How do you let go of stress? Do you walk, run, indulge in a hobby?
I’m a gardener, but I do love autumn, appreciate the end of things, the respite. I could say I just need a break, but because of the many things & duties we take on in our lives, it’s good to anticipate some letting go, to be creative with how we use that freed up time.
LOOK TO THE SEASONS
After our wild fertile spring blasts her seeds, creates weeding headaches, I truly don’t mind a halt to that growth, to the gradual letting go as the earth grows cold and the sun’s angle changes. Autumn is when flowers stand out against the returned vigor of green grass, the shouting changing colors of the trees. Being outside on a warm day becomes a gift. I soak up the sun, become even more aware of the beauty of the earth, as I rake, pick the last flowers in the garden, put away flowerpots. Because I am preparing my garden and myself for the onslaught of winter. As folks like to say, IT’S ALL GOOD. But it is major change.
CHANGE: SOMETHING WE CAN’T ESCAPE
The cycle of the seasons affects many things in our lives: school ends in one season, begins in another. Jobs and job responsibilities cycle throughout the year. Our very existence can change from the height of abundance to the depth of loss. But change is inevitable, and in these past seasons dealing with COVID, loss and gain have been the primary struggle. So are you okay? Have you lost anyone?
SOME SIMPLE PHILOSOPHY
To stay healthy in mind and body, we all have to try to avoid the stresses related to expected and unexpected changes–even those as basic and expected as the change of seasons. Jane McKeon, of Better Homes and Gardens, wrote in one of her gardening articles: WISDOM: Frost reminds us that we’re not in charge after all. How do we let go? Laugh at our failures, but don’t repeat them…Observe. Learn. Let go.
On one level, Jane is talking about gardening, but on another her words mean much more. We all experience life changes that affect our physical and spiritual health. Sometimes we are happy for these changes, other times we pray that they never happened or that they will end. In the latter case, we might clench our teeth, tense up our body muscles, even lash out at those around us, the people we love. Or…we can let go. It’s challenging, but there are times that call for examining or admitting our struggles and our failures, discovering what might have contributed to them, trying not to repeat them. Bottom line, we are allowing a change in our own personal seasons.
There will be frost—for we are not in charge. But we can live happier, better lives if we find something about change that strengthens us. A broken bone, a pulled tendon, painful and inconvenient, is not life threatening. It can create a lasting appreciation for that body part, and for the people who do the littlest thing to help us weather that cycle.
On a different note, it’s totally challenging to find anything good in a job loss. That’s a change that requires strength, positive thinking, the belief that attitude is everything. That kind of stress can hurt family relations, ruin a person’s health. In times of struggle, we have to let go, accept the help of others while we are doing everything we can to help ourselves: observing, learning, planting those new seeds. Then we will weather such a season–have hope for new growth; it’s a process we perfect one day, one week, one year at a time.
Jane McKeon may have intended her words just for gardening, but they are words of true wisdom. For spiritual and physical health, it’s best to accept the flow of the seasons in life, to weather the springs and the autumns. Then you’ll be ready for the winters when they come. Because after frost and snow, spring always returns.
When Will All the Leaves Fall Primitive art by Debbie Criswell
History: I am no sociologist, but for many years, riding the train from the suburbs into Chicago, I remember being uplifted and then discouraged by what I saw from the train’s windows. I became unconsciously aware that my spirits could rise and fall, just looking out a window. Why? Environment.
I always exited those rides either entering the canyon of tall Chicago buildings, or the quiet neighborhoods where I lived, places of green lawns and tidy homes. But I could not forget the buildings, the tracts of land in between that made me sorrowful for the people who lived there. I was looking at struggle, at the disadvantaged. In some cases, I was looking at real poverty. But then the train kept going, taking me away.
A CRITICAL EYE
Actually, back in the day, I could tell you who in my town, my neighborhood, was lax in keeping up their houses, their yards. When you live in a place of order, the disorder stands out. And when two or three homes in a row begin to slip, gradually the entire block can fall into a pattern where upkeep is ignored for one reason or another.
Deterioration can quickly occur in small towns, suburbs, but also in our PUBLIC SPACES if we are not alert to preventing a downward spiral. Research that proves this is always welcome, especially when it is backed by people like Eugenia C. South, Charles Branas and John MacDonald who decided to do some investigating of the subject, because they wanted to make a difference.
In the city of Philadelphia, they randomly chose places to receive an intervention. Partnering with the Pennsylvania Horticultural Society, they transformed vacant lots by cleaning up abandoned mattresses and furniture, condoms, needles and other trash. They then planted new grass and trees, installed wood post and rail fences around the area and made sure that regular maintenance occurred. The grass was cut, weeds pulled and trash picked up.
Gun violence went down significantly. Quoting the article: “The steepest drop in crime, up to 29 percent, was in the several blocks surrounding vacant lots in neighborhoods whose residents live below the poverty line…Over 18 months, we analyzed for and did not find any evidence of crime simply being pushed to other parts of the city.”
STEP TWO: ABANDONED HOUSING
The group then studied abandoned houses with broken windows, crumbling facades and interiors riddled with trash. They randomly selected houses to 1. receive new doors and windows, full interior remediation (adding new doors and windows, cleaning the outside of the house and yard); or 2. only a trash cleanup intervention, or–no intervention at all. Their findings, which will be published, demonstrated a clear reduction in weapons violations, gun assaults and shootings as a result of the full remediation.
Similar interventions have strong evidence toward violence protection efforts. An interesting example: in Cincinnati, a loss of trees from pests was associated with a rise in crime. In Chicago, people living in housing that was surrounded by more trees reported less mental fatigue and aggression than counterparts who lived in barren buildings.
Thus I think back to my train ride–and though I always was blessed with a destination that included trees, grass and in warm weather bird song–compare that to garbage strewn streets and buildings barren of greenery.
The team of researchers also discovered that structural repairs to heating, plumbing, electricity and roofing to homes of low-income owners were associated with a drop in crime, including homicide. The more homes that were repaired in a certain area, the higher the impact in preventing crime.
The author, Eugenia C. South, who is an MD working in the trauma bay, leaves us with this thought: …after I care for shooting victims in the trauma bay of the ER, I ask myself–what if we, as a country, make intentional decisions to invest in people and their neighborhoods? Instead of dying, would they flourish?
I am grateful to GREEN STREETS CAN REDUCE VIOLENCE Eugenia C. South, which appeared in THE NEW YORK TIMES.
Autumn is approaching…with winds and light rains, leaves beginning to fall, crops being harvested, trees becoming barren. Ah, the cycle. These weather patterns contrast with the drought and dryness in other parts of America and the world. What does nature know that we do not about the length of our days? Why do some regions have bounty and others experience loss? Is there something we need to atone for?
Probably. But though despite the shadow fo global warming, I’m determined to enjoy autumn once again. I have a large planter of yellow and burnt ocher mums nestling by pumpkins on my front porch. My autumn welcome sign is hung and a wreath of yellow leaves blazes in in my living room. This is my time. For me autumn is always a beginning.
A CLEARER PICTURE
When things fall back toward the earth, the outlines of garden and lawn, of walkway and road become more apparent. This precise definition creates a sense of order and organization. In fall there are memories of wild vines and riotous summer flower color. But now it’s best to be more satisfied with quieter denser things like clipped boxwood and evergreens, like bare tree trunks of grey and soft brown. The air is cool. The skies seem swept up too, presenting swathes of crystal color. Cold air outlines things so definitely, you can almost see each leaf and branch.
ORDER BRINGS TIME FOR CONTEMPLATION
Definition and order soothes the soul. I lean toward putting things away in their proper place. I lean toward knowing that everything sleeps quietly waiting for a reawakening. This is a time to store energy, to store knowledge. It can be a time to read great books and contemplate, make decisions.
If you seek solace and quiet, this is your time. For as we move inside to do our living, placing things we love like a bright pumpkin or a sheaf of leaves on table surfaces, or brightening a room with a flowered pillow or candlelight, it can also become a time to move inward in our thinking–to meditate and determine more and more exactly who we are.
Autumn decorations can remind us of endings, yet good endings that are resolute and leave us feeling blessed, not sorrowful. Autumn is the time of atonement for the Jewish people and how appropriate to tidy up one’s soul as the earth is preparing for sleep and hibernation, as winter winds are soon to come and humans are stocking up on food energy and light energy, hoping they will provide the ability to survive.
But no matter what the season, we should atone for the hurts we have caused; we should try to mediate our expressions of anger. And certainly if we have hurt someone we need to ask for forgiveness, hoping that if someone has hurt us, we can find a way to forgive that person, lighten the loads we often carry. And of course, we must try to forgive ourselves.
It’s a little early, but there will come a time as the days get shorter that we will want to settle back into our brains and examine who we are, where we are going, and how we might improve. Life cannot be lived like the riot of spring where nature blows her wad and lets everything grow and rush about. We enjoyed that fertility. But now it’s time to be more judicious in our use of harvest fruits; we need to carefully use and share our bounty.
Certainly in the spring, when life comes back, we have no fears of the future. But in the autumn, we need to count the jars in the cellar, the apples in the basket, the sins on the soul. We need to tidy our lives and draw within to discover how we will survive, how we will make it through the dark times of our life. And how we can help others through their darker, harder times.
In each of us is a light deep within. Sharing that light draws bounty, brings good things to us whether the world is hard-packed snow or dry desert. Autumn can provide a time for atonement. Winter and beyond can be full of the light of love as the grace of forgiving someone brings the warmth of reclaiming love. If you are feeling like all the days of your life are hard, cold winter, then it’s time to open up to those around you, to share the light within you. IT WILL BRING YOU HAPPINESS. As a wise woman once said to me: “Feeling sad today? Then go out and help someone else.” She was so right.
(this is a rewriting of an older post, but it always feels just right…)
Sometimes there are rewards when one goes into EVERNOTE and finds things. This was a response to a question that came in my email, but McSweeneys never responded. Oh well, dissed again…so I’ll share it with you…
Dear McSweeney’s, Here is my answer to: WHAT SHOULD THE CITIZENS OF THE US KNOW ABOUT YOU AND YOUR PLACE IN SOCIETY?
It is always better to approach a fearful time with knowledge and understanding. We can downplay fear if every individual focuses on personal worth, yet believes in specific goals going forward.
Partisans who fight against a conqueror display a deep love and belief in the country they fight for. In this time of Coronavirus, our goals must be to save lives, but also to preserve positive elements of our culture.
STAY WELL; PRESERVE OUR CULTURE
I value what the generations before me and my generation have brought to the foundation and advancement of our country. Turning against a particular group of people in a time of upheaval and fear is always misguided and can get out of control in the hands of overly frightened people. That’s called hysteria, and though we are not there yet, it would be so wrong to see older generations, people of color and newly arrived immigrants as sacrificial lambs. (rereading this maybe we are there now…at least in the minds of some.)
Now is a time for each of us, regardless of age, background and status to view life on a continuum.
GENERATIVITY: WHAT IS IT? DO I LIVE, BELIEVING IN THIS?
Psychoanalyst Erik Erikson wrote about generativity, stating that in the middle years of adult life we come to realize: I am what survives me.
Though giving birth is the ultimate act of generativity, it is a parent’s follow-through, his and her commitment to nurturing and growing this person, that truly matters. People of all ages experience generativity by creating: a business, song, piece of sculpture, the resolution of a problem, a scientific theory, recipe, article, novel, hybrid-rose.
Generativity means creating the very future itself through teaching, volunteering, voting, forming and helping social institutions—and by currently working to save lives in hospitals, community centers, churches and health centers. In each of these actions resides a part of us and the good in us—because what we generate moves into the future and provides for those coming after.
I am what survives me.
YOUR KEYS TO A HEALTHY LONG LIFE…
Psychologists confirm, that people who want to generate and create, do experience feelings of well-being and low levels of depression. And it is always true that if you are feeling sad or lonely, the best cure is reaching out to help someone else. (In our age of communication, many of us can do this without worrying about exposure to the virus.) And yes, there is some ego or need for power in our acts of creation, but when we generate for future generations, we cover over the power with love.
TAKE THE TEST BELOW
Erikson reminds us that our acts of having children and building societies indicates our “belief in the species.” Even though we know that horrific things can happen on our planet, like this virus, daily we forge ahead believing in our own generative powers and the goodness that can still exist on our earth. Let’s not forget that in these contentious times, if there is to be sacrifice—it should be the giving of time and energy, or of funding hospitals and health centers. This is not a time to distain a generation who has brought our people through other traumas and still have energy, knowledge and hindsight to give to all generations.
P.S. Below is a self-test that each of you can take to see if you believe in generativity. The test if from the Loyola Generativity Scale (LGS).
Read the following six items and mark:
O if the statement never applies to you;
1 if the statement sometimes applies to you;
2 if the statement often applies to you;
3 if the statement always applies to you;
Then add up your score. Men, women in their 30s, 40s and 50s usually score 11. Younger adults and adults in their 60s and older usually score slightly lower.
___ I try to pass along knowledge I have gained through my experience.
____I have made and created things that have had an impact on other people.
____I have important skills that I try to teach others.
____If I were unable to have children of my own, I would adopt children.
____I have a responsibility to improve the neighborhood in which I live.
____I feel that my contribution will exist after I die.
Thanks to Dan P. McAdams for the inspiration from his article GENERATIVITY:The New Definition of Success
P.P.S. McSweeney’s is a nonprofit publishing company based in San Francisco. McSweeney’s exists to champion ambitious and inspired new writing, and to challenge conventional expectations about where it’s found, how it looks, and who participates.
After 9-11 life was totally altered, for all of us. As a writer, I sat and stared at my manuscript wondering if anyone would ever read a novel again. My husband had been traveling—not to New York, but to Connecticut. When he finally got home late on Friday, there was relief. But normality escaped us. It escaped everyone.
Then in those next few days, a friend offered me some insight. It came in the words of Father Richard Rohr, a Franciscan priest whose teaching is like that of the first St. Francis: empty yourself, be compassionate of others, especially those that are socially marginalized. Okay. How do I do that when I am angry and confused.
TWENTY YEARS LATER
And though time has passed, many of the same questions circle around us. So today, let me offer this…because the words that Father Rohr used to explain liminal space, will always be relevant and helpful when we find ourselves full of questions.
Liminal Space is: a unique spiritual position where human beings hate to be… It is when you have left the tried and true, but have not yet been able to replace it with anything else… It is when you are between your old comfort zone and any possible new answer. If you are not trained in how to hold anxiety, how to live with ambiguity, how to entrust and wait, you will run…or do anything to flee this terrible cloud of unknowing. - Richard Rohr
HOW WE REACT: COVID 19 and LIMINAL SPACE
Many of us once again feel this terrible cloud of unknowing. Some of us are angry that our lives have suddenly changed, that we are struggling with loss, death, an alteration in social habits like wearing a mask, avoiding closeness to strangers, having to prove we are vaccinated…the list is long.
Families have been pulled apart, because some refuse to be vaccinated. Why? There are many excuses, some of which I find hard to accept when my generation and the generations of my children began with a series of vaccinations to protect them from illnesses that were not only inconvenient (chicken pox) but could also lead to blindness and deafness in their future children, German measles (rubella), and sterility in males (mumps). So it makes no sense to risk death, damage to one’s lungs, having to be intubated etc etc when many of the refuse-nicks started out their lives being vaccinated. And all they have to do now is WEAR A MASK.
SO ARE WE AGAIN LIVING IN LIMINAL SPACE?
Let’s look at that definition again. “You have left the tried and true, the familiar, but have not been able to replace it with anything else. Being under a terrible cloud of unknowing.”
Having been a healthcare worker, the first thing I would suggest is to work against that vacuum, that feeling of unknowing. Examine questions–can we go out; will we be safe; will my children be safe and still get a good education; can I go back to work instead of working from home? will life ever be normal again? YES TO ALL THESE QUESTIONS. IF YOU ACCEPT THIS NEW REALITY AND GET VACCINATED–and during this interim time, WEAR A MASK.
THOUGH LIMINAL SPACE IS ONGOING… we must accept it. The feelings that are part of liminal space are common to daily living. We are always waiting for something: a job, a pregnancy, a graduation, a diagnosis, an acceptance letter, even a death; or a yes from someone whose yes might change our lives, and until we get that yes, we feel like someone else is holding the rest of our lives in his or her hands. IT’S NOT EASY. Liminal space brings frustration, depression. We hate living under that cloud of unknowing.
Thus we must look for the good news. It was true post-9-11, that we saw, heard and felt the warmth, love, understanding and giving of many Americans who did whatever they could to help those who had lost someone. Later it was young men and women who joined our volunteer army, feeling that was the best way to give.
Certainly liminal space always challenges us. We are rarely free of the unknowing—because we are mortal and have no knowledge of the date of our demise. That’s a given. But it can be used to power our love of self (taking care of our bodies) and love of those we live and work with (getting vaccinated so that we don’t get sick and infect others.) For how much better to offer understanding, honesty and friendship on a daily basis—because who really knows what the next hour will bring.
You’ll find examples every day of folks who have conquered the awful questioning of liminal space:
the cancer patient who goes into remission and dedicates her time to helping other patients; the teacher who takes extra time to work with the very student who upsets his classroom; the doctor or nurse who enters the clinic every day, even when Covid death stats are rising; the cop who does all he can to make certain-sure before using deadly force; the mother, father, neighbor, citizen who listens and evaluates any situation before making a judgment or rising to anger.
THE CITIZEN WHO FINALLY REALIZES THAT GETTING VACCINATED IS GOOD FOR HIM/HER BUT IS ALSO A WAY TO GIVE BACK TO THIS GREAT COUNTRY.
After 9-11 Richard Rohr reminded us that both Christian and Muslim mystics preferred the language of darkness. That is: they were most at home in the realm of not-knowing. In such darkness, Rohr writes, things are more spacious and open to creative response. We are more open to letting in God or blessed, positive thoughts–just like the cancer patient who is grateful for every day and turns darkness into light.
This from the Persian mystic Hafiz:
Don’t surrender your loneliness so quickly.
Let it cut more deep.
Let it ferment and season you
As few human or even divine ingredients can.
Something missing in my heart tonight has made my eyes so soft.
My voice so tender, my need of God, absolutely clear.
In this time of questioning, where we find ourselves often divided, even from friends and loved ones who feel and think differently than we do, try to accept and live in the cloud of unknowing. Try to move a bit closer to the other side or try to find something they share with you. It can be very challenging and just downright hard. But remember, you are both in liminal space, not truly knowing all. And if you have time: watch the film The Hundred-Foot Journey which underlines that people and cultures that are vastly different can cross the threshold and come to a place were there is not only knowing, but sharing and love.
Truly, we have no choice but to live on the threshold, uncertain of which path to take. We exist in this liminal space, a new normal that we must accept and work with so the cloud of unknowing will be transformed into one of understanding.
Thanks always to Father Richard Rohr and the art of Charlie Bowater
When my mother would gaze out at the late afternoon light, the golden afternoon she often called it, (a reference to a song lyric), she often become sad. “Why?” I once asked, and she explained that she would see the fathers coming home to their families, and those moments in the day, more than any of the others, reminded her–she was doing this all alone.
My mother was widowed at the age of 34, my father dying too young, leaving her with three children under the age of six, and the possibility that she would pull into herself, wish for a vastly different situation and let sorrow and anger fuel her life.
She did not. My mother taught us responsibility, loyalty.
Her complete love for us became her focus, her sadness more and more remote. With creativity and love, she took on every challenge, big and small. When I look back on how she raised us, loved us—there was no better role model, ever. My mother became one of the first working mothers in our neighborhood, and like everything she did, she excelled.
She taught us the rewards of a consistent, well-organized routine—today we would say she was multi-tasking.
To pay the mortgage and feed us, she worked at home, typing insurance policies in our dining room. At night, after dinner, she did what she called “processing” of the work she had completed during the day. She would sit at a card table in our living room, pull the copies she had typed apart, sort them into neat piles. This required paper clips, staplers, pens, glue and often her signature. While doing this, she could monitor our television watching, help us with our homework, even comment on the books we were reading.
My mother taught us that all you really need for entertainment is books, art and music.
As we grew, our living room vibrated with classical music, jazz, opera, musical comedies, The Beatles, The Beach Boys…my mother encouraging my older brother to read the Schwann catalogue and order recordings from the local record store; (in college he had his own classical music program on the university’s radio station); she encouraged my younger brother to learn how to play the guitar; (after college he moved to LA and within a year was on his way to a career in recording and promoting pop and contemporary music.)
From the moment we all could sit still, my mother read to us, shared storybooks, later colorful art books with glossy photos. When we learned to read, there were weekly trips to the library where we checked out stacks of books, my mother modeling the importance of reading for knowledge as well as enjoyment.
And there were chores. Each of us had an assignment to keep our home clean and efficient. We made up songs, created lyrics to get through doing the dishes, though sometimes those lyrics were created to tease our youngest brother. We got in trouble for it.
Our mother taught us that when feeling sad, you might try singing.
Our mother had a beautiful voice and whenever we traveled she would sing while she drove–another way for us to learn popular music and how it just made you feel good. Crayons, paper and water colors were always available in our home to encourage creativity and to celebrate birthdays, holidays or just to say thank you. Mom loved receiving the tree and house drawing that were my staple–and the I LOVE YOU message with X’s and O’s.
Our mother taught us responsibility, and that it was wise to save money.
All of our lives, we were witnesses to good mothering—our mother, grandmother and our wonderful aunts. They challenged us, helped us look to our futures so that we might learn to dig in, contribute to the pace and satisfaction of our shared lives. We put up storm windows, mowed the lawn, raked leaves and planted a garden. I always cleaned the house. There were days when we fell back into kid-like behavior and Mom wasn’t all that happy: found us laughing at cartoons on a Saturday morning (two of us in college) while she came stomping up the back steps loaded with groceries. She got over it. She was human too.
Our mother was frugal, always driving used cars and buying her clothes on sale. She saved money for those things that brought true meaning into our lives. Thus we had a piano, and eventually a good turntable and speakers, as well as hundreds of books and framed watercolors on our walls.
Mom, through her example, taught us how to be kind and generous.
We learned that acceptance leads to happiness, contentment, though our mother certainly felt anger and disbelief when my father died suddenly, when she had to realize that she could make her life about us, about helping anyone else who was experiencing sorrow. She replaced her sorrow with gratitude, and whenever a friend or acquaintance was ill or had died, my mother was there to provide comfort. Our mother could give—but she could also receive.
Our mother taught use to accept gifts graciously.
The doorbell would ring and there was Gen and her daughter with a box of hand-me-down clothing for me. There was also a friend who actually worked in a toy store and once a year he’d arrive with very expensive toys in three huge boxes—one for each of us. We were thrilled.
When you accept the generosity of others, the upside is giving back. Mom always had a bag or box or envelope for the people who cleaned for us or did repairs. Thank you were two words often heard in our home. We took them with us, bestowing them on others throughout our lives.
Our mother inspired our desire to travel, to experience the world. She took us on a train trip from Chicago to California. She drove us to Washington DC and back, widening our vision and future goals. She sang as she drove, love songs reminiscent of my father’s courtship days—The Man I Love, Someone to Watch Over Me, Night and Day. I watched the land flow and listened to her beautiful voice, realizing that the songs brought back comfort and the powerful memories she cherished. I will always be grateful she shared them with us.
Our mother’s gift of freedom….
Our mother never married again. When she wasn’t busy caring for us and then for her grandchildren, she continued to work as a secretary in downtown Chicago. She always loved to travel—her last trip flying to Prague in her late eighties. Everyone who knew my mother received a gift from her—a note, a letter of encouragement or a series of prayers said with her worn rosary beads. Mom’s gifts were endless and enduring and I was gifted when she allowed me to hold her weary hands as she took her last breath.
Her final gift: she taught us that we could go on living without her.
Barbara Fassbinder, one of the first health care professionals to be infected with the AIDS virus while on the job, died on Tuesday at the University of Iowa Hospitals and Clinics in Iowa City. She was 40 and had lived in Monona, Iowa. Barbara Fassbinder died in 1994.
BUT WHY TELL ME THIS? Because this was the headline in an Iowa newspaper that hospital staff at all levels will never forget. It was a headline that became national news and changed hospital practice.
Because soon after Ms. Fassbinder’s death (and others that followed, a patient of a dentist in Florida etc) radical changes were made as to how doctors, nurses, nurses aids, and people who cleaned OR’s and patient rooms–anyone working near blood and body fluids would practice their skills.
Below is an excerpt from an article that eventually appeared in the NY TIMES.
In 1986, Mrs. Fassbinder was infected with H.I.V., the virus that causes AIDS, while helping treat a patient in the emergency room of Memorial Hospital in Prairie du Chien, Wis.
While pressing gauze on a needle puncture, the patient’s blood apparently mingled with her blood through small cuts on her hand from gardening, she said in 1990. The young man died, and an autopsy showed he had AIDS. But it was not until January 1987, when she tried to make a blood donation, that she discovered she had been infected.
She and her family kept the infection a secret until she decided to speak out in 1990. “My biggest fear was how the community would react to me and my kids and my husband,” she said at a news conference in Iowa City in which she told her story in the hope that it would warn other health-care workers. The 1,500 people of Monona, a farming community in northeastern Iowa, gave her family “nothing but support,” she said at the time.
Dr. Michael Osterholm, an AIDS expert and epidemiologist with the Minnesota Department of Health who became a friend of her family, said she “helped bridge the gap between the worlds of the health care provider and the AIDS patient in need of competent and compassionate care like no one else could.”
Mrs. Fassbinder traveled extensively, talking to people about AIDS and how to prevent infection by H.I.V.. She testified about AIDS before Congress, and in 1992 she was recognized by the Surgeon General and the Department of Health and Human Services for her work. A native of Marion, Ohio, she also served on the National Health Care Reform Committee set up by Hillary Rodham Clinton and was a member of the Iowa State Commission on AIDS, Dr. Osterholm said.
SO WE ALL KNOW ABOUT AIDS, WHY FOCUS ON THIS DEATH?
MY ANSWER, OSHA, The Department of Labor’s Occupational Safety and Health Administration. It was Mrs. Fassbinder’s death and the subsequent deaths and illnesses of other healthcare workers that revolutionized the practice of dealing with blood and body fluids in hospitals.
All of this was done to protect doctors, nurses and anyone working in a hospital from contacting AIDS. The stringent regulations offered other benefits to hospital personnel who for years treated patients with bare hands and were exposed to bacteria and viruses, which they could then pass on to other patients and their families.
THE BIG RED OSHA bags became standard use in hospitals as a way to bind up materials that carried viruses and bacteria.
When you are admitted to a hospital today, you take it for granted that anyone entering your room will be using hand sanitizer. That’s not because of Covid. That’s because of Mrs. Fassbinder contacting AIDS.
MORE DETAILS ON THE LATEST NEWS CONCERNING OSHA (NY TIMES)
The Biden Administration, in its efforts to combat Covid 19 has tasked the United States Department of Labor with writing a regulation that will force tens of millions more workers to get vaccinated—or to produce weekly negative test results. This move will test the agency’s legal power and could draw a legal challenge.
The Labor Department will issue a regulation requiring companies with 100 or more employees to follow the above directives….Although the agency’s ability to meet legal thresholds necessary for such a forceful intervention into the private sector remains unclear, some in the business community who’ve been wrestling with how to increase their employee vaccination rates without controversy are indicating support for the move.
Some of you reading this post will have worked in healthcare. And you know and many people who have been hospitalized and even visited an ER, know that people who work in healthcare believe in and must comply with certain health requirements.
Currently those include inoculations for: Hepatitis B, Annual Flu, MMR (measles, mumps and rubella) Varicella, Tdap (tetanus, diphtheria, pertussis) and Meningococcal. And all healthcare workers should be screened for Tuberculosis.
Copies of the OSHA Bloodborne Pathogens standard are available from the OSHA website.
Because of their ability to conceive a child, give birth, perpetuate the species, women have for centuries been honored, sometimes considered saintly, but often buried too soon to live a full and creative life. But precisely because of this biological endowment, this ability to help perpetuate the species, women have also been treated cruelly, taken for granted, sometimes considered evil witches with powers that require control and abuse.
As a former Labor and Delivery nurse, I was fascinated by a recent article that appeared in the New York Times. It’s a personal recounting by writer Leslie Jamison of her C-Section experience, and the research she did concerning this medical procedure. (Posting this after the unethical decisions being made in Texas, only underlines the importance of healthcare for women in any situation related to their reproductive rights.)
JAMISON, A PERSONAL HISTORY
Jamison starts her piece by recalling the words she used to discuss the birth of her daughter. “When they got her out…”
Jamison writes: “…the day after my daughter’s birth, I found myself emphasizing how much I held her, how I never wanted to put her down. It was as if I felt the need to compensate narratively for that first hour, when I wasn’t able to hold her at all—to insist that we bonded just as much anyway. I found myself exaggerating the part about the not caring if I was numb before they cut me open, when in fact I did care. I told the doctors that I would actually love some more anesthesia in my epidural…as if I were trying to make up for other kinds of pain I didn’t experience – unwittingly obeying the cultural script that insisted on suffering and sacrifice as the primary measure of maternal love.”
Jamison states that even now, 3 years later, when women describe pushing out their babies or having 40 hours of labor, she feels a pang of guilt, a kind of shame, as if her own birth story “wasn’t one that merited pride or celebration, but was instead a kind of blemish, a beginning from which my daughter and I must recover.” She then provides a fascinating history of the Caesarian section. A few excerpts: French obstetrician Jean Louis Baudelocque wrote: “That operation is called Caesarean by which any way is opened for the child other than that destined for it bye nature.”
JULIUS CAESAR–AH, THAT’S WHERE WE GET THE NAME?
There is an apocryphal story that Julius Caesar was born by cesarean, as his mother survived the birth and went on to bear more children—at a time when it was impossible to survive a C-section. She tells us that in 1925 Herbert Spencer, a professor of obstetrics at the University College London, speculates that it “was called Caesarean as being too grand to have been first performed on ordinary mortals.” He also calls it: “the greatest of all operations, in that it affects two lives.”
But Jamison knows and we know, that for most of history, the procedure saved only one life. The mother did not routinely survive, until the 20th century, because before then, the procedure was usually deployed as a last-ditch effort to save the child, the mother dying, bleeding out, or already dead.
MACBETH, A FORETELLING
Historically and in literature, the C-section was often associated with the imperial, with the divinity. In Shakespeare’s Macbeth, the cesarean-born Macduff experiences a birth that is an answer to a riddle: The witches have promised “that none of women born shall harm Macbeth” but in Shakespeare’s creativity, Macduff is exempt from such a foretelling as he “was from his mother’s womb untimely ripped.”
Jamison, a modern woman looking back on the history of a procedure she has experienced, makes the comment that Macduff’s exceptional birth might grant him some singular power, but such a birth also relates monstrosity. “Untimely ripped doesn’t exactly summon the epidural and the blue tarp.” Jamison knows, she’s been there.
Of course, the early history of the Caesarean, a little used and experimental procedure, did not insure life for either the infant or the mother. But neither did natural childbirth. The baby was often fortunate if he or she survived. But in the graveyards of Boston and other parts of the New England states, where our early settlers are buried, you can often find a series of graves for a family. First is the grave of the husband, his dates, which always extend his time of life. Then alongside him are his wives—sometimes two or three. No, he wasn’t a bigamist, but when the first wife died in childbirth or from puerperal fever (see below), he married again, and if that wife died, he married again—eventually not for sex or more children, but for someone to raise his progeny, feed and clothe them, tend his garden.
THE SHAME FACTOR
Jamison also discusses how the advent of the C-section has been used by some to shame mothers. In his book, Childbirth Without Fear, Grantly Dick-Reed inferred that pain during delivery was a lesson women needed to learn. “Children will always mean hard work and will always demand self-control.” Easy for him to say when he’s standing by the delivery table and not lying on it.
Jamison’s article is pivotal and for her, she worked through the angst of her fears and regrets. But the end of the article speaks truth for all mothers, no matter how we have brought our children into this world. Jamison writes: Why do we want so much from our birth stories? It’s tempting to understand life in terms of pivotal moments, when it is actually composed of ongoing processes:not the single day of birth but the daily care that follows…diapers and midnight crying, playground tears and homework, tantrums…If we are lucky, birth is just the beginning. The labor isn’t done. It’s has only just begun.
I like reading and sharing pieces I find in the NYTimes, Chicago Tribune, WSJ. THIS IS ONE OF THEM… the title of the piece:
IN A TV SCRIPT, I CAN REWRITE A PATIENT’S FATE by Daniela J. Lamas
Dr. Lamas is a writer and co-producer for the television medical drama, The Resident, though her main employment is that of a pulmonary and critical care physician at Brigham Women’s Hospital in Boston.
MEDICAL DRAMAS AND REALITY
In her piece in the NYT, Dr. Daniela J. Lamas is very aware that she straddles two worlds, finding the writing gig an uplift from the death and dying she sees in her hospital’s Covid unit. When she can retreat to her messy call room, she uses Zoom to join a group of writers struggling with a scene, another medical emergency for Conrad Hawkins (Matt Czurchry), the eponymous hero of the The Resident.
Lamas never works in a vacuum, taking with her the image of the older female patient who now has Covid, her pastor having insisted she not get the vaccine. Dr. Lamas presents this situation to her writing team, hoping they will change the story line. Example: the pastor visits, sees his parishioner suffering and begins to preach from the pulpit that all his people need to get vaccinated. (But like Dr. Lamas, this story line is my creation. Will the writers group accept it?)
Dr. Lamas writes her reality: …though her lungs are slowly improving, her kidneys are worsening, and she is profoundly delirious, not waking up. We stand at the bedside and call her name, her eyelids flutter.
Down the hall, we titrate drips and manage vent settings for a man whose stem cell transplant cured his leukemia but ravaged the rest of his organs. His wife would be at his bedside, but she is at her father’s funeral.
And though the article does not say, I imagine this elderly woman did die from Covid, an unnecessary death.
STORY LINES THE WRITER’S ROOM REJECTS
Dr. Lamas writes: I used to want to show the hospital as it truly exists, to reveal the humor and tragedy and grace that characterizes my world. (She explains with the following examples.)
The family that came to say goodbye to a dying woman, a misplaced ID card leading them to believe, wrongly, that she was their mother.
A patient’s brother, with skull tattoos on his shaved head, who told us he could not be in the room when we took his brother off the ventilator. So when he left, we thought we would never see him again, but were surprised when he returned, not to sit by his dead brother, but to collect the man’s prosthetic leg. Another nurse said he spent the rest of the day in the hospital chapel with the leg beside him.
Dr. Lamas writes that even producers and writers for The Resident say such stories are simply too grim. The public does not need or want to be reminded of how quickly things can go bad, how families fall apart, how doctors do their best but patients still die.
Especially now, viewers want to see their doctor as heroes, to follow a formula that has doctors saving lives more than losing them.
IN THE WORLD OF THE TV HOSPITAL
Dr. Lamas writes: “During my first experience on the set…I learned that when things went wrong (a medical word being mispronounced) I was assured, “Don’t worry. We can fix it in post.” She underlines that she loved that phrase, one she wanted to say to her patients over and over. “…to be able to have another chance, to treat the sepsis earlier, to stop the pastor form advising against vaccination, to fix it in the post.”
Dr. Lamas reminds us that during the pandemic, her roles as a critical care doctor and a television writer are often in conflict. Though she wants to honor and remember every patient who died, she also yearns to tell stories that are hopeful, where there is always the chance for recovery, no matter how dire the diagnosis.
“It’s a tension I am still learning to navigate. How do we tell stories that feel true while also keeping viewers engaged? What kind of cheats are acceptable, and which are irresponsible?”
Dr. Lamas then makes a particular reference to the struggle that often ensues when the team is trying to save a cardiac patient. She reminds us that TV characters survive cardiac arrests far more often than people in real life do.
“…and the nurse left alone to clean up after the death…” If our viewers could see that, “they would change the channel.” She is right. I still remember during my Cardiac rotation, watching a team try to save a patient, the family waiting in an adjoining room. The man died. And yes, the floor was littered with medical pads, bottles, wipes, tubing…
IN THE REAL WORLD
Dr. Lamas is right when she stresses that medical dramas are important, that they can provide escape, but also education.
“In the writer’s room, we have a change to …offer a different ending to the story. And in doing so, we can sneak in potentially lifesaving education—early warning signs of certain illnesses, the dangers of overtreatment or the impact of inequities in access to care…television dramas have an unparalleled opportunity to educate and even to change behavior…I have come to believe that it is worth glossing over the facts IF we can weave a story that encourages viewers to trust science, to get vaccinated, to look differently at disease. When I find myself fact-checking what I see on the television monitors, I remind myself of this more important goal.”
Dr. Lamas ends her piece, mentioning a patient that she met one morning on rounds, asking him to mute the TV show he was watching, a medical TV show, as she needed to listen to his heart. He seemed surprised that he had to miss something, explained that medical dramas had been his one constant. The plots reassured him, taught him what might be ahead in his own medical story, while helping him feel less alone on his own medical journey. Dr. Lamas smiled. She understood.
(I confess that one of the reasons I became a nurse after having my three children—was my propensity to be gripped not only by books and articles about medicine, but by watching television medical dramas. I’ve written about that before. I was an avid ER fan. Now it’s New Amsterdam, Chicago Med, and of course The Resident.)