LIFE – Page 39 – Don't Gel Too Soon

Scared and Grateful

You know how the US health care system is allegedly dead? Mangled beyond recognition? Well — don’t you believe it. There are places here where the true wonder of good health care is visible in abundance. The best of them, in my opinion, is the Cleveland Clinic. I need to tell you why.

When someone you love – and live with – is sick, it’s scary. When they’ve been through open-heart surgery, a shattered shoulder repair and a lengthy illness, it’s very scary. That’s where I am right now. Scared.

My husband’s heart surgery was in 2002. Five years later, he began to feel sick. Many of the symptoms were similar to those from his initial illness, congestive heart failure caused by a faulty aortic valve. The fear: that his valve was again failing — that the repair had not held. So we went one more time to Cleveland to the remarkable institution where he’d had the surgery, to find out what was wrong.

After many tests, all perfectly scheduled and wonderfully administered, we learned that his heart is in good shape – at least the part that had been repaired. The trouble was that the arrhythmia – irregular heart beat — sometimes very fast — that had also been dealt with in the surgery, had returned. Now he’ll take a medication that, at least initially, is like being kicked by a horse. If medication can get his heart back into rhythm, he can avoid the thing that scares me most. It’s a surgical procedure, far less invasive than heart surgery, but still with some risk. And it’s not fair. He’s had enough to deal with – and frankly – so have I. But apparently, higher powers have declared that not altogether true and this is our next mission. So we’re on it.

The thing I try to remember and I want to tell you though, is how blessed we are to have access to the best that health care can deliver – and how remarkably common-sense a lot of it is. This hospital is declared number one in cardiology every year because it is excellent. The staff standards are high — and the hospital is headed by one of its top surgeons ( who operated on my husband.) His standards are demanding and every surgeon who is hired "from Hopkins or Harvard or anyone else" still is vetted in action by the Director. In addition, the nurses are empowered to make decisions and raise issues with physicians, the morale is positive and energetic and there’s not a nasty or impatient person behind any desk or lab coat.

All of these truths add up to a single truth: there’s no mystery. To get good health care we need a nimble, well-educated, trained and motivated staff and leadership to keep it that way. Of course the equipment and endowment matter too. But somehow in the insurance mess, the malpractice mess, the escalating cost mess – all provoking defensive driving by doctors and hospitals, we’ve weakened quality control and management in service to these other issues. It’s a tragedy — one made far more real to me by our experience with the best – something that used to be true of our health care system altogether and sure isn’t anymore.

I’m desperately grateful for what we are able to do to keep Rick healthy but every time I walk into the Clinic I remember again what’s going on in so many other health care sites and seeing what could makes it all even more tragic.

SHARING HAPPY DAYS

For the past month I’ve been working almost all the time. Between all the blogger work I do and the benefit I co-chaired it’s been madness. Still is, a bit. But we’re rolling up to two summer weddings and a weekend at the beach so I will recover I’m sure. We spent a good deal of this past weekend celebrating with our friends in the last official activity before their wedding – it’s called an aufruf and it’s part of the Saturday morning service. The groom reads from the Haftorah and then – I know it’s goofy — everyone throws soft candy at him. It’s kind of a welcome into the almost-married state.

I was surprised at how moved I was; seeing a young couple of whom we are so fond pass another milestone on the way to their wedding in July. I am always struck at the value of ritual — something I suspect I’ve spent much too much time avoiding. Because we have been part of this relationship for some time, and because my husband was part of the service and all those called to bless the Torah were close both to the groom and to us, every moment was rich with meaning. The more I learn about the value of these moments the more I see the value behind religious observance. There are many days when I just get angry – don’t want the restrictions and rules and dos and donts. Days like Saturday though, I understand the connection between the lovely and the difficult. Just like the rest of life in some ways I guess.. only more so.

FLOWERS IN THEIR HAIR

This morning the New York Times told me that the San Francisco Summer of Love was 40 (forty!!!) years ago. No, I wasn’t there. I was still in college, and that summer I was working a the Housing Authority of Pittsburgh, Pa, taking pictures in various buildings and helping with community organizing.

It was the days of VISTA and there were volunteers all over town, working with residents to learn how to budget, how to prepare nutritious food, child development and work skills. It was moving, exciting work – a job I’d gotten for myself after the director initially told me that "no nice girl from Smith belongs in the projects." He was from the original public housing establishment and a great teacher, once I convinced him I wasn’t some Muffie prepazoid.

But the Summer of Love… my boyfriend was out there – his family lived in Berkeley – and it all looked so romantic. I was far too committed to what I was doing – and too much of a coward to ever tell my parents I was going. I also knew that hanging around stoned was not the way to help people who couldn’t help themselves – and that was what I most wanted to do. Even so, it was tough thinking that all the action was "out there" and I was on the shores of the Monongahela River in Head Starts and food banks.

Between my house and "downtown" there was a bridge that went through the famous Homestead neighborhood where the Pinkertons beat up the steel strikers so brutally. Crossing between a smoking mill with a red aura generated by molten steel and the Mesta Machinery plant, it rattled and clanked with age and instability. Ever since we were little we had called it the "rickety bridge." I loved it.

One day that summer, somehow emblematic to me of the whole three months, I was driving along and, just as I began to cross the bridge, Scott McKenzie’s "If You’re Goin’ to San Francisco" came on the radio. At first I smiled, then – suddenly – without warning, I began to cry. I ended up sobbing, almost unable to drive. I still don’t know why. The song was moving, of course, and very seductive, but now as I recall that day I think I was also crying for the side of me I couldn’t allow to rule. I loved the ideals of the counterculture, adored the music and light shows and communes and home-made bread — but either my fear of the risk or my commitment to politics or both kept me home. It was probably better. I later left college to work in the anti-war campaign of Senator Eugene McCarthy – a risk more suited to my nature and dreams. Even so – remembering that day, which I do, with particular intensity – I’m still sad – for what I may have missed, for what the movement disintegrated into, for those shiny dreams that even then seemed a bit naive. You know that old Gerard Manley Hopkins poem that ends: It is the blight man was born for,It is Margaret you mourn for. True then – and sometimes, just as true now.

SNOWED UNDER

I’m making a presentation on Thursday and co-chairing/producing a benefit on Sunday so this is it until Monday. Wish me luck — and a good week to all!

LEAVING WAY TOO MANY BEHIND

This is the kind of thing my friend Cooper usually writes about, but foster care has been an obsession of mine for as long as I can remember. Kids who, because of the incapacity of anyone in their families to care for them, get placed "in the system" and shuttled among foster homes – some group homes, some loving families and some just plain horrifying. It’s a disgrace.

Now, there’s some particularly disturbing news. When foster kids turn 18, they "age out" of the system. Often they have nowhere to turn and end up on the streets, in jail or both. They don’t know how to get a job, open a bank account, balance a check book, fill out a resume or be a family. As of this year, reports the Pew Charitable Trusts Kids Are Waiting campaign , the number of kids aging out of the system is up 41%. Here’s some of what they say:

The report, Time for Reform: Aging Out and On Their Own, found that although the total number of children in foster care has decreased, the number who "age out" of the system has grown by 41% since 1998. In total, more than 165,000 young people aged out of foster care between 1998 and 2005 – nearly 25,000 in 2005 alone.

"When children are removed from their homes because of abuse or neglect, we, through our government agencies, assume responsibility for their protection and care. We have failed these children if they ‘age out’ of foster care without a safe, permanent family they can count on," said Jim O’Hara, managing director, health and human services, The Pew Charitable Trusts.

"Every day we do not reform foster care, we fail 67 more young people who exit foster care completely on their own."

Think about that – 67 kids a day set loose with no moorings, nowhere to go for Thanksgiving, no apartment, job, phone, home address.

I have no answers for this; I know there has been work to try to reform a foster care system which has been burdened by budget cuts and a surge of (truly) broken families. But I don’t see how we can continue to allow our supposedly "child centered" society to allow these kids to tumble into adulthood with no safety net at all. Not much help to rant without suggestions — I know that in LA for a while there was a group that held formal "graduations" and "proms" for kids aging out and that in some places there is some effort to help the kids learn how to live on their own before they have to — it just seems we should have it on our radar.

GETTING EXCITED FOR BLOGHER

Boy is this getting exciting! I’ve been on real deadline rollercoaster and will continue to be but seeing BlogHer at the end of the tunnel makes the journey easier. If you haven’t gone in the past, I’d give it a try – last year was a real blast. Here are a couple of photos from then – just to inspire you (Oh and this is not a commercial; no one asked me to write this…) I think I downloaded most of them from Flickr so they’re borrowed – but fun.

Here’s Cooper Monroe (Been There and The Motherhood), Jenny Lauck (Three Kid Circus) and Mary Tsao (Mom Writes)

Posting during lunch.

Come on – it’s really fun and Chicago is a beautiful city. More here.

HER WEDDING, AND MINE

I am a huge admirer of Mir – whose blog Woulda Coulda Shoulda bears a rare warmth and humor. She’s an amazing writer and an even more amazing person. I learned, late, that several people were writing about their own weddings as a kind of virtual bridal shower. Because of my affection and high regard for her I thought I’d come along. We got married on a boat on the Monogehela River in Pittsburgh in 1971. We’re still married. I wore an Israeli Bedouin wedding dress and flowers in my hair; Rick wore a navy blue suit and a fancy tie. He spent hours in the Library of Congress researching Jewish weddings and wrote the service; I inserted quotes from William Saroyan, a speech about our families and another about the Vietnam War. Margot Adler sang Last Night I Had the Strangest Dream. My sisters and college roommates were bridesmaids. Lots of our best friends, family and even a few people you’ve probably heard of were there. It was a wonderful day. As Jenn offered a quote about marriage, I offer one from the Wlliam Saroyan speech that opened ours. In the time of your life, live—so that in that wondrous time you shall not add to the misery and sorrow of the world, but shall smile to the infinite delight and mystery of it. Be happy Mir.

WAY BACK IN EAST BERLIN AT STASI HQ

This is the headquarters of the East German Security Forces – STASI. It’s now a museum. We went there today in an appropriately grey, rainy day. We left the brightly lit neighborhood where we’re staying and took the U Bahn (subway). The exit from the station was breathtaking. Literally. I’d been all over East Germany, in Dresden, East Berlin and all the little towns along the way as well as in both Prague and Budapest — on several occasions before the Wall fell. I know more than most Americans about the grossness of life for the people trapped there for so many years.

Somehow though – after leaving funky Prenzlauer Berg – and even the U Bahn station with its neon and magazine stands and climbing the stairs to find – the past – was stunning. This part of Berlin is still as it was – lines of grey, sterile, tall apartment blocks. Each looking like the end of the line. No signs. No ads. No nothing. You walk a block and go into a parking lot, up a little rise and there’s the building in this photo.

Enter and its shabby and grey. Here’s whose statue is in the lobby.

Yup it’s Karl Marx – but this time he’s a small copy and here to remind us what used to be. And what used to be is pretty bad. I wish I could explain what it felt like to wander the halls where these men (it was mostly men) dominated and terrorized generations of East German citizens. To see truncheons and vans that travelled day and night with receivers to pick up random conversations – and photos of sweeps and arrests – and of this cell.

Now remember, I’m an old leftie myself. I wish the world could allow people to give what they can and receive what they need. But this is not what was happening here. Not at all. Fear was the dominant value – and conformity to prevent any threat to the state. Walking around looking in those bland offices and at the room after room of photos and documents had far more impact than even atrocity stories about the period. Because if you’ve been around eastern Europe before 1990 you knew the weight on your heart; you could feel the thickness in the air. And it was from this place that enforcement of that weight emanated. The museum not a fancy place and I don’t think much visited but if you come to Berlin (and you’ll love it here) come here. It’s a deeply disturbing reminder of what people are capable of doing and of how they always call it something else when they’re doing it. We had lots of thoughts about what’s happening at home now in relation to this – but that’s a conversation for another day.

And here’s a little bonus – the view out the double decker top deck on a bus later in the day — in a more liveable part of what was the East, in the same rain…..

Chuppas, Kallahs and Spiderman

Today I went to a wedding – the first in the new building donated to the Ronald S. Lauder Foundation for its work helping to rebuild Berlin’s Jewish community. This is the bride (Kallah) and groom. Here are a couple more:

The bedeken – where the groom lowers the veil over his wife-to-be’s face in recognition of the ploy that led to Jacob’s marriage to Leah when he thought he was marrying his beloved Rachel —

Men dancing in celebration.

This was the first Orthodox wedding I’ve ever attended – and since almost everyone was from someplace in Eastern Europe- especially Russia, – it had an exotic flavor anyway. I have lots to say about it but I wanted to post the photos now because I have to think a bit about how to describe the intense feelings it evoked.

Strangely – we decided this evening to go see SPIDER-MAN 3 in German, since it wasn’t playing in English except way downtown. It was just such an interesting contrast – a quiet reverence and sense of something sacred at the wedding, and brash, crashing violence and special effects at the movies. I speak almost no German yet only had to ask Rick what was happening maybe 2-3 times since almost none of the exposition was verbal. It does make you wonder how to understand one’s modern self as respect for old, old traditions grows with understanding.

I’m grateful for days like today, when my life lives up to the title of this blog — never gel. “Life moves pretty fast. If you don’t stop and look around once in a while, you could miss it.” Another, more attractive (at least to me) movie hero said that….

IT WAS [ALMOST] 20 YEARS AGO TODAY….

Around seventeen years ago this playground, built by the parents of Prenzlauer Berg, then part of the Soviet-dominated East Berlin, opened. Just a little while later Rick and I came upon it. We usually spent much of our time in Berlin in the East, and still do. It was a cold day, and in the home-made fireplace a bright fire burned. Kids were running, climbing, and having a wonderful time in this very low-tech “adventure playground.”

It’s still here, still low-tech and still much-beloved. It’s always meant a lot to me; it was very dramatic to cross into the East, see trees growing from the roof of the decimated central Synagogue, see a wall right across the very beat-up Brandenberg Gate (which now looks like this by the way) and to know that the people whose children played here were trapped, and, much of the time, scared. That they were able to create this for their kids in the middle of it all was inspiring. So, tired and not really up for a serious narrative tonight – I offer you this lovely little place – still loved by parents and kids alike – and probably, among those kids, some whose parents were playing there when we first visited. Goodnight.