Friday, October 31, 2008
We carved the pumpkins* on Wednesday night. Eve hung up her homemade witches and Frankenstein monsters and tombstones, as well as the pumpkin lights and bat wreath she bought at Target with the $20.00 we gave her to spend. I'm off to the grocery store for last-minute items (candles for the pumpkins, food for dinner tomorrow, minor things like milk and eggs and bagels) and then Eve is entertaining three friends for pizza, trick-or-treat and cupcakes.
If you're Halloween-ing, enjoy! and if not, feel free to giggle at those of us who are awash in candy corn and tacky plastic gewgaws.
* please note the Obama-eyes on the middle pumpkin. That's Sam's work.
Wednesday, October 29, 2008
And I liked it.
Not the test itself - that was harder than I'd anticipated, and I have no idea how well (or badly) I did. My track record with standardized tests is pretty good, and one skill I have mastered is the ability to put a test behind me once I'm done with it, so I'm shrugging this off until I get my scores, whenever that is. What really surprised me was how much I liked the computer interface. I had expected to hate it, or at least find it uncomfortable, but I guess I finally got the payoff for all the hours I spend staring at this screen. It was easier to go back and review the questions I needed to look at again, and there was no worry about mis-marking the answer sheet or incompletely erasing anything.
One thing hasn't changed, which is my ability to do these things fast. The test consisted of four two-hour sections, with three breaks. Each section contained 60 multiple-choice questions. All the questions were "choose the one best response" - no annoying changes of direction - and none were longer than two brief paragraphs. So my very, very favorite thing about computerized testing is that you don't have to take the breaks, and if you do you can take shorter ones and start the next module whenever you want. I took one break, between the second and third module, which would have been the lunch break, except that I finished the second module at 9:40 AM. So I went home, had a bagel and a cup of tea with Sam, unloaded and reloaded the dishwasher, and went back at about 10:45. I finished the whole thing at 12:30 and had the rest of the day free.
I'm caught up on blog-reading (or I was at 3:30, when I left to go the library and to collect Eve at school) and ready to carve pumpkins tonight and plan Eve's Halloween part for Friday and have a weekend with no studying. Yay!
Tuesday, October 28, 2008
Years later, I found out that my mother called the Rabbi and told him that if he said no to us, and turned me against Judaism, she'd never forgive him. He didn't tell us that when we met. He asked us why we wanted to get married, and why we wanted a Jewish wedding, and whether Sam had considered converting, and what we planned to do when we had children. We explained that we wanted a public commitment; that Judaism was important to me and thus to Sam, who had never felt connected to the Christianity of his youth; that yes, Sam had considered conversion (this was news to me) but didn't feel it would enhance his life at that moment; that we intended to raise our children as Jews. Whatever the test was, we passed it, and we were married under a chupah by the same Rabbi who taught my first religious school class and, years later, officiated at my father's funeral.
What does this have to do with Proposition 8? Well, marriages between a Jew and a Gentile were entirely legal in 1984. Our marriage was legal in 50 states and the District of Columbia, as well as Puerto Rico and Guam. But the Rabbi could still have refused to marry us. Six months later, when Sam's brother married a Jewish woman, two rabbis did refuse to officiate. No one arrested them.
Same-sex marriage is legal in California now, and churches and synagogues and (I assume) mosques and Hindu temples and drive-throgh chapels all over the state are still refusing to perform weddings that conflict with their values, just as many Rabbis still refuse to marry a Jew to a non-Jew.
Vote No on Proposition 8. Just because it's legal doesn't mean you have to do it.
Sunday, October 26, 2008
Then I was brought up short at the "beneficiaries" page for the life insurance. Not the primary beneficiary - that was easy. Fill in Sam's name, skip his SSN because I don't have it, choose SPOUSE from the drop-down list of categories. Move on to contingent beneficiary - and stop, because after I fill in Eve's name and date of birth, I look at the list of categories and realize I have to choose between CHILD and ADOPTED CHILD.
So now instead of being bored, I'm furious. Eve is my daughter. She is legally my daughter. Her birth certificate* says she's my daughter. I'm not ashamed that she's adopted. It's a fact of our lives, but it's not anybody else's business unless Eve says so. But at the same time I can't say she's not adopted, because that's denying something fundamental about who she is and how we came to be a family.
I have until November 7th to finish filling out the forms. At the moment, I have no contingent beneficiary because I couldn't bear to check one of those boxes. I can't choose between her identities. Eve is biracial; don't ask me if she's black or white, because she's both. And she's adopted; don't ask me if she's my "adopted child" or my "child", because she is both, and so much more.
*I actually don't think Eve' s birth certificate should list Sam as her father and me as her mother. It should list her biological parents, and we should have an adoption certificate to go with it. Revised birth certificates are a relic of the bad old days of secrecy and fear, and hamper adult adoptees efforts to find their biological parents. I believe everyone has the right to know their own stories, and that the state should not collude in what is essentially a lie.
You are The Wheel of Fortune
Good fortune and happiness but sometimes a species of
intoxication with success
The Wheel of Fortune is all about big things, luck, change, fortune. Almost always good fortune. You are lucky in all things that you do and happy with the things that come to you. Be careful that success does not go to your head however. Sometimes luck can change.
What Tarot Card are You?
Take the Test to Find Out.
Saturday, October 25, 2008
Does this actually improve the ability of the test to make meaningful distinctions between one level of knowledge and another?
Seriously, I'd like to know.
Wednesday, October 22, 2008
It's election season here. Streets are lined with red, white and blue signs pushing various candidates and various positions on the issues. Several neighbors have large lawn signs letting the rest of us know where they stand.
There is a tan house with white trim that sits a fair walk down the road from me. It's close enough to me (and on a busy enough street) that I pass it nearly every day, but it's far enough from my house, that I've never had the chance to meet the folks who live there. I know them only from the parts of their life that face the road. I know their lawn is neatly kept and the house is well maintained. I know they have a child, because there is a Razor scooter next to the garage. I know the garage is bursting with clutter, because the door doesn't shut all the way, and some of the detritus creeps out onto the driveway in a way that's not in keeping with the rest of the exterior. I know that this year they are voting McCain/Palin. And I know that in a previous election they wanted to make sure that gay people wouldn't be able to marry in our state.
Each time I pass their house, ever since that previous election when they supported a ballot measure banning gay marriage, I think about another house on my street. It's across the street from me and a little down the road, close enough that I have a nodding acquaintance with the occupants. They're an attractive couple, with a young child and a dog. I see them out together some evenings pushing the stroller and walking the dog. And they're lesbians.
I always wonder what the people in the tan house think of that family. What does being against gay marriage mean to them? Is it just the idea of same sex couples marrying that they have a problem with or is it gayness itself? Do they know the lesbian couple? Have they seen them out walking the dog too?
And I wonder how that family feels when they pass that house. They've been living here as long as we have and travel the same roads out of the neighborhood to work and grocery shopping. They must have seen the sign when it was up. Did they feel the way I felt? Because even though I'm married to a man, I felt assaulted by that sign. I felt hated, even if that wasn't the intention. I wondered if people had yard signs like that around the time I was born, when as a white woman, my marriage to my black husband would have been illegal.
I'm curious about the family in the tan house with their tidy lawn and messy garage. But I hardly feel comfortable walking up to the door and saying, "Remember that sign you had on your lawn years ago? It's still bugging me. Who are you and what are you really like?"
Do you have your own Web page? (1 point) Yup. (It doesn't say it has to be up-to-date)
Have you made a Web page for someone else? (2 points) Um, nope.
Do you IM your friends? (1 point) Yup. Not many of them, but some.
Do you text your friends? (2 points) Yup. Assuming my husband counts as a friend (and, actually, I've texted other people, too. Hell, I think I should get a point for using "text" as a verb).
Do you watch videos on YouTube? (1 point) Doesn't everyone? I didn't watch any of the debates on actual TV.
Do you remix video files from the Internet? (2 points) Didn't even know that was an option.
Have you paid for and downloaded music from the Internet? (1 point) As we speak.
Do you know where to download free (illegal) music from the Internet? (2 points) I know where. I haven't done it, but I know where it is.
Do you blog for professional reasons? (1 point) Can't decide. It's not part of my job, and since it's not connected to my real name, I'm saying no.
Do you blog as a way to keep an online diary? (2 points) Yes.
Have you visited MySpace at least five times? (1 point) I don't think so. I don't have a MySpace page and I think I've only been there once or twice to check out singers.
Do you communicate with friends on Facebook? (2 points) Yes, under my real name.
Do you use email to communicate with your parents? (1 point) Whenever possible.
Did you text to communicate with your parents? (2 points) Are you kidding? My mother doesn't even keep her cellphone turned on. "Why should I turn it on? No one ever calls me".
Do you take photos with your phone? (1 point) Yes. I have a very cute photo of Eve at the paint-your-own pottery place from last Sunday.
Do you share your photos from your phone with your friends? (2 points)Again, assuming my husband counts as a friend - but now that I think of it, I sent that photo to someone else, too.
0-1 point -
2-6 points -
6- 12 points -
12 or over - Generation Y
My tally is 14 points. Generation Y. For the record, I was born in 1960 - turned 48 last July. Forever young.
Tuesday, October 21, 2008
Don't get me wrong, I am grateful every day for the research and development done by pharmaceutical companies. My patients and I live better for the chemistry available to us all.
But it costs a fortune to develop new drugs. So they cost more while they are on patent before the generics come out. So the insurance companies restrict what new medications get reimbursed. So the patients and doctors have to make choices of expediency.
I saw a new patient with depression. The patient has never been on a medication before to treat the depression. The patient also has debilitating chronic pain. A new medication out there can treat both problems very effectively and with minimal side effects.
Well, the insurance company won't cover it since the patient has yet to fail two trials of generic antidepressants.
I tried to fight the great fight: filled out all the prior authorizations forms, tried to have a doctor to doctor conversation with the doctor who denied the request.
But the request was denied.
And no doctor ever called me back.
Meanwhile days and days have gone by. So I went with the shorter term greater good and got the patient started on a generic medication.
Better the person should get started on something.
Friday, October 17, 2008
I have one at work
because I don't have one at home.
I find if I leave a pile of papers for long enough, once I do go through them, I can safely recycle or shred most of them, leaving my file cabinet a little leaner.
But today, I found three unsubmitted out of network dental claims.
I have to thank one of my more obsessive/organized patients who told me how to make sure to get paid for out of network medical expenses, like for having seen me. Here is the trick:
-Keep a file folder for the out of network provider.
-In the folder keep stamped envelopes pre-addressed to the insurance company and pre-filled out forms for the submission.
-Take the necessary form, fill out the recurring information, like name, address, and provider.
-Xerox many copies.
-Send out on demand.
Can't wait for the check.
Wednesday, October 15, 2008
With another form that we're supposed to return, signed by the "eye care professional".
So this is deja vu (or deja unable-to-view). We took Eve to the eye doctor LAST year, after she failed the same screening, and now she has glasses. Which, admittedly, she prefers not to wear.
Eve, did you wear your glasses to the vision screening?
Did they ask you if you had glasses?
No. They never said anything to me except "Please cover your other eye".
Seems to me that if your form has a line for "with glasses" and "without glasses", it behooves you to ask the child if she has glasses and, if the answer is yes, suggest she put them on. I wonder if they'll accept "WE ALREADY DID THIS" scrawled over the form by me, instead of an "eye care professional".
Tuesday, October 14, 2008
I don't know about Mim, but I know that neither Mary nor MomVee saw "Star Wars" in its first run in a big, fancy theater in New York City, like I did. So there.
Sunday, October 12, 2008
MUR says Savage's piece left hir shaken, and continues
What do you think about the issue? You are probably against it because of religious reasons, right? If you didn't believe, would your opinion be the same or not?I'm not opposed to physician-assisted suicide. I would have voted for the Oregon statute. I haven't read the proposed Washington State law, but if it's the same model I would probably vote for it, too. My religious faith informs my values, and my values inform my practice of religion - and my practice of medicine - but I am a Reconstructionist Jew and don't consider myself bound by halakhah, Jewish law. So I am not opposed to the idea. It's been my experience, though, that very few people actually make that choice - and that's what we've seen in Oregon and in the Netherlands. Most people who say they would choose assisted suicide are afraid of pain or other symptoms, and if they are sure their symptoms will be treated, they change their minds.
I was also shaken by Savage's article, mostly because his mother had lousy care. I don't see any mention that hospice or palliative care was offered to her at any point, although she clearly knew she had a fatal illness and was deteriorating. Even when they knew it was the end, her doctors did not adequately treat her anxiety or her shortness of breath, and they did not offer anything approaching appropriate support to her family. No wonder Dan Savage thinks she should have been able to choose suicide.
That said, I take issue with one statement in the article. Savage equates physician-assisted suicide with "end-of-life-pain-management". No. No. No. The medications used for suicide are not pain medications; they are sedatives. We can achieve adequate pain control for more than 90% of people at the end of their lives (see, I told you I've been studying). For those unfortunate enough to fall into the less than 10% who have pain we cannot control, or other symptoms we can't manage, we can offer palliative sedation, which means effectively rendering the patient unconscious with strong intravenous sedatives. This may well shorten life, but ending life isn't why we do it. We do it to relieve suffering.
If Savage was trying to say that assisted suicide can be merciful, I would agree, but I think he is speaking from the common - and mistaken - assumption that good pain control will shorten life, and is only offered as a means to death. Most people with pain and shortness of breath can benefit from treatment with narcotics. The medications do have side effects, but they don't cause respiratory suppression and can be safely used even in people with severely compromised lung function.
Initiative 1000, I presume, is the end result of Booth Gardner's campaign, which was described in a piece in the New York Times Magazine last year. It's worth reading the article if you're at all interested in this subject. I found myself questioning my own stand when I read about the work of Susan Wolf, who opposes physician assisted suicide because she believes women will disproportionately choose this option.
If women are expected, above all, to care for others, for children, parents, husbands, she asked, aren’t they particularly likely to view their own lives as without value when they become so sick or disabled that they are the ones who must be cared for? Might they be especially likely, at that point, to see themselves as burdens and, if assisted suicide were legal, to request that their deaths come right away? And might this tendency be compounded by a cultural lineage exalting female suicide, a tradition going back, Wolf suggested, borrowing from the work of the French classicist Nicole Loraux, to Greek tragedy, where suicide is carried out almost exclusively by women?
Wolf cites Jack Kevorkian's record; approximately 70% of the suicides he assisted were women, and a number were not terminally ill. She makes a compelling argument. No one reading this will be surprised to hear that I believe we have a lot more work to do before we live in a society where women's lives are seen as having worth equal to the lives of men. But I can't convince myself that we should restrict everyone's liberty because of the patriarchy.
I don't think we'll ever know just how many physician-assisted suicides there are. The practice was illegal everywhere in 1991, when Tim Quill wrote about his patient Diane in the New England Journal of Medicine.
Diane taught me about the range of help I can provide if I know people well and if I allow them to say what they really want. She taught me about life, death, and honesty and about taking charge and facing tragedy squarely when it strikes. She taught me that I can take small risks for people that I really know and care about. Although I did not assist in her suicide directly, I helped indirectly to make it possible, successful, and relatively painless. Although I know we have measures to help control pain and lessen suffering, to think that people do not suffer in the process of dying is an illusion. Prolonged dying can occasionally be peaceful, but more often the role of the physician and family is limited to lessening but not eliminating severe suffering.Tim Quill acted as a healer when he helped Diane end her life. That is profoundly paradoxical, but true. Healing is the relief of suffering. I imagine that Diane's suffering in the last weeks of her life was eased by the knowledge that she retained control, and by the deep and meaningful relationship she clearly shared with her doctor, who was able to hear all her needs and do what he could to meet them. If only Dan Savage's mother had had a doctor like Timothy Quill.
Financial stress make us wonder what is happening to our retirement accounts? Will our jobs still be there for us? Should we be changing our everyday habits as well as our plans for the future?
So we cut back.
We cut back on our fancy coffee trips.
And we cut back on our health care. In every economic downturn, mental health care is the first place people cut back.
If feels like a luxury.
A broken leg? Sure it needs to get an X-ray and a cast.
Anxious? Well, who wouldn't be!
Depressed? Well, buck up and pull yourself up by your own boot straps.
Yet, it is during just these most stressful times when we most need to take tender care of our psyches.
Anxiety and depression have effects that reach far beyond the discomfort of the person with them. Anxiety and mood disturbances disrupt a person's sleep, mood, relationships, influence families, ability to show up on time at work, to be effective at work, to drive safely, to drive without a higher risk of a car accident from chronic sleep-deprivation.
You get the idea.
So how can you afford a trip to the therapist?
One of the most historic parts of the "pork" slipped into last week's bailout package was that for "mental health parity." That means that paying for mental health care will be treated the same as paying for other types of health care. Right now it is not, but will be phased in over the next 5 years. For more information about the bill just passed, look here.
What do you do for help right this minute?
Use your resources:
ask your therapist for a payment plan or discount
talk to your internist/primary care doctor
go to your local community mental health center, which provides FREE mental health care
talk to your clergy
talk to your friends
Don't cut out your mental health care! The healthier you are in mind, body, and spirit, the better you and your family will ride out this downturn.
Here are some national resources:
The American Psychiatric Association
The American Foundation for Suicide Prevention
National Association for the Mentally Ill
Here are some hotline numbers:
|National Drug and Alcohol Treatment Hotline||800-662-HELP|
|National Domestic Violence Hotline||800-799-7233|
|National Child Abuse Hotline||800-4-A-CHILD|
|NIMH Info Center||800-647-2642|
|Project Information HIV/AIDS Treatment Hotline||800-822-7422|
|National Suicide Hotline||800-784-2433|
Take good care.
Saturday, October 11, 2008
For Yom Kippur this year, I wanted to write about what it’s like to know you are dying, to contemplate the end of your life. Many of my patients know what is sealed in their book. I wanted to talk about that experience. That was pretty presumptuous of me. I’ve been struggling with this piece for weeks, and now I realize that I can’t know what it’s like to contemplate your own death. What I can do is reflect on what working with the dying means to me.
I started my medical training during the early days of the AIDS epidemic, out in the SF Bay Area. One of the first things I learned was that we can’t cure everybody. Some days it felt like we didn’t cure anybody. Can’t cure diabetes, or heart disease. Can’t stop emphysema. We had lots of technology, lots of monitors that beeped and machines that whooshed and medications that did all sorts of stuff. Don’t get me wrong: high-tech care saves lives. I wouldn’t want to practice medicine without it. But I also don’t want to practice medicine as if high-tech is all we have.
When I was a second-year resident, I spent a month working in an ICU at another hospital. I learned a lot about ventilators and blood pressure and heart transplants, and I’ve forgotten most of that. What I remember is the family that sat with me in the conference room, listening to me tell them that their mother would not recover, and asking me if I could keep her going long enough for the rest of their siblings to arrive. That took two days; some of them were in Africa and Asia, doing missionary work. But all nine of them finally made it, and with their spouses and children they stood around their mother’s bed after we’d disconnected all the machines. They stood there, and they held hands, and they sang. In that moment, I began to understand healing.
Since then, I’ve learned that when I focus on cure, when I go into my work with the idea that I have to fix somebody’s problem, I come home drained, frustrated and often angry. When I step back from that goal and instead think about healing, I am far more likely to feel peaceful and content when I’m done. I’m still tired - I’m always tired - but it’s the kind of tired that tells me I’ve done good work, and I can rest for a bit. In my primary care practice, people are sometimes cured, and that’s pretty cool when it happens, but it’s not what I set out to do every morning. I set out to be present for what my patients need, and to seek healing where I can find it.
Now I spend much of my time taking care of people for whom cure is no longer an option. People come to hospice care at the end of their lives. For some, it is a relief. They can give up the struggle, lay down their shields, stop trying to pretend everything is OK. They can ask for and accept help from their friends and families, and from all of us at the hospice. They can rest. For others, hospice is the beginning of another kind of struggle. It’s a terrible loss to give up the idea of cure, to accept that death is inevitable. That acceptance doesn’t come easily, and sometimes doesn’t come at all.
What is healing without cure? Healing isn’t something I do. I can be in the presence of healing, and sometimes I can facilitate the process, but I can’t make it happen. Healing happens with loving presence. Loving presence can it itself be therapeutic. That doesn’t mean my training was a waste - loving presence and evidence-based medicine can work together. But evidence in and of itself doesn’t heal. We have to recognize the individuality of each person we treat to know how to apply the evidence. We have to agree about the goals of care before we even think about the evidence. I love hospice work in part because the goals of care are so clear, and our charter - our very mission - is to meet the goals set by the patient and family. Our goal is to relieve suffering, and to do that we have to know how that suffering is experienced.
Sometimes we use medications to ease suffering. Sometimes we use ourselves. A few weeks ago, I went with one of our nurses to visit Sally. Sally has dementia, and we couldn’t really converse with her. We could tell she was suffering, though; she twisted her body and she waved her hands and she spoke in an endless, anxious stream of words that made no real sense but told us she was miserable. The nurse laid her hand on the patient’s arm and spoke to her, slowly and calmly. She talked about what we were doing, and where we were, and what our patient was wearing. As my colleague spoke, I watched Sally. Her movements slowed and she looked directly at the nurse. Her speech became less pressured, and more conversational. Finally, after about 10 minutes, she sat back in her chair and took a deep breath - and smiled.
When pain is relieved, that is healing. When anxiety and fear give way to even a moment of serenity, that is healing. When someone who needs quiet is allowed to be alone, and someone who needs company has a friend, that is healing. When an exhausted caregiver can sleep, that is healing. When a son gives his mother permission to die, when he says “I’ll be OK; you can go now”, that is healing.
I am privileged to serve in several roles. I am witness, and I am healer, and I am also healed. That loving presence works in both directions. I marvel at the gifts I receive from my patients, but I know that it is my job to take care of myself so that my needs don’t interfere with my work. That’s one of the reasons I love Debbie Friedman’s mi sheberach so much. We are asking God for healing, but we are not expecting God to act alone. Before we ask God to renew our bodies, we ask for strength to do the work ourselves. Every time I sing that, I am renewed, which means this community and our observance is also a source of healing. For that I am deeply grateful.
“May the Source of Strength/who blessed the ones before us/help us find the courage/to make our lives a blessing/and let us say/Amen”.
Why is it weird?
Ghosts aren't orange. Ghosts are white.
Well, since ghosts are imaginary, they can be any color, I think.
I have a ghost.
Yes. His name is Ghostie, and he lives under my bed. Well, sometimes in my closet, but usually under my bed.
I hope he's a friendly ghost.
He is. He gets rid of my bad dreams.
Oh? How does he do that?
He talks to me. He says "That's just your mind replaying something you saw today that scared you. Or something you saw before, not even today. It's just replaying that. You can go back to sleep". So then I do.
Friday, October 10, 2008
That's what happened with the Board Exam in Hospice and Palliative Care Medicine. It's October 29th. When I signed up for it, that seemed like a loooong time away. Now it's, um, just around the proverbial corner. Uh-oh.
The monthly study group was great, but I really need to do some intensive preparation, and since I still have the full-time job and the kid and the husband (who will be at a conference for several days between now and The Day) and the week on-call and the rest of my life...my studying time will have to replace my online time, which means less blog-reading and less blog-writing.
Somehow I don't think you'd be interested in the chemoreceptor trigger zone, the Conditions of Participation for Medicare, or the conversion factor from oral morphine to parenteral hydromorphone, so I'll keep all that wonderful nerdly goodness to myself and hope to remember it long enough for the exam. Which, may I mention, is on a computer: no exam booklets. No answer sheets. No #2 pencils. No little boxes to fill in. I've been taking #2 pencil exams since 1968, or thereabouts. They're screwing with my strategy.
I'll try not to disappear completely, and I'll still have a couple of days to be infuriated or despairing or optimistic about the elecion after the test.
Back to the books I go....
Wednesday, October 8, 2008
Sam and I do not observe the laws of family purity. I don't go the ritual bath every month. I didn't go before my wedding. But for the past ten years, I've been to the mikveh some time between Rosh Hashanah and Yom Kippur. It has become an important part of my observance of yamim nora'im, the Days of Awe.
I go because I treasure my community of Jewish women, and because the trip to the mikveh promises me a moment of peace and contemplation in an otherwise hectic and stressful season. When I'm part of congregational leadership, and especially when I'm president of our shul, I have a much harder time finding spiritual sustenance in the services themselves. I'm too busy making sure everyone has a prayerbook and that there are enough chairs and that the security guard showed up and that the greeters are out front where they belong and that the babysitters are actually paying attention to the children. But mikveh time isn't about the shul. It's just about me, and quiet. That's been enough for me. I usually leave feeling calmer and more centered, but not spiritually transformed.
Today was different.
I've always said the standard mikveh blessing, thanking God for sanctifying me with the commandment to immerse. But there is no mitzvah to immerse before Yom Kippur; it's minhag, tradition, not mitzvah, commandment. Today our rabbi offered us alternate observances, taken from the Mayyim Hayyim website. I chose the ceremony of forgiveness.
As I immerse myself in Mayyim Hayyim, may I open to the possibility of forgiveness.The air was warm and the room entirely still. I walked down the steps, floated for a minute, and pulled myself under the water.
May my entry into these waters mark my intention to forgive myself, forgive others,
and ask others to forgive me.
Baruch atah Adonai, eloheinu melech ha’olam, asher kidshanu bi-t’vilah b’mayyim hayyim.My tears surprised me.
Blessed are You, God, Majestic Spirit of the Universe, who makes us holy by embracing us in living waters.
The gates are open. Hear my prayer, God. May I have the courage and clarity to engage in the process of teshuvah.The rabbi said "be gentle". I floated, and brought my head completely under the water. I could not distinguish between the living water and my tears.
I stood up and the rabbi began to sing; I joined her and there was harmony.
V’al kulam, Elohah s’lichot, s’lach lanu, m’chal lanu, kapper lanu.I do not need to be worthy. I simply need to be, to be open, to be forgiving myself and of myself. To have intention.
For all my wrongs, O God of forgiveness, forgive me, wipe the slate clean, grant me
I pulled myself under again, rose to the surface.
I know you mean well, and we appreciate that - we really do - but it's just not that sort of holiday. That sort of greeting leaves me feeling as if I should be grateful that someone knows it's a religious holiday, and I'm not just goofing off in the middle of the week, but feeling obliged to educate her. And sure, that's my stuff - I could just smile and say "thank you" - but this is my blog, so it's OK to say this here.
You can ask "how will you be spending the holiday?" or you can say "Happy New Year", or "have a sweet year", or "l'shanah tovah". If you want to really look like you're "in", you can say "have an easy fast", or "g'mar chatimah tovah"*, or "g'mar tov", but if you do that, you might be mistaken for one of Us.
So for those who are observing, I wish you an easy fast. *May you be sealed for a good year. And for those who are observing our observance, thanks for listening.
Tuesday, October 7, 2008
Monday, October 6, 2008
I'm a doctor. I'm for Obama. While I'd prefer a single-payer system, we're not going to get one, and Obama's healthcare plan is as good as we could hope for right now. I put my cursor over the link in the email....and stopped.
Is it a good idea to support Obama publicly, with my name and degree attached? I was raised in a small town where my father practiced medicine, and my mother would not allow us to be politically active. What if one of Dad's patients found out and left the practice? (That didn't stop her from supporting NARAL and Planned Parenthood, but at the time I didn't quite realize that work was political. Now I realize just how important the reproductive rights work must have been to her.) When I wanted to work on a school board campaign my senior year in high school, I finally asked Dad and he said "If someone cares more about my daughter's political views than about how well I treat them, that's their problem. Do what you feel you should". Would he say "go ahead and sign it"? I don't know. I don't remember ever hearing him talk about his own politics anywhere other than our kitchen table.
About three weeks ago, I got dragged into a political discussion with two of my patients. The first two times she asked my opinion, I said "That's not a topic we should discuss". Then she said "Well, you know he's a Muslim" and I said "Oh, no, he's not", and we were off to the races. I doubt I convinced them of anything, but at least the relationship survived.
I think I need to trust my patients and my relationships with them. This is who I am, and this is what I believe. I'm off to sign the letter.
Saturday, October 4, 2008
Want to check if Sarah Palin really did try to ban books?
Sure that last attack ad you saw was off base?
Check it out at Politifact, the best political news to come out of Florida in a long time. The site was created by the St. Petersburg Times. You can check the veracity of campaign claims by politician, topic or degree of untruth. I especially like the "Pants on Fire" category.
I tried it. It works. Amazing. If you want to know how to use it, text "help" to that same number and they'll teach you.
The listings aren't perfect - I tried "pizza" in my zip code and it only gave me three locations, missing at least 10 that I can think of - but it's still pretty impressive. As they say, standard text messaging rates apply.
Thursday, October 2, 2008
The only good thing I got out of the 1980 election was a well-cooked steak. My then-boyfriend was a fervent Reaganite, and we had a bet on the outcome of the election - winner takes loser to dinner. It was a delicious meal. The relationship - and the country - went downhill from there.
Ever since then, it's been received wisdom in the US that government is a Bad Thing. Corrupt, wasteful, inefficient, bureaucratic. Big Government buys expensive toilet seats and interferes with heroic, Horatio Alger-ish business owners and forces people to drive slowly and wear seatbelts against their will. Government takes our money - our hard-earned money - and wastes it on things like roads and post offices and feeding people and providing health care.
I don't see it that way. I look at Medicare and see a program that despite its flaws, actually improves the health of its recipients. I look at the VA (when it's fully funded) and see an institution serving a deeply challenged population with dignity and excellence while simultaneously providing medical education to students and residents and producing research that changes the standards of care. WIC feeds real people. Title IX opens real doors for real women. Highway taxes build roads that everyone gets to drive on. There's a lot about the government that works.
I admit to a bit of amusement earlier this week at the spectacle of Republicans trying to explain why the government needed to intervene to save American businesses. Unfortunately, I think the government does need to intervene, and since so many Americans believe in the idea that government can't do anything right, it's hard for them to trust the government now. The very people who told them not to trust the government with their money are now talking about spending an unimaginable amount of somebody's money to do something they swore they'd never do. And this particular government has misled us for so long that even when they're right, they sound wrong.
Seems to me that if you believe governing is a fool's game, it should come as no surprise when you end up with fools running the government. One thing Hillary Clinton and Barack Obama share is the conviction that governing is a calling, an opportunity to serve, and a noble pursuit. Our leaders should be proud to be part of the government, and we should be proud of them. It's been a long time coming, but I think that pride is on the way back.
Wednesday, October 1, 2008
She knew I was upset because I started to cry afterward, but it wasn't because I bollixed up my Hebrew. It was my other assignment that got to me, the little slip of paper I was handed at the beginning of the service. "English reader for the Torah service. Please read the English translation of each aliyah after the Hebrew reading is complete".
Today's parsha was, of course, the akeydah.
Take, now, your child,
your only child, your beloved Yitzhak,
and go forth to the land of Moriah,
and offer him up there as a burnt-offering
upon one of the mountains I shall indicate to you.
Whatever is it that I'm working through, I guess I'm not done. I could have refused the assignment as another way of protecting myself, but the idea made me angry. I don't want to be defined or limited by my grief any more than I want to be overwhelmed by it. So I kept the little slip of paper the coordinator handed me when I walked in, and I read each section in English, and I survived. My discomfort allowed Miriam to do something she didn't think was possible, and in a way I suppose I surprised myself, too. I read the whole thing without actually breaking down or running away.
We read the Torah every year, and there is always something to learn: some new insight from the text, a midrash with a different perspective, a question we hadn't considered. The rabbis who codified the liturgy believed the akeydah was so important that it should be read every year on Rosh Hashanah, the anniversary of the birth of the world. In my own heart, I am playing out some piece of the story of our people. Year by year, reading by reading, I face Abraham's grief and Isaac's fear and my own tears. And year by year, I grow stronger.
May this year bring us all peace.