The Good, and health care policy

About a year ago, we discussed the topic "goodness" or the "Good", at our Heart of Medicine community of doctors' meeting. I brought the story of Joseph of the many-colored coat from the Hebrew scriptures. It seems very compelling to me that when his brothers go to Egypt to beg for grain during the years of famine, and Joseph has become the head magistrate to purvey the grain, the brothers try to apologize for their brutal treatment of him as a boy. And Joseph says "Never mind. What you intended for evil, God used for good. Because now I am here, and can help you and my father in the time of need." To me that is one of the best stories about what is "good"-- because it points to what is beyond the ken of the humans in the immediate story-- the possibility of some new good that can be brought from the most disastrous occurrence. And that somehow, the Divine Mystery does not allow full destruction-- some new creation or good can come from whatever may seem evil or bad to us at a particular time or place, or from a particular viewpoint. The Hebrew scriptures say reassuringly, at the end of each of the passages on creation, that "God saw it, and it was good." The idea of human sin is a corollary to this idea of good. When we "miss the mark" it may be that we aimed wrong, or the trajectory of the action we intended went off-center. But it may have been with good intentions; and somehow, as we judge between good and bad, we need to take that into account. It is helpful for me to think about these distinctions as the nation brings this debate to a vote. So many people have tried so hard to move the work of reform and increased social justice, and help to the poor and sick, forward. I am praying it will pass. But even if it does not pass, God will find a way to bring some new good out of something that seems to me totally bad. It is the lot of humans not to have that divine insight into the future and all its possibilities-- and makes it important and possible to have both faith and hope!

the Main Frame of the Democratic ideals

We Democrats are diverse, but we are FOR clean water, and enough water-- which means pipes and dams and infrastructure for water; and preservation of the land and resources from environmental degradation. The underpinning idea is good steardship of the Earth. We should be known as the party for women and children-- to recognize that our parents and our children need health care, and need it to be reasonable and available to all families; and we are ADVOCATES for health care and education! We are FOR a living wage, and FOR the rights of individuals to earn a living and have a home, and FOR protections in the workplace. We are FOR support systems to keep families healthy and vital. We are for diplomacy, and making the world safe for democracy. We are FOR the veterans, and their benefits for health care and housing. We are against a burgeoning 60%-of-our-taxes being used for war, bombs, and related costs from the Pentagon. We want to beat the swords into Ploughshares. Many of us were in the Peace Corps, or in NGOs which are trying to help the developing world. We are FOR solar energy, and clean energy from new technologies building on wind power, and other non-toxic sources.
We see that the building up of the country is something no citizen can do alone, and that for all of us to live better means that we need social systems which help put technological and sophisticated intelligent design-systems at the disposal of the common good of our people. This includes engineering costs and infrastructure of roads, bridges, dams, and oversight agencies.

Eulogy for Aunt Popie, 12/6/11

Eulogy for Popie 12/6/11 

(poem-- Popie and her Blue T Bird)

Popie and her Blue T-Bird

The Blue Thunderbird

Roars up to the door,

And Popie smiles at us over the wheel.

Our aunt,

The fairy godmother of our lives,

Sweeping in with love and presents,

Making the day a holiday.

After school,

Where she is the counselor for young women,

And the model of propriety and prudence,

She hops into the Thunderbird

Bright blue, shining, with white sidewall tires,

And comes to visit us,

Like the blue bird of happiness

Landing in front of our house! 

She notices everything, 

Questions us closely about school and projects,

Gives us good advice.  

Sometimes she brings a pan of her green jello,

The creamy kind, with little bits of pineapple,

And the tart flavor of lime.  It is in a large pan

On the back seat, covered with aluminum foil. 

Carefully, we carry it to the refrigerator.  

It is my favorite part of holiday dinners.

The blue T-bird sits proudly in front of our house

Like the coach of the fairy godmother.

 “I love you Truly!” --- when I called her on the phone, Popie always signed off with that lovely lilting phrase-- and a voice full of affection and affirmation-- and I last heard her say it just a day before she went into the hospital for the last time. I think about the amazing fact that God decided to send my parents 6 daughters, and maybe as a gesture of insightful compassion, He sent Popie as the right hand-- a sort of Lord Chancellor-- to mom. She might have gotten the nickname because she LOOKED like the Pope, but the nickname stuck because she was always “RIGHT”; she had that perfect memory, so that you knew the last time she was wrong was on a Tuesday in 1956! Mom always said, when she wasn’t sure-- “ go ask Popie!” She was very smart, and an easy source of advice for how to set a table, who ought to sit next to who; what you should serve, and how to do the invitations-- so she also got called “Emily Post--- or Emily Pope”. She knew so many things about etiquette, and she was a natural at acting like a lady; which was what we were trying to grow up to become! Stanford just helped polish her natural acumen in giving good counsel. Popie was my godmother, and like an extra mom-- for my whole life, she has always LISTENED very carefully-- and with interest, wanting to know what I am going through, and willing to believe I am trying my best. SHe invariably asked great questions, and helped prepare me for any upcoming conversation with difficult people. She would have been a great lawyer-- or a judge! She always cheered me up ---when I was devastated, or worried about something; and especially when I was humiliated, feeling defeated or depressed. When I was young she helped me do school projects, especially in history. She helped get me through the tribulations of going to medical school. She never stopped believing the best about me. I think of that line in my favorite book “Cutting for Stone--- what is the one medicine which can be given by ear?---- words of comfort”. She gave me words of comfort, my whole life, with gallantry, affection, and kindness. And she did it for everyone else in our family, too. Kids nowadays have Google and Wikipedia-- in our family we had Uncle Gerald and Aunt Popie, to answer questions, and to try to teach us a little history, or give a context for some story, or point out something we should know. They were marvelous together, because they both had that quickness of mind-- that FitzGerald brilliance-- and Uncle Gerald could bring us to tears of laughter as he played off Popie’s prim and proper opinions, with puns, jokes, and riffs of all kinds. She would laugh as hard as the rest of us; and wherever we all were, was a party! I tried to remember to call her often, because I know how hard it can be to be stuck in bed. Popie fell and shattered her leg at almost the same time I had the near- fatal car accident 7 years ago. It was hard for her to get out of bed, because it hurt to walk, and as time went by it got harder; and so she put all of her energy into those phone calls, and visits from the family members. She remembered and asked questions about everything going on, in each of our children’s lives, in all of the whole family. One of the happiest days of her life, I think, was her 75th birthday-- everyone in the FitzGerald clan was there, at the Pierpont Inn in Ventura-- having a great party, visiting, and glad to celebrate with her. She was definitely a person who deeply believed in family-- It suited her well, that the FitzGerald war cry is “crom a boo!”-- hearth and home! She was proud of the history of Camarillo, and wanted us to grow up to be good stewards of the land, and to care for the legacy of our family; and she and mom both tried to educate and foster interest in the history of Ventura county, and the Camarillo ranch. She encouraged us all to do well in school. She hoped each of us would go to college. Her father’s mother had been a very intelligent woman, and Popie’s middle name, Chapman, was for her grandmother. It was legendary that all the FitzGerald boys (her father George, and his brothers, Gerald and Grattan) went to Georgia Tech to become engineers, and their mom Carrie Chapman had been the one to tutor them in math to get them ready for college! She showed us by example how to take care of Nana, especially when she was sick; and how to care for the older aunts and friends and relations. She was always sensitive and caring about their feelings and needs, and anyone who was ill, or depressed. She also taught me to make enchiladas, and her famous lime jello was my favorite family recipe! When Popie said “Cheers!” or “Crom a Boo!”-- with that lightest of lilts in her voice, I remember that she lived with severe anxiety, and that it was often like “walking in the valley of the shadow of death”. She concealed her anguish so well, to be able to bravely and cheerfully give us that salute. Most of us will never have to endure the kind of suffering she faced down, daily. She was truly an Irish warrior, conquering demons of the mind, to be able to engage US in bright conversation, and to offer US love and support. “Crom a Boo”, Popie, from all of us, who loved you TRULY! -- “Crom a Boo!”

Ecclesiastes

ECCLESIASTES
(for my son Andreas)


“the stars go by in their serene beatitudes”
William Stafford


Honey, I want to curl around you
And listen like old people listen.

I am sure the fields which are full of winter,
sodden with rain and mud,
will bring green drifts of spring again,
when it is time.

You said to read Ecclesiastes.
I read it, and still can’t tell what time it is.

Honey, have you heard the rain on the roof
In the night?
It was quiet, but still I could hear it.

I am looking for signs and wonders.
Yes, in the night there are stars, to help me.

Honey, I send you Palestrina--
strands of rainbows woven into songs.

I hope it will be enough for the stars,
And every prayer I have said,
Between the rain and the green shoots
Telling me it is spring.

The Singing Creek

The Singing Creek

Bend low over the bridge
Among the ferns,
You can hear the mysterious toccata and fugue,
The music reflecting stars,
Where the bending trees
Wash their hair,
And moan with the wind,
And shiver with starlight.
Oh, send the cellos
Like sap in the greenwood!
Now flutes,
And the whisper of creekwater
Over the flat rocks;
And one frog
Leaping into the pool.

mn 2005

Sex and violence

It has been a long while since I felt like writing something about this issue. Recent events have been a goad, and a sort of coming-to-terms with things in my life which have taken a lot of years to work through. The two recent events which really affected my reflecting on the issue were the arrest in NY of Doninique Strauss-Kahn, a senior diplomatic person for the IMF, who was charged with raping a maid in a hotel in NY. He was lead off the airplane in handcuffs, just before the plane was going to take off for France. The first response from France that we were told was that they thought he was "set up" for this, in order to put someone else into the top job at the IMF. The woman who was assaulted was a widow, an immigrant from an African country, and her religion is Islamic. She did not know the name or position of the person she accused. To my mind, it was almost miraculous that the hotel staff and police believed her, and arrested him so promptly.
The second case, following closely on the first, was the revelation of an affair between Governor Schwartzenegger and a housekeeper, and having had a child with this woman, who is almost the same age as his youngest child with Maria Shriver Schwartzenegger. The most interesting fact in this case, to me, was that Mr. Schwartenegger's son Patrick has said he wants to change his name to Shriver, to distance himself from his father.
Just prior to these two cases, about a week ahead of them, there was a front page article about rape in the Peace Corps, and the article said that the Foreign Affairs committee in the Senate was looking into this issue, to try to see if the Peace Corps was not properly protecting the women who serve in it, as the average number of rapes each year among volunteers is 22.
One of my physician colleagues asked incredulously whether such a thing had ever happened to me, assuming I would say no. I told him, and another doctor friend, about the case that happened to me, in Paraguay, 40 years ago. I was coming home from a far rural farming cluster of homes to our county seat, after giving a "health" talk related to my work as a health educator in a country town. On a rainy night, I was the only passenger, and was assaulted in the bus at gunpoint, by the bus driver. He temporarily went insane, as far as I could discern, and was not reachable by normal communication means. The doors were locked, and I tried to break a window, but couldn't. What ended up saving me was the reflex of defecating in my pants as he was forcibly removing them, as I was scared and fighting. I got him to let me out of the bus, and went back to the nearest farm house. I was helped to get home the next day by the good folks there. The town and my Paraguayan family were very kind, and I kept shaking and falling apart, but I was believed and supported. I had a good reputation as a Peace Corps Volunteer, and it was in my favor, that the people would believe that it was not something I brought upon myself. The lawyers and policemen and the Peace Corps officers all asked gently whether I would be willing to stay in the country, to try to help prosecute the case: and more than punishing the man, try to get a law passed, to prohibit rape in the country. Up until that time, there was no such law on the books, and the Peace Corps was trying to make them put a law in place, which would help other volunteers. As things turned out, when I left the country several months later, the law had not yet been passed, and we all thought the effort had been futile.
As everyone who knows me knows, I became a physician, an OB-GYN. I partly got this vocation out of the intent and desire to help serve other women who had been so traumatized with rape. Soon, I participated as a health educator in conferences which had to do with sexual violence of all kinds, including both rape and incest. As a physician, when I was an intern, I worked in a hospital in New York which had an average of 10 rapes a night come through our Emergency Room. We had a specific rape kit protocol, and advocates and well-trained and gentle police-women to help the victims go through this protocol of trying to get evidence which could be used in court. We would do our best to soothe them. I was able to understand why so many had become eerily numb and unable to emote. Now, in our hospitals, we have advocates who stay with the victims and they get automatic follow-up counseling, but in the early days there was no automatic referral process, or services provided.
The cases I have seen in my office are much fewer, than in those early days in an inner city hospital. I have tried to be as compassionate as possible, and also always to start the interview with the line "it also happened to me". Women are comforted to know someone else has had this happen, and gotten through it. It is important to share that with help, we can get past this trauma, but acknowledge that it will take time, and that it is ok to need a lot of reassurance, and back-up for safety.
So this is the background story for my facing these two recent cases. And I thought a lot about men in power, and men who take for granted that they can have sexual access to someone besides their wife, besides someone they might pay for this.
In Paraguay, after I left, the little daughter in my Paraguayan family grew up to be a psychologist, who teaches about rape and sexual assault, and women's rights, at the university in the capitol. And there are laws now, and my town has had a Peace Corps volunteer in it continuously for over 40 years. The modelling that we began has born good fruit, in the mores of the country. So, it seemed to me, that Peace Corps volunteers over the years may have made an immense contribution in helping women in rural and poor countries all over the world to live safer from this sort of violence. And if we helped the women, we most likely also helped the men and boys. Because some of the rapes which occur happen to young men. And it is often incest, but sometimes it is not a family member who is the attacker.
I know an American midwife who was in the Peace Corps in Yemen in 1980. She confirmed that a young woman was pregnant, with a fetal heart-beat, not a tumor in the belly. The young woman walked out of the clinic where my friend worked, and was stoned to death by the townspeople, right in front of her eyes. The young woman's father was the first to throw a stone. We cannot believe these things can still be happening, in the world we know, but they are.
When thinking about Strauss-Kahn, and his assumption that his behavior was normal or ok, I keep thinking that most likely he also was abused as a child; because relief from abuse sometimes comes from becoming the abuser, pushing the identity of the abused off onto another person. And most likely it is a long-standing pattern.
And then there is the Schwartzenegger case. It is interesting that the woman in the case is a domestic worker. I lived in Mexico, as well as in Paraguay, and it was often the case that the maids were the sexual outlet for the men in the family who hired her. Because people seldom divorced, these liasons were tolerated, over-looked, born by the women in the family as a sort of way to keep the family stability. One did not discuss the subject. If a maid got pregnant, she was sent back home with some hush-money.
What is the underlying reason that these men felt they could have access to these women? My nephew recently asked whether prostitution could be the cause. I think prostitution takes advantage of the behavior of the men, because the women and the children need the money to buy food and shelter, and the necessities of life. If a woman is not married, she may not have an income sufficient to pay the bills, and until the past 50 years, there was no dependable contraception, and often the women couldn't afford it, even if it were there. Even if a woman is married, if her husband can not get enough income to pay the bills, she may consider prostitution to supplement the income, and meet the children's needs, especially if she has no other skills.
Jim Wallis, at Sojourners, recently wrote a blog, saying he believes that until good men start speaking up, saying it is reprehensible behavior, some men will continue to be promiscuous. When other men do not approve of the behavior, we actually will have social opprobrium, to help back up laws proscribing the behavior, and punishing it. But the best answer to reducing and hopefully over time eliminating these behaviors, will be the social opprobrium of good, wholesome men.
I am a Catholic, and I have deplored and been ashamed and confounded by the ongoing revelations of clergy sexual abuse of children. I have hoped for 30 years or more that Cardinal Bernardin's rules would be put in place, to protect children within the Catholic church from this most heinous ruin of the trust of children by men who are supposed to be working for God. But I know that it occurs in other religions, and in people with no religions, and that society needs to root it out, and stop it, because these pederasts are the true bogey-men who are destroying the next generation of children. Our laws need to be clear in respect for all persons, and we need to stop the violence. Violence which is sexually-focused is always destructive, and it destroys and cripples for decades and often whole lives of the people who experience it.
Stopping the violence, and keeping the offenders safe from themselves, is of utmost urgency in every land, every culture, every society. We cannot leave it to their self-discipline, because they are crippled emotionally in this issue, and do not HAVE any appropriate self-discipline. They must be kept apart from the people they might abuse.
One of the most profoundly lovely things that happened in the Jasmine revolution in Egypt was the rescue of an American journalist woman, who was being attacked and stripped by a maddened crowd, who seemingly intended to tear her apart. The women surrounded her and covered her naked body with their huddling, soothing presence, making a wall of themselves between her and the abusers. Would this were the way we take care of all women who have been subjected to sexual violence! Unfortunately in many places, women and men are still being stoned to death for being the victims of this crime. And children are being infinitely hurt, sometimes in repetitive cases, in or out of brothels, with or without being "paid" for their enduring the unendurable.

Pilgrim to Esalen

This is the story of driving to Esalen, to get to the lady doctors' retreat. It is late March, and ever since the massive tsunami in Japan, which started with the earthquake there, we have had soaking drenching rain. The hills are so wet that we are starting to have mudslides which are dangerous, along with some falling trees. Usually the trees fall when the rainy season starts, as the ground loosens. But these are trees that made it through the rain and wind all winter, and now the ground is SO wet, they are falling. SO it is worrisome to be out driving. I also get worried because of the body-memories of the accident in which I hydroplaned, and almost died. It comes back, every time I see a slick road, and the anxiety worsens when rain is sliding down the windshield. So I was determined not to have a difficult drive, and they had said that although there was a landslide on Big Sur south of Carmel, so the northern route was closed, the southern route was still open, and would add another two hours at least, to the drive, but would be safe. There is a narrow place behind the San Antonio mission, near Lake Nacimiento, behind the Fort Hunter-Liggett army base, which goes due west from Hwy 101, over the mountains to Big Sur, and comes out just below the New Camaldoli monastery, which is just south of Esalen. This road was also open, but it is narrow, dangerous, with frequent rock and mudslides, and very windy-curving road; and they said not to attempt it after dark.
I got to Cambria at about 5 pm, with good golden evening light, and no rain all day on Monday. I had to work til 1:30, so left the office much later than I wanted to-- but got immediately on the road. Driving north into Big Sur past Hearst Castle, the ocean looked stormy, full after the rain, and the hills were so wet and velvety green I had to stop frequently to take photos. There were cattle on the hills down close to the sea. The rivulets were full, cascading down the mountain. There were gorgeous hawks floating on the updrafts, and the seagulls flying close to the waves. At Salmon creek, the water was pouring from a cataract on the steep cliff. Then there was a sign saying "road closed"-- and just beyond that, a big land-mover bulldozer. The guy in the bulldozer told me that there was another slide the night before (Sunday) and the road would not be open for at least 5 days. I drove back to the inn at Ragged Point, and called Esalen. They said they would refund the room cost, and were sympathetic. I met another woman physician who couldn't get through, and she had decided to stay the night there, as she had her aged mom with her, and they were tired. It was almost 6 pm when I turned around to go home, figuring I could get home by about 9 or 9:30. Around King City, it was getting dark, and I thought maybe I could stay in the hotel next to the Ft. Hunter-Liggett army base, and so I took the road west, thinking I would get up early and go over the Nacimiento road early in the morning. Well, they have changed the road, and it didn't ever seem I was near any hotel, or the mission either. Suddenly I was on the mountain, in the Los Padres National forest. It was open. So I just kept going, thinking "ok, I guess I WILL get there tonight!" This was not so smart, but I kept saying to myself, "I am a Peace Corps volunteer-- I can DO this!" After a few curves in the road, and passing one white pickup truck, I realized I was likely to be totally alone on that road. I kept the high beams on, but realized they looked like parking lights, in what they could illuminate. The air was balmy, spring-like. The road runs next to a creek. I opened the windows and the skylights-- the roar of the full-spate creek and some frogs were filling the air. The wet mountainside had some trickles, and musty smell, and new shoots of ferns. The big live oaks were gorgeous in the headlights, and some willows, over the tops of the newly plowed areas with piles of dirt along the road. Probably 1/3 of the road had been newly plowed, and you couldn't see over the sides of those piles of dirt. The road was so sinuous and winding, I felt that at any moment I would fall into the creek, or a humk of mountain would fall on me. I felt that it was just like Dante, in the middle of my life, in the middle of the night, losing my way in a dark forest. Overhead, I had opened the skylight, and there were masses of stars in the dark sky-- no lights for at least 50 miles in every direction. A great white horned owl flew over about 10 inches above the skylight-- I thought it might enter the car-- it was so powerful-- a watching wild spirit. I kept creeping along at 10-20 miles an hour, being glad I had just had the car checked, and that I had gotten gas just a little before King City, so almost had a full tank. But it was definitely that feel of being alone on the mountain, possibly never to be found again. The road climbs slowly, then at some point it starts to descend. Utter blackness ahead, unable to see past the piles of dirt on my right or left, as we twisted through the pass. No other cars. Finally, I felt the air change, and we were at the sea. Ahead of me were millions of stars in an uninterrupted sky. I saw a sign saying HWY 1. So I had made it to the Big Sur. I turned right, heading north. NO cars. Empty, silent; and then a one-lane place with monstrous backhoes and bulldozers parked alongside, and the signal lights still working. The sky was immense, full of stars. I passed the monastery, and then was on the two-lane empty road, heading toward Esalen. I got there at 9:45 pm. I was exhausted, and yet exhilirated! I would be able to see those fantastic women doctors; brilliant, powerful, amazing, strong women-- and participate in the retreat! Shangri-la! I had to find my room, and then I went down to soak in the baths. Lowering my tense body into the hot water, I looked up at the sky full of stars, and thanked God for the help getting me there. I had not really intended to take that road, at least at night, but it happened. It was such a metaphorical lesson in just putting "one foot in front of the other"-- and so I continue to continue...
The next morning, I woke up to a sunny bright spring day, at the place which always feels like heaven to me.