Monday, September 24, 2007
So Monday is sacrificed to the God of Kleenex, and Tuesday I have a conference call at 8:30, then have to dash off to make nursing home rounds before I start seeing patients at 12:45, and I've already booked myself over my dinner hour so I'll go straight through until 8:00 PM and then have to clear off my desk before I go home, because I'm leaving for a conference on Wednesday morning and won't be back until Sunday evening.
I could post during the conference, but then again I'll be there with Kate, my closest friend from residency, and it will be the first time we've had a child-free conversation since her oldest was born nearly 18 years ago. So probably not.
While I'm gone the leaves will start to turn, the baseball season will end and my daughter will probably grow out of all her clothes. I'll pick up the threads of all of this when I get back and I'll be posting again next week.
Sunday, September 23, 2007
I've heard this question at least once a week since I started working as a hospice doc two months ago. I'm still practicing primary care 75% of the time, but 10 hours a week I work with a team of nurses and social workers and chaplains and physical therapists doing home hospice. Our patients have all sorts of medical problems, not just cancer; the one thing they have in common is that they're all approaching death, and those who are still aware know they're dying. Sounds awful, doesn't it?
Here's the funny thing: it's not that hard. At least not for me. It's not as if I can hide from death and dying by staying in my safe little office. My patients die, too. I'm good, but I'm not that good. I can't say death doesn't upset me, either. I grieve when my patients die. That grief is one of the reasons I choose to believe in God and follow a spiritual practice. The rituals of mourning comfort me.
But hospice work is in many ways easier for me than primary care. It's not as challenging intellectually - the diagnostic process is much more straightforward, the therapeutic options are more limited and well-defined. The people who say "that must be hard" don't know that. They think it's hard to deal with dying people all the time. I think it's a relief.
The people I care for have chosen hospice. They, and their families, understand that death is coming. Sometimes they've accepted it; sometimes they haven't. But they have agreed that the goal of their care will be management of their symptoms, comfort and support - that negotiation is completed. And there is a network to help with that. I meet regularly with the team and we share our experiences and encounters with our patients and families. That meeting time helps us plan treatment and it also allows us to support each other. We have created rituals to mark deaths and honor the lives of those we've known.
When my hospice patients are anxious or agitated, there's someone they can call. When their family members need to talk, there are trained counselors available. When I feel overwhelmed by something I've heard or seen, I can find a sympathetic ear and feel comforted and validated. That's hospice. Yes, all our patients are dying - but before they die, we have the resources and commitment to help them, and help ourselves, live as best they can.
My "regular" work is much harder emotionally. The woman I saw last week who said "My husband and I haven't spoken for four months. He thinks we should stay together for the children but I don't want to teach them that this is what marriage looks like". She can't afford a therapist, and her insurance doesn't cover mental health care. Then there's the man who was told by his previous doctor that the mole on his thigh was nothing to worry about. I'm pretty sure it is indeed something to worry about, and I want to be clear about that so he'll follow through on the referral but I don't want to completely terrify him. And the woman who is now disabled by complications from her diabetes and has been turned down for disability; she needs to sell her house so she can afford her medications and the lawyer she needs to appeal the denial. In the meantime, she needs me to listen to her despair and figure out how to control her blood sugars.
And then there's the patient I came in early to see last week because I had no open appointments. She was about to embark on a third round of chemotherapy, even though her quality of life is markedly diminished already and she'd really rather not. The oncologist never so much asked what she thought. I spent 30 minutes meeting with her and her daughters, and that went more easily than I expected because they all agreed about what they wanted. Then I spent more time calling the oncologist to confer about the plan, and diplomatically suggest that no, she didn't really need another MRI or PET scan or bone marrow biopsy and no, I didn't really think oral chemotherapy would be helpful and no, I didn't think she needed weekly blood draws any more. And then I referred her to hospice, and the nurse who answered my phone call said "How are you doing, Dr. Jay? It sounds like you care a lot about this woman, and this must be difficult". Yes, it was, but once hospice was involved, it wasn't nearly as hard.
Friday, September 21, 2007
Saturday, September 22nd: here's the post I started yesterday to go with that video* and didn't finish, because I had to go make an emergency house call in the middle of the day. But I wanted to post it anyway, now that the fast is over and another year has begun.
May we be sealed for a good year, a year of peace.
Friday, Sept 21st: Yom Kippur begins tonight. Yom Kippur marks the end of the yamim noraim, the Days of Awe. On Rosh Hashanah the gates of repentance open and over the next ten days, God ponders our fate in the year to come. With the last shofar blast tomorrow night, the gates swing shut, the book is closed, and our future is sealed.
Tonight is the beginning of the longest day, the Shabbat Shabbaton. It is the only evening service for which wear our tallisim. And we begin with the ancient prayer of Kol Nidre. The words are Aramaic, and the tune has been chanted for at least two thousand years.
The first time I heard the Kol Nidre, I was 15, attending services required for my confirmation in the Reform congregation where I was raised. My minimally observant family never went to evening services. I was an adult before I realized that traditional Jews don't play musical instruments on the holidays, but in our thoroughly modern sanctuary, we had an organ - and a cello. The cellist picked up her bow, played two bars, and I started to cry.
Kol Nidre is a legal formula renouncing all vows taken in the previous years, designed to free us from earthly obligations we can't fulfill. It's in Aramaic, and I'm glad I don't understand the words, because I can be penetrated and transported by the music itself. That night 30 years ago marked the first time that I found something in the Jewish liturgy that spoke to me, that connected me to the ancient tradition and actually felt like prayer.
Sam and I are Reconstructionist Jews, active members and past presidents of a small congregation. The services of my youth were theater, performed on a raised and lit stage before a quiet and respectful audience. The service we will attend tonight will have moments of quiet and times of great respect, but the congregation will be more than an audience. We will speak and pray and sing and participate, a group of sound and worship that I couldn't have imagined at 16.
And I will be chanting Kol Nidre. I think this is why I learned to sing, why I took voice class in high school and sang in choirs in college, why I returned to music after residency and learned to read Hebrew 10 years ago. All that happened so that when I was offered the chance to add my voice to thousands of years of tradition, I would be ready.Tonight I will chant the Kol Nidre. Tomorrow I will chant Yizkor for the first time since my father died. On this holiday, I claim my own place in the legacy of grief and awe and steadfastness that is the story of my people, and that lives in the melody line I sing.
*After I finally posted the edited version of this post, I realized that the video I chose couldn't be embedded. You can hear a cello play the Kol Nidre here.
Wednesday, September 19, 2007
Plus a whole lot of other thoughtful, insightful, angry women. And a few men. Worth checking out, in any case.
Now I just have to stop clicking on links...and clicking on more links...and reading all the archived posts on the blogs...
I can stop clicking any time. Really. Any time I want to. I just don't want to.
Tuesday, September 18, 2007
My favorite thing about Tuesdays: I drop my daughter off at school and come home to an empty house. Sam's at work, the dogs are asleep in their crates, no one knows I'm here, so the phone doesn't ring. I can go upstairs and take a shower - as long as I want. As hot as I want. No one will inadvertently start running the water downstairs and scald me. No one will come running in to ask where the Polly Pocket shoes are. I won't have to fight the dog for the bathmat. I can turn the TV on and watch what I want to while I dry off and dress.
Saturday, September 15, 2007
Our congregation is small and our rabbi works part-time, so we didn't have a Shabbat service today. We decided to have a study session instead. I'd completely forgotten about that until Sam mentioned it, and since we were providing the Havdalah set one of us had to go. He has a cold, so off I trotted to bring the supplies and stay for the Torah study.
After I was so pleased to get past the akeydah yesterday, I found myself facing it again tonight. Seems my usual strategy of avoidance just wasn't going to work for me this year. The discussion circled around all the reasons why God might have asked Abraham to give up his son, and how the family must have felt afterward. And then we shifted our focus. We're Reconstructionist Jews, after all. We don't believe this is a literal retelling of an actual event. We experience these stories as myths, as narratives so compelling and so vital that they have been told and retold for thousands of years. What purpose does this story serve? Why has it persisted? Why have we chosen it for our central text? Why do we chant it every year on Rosh Hashanah, the day when we celebrate creation? The first day we read the story of Hagar and Ishmael, and learn that Abraham exiles his eldest son to the desert and leaves him to die. The second day we hear that God called Abraham to climb that mountain and bind his other son, his beloved Isaac, to an altar of sacrifice. Why do we need to hear this? What do we need to learn?
This sculpture of Abraham and Isaac by George Segal was conceived as a memorial to the Kent State shootings. You won't see it in Ohio, though; Kent State refused it. It's life-size. The first time I walked past and realized what it was, I had to stop and catch my breath. I used it in my first post because it is a single image that holds all the complex emotions of the story.
Tonight as we talked I remembered that statue, and I thought of other wars, of the war in Iraq, of the generations of young people who have been betrayed and sold and slaughtered and yes, sacrificed by their elders. Countless other parents have lost their children, and each of them grieves.
Perhaps this story persists because we are ultimately powerless to keep our children safe, and that deepest of parental griefs has been with us throughout human history. We tell stories to explain ourselves, to make sense out of our world, to connect our own personal experiences to something larger and more significant. We tell stories to make order out of chaos, beauty out of pain, community and totality out of isolation and shards of self. I remembered how I felt reading Recovery Discovery's comment to my first post: I was not alone. Telling my story created a connection to her, and opened my heart to hold more than my own grief, as she opened her heart to help me bear mine.
From now on I think I can sit in shul and listen to the portion. Next year I may even volunteer to read it again. I'll still cry, and I'll still see myself in the story, but I no longer feel angry that I am forced to face this. I feel supported, connected, seen - and I feel at peace in a way I have not felt for years. I am grateful for the ancient practice of Torah study, and the very modern practice of blogging, which together have brought me to this day.
Thursday, September 13, 2007
Wednesday, September 12, 2007
My new favorite site: The Jew and the Carrot. Interesting posts about how we eat and how we think about about eating. And GREAT recipes. I made three dishes I found there - two from the site (Ginger Orange Baked Tofu and Honey Apple Challah) and one from The Flexitarian Table, which I read about on The Jew and the Carrot.
What I learned about myself today: I can make a round braided challah (thanks to the link in the recipe) and I can make a brisket. I think I can even do the brisket again without my mother's help.
Mom brought more than her brisket expertise. She brought real pike and whitefish, the actual stuf, so I can make gefilte fish, and she brought her own chicken soup. Yum. And she brought herself and a pile of presents for our daughter, and even though tomorrow she will try to serve me breakfast in my own house, I'm glad she's here.
I doubt I'll be posting much over the next few days. I wish for all of you - for all of us - a year of health, happiness, fulfillment of dreams - and peace.
Tuesday, September 11, 2007
The central prayer of Judaism is an act of witnessing. When the sh’ma is written out in the Torah, the ayin and daled are enlarged. Ayin daled. Ed. Witness. The sh’ma itself is an act of witnessing the presence of God. It is also a command to be witnesses, for it is not enough to “listen, O Israel”. We must also speak the words, and teach them. Witnessing is an act.
We do not always know what it is we are called to witness, and on September 11th, 2001, I do not know. First there were voices – announcers on the radio; patients coming in and sharing what they knew; my brother, finally, at his office in midtown Manhattan. Then there were images, compressed into a terrifying narrative arc – see the first plane, see the second plane. Then the fire. Now the towers collapse. Watch it again. Watch it again.
But watching is not witnessing. We watch only with our eyes. Watchers don’t participate. Watchers stand apart. Our tradition calls us to do more than watch; our tradition demands that we witness. Witnessing is an act that requires our entire beings. It calls on memory, courage, voice and spirit. It is not enough to watch. We must also know. What we know, we must remember. And that memory calls us to act.
Another televised narrative arc: a black-hooded head on a concrete hotel balcony in Munich. I am twelve years old. My parents do not shield me. I hear my mother say “Don’t you ever forget: this is what it means to be a Jew”. Twenty years later, a single shot of that hood, that balcony, on another television show leaves me shaking. I have not forgotten.
But remembering alone is not witnessing. It is not acting. It is simply terror. It leaves us silent, isolated, paralyzed. At twelve, I could not be a witness. Thirty years later, I had learned that there was more to being a Jew than being afraid, alone, and powerless. So on September 12th, I found myself at morning minyan, holding my daughter and feeling both at home and out of place in a different shul. The prayerbook was unfamiliar. I realized that I was worshiping in a congregation where I could not stand and recite the Kaddish Yatom unless I were officially in mourning. At first, I resented what felt like an archaic rule. I wanted the comfort, the peace that comes from raising my voice in the ancient cadences. I did not want to listen; I had heard enough of other voices. I wanted to speak, but I did not. But as I chanted the lines of response, I realized this was why I came – it was the act of witnessing. It transformed the watching of the day before into something far more powerful. Mine was one voice in many that said “I see. I hear. I am present for this moment of grief”.
To act on that presence is to raise my voice against the re-interpretations and misinterpretations of events, to speak my truth about what happened that day and why. That narrative arc we see on television is only one heavily edited version of reality. If I am truly to be a witness, I must find the courage to speak out against the abuse of that powerful tool, the visual image of tragedy and fear. Fear can isolate us. We may feel safer if we lash out or hide away behind walls. It is easy and comforting to demonize the Other, to hold onto our grief as it transforms into rage. But when we do so, we forget the lesson of the sh’ma; we no longer are witnesses to God’s presence. The presence of God lives in each of us, in that small piece of the Schechinah that we were each created to hold. I catch glimpses of it when I am lucky enough to be in the presence of healing, of that deep connection that exists when I am really seen and really see-ing.
It is the Shabbat after my grandmother’s death. We meet on our screened porch for services, and we do not have a minyan. I know that we are not supposed to say Kaddish, and yet I deeply need to do so. My friends, my witnesses, willingly participate. It is a gift I treasure. My grief is eased by their presence.
From that moment of presence both the mourners and the witnesses gather strength. We come together at terrible times to act as a community, to forge new memories and hear stories that will help us to act on our values, to live out our prayers and our hopes rather than our fears. The Kaddish we speak out of our deepest grief is composed words of praise for the Divine, and by witnessing that paradox of praise and pain we can conquer the isolation of terror. We can become true witnesses: not just those who remember, but those who act to heal the world.
Never forget, this is what it means to be a Jew. To be both a mourner and a witness. To hear, to see and to act. Never forget.
Sunday, September 9, 2007
For about three years of my adolescence I called myself an atheist. No one in my family really cared one way or the other. I was still Jewish, I still went to High Holiday services, so nu? What did it matter. But when I was 17, one of my best friends died, and I found myself talking - praying - to something. Or someone. I don't think it was God's will that she died. I don't believe that she's in a better place, or that God called her home. I just needed to feel some connection to something larger than myself, something deeper and more mysterious than the tragic facts of her life and death.
It's been 20 years since Jennifer's death, and that belief continues to sustain me. That doesn't mean I condemn those who don't share it. There are plenty of reflective, intelligent people living ethical lives without any spiritual practice or belief. (Yes, Orange, I read your post on the subject, and you're not the only one I know.) I recognize that spiritual practice and belief in God is something I choose, and I choose it because it helps me find order and meaning and beauty in the world.
My spiritual practice gives me a structure with which to manage the chaos that enters me through my work. The man with a shadow on his Xray, the woman with an an abnormal CAT scan 6 years after her breast cancer, the daughter caring for her dying mother; it is my privilege to walk with them. Even in the midst of such grief, there are moments of connection that are deeply satisfying and renewing for me, and in those moments I believe God lives. Ritual gives me space to recognize and honor that connection, to reflect on my experiences, to care for myself. I can't always cry with my patients, but on Yom Kippur I can weep in public, and those tears increase my strength.
Life is chaotic, and death is final, and illness strikes for no reason. Mary said "it's almost unbearably frightening to think that we're not the ones calling the shots" and she's right. So, even though I am not really working the 12 steps, I admit that I am powerless, and I recognize that a Power greater than myself can restore me. Avinu malkeinu, remember me although I am made of dust...be gracious with me...deal with me in righteousness and love, and save me now.
We'll say things like: "It's not his fault that he got colon cancer, but still, I do eat a lot of fiber. It's not their fault that their child is disabled, but still, I wouldn't have made the choices she did during pregnancy and childbirth. It's not her fault that she was raped, but still, I wouldn't wear that outfit. It's not her fault that her husband cheated, but still, she probably should have done more to satisfy him." We always think there really was a little something more those other people could have done. We would have eaten better, exercised more, prayed harder, worn different clothing, watched our children more carefully, done background checks on every last friend and neighbor, taken every precaution in every situation, right? We believe that we're luckier or smarter or that God likes us better. And as long as things go right, we can believe that.
My husband is a sex addict. He's like any other addict looking for a high, but his escape comes in the form sex and fantasy: affairs, pornonography, sex workers. There are people who blame him for being weak and immoral, but they also blame me, for somehow not satisfying him. I've met the wives of other sex addicts, and they too usually blame themselves to some degree: if only they were prettier, thinner, more exciting in bed...
Our culture constantly reinforces that stereotype: men are thoughtless pigs who will fuck anything that breathes if they aren't kept constantly satisfied by a beautiful, exciting woman with a ravenous sexual appetite. Look at the supermarket magazine rack. What does Cosmopolitan magazine (more aptly titled "Sexual Codependents magazine") tell us? Why do we love the stories of celebrity breakups? Is it because we know, beautiful as they are, there must be something wrong with them if they can't keep their lovers satisfied?
I was certain that my husband would never cheat on me, not only did he love me, deeply and passionately, we had a fabulous sex life. I wasn't like those other uptight women who couldn't orgasm or who had a low sex drive or who thought pornography was immoral or who wouldn't change up positions or wear kinky lingerie. I didn't need Cosmo to tell me how to make things hot in the bedroom; I was hot in the bedroom. I'd read, watch and look at pornography; I'd even create pornography; I'd send him stories and photos and videos of myself. I'd dress like a prostitute one night, a virgin the next. I'd ask him to tell me his fantasies and let me fulfill them. But more than in the bedroom, in all of our life, I was attractive, I was smart, I shared his interests and I let him be himself. Men cheated on women who hated action movies and sports and sci-fi, women who nagged them about leaving their socks on the floor and talked about shopping and wore frumpy sweatpants, women who were mindless and ultimately dull, women who were unattractive in their looks or their personalities. Men didn't cheat on women like me.
My husband was never faithful to me: not for a day, not for an instant. He was constantly looking for other women to have sex with, not because I wasn't satisfying him, but because nothing could fill the emptiness inside him. All the women and all the sex in all the world couldn't meet his needs. He couldn't control his addiction, and neither could I. We both had to let go of that illusion in order to heal. And I knew as soon as he came clean and told me about all the lies and cheating, knew in a way that I could feel at that deep down gut level, that his actions had nothing to do with me or his love for me.
Of course, we all know that that's because I'm luckier than those other addicts' partners or I did the right thing by trying so hard or God likes me better or something like that...
Saturday, September 8, 2007
After these things, G-d tested Abraham, saying to him "Abraham!" And he said "Here I am." God said, "Take your son, your only one, the one you love, Isaac, and go forth to the land of Moriah. Offer him there as a burnt-offering, on one of the mountains that I will show you." Abraham rose early, saddled his donkey, chopped wood for the burnt-offering, took Isaac his son and his two lads, and set out for the place that God had spoken of to him.
Bereshit Chapter 22 v 1-3
This is a deeply troubling story, this legend of the piety of Abraham and the magnanimity of God. We wonder how Isaac must have felt. We remember that the next portion of the Torah begins with the death of Sarah, and why not? Her husband was willing to sacrifice the child for whom she waited 90 years. I still wonder about all that, but I think I know, now, how Abraham feels. I know this because four years ago I had to sacrifice my son.
No, he's not dead. I didn't carry him up a mountain to be burned. But sacrifice him I did, give him up forever. Was he my son? As much as my daughter is my own; we brought him home from the hospital. He had a brit milah, and we named him Jesse Daniel, after my beloved great-uncle and one of Sam's ancestors. We fed him and loved him and sang to him and told our three-year-old she was a big sister. We knew, as we had with our first adoption, that we were "at risk", that we were not yet legally his parents, that his birth mother retained all rights to him until they were formally terminated in a court proceeding. And she chose not to terminate her rights. She chose to take him back after ten weeks, ten weeks during which we had to live as a family of four while recognizing that in truth we were not. Not yet. Not ever.
I didn't quite realize it, but I spent that ten weeks looking for the sign - for the angels who would tell God that the sacrifice wasn't necessary, for the ram caught in the thicket who could stand in. I do not believe that God intercedes directly in our earthly lives and yet I prayed as if I did. And I realized that I couldn't really pray for another woman to have to make the sacrifice that I didn't want to make. So when the call came, when the agency told us that she had decided she wanted him back, we took him - not up a mountain, but to a very prosaic office building, where we kissed him goodbye and left, sobbing.
Just as the Torah text is telegraphic, giving us small pieces of information about the figures in these archetypal stories, our knowledge of Jesse's birth mother came in small bits. Young, not well-educated, very limited family support, two other boys; an abusive partner who didn't want her to have another child. Just as we imagine how Sarah and Isaac must have felt, we can imagine her terror and pain, the power of the fear that drove her to sign the first papers at his birth. I don't have to imagine the love that compelled her to take him back. So now I pray that she has found what she needs to act on that love, to raise all her boys well. Poverty makes it harder to be a good parent, but it's not destiny. She loved him enough to send him away, and she loved him more, so she took him back.
Offer him there as a burnt-offering. I imagine Abraham was angry with God. Abraham, who argued for God to save Sodom and Gomorrah, didn't argue to save his own son. The anger over that call to sacrifice was too deep, too fierce to be spoken. So he saddled the donkey and he climbed the mountain.
The grief and anger didn't kill Sam, or me. They didn't end our marriage, although there were moments when I thought they would. But we have been forever changed by our own fire in ways we could not have imagined when we set out on our journey. We think we have healed, and then something triggers the pain - an image of a small boy, a photograph we thought we'd put away, our daughter's questions about "when I was a sister". Or the words of the Torah, chanted the second day of Rosh Hashanah, this year by one mother who will in part be singing her own story.
Her brother thought she was crazy. Why would anyone want to give up the cushy life of a stay-at-home suburban mom? Wasn't that what all women wanted? Wasn't that what I was going to do when I graduated college and finally landed a man? Um, no. Not ever. I appreciated what my mom did when I was growing up, but I didn't want to do it myself. He smiled at me and said "Oh, you'll change your mind".
Nearly 30 years later, my uncle is still a condescending asshat, and I haven't changed my mind. Oh, I had an eight-month gap between jobs when my daughter was an infant, and I allowed people to think that I'd decided to spend some time at home with her, but that wasn't so much the truth. The real story: I'd been in a job I hated before she was born, and it turned out I still hated it after she came along, and I didn't bother to find another job before I quit. So it took me a while to figure out what I was going to do next, and it was easier to let people think that was because I was staying home with the baby. Actually being at home with the baby nearly drove me around the bend. It was stifling. I couldn't wait to hand her over to someone else - Sam, visiting friends, the day care two days a week - especially if the somebody else would hold the baby and talk to me, too.
So why tell this story? Well, I know you all just hang there waiting for some personal tidbit from me. After all, Mary says I'm famous. And Mary said something else, too
When I was working for pay I was economically dependent upon my employers, whose loyalty was to the bottom line and not to me, and so they never earned my loyalty or trust in return. I chafed at having to sit in a cubicle and do the uninteresting work that was someone else's top priority. As an introvert, I came home exhausted at the end of the day from being away from home and dealing with people.She's happier at home. I'm an extrovert who now has a job I find challenging and fulfilling. I love being out all day in the world. If I don't have that time at work, home feels confining to me.
And then there's this post from FemaleScienceProfessor:
I certainly didn't question her decision to start working part-time now. I consider those kinds of decisions intensely personal -- only she and her family know what works best for them, and I have no basis (or inclination) to judge. She volunteered the information, however, that her main motivation is that she hates her job.One presumes that FSP's colleague is also, actually, happier working less. And it seems clear that FSP is happier working more. So where are the vaunted "mommy wars"?
As I've taken my place in the mom network and navigated the SAHM/WOHM divide in my own community, I've found that I have friends who work full-time, friends who work part-time and friends who don't work for pay at all. There are many women in each category to whom I feel no connection, and a few for whom I feel a real antipathy. Reading these posts has helped me realize that it's not so much about who draws a paycheck and who doesn't. The women I feel connected to, like Mary and Orange, are honest about their motivations for staying home and realistic about the trade-offs and risks of their decisions. They're not infantalized by their financial position like some people I know. Orange says she doesn't feel she's "giving up all feminist credibility as a result" of her decision to work part-time from home. I know she doesn't think I'm giving up my mom credentials by working full-time and sending my kid to daycare. So it's not about working; it's about integrity, about owning your own decisions and respecting other people's rather than claiming that there's only one right way to live our lives and raise our kids.
I still think it's crucial that we all have the ability to support ourselves and our kids. My mother was lucky: she married a man who not only adored her from the moment he saw her until the day he died, but who appreciated the unpaid work she did to make his family's life possible, and made sure she had financial security. Most of us aren't that blessed. I wish we could all walk away from the jobs we hate, as Mary and I both did. I'll keep working toward a society that provides health care for everyone so none of us are stuck in jobs to keep benefits. And I'll keep feeling grateful that I have friends like Orange and Mary and kindred spirits like FSP (read her blog!) to make life interesting and rich.
And I'm not going to change my mind.
Friday, September 7, 2007
My husband initially felt uncomfortable with my decision to quit my full-time job to stay home with the kids. He worried that I would end up like his own mother, who has been cared for by someone (parents, lovers, siblings, husbands or children) her whole life. She has never supported herself, or not for very long. She had her first child, the child who now owns the home she lives in, when she was 16. She never finished high school but instead married very young, divorced, married Mark's father, divorced again when Mark (her youngest) graduated from college. She was 60 years old (or very nearly) at the time and had been taken care of all her life; she had no home, no job, less than a high school education and no means of support.
I hope you're not expecting this to be one of these great success stories about a woman who finally, late in life, freed of her domineering husband, goes on to achieve great things, like getting a PhD or starting a small business or taking up mountain climbing. It's not. She did get her GED, and she has worked odd jobs: babysitting her grandchildren and great-grandchildren, baking cakes for folks at church, working at the laundromat. She makes enough money to buy herself whatever odds and ends she needs, but not enough to support herself. She lives with relatives (first siblings and now her daughter) who are ultimately responsible for paying the mortgage and putting food on the table.
I don't think my mother-in-law ever really felt comfortable with or understood me (her well-educated, self-supporting daughter-in-law) until I stopped working and buying take-out and started staying at home with the kids and cooking dinner. We have something in common now. We are, in a way, alike. But before I stopped working, I reassured my husband that we weren't completely alike. I have another role model: a mother who stayed at home, but who had not just completed high school, but a master's degree and teaching credentials before she had me (her first). When my alcoholic father spent several years depressed and out of work, she supported the whole family, including him.
So, yes, my income both in the present and the future take a hit when I choose not to work for pay. Yes, my retirement savings do as well. I was, and am, willing to accept a lower standard of living now and in the future in order to do what I want to do: be at home with my children. But that's what it is for me, a choice: a choice that will reduce my standard of living, but not throw me into poverty. My education, my career and my experience give me options my mother-in-law has never had, options that most women don't have, but options my mother did have, options I have.
When I was working for pay I was economically dependent upon my employers, whose loyalty was to the bottom line and not to me, and so they never earned my loyalty or trust in return. I chafed at having to sit in a cubicle and do the uninteresting work that was someone else's top priority. As an introvert, I came home exhausted at the end of the day from being away from home and dealing with people. Today I'm economically dependent on my husband's employer, but my husband, whom I love and trust, negotiates the relationship. As a stay-at-home mom, I'm (as the name implies) at home, my energy center. I may have two little bosses, ages 6 and 4, who are much more demanding than anyone who ever paid me, but unlike my previous bosses, I love them more than life. I'm where I want to be, and I'm happier than I've ever been. I may be a dependent, but I feel more independent, more free, than I ever felt in my working life.
Wednesday, September 5, 2007
So last week one of the other women in the group looks at me and says "so he won't let you buy one, either? My husband says he needs to hear me play more before I can".
Maybe before our next class I can figure out what to say in response, since I just sort of stared at her. I wanted to say "just go buy one" or "if that bothers you, get a job", but those seemed, well, rude. I know she doesn't draw a paycheck - she's a stay-at-home mom - but it still astonishes me to hear women acknowledge their economic dependence nonchalantly, as if it's normal and acceptable. It's like the whole name-change thing: I just don't get it. Sure, I read the commentser who said having the same name unified the family. If you want unity, I really like Ponderosa's plan to pick a new name for the new family (although that would make the Mormons work a lot harder). I can respect changing your name, but I don't get it - deep down I wonder why other women don't feel the same way I do. And that's how it is with "he won't let me". I just don't get it. I couldn't tolerate it. Honestly, it's easier for me to understand why a woman would stay in a physically abusive relationship. (I am NOT equating the two, and I am NOT condoning abuse. I'm just saying I have more empathy for an abused woman than the "my husband won't let me buy that" woman.)
This is not about being a stay-at-home mom. I get that, I really do. I couldn't do it myself, but I get why other people want to. But a lot of the stay-at-home-moms I know are like my mom: they actually control the money. It was a standing joke in our house that Daddy never had any money, and when he wanted to buy something extravagant - like our first color TV, back when they were the coolest thing going - she often stopped him. At least temporarily. So I grew up in a one-paycheck family, but it was clear to me that Daddy didn't tell Mom what she could and couldn't buy. If anything, it was the other way around.
So I don't know what to say to this woman. I'd kind of like to come up with a fast answer (well, a week later means it wouldn't be "fast" - maybe witty). I don't know or like her well enough to get into an earnest discussion about feminist principles. Maybe I should have gone with my first response, which to slap her the way Cher slapped Nic Cage in "Moonstruck" and yell "Snap out of it!" I'd do that, but my husband won't let me.
Tuesday, September 4, 2007
Each day I post to my own blog, and each day I feel guilty (read: the perpetual state of a woman raised Catholic in an alcoholic family) for not chiming in here as well. Sure, I've spent the summer cleaning up after my destructive three-year-old daughter, fighting the school district for services for my autistic son, traveling back to my 20th high school reunion, attending a very traumatic wedding and coping with my father-in-law's lung cancer diagnosis. But that is all no excuse! There's never a good excuse for anything, because I'm always supposed to be more, to do more, to be perfect and look good while I'm doing it.
I know I needn't throw myself on Jay's mercy, but I will throw myself on the mercy of the blogosphere, and now that the kids are back in school, I plan to take up my end of the conversation again.
Monday, September 3, 2007
A friend of mine confided today that she still feels anxious this time of year, still has the physical echoes of first-day jitters. Not me. I loved the first day of school. For some reason, my early school memories are all plaid, although I must have had solid-colored clothing. No matter - I adored the new clothes, the blank notebooks, the extra pencils. I couldn't wait to meet another teacher and open another book I would race through. Recess was a mystery; I didn't understand the social rules that governed kid behavior and I wandered around by myself. But in the classroom I was secure. I was happy. I was in my element.
My daughter has always needed to adjust slowly to new situations. She doesn't panic and scream for us. She just stands or sits quietly on the edge of the action for a while before she gets involved. I wish she could know some of my bubbling first-day-of-school happiness, but I recognize that while she may worry more than I did before the door opens, she's more secure on the playground and with her friends than I ever was. So we go to bed tonight on the eve of second grade, ready to let her build her own future.
Sunday, September 2, 2007
I like looking at the Google search strings. I wonder about the people who searched for "white coat ceremony" and ended up here. I hope some of them were young women who will now enter medical school with a slightly different lens on their experiences. I figure most of the people who were looking for "Wizard of Id" were surprised to end up here! I'm not the only one looking for that shampoo commercial. And I can't figure out if the person who searched for "cheerleader mall" was looking for outfits or, well, cheerleaders. I've always looked at these searches for amusement, but today I found one that wasn't so funny.
The search string was "can a doctor tell if you had an abortion". The simple answer is "no". A doctor doing a pelvic exam can tell if you've delivered a full-term baby vaginally, but a first- or second-trimester abortion doesn't alter the cervix in the same way.
But that's just the simple answer. Reading the question makes me sad and a little sick inside. I can feel her fear. Maybe she had an abortion in the past and is afraid that someone will find out. Will the doctor condemn her? Will the doctor tell her partner? Her parents? Her employer? Like my own patient, she may already be judging herself, may have been shamed by her culture or by a previous encounter with one of my colleagues. Not all women feel guilty after an abortion; many feel relieved, and many are ambivalent. But women who don't feel guilty or ashamed don't want to hide their history from their doctors.
Earlier today I read this article from the New England Journal of Medicine, reporting a study of physician attitudes about controversial procedures. They found that the physicians who were personally opposed to abortion and to prescribing birth control for adolescents without parental knowledge were also least likely to agree that they had a responsibility to disclose their opposition or to refer to someone who offered that service. It was a minority of doctors who held that view, but I am still disheartened to learn that doctors who believe abortion is wrong also believe that they have the right to deny patients information and access to a legal medical procedure. That takes paternalism out of the medical realm and into a place where we run the risk of imposing our version of morality on someone else. That's a dangerous and unprofessional place to be.
The good news is that a significant majority of physicians in the study, even those who were personally opposed to abortion, did believe that they had an obligation to disclose their views, and even to refer to an alternate provider. I hope they do so with compassion, and with some understanding of the difficult options the woman is facing. When I was in college, I read a quote that stayed with me, although I've lost the source: "A woman doesn't want an abortion the way she wants a new pair of shoes. She wants an abortion the way an animal will chew her own leg off to get out of a trap". Our own attitudes create the trap. We are all injured by our economic and social structures, our deep-seated ambivalence about sexual women, our terror of The Other and of real change.
I like to end my blog posts with pithy little observations that sum up what I've written, or a snappy line that shows off my wit and intelligence. I don't have anything here. I can only hope that in this blog, in my exam rooms, in my home and in my life I can begin to work towards that change.
Saturday, September 1, 2007
As they spread icing and sprinkles, they are reminiscing about "Sesame Street".
"Remember Mr. Noodle? I really liked Mr. Noodle."
"Yeah, Mr. Noodle was funny."
Ah, the good old days before they were 7 and had the weight of the world on their shoulders.