, the Disney movies were very consistent. There were no good Disney Queens. The good ones died in childbirth, or were absent, or their ship went down. The stepmothers were evil. The princess career ended with marriage. Pregnancy either kills you or turns you evil. Actually, sex turns you evil if you are a female. That was the very clear Disney message judging by the animated features. Virgin girls are pure princesses but there are no adult female role models for years and years and years. By my preteens I wanted to drive my own wagon: I was not going to be taken care of, controlled, or left poor and with small children through divorce. I would have a career and children.

What IS the happiest day of a man’s life? Do we have any map of that? When they are promoted? When they buy twitter? When they are elected President? When they get married? Why do we have a happiest day for women (and is it the marriage or the sex?) but not for men?

In the romance novels, the man is usually older, “experienced”, rich, and has a reputation for seducing women. The woman is often a virgin, or she has a child because there was an evil man who she thought loved her, or the older man got her pregnant and she never told him. She knows it is true love because she is pure and yet is overcome by lust, so it must be true love. Snort. I have always thought this is stupid and silly. So men in the novels are experienced, have sex with lots of women, and then are carried away by lust that turns out to be true love with this woman? What about all the others? Did they think it was true love too? Or were they “bad” women, who had lust without true love? Impure, not virgins, not a “good” girl. Seems pretty confusing to me. Often the virgin gets pregnant because, hey, she is carried away by uncontrollable love, so of course she would not think about birth control. What is the experienced man thinking? Hey, let’s get this one pregnant, I’d like to pay child support? Oh, he’s carried away by uncontrollable love, but really now, you’d think after all that experience that he would use birth control. Apparently the rich experienced older seducer males are all morons when struck in the heart by true love. These books should be burned, really.

Anyhow, I was suspicious of the princess story and I wanted my own horse and armor and sword and I’ll fight my own dragons, thank you! I was much more interested in the super hero story, even though the superheroines were still pretty lame and likely to get killed off. Oh, and girlfriends get killed off. Gwen dying from fear during a fall: give me a break. Yuk. Made me glad she was dead if she was that much of a weakling. At least she couldn’t reproduce. I liked Mary Jane a whole lot more: feisty.

I wanted to be a superhero and still human, not a princess.

So what is the happiest day of a man’s life?

_____

The cat is Boa, not Sol Duc. Boa died at age 17 right before Covid-19 started.

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Vaccination talk

My cousin asks me once, why do doctors say, “This will only hurt a little?’ when they give a shot.

I thought about it. “It’s a matter of scale. Picture this: in room one, I have a woman who thinks her lung cancer is back and it is. In room two I have a mother and daughter crying because the daughter is pregnant and frightened. In room three, I have a well adult who needs a vaccination. Scale their levels of pain.”

Room one is very high, room two is very high, room three barely registers on my pain scale.

Poll: 1 in 7 parents have not talked about vaccines with their child’s doctor

I would give out a health department vaccination information booklet by 24 weeks to my pregnant patients, especially the first pregnancy. I previously had given it later, but then I had a woman who refused the child’s vaccines at visit after visit after visit, saying that they were still doing research. The child still had no vaccinations at 9 months.

Remember the woman who refused vaccinations for her children? She had more than four children. They all got whooping cough, pertussis. They whooped for months and were on quarantine. They were not allowed out of the household, any of them, until they were no longer infectious. The mother said she now was for vaccines and got them vaccinated.

I have seen adults with pertussis. Adults do not whoop but they cough. They can cough until they throw up or until they break a rib. For months. It is not fun at all. The adult Tdap stands for tetnus, diptheria, and acellular pertussis. I have never seen a case of diptheria and I don’t want to. It sounds horrible and can kill.

Have I seen a complication of a vaccination? One in 30 years of practice. And I know a person who had a complication, but they were not my patient.

The illnesses cause way more damage and disability than the vaccine. In residency I care for a young man in a group home. He can’t talk and has an odd skull shape. His mother got measles during the pregnancy. Measles is one of the infections that can cause severe birth defects. Get vaccinated before getting pregnant, though half the pregnancies in the US are “unintended”. That usually means “unbirthcontrolled”. I do not really understand that, since the risk of pregnancy in a fertile woman is one in four every time. Twenty five percent seems a pretty high risk to me.

I’ve written about my response to my last Covid-19 vaccination. It’s not a complication. It is an antibody response and it means that my immune system is WORKING, though admittedly it is weird and annoying. I don’t like the muscle dysfunction, but I will get the vaccinations anyhow.

I have a very alternative young woman in for prenatal care once. I give her the vaccination booklet. “Oh, my child is getting every vaccine there is,” she says.

“May I ask why? I was not expecting you to say that.”

“I was in the Peace Corps in Africa. I have seen kids die from every single one of the diseases we vaccinate for. My kid will get ALL the vaccinations.”

I said, “Please would you talk to my other moms?”

She smiled at that. “Maybe.”

I hope she did and does.

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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.

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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/

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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.

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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

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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

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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.

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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.

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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