New School, Old School

2011.10.14_LEGOLANDMEDIADAY_001.jpgOur eldest daughter Tasia starts school at the University of Michigan in about 2 weeks. This summer has been a blur of getting ready. And by getting ready, I mean materially, but more so emotionally. It has been like a mini-roller coaster ride as we experience each related milestone. Orientation: “Did I do it too late? Who will be there? Will they like me?”. Class scheduling: “Mom! The psych class I wanted is full! Will this other one be ok?”. Dorm assignment: “Oh no! they put me at Bursley and not on main campus!”. And, less often, but underlying it all:  “I am really going to miss you seeing you guys every day”.

 

And of course, I have had my own separation issues too. Our family is a pretty tight unit, and while Tasia will be here in the same town (thank you God), she will not be HERE. I will miss our nightly meetups before bed when we talk and compare notes about our days while she snuggles our dog Sasha. I will miss her snappy wittiness. I will miss her luminous face in the mornings. I will miss her chasing her 11-year old brother around the house to try to snag an extra hug from him to his protest. I will even miss her nonsensical bickering with her 15 year old sister over bathroom time.

 

I will miss everything about her being here, in this house, with us. This is a two-way street.

 

Flying back from a conference in Boston this summer, a toddler “flirted” with me and other passengers over the seat as we waited to get off the plane. Without even processing it consciously, I suddenly found my eyes swimming with tears. What the hell? As I thought about it, I realized that Tasia used to do the same thing when she was that age. My husband Pat dubbed it “fishing for customers”. And of course, the next thought was that it seemed like only yesterday that Tasia was fishing for customers, and now she is about to go to college.

 

To manage my own feelings, it seems like I have adopted a “no-nonsense” “just the facts” approach at times. Mary Poppins-pish posh-style.  “Oh, it’s going to be fine” I say. “Oh c’mon, you are going to love it” I say. I even said (after talking to a colleague and good friend) “So and so’s daughter is really excited about college, not anxious at all”. No wonder Tasia told me the other day “I get that you are a really good researcher, but sometimes I question how good a therapist you are”. My Mary Poppins persona said “Well, Tasia, I am not YOUR therapist “. Pish posh! But really, it gets hard to be “therapeutic” when you are experiencing the loss too.

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But there has been some fun too as we “get ready”. I love to shop. I love to shop with Tasia. And there has been a lot of associated dorm room shopping. She and her lovely best friend and soon to be roommate Dany decided early on that the colors of the room would be aqua and salmon. Sounds great, but do you have any idea how hard it is to find the right shade of salmon? (“Um…no…that’s peach mom!”). We have worn out the route to Bed Bath and Beyond, my kids laughing as I never seem to be able to find that ubiquitous 20% off coupon when I need it. A trip to IKEA was a huge success, but I largely credit that to Dany’s Ukranian-born mom, a beautiful and petite woman who maneuvered us deftly through the store with military precision.

The IKEA gang

The IKEA gang

Along our summer journey, I have also experienced some wistfulness about my own college experience that prompted me to think about one of my favorite movies, Old School. In the movie, Will Ferrell, Luke Wilson and Vince Vaughn find their lives at a crossroads in their thirties and decide to experience a “college do-over” and form their own frathouse on a college campus. The college fun without the college classes. The thought has definitely occurred to me that I would “do so well” at college if I could go back now. Not the class part (I did pretty well there the first time) but the fun part. I was an anxious homesick kid and it definitely impacted my freshman year. Now? With all of my adult toolbox? I could totally manage it!

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But that’s life, right? We don’t get do-overs. The trick is to try to do the best you can. And of course, everything—and perhaps, especially- the mistakes, warts and disappointments can sometimes lead to the best opportunities and outcomes. Tasia and I were talking about my own freshman experience the other night before bed (while snuggling Sasha), and she said “So, what are you complaining about? You turned out pretty well.”. Nice. That girl might make a good therapist someday.

 

So, we will do the best we can and savor what we have and hopefully what is coming.

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Giving Voice to the Silent Sisterhood

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I don’t talk about it a lot and I have certainly never written about it. “It” is that twelve years ago, we lost a baby sometime between 16 and 20 weeks of pregnancy. I still feel a stab of pain as I type that.

 

Life has moved on, but that loss will always be with me. I was inspired to write this after I read a post by Facebook founder Mark Zuckerberg as well as a blog about miscarriage on the always excellent website The Mighty. In announcing his wife’s pregnancy, Zuckerberg mentioned that he and his wife had endured a number of miscarriages and wrote about the need to bring pregnancy loss into the open. Indeed, miscarriage is a truly “silent sisterhood” including members of all ages, races, faiths and beliefs. But few people talk about it. So, here goes.

 

I got pregnant in 2003 after a trip to Hawaii. My husband and I were a bit overwhelmed by the thought of a third child when we already had two girls (at that time aged 6 and 3), but we were pretty stoked. Our kids are our life, and the more the merrier. The fact that I got pregnant while on Maui was pretty magical.

 

My third pregnancy was not different in any way than the first two, in fact, when I got pregnant that time, I was actually in better physical shape than prior to the others. Despite the typical pregnancy accoutrements like morning sickness and fatigue, things sailed pretty smoothly, until suddenly, they didn’t. I will never forget sitting in my office at the VA Hospital and getting “the call” from my doctor at 20 weeks. As I sat frozen in my office chair, he told me that one of the measures on my triple test was markedly elevated. Something was “very wrong”. I didn’t sleep at all that night. Terrifying thoughts.

 

The next day, my husband and I went to the OB’s office. The drive felt like a death march. And when we got there, there was no heartbeat. What happened after that was a blur, but I recall we were sent for a confirmatory ultrasound at UM hospital. Our baby looked perfect, but was no longer with us. Numbness set in.

 

We went home and we watched a rented Margaret Cho standup video to distract ourselves. It didn’t work. Our doctor called and explained that it was likely our baby had died sometime between our 16 week checkup when there was a strong heartbeat, and 20 weeks.  The measure on the triple test was so elevated because our baby was already gone. Somehow my body hadn’t gotten the “message” and I hadn’t miscarried on my own. I would need to have a “procedure” to do what my body hadn’t done.

 

We dropped our kids off at my parents and told them some lie. We were not ready to tell them. As the “procedure” started, the resident laughed and joked with the nurse assisting. In fact, I clearly recall her saying jokingly “Oh, I am such a retard sometimes!”. I also recall wanting to jump off the table and throttle her, but being sedated and beyond paralyzed by grief, it was not in my capabilities at the time. To say we were treated with insensitivity as if the loss was “nothing” would be accurate. After the procedure, care staff said some brief platitudes, “sorry for your loss” etc, but that was it. We were given a small pamphlet-like book called “Empty Arms”. I read, reread and highlighted that book like it was my new Bible.

 

In the hazy, painful days that followed, a remarkable thing happened. My “silent sisters” came out of the woodwork one by one, calling, visiting, writing and taking me out to lunch. They each had their own stories of loss that were sadly powerful. My own mother and grandmother (“YiaYia”) each revealed their own losses to me. Tears still came to these women’s eyes as they told me their stories. For my YiaYia, this was 60+ years after the fact, but she still teared up in talking about the daughter she had lost. And in every case, they had “moved on” but somewhere, “it” was still with them. I drew strength from them. Particularly as a part of me viewed the miscarriage as a sign that my previously healthy body had failed me in some way. I was not alone. I was not defective.

 

About a month after the procedure (sorry, I have a difficult time typing D&C for some reason), we got a letter from a pathologist. They couldn’t figure out what had “gone wrong” but wanted to console us on the loss of our “baby boy”. I can see myself standing by the mailbox as I read those words. It will never leave me. Thankfully, I had two lively and loving little girls whom we loved a little extra hard that day and pretty much every day that followed.

 

The acute pain receded. Things did get better. I would like to note that the platitude/misstatement “you can always have another” (along with the even worse “it’s a blessing, something must have been very wrong” or “it’s Nature’s way”) while well-meaning, was never helpful. What was helpful? Family, love, friendship, faith, time and most of all the sisterhood (and brotherhood for my husband).

 

Six months later we found ourselves trying again. Our son Theodore (Greek for “gift from God”) was born in August of 2004, a year and a couple of months after we lost our first son. I have never felt that Theo replaced our loss, but somehow he did make our lives measurably better.

 

Every time I go to church, I light a candle for the son that we lost and feel that connection. One very positive thing the UM hospital has is called “The Walk to Remember” where a huge group of people who have experienced pregnancy or infancy loss walk together, culminating in a tree planting ceremony. Over the years, we have attended this several times and it is very healing.

 

I only hope that by more people (women or men) sharing their own losses and stories that we can make miscarriage something less hidden and help others to feel less alone.

Dr. Kales Goes to Green Acres

MV5BMTczMTQ1ODg3N15BMl5BanBnXkFtZTcwMTQ2NTQ4NA@@._V1_SX214_AL_Do you remember the show Green Acres? It was in reruns when I was a kid. The premise was that a New York lawyer (Eddie Albert) drags his protesting socialite wife (Eva Gavor) to a rural farm outside of the  town of “Hooterville”. Hilarity ensues.

It occurred to me the other day that, in some ways, I am the Eva Gabor character in my marriage. Not in being high maintenance or really rich, but being in a “mixed marriage”. You see, my husband is from a family raised in Nebraska and Idaho. They have a rustic family cabin in the Boise National Forest near the Sawtooth Mountains of Idaho that is like Mecca to them. There is no electricity (gas lights only!), no cell phone service, and certainly no wifi.

The Gibson Family Cabin, Boise National Forest

The Gibson Family Cabin, Boise National Forest

In contrast, both of my parents were raised in a city (Detroit) and the dominant culture in my family is that of being Greek-American. Once when he was in his residency at UCLA, my father, goaded by a colleague, went camping and HATED it. He never went again. When I told my dad that my husband and I were going camping shortly after getting married, he said with horror in his voice: “and after you cook the food, WHAT are you going to DO there?”. A famous family story tells of my husband early in our relationship meeting my dad and asking him if he liked fishing. My dad replied with two words “Too pastoral”. My mom, although not Greek, also came from more recent (Polish) immigrant stock and always said “my idea of camping is checking into the Hilton and ordering room service”. For some immigrant families, it seems, the idea of camping and getting out into the “great outdoors” seems ridiculous. I mean, didn’t the family leave the old country to get away from having to gather wood and cook over a fire?

While over the years I have grown to appreciate the outdoors (certainly more than my parents), I still struggle with some aspects of the ‘rustic’ experience. Let me list my top 5: 1) Bugs (and especially those %^&%$@! deer fly that populate the cabin—they hurt like a mother trucker when they bite. And they seem to love me a bit more than others); 2) no blowdryer (I have very temperamental bangs that curl every which way when airdried); 3) being unplugged (with three current federal grants as principle investigator, I like to stay on top of things); 4) “doing nothing” (I start to get itchy and feel like I am being indulgent and lazy); and 5) feeling isolated from civilization (I begin to crave contact with people, even annoying people).

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%^&%$@! Deerfly

So when this year, my husband proposed a two-week vacation at the family cabin in Idaho (again, no electricity or wifi), I was a little bit trepidatious. In addition to my addiction to checking email and in with “work” multiple times per day. I also have two teen girls (aged 18 and 15) who are constantly on their smartphones (Instagram, Snapchat, etc). I have a 10 year old boy who loves playing computer games on the Ipad. What would happen? But like the Eva Gabor character, I decided that love won out. We had spent last summer’s vacation in England and Ireland on my sabbatical, most of it in cities. We would go to the cabin in Idaho for two weeks (a la Eva in Hooterville), come hell or high water.

So how did it turn out? Well, I am not going to say it was easy. I definitely had some Eva Gabor moments of being a “city girl” (two highlights: sliding down a huge log in a jeans miniskirt on a hike and landing into a pricker bush and being popped out of the raft on our white water trip and getting fully submerged into the Payette River). Oh and also? Those deer flies are still sons of a %^$#$.

Me having a moment in the Payette River. I am under that helmet on the left.

Me having a moment in the Payette River. I am under that helmet on the left.

However, going “off the grid” and “offline” for the most part was a gift. Yes, I came back to Ann Arbor and was confronted by about a thousand emails (literally). But none of those was truly urgent. And in return, the family: played cards, read books, hiked, went white-water rafting, had conversations that lasted more than five minutes, watched humming birds, listened to family stories/legends/tall-tales, cooked amazing food, looked at the stars, fished, and slept REALLY well. Idaho is a gorgeous (largely undiscovered—shhhhh) place.

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At Stanley Lake with Pat and Theo.

 

Outside Stanley Idaho #nofilter

Outside Stanley Idaho #nofilter

One of MANY hummingbirds at the Cabin. Sometimes there were 5 at the feeder.

One of MANY hummingbirds at the Cabin. Sometimes there were 5 at the feeder.

I also thought of a way to manage my (likely genetic) need to be busy and productive. As I talked to Pat’s grandmother, dad and aunt and uncle, I began to gain an appreciation for the role this cabin (in the family since 1961) has played in holding the family together. Through death, divorces, moves and other life changes, this cabin has represented “home” to this family. Without realizing it, I created a little anthropology project for myself, taking notes on what they told me about the history of the cabin and the tchotchkes/treasures it holds within itself. Pat’s grandmother Helen, who more than anyone, has kept the flame of the fire of the cabin “lit”, has stories to tell. At 98, Helen continues to amaze. She drove and volunteered at St. Vincent’s into her 90’s. Although in recent years, she has slowed down and her memory is less sharp, she remains the pillar of the family, weathering each and every ebb and flow with aplomb.

My family with Grandma Helen Gibson, the 98-year old matriarch of the Gibson family

My family with Grandma Helen Gibson, the 98-year old matriarch of the Gibson family

I decided to catalogue what I found at the cabin and began to ask her about each item. The joy in Helen’s face as she told me what she remembered was priceless, and this knowledge will make these objects and experiences even more meaningful and connected for the next generations.

Grandpa Hoot's chair. We found out from Grandma Helen that he had it recovered with this 70's vintage covering.

Grandpa Hoot’s chair. We found out from Grandma Helen that he had it recovered with this 70’s vintage covering.

I have returned from Green Acres refreshed and awakened, glad to have been there…and glad to be back.

Sometimes old dogs are good sticking with old tricks

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We just returned from a week with my parents in Florida. At 80, they continue to amaze; fully independent, active, and enjoying life. But there are changes. My mom’s ankle is now giving her trouble. She visited a specialist who took one look at her X-ray and solemnly pronounced his best medical opinion: “your ankle is all whacked out.”

My mom and my daughter Sophia

My mom and my daughter Sophia

While steroid shots are helping, she can’t walk as far as she used to, but she has readily adapted, taking sitting breaks during our traditional marathon mother/daughter/granddaughter shopping excursion to Sawgrass Mills mega outlet mall. She was also content to have us rent a “Safari Cycle” during a trip to Zoo Miami and declare “I’m not going to pedal”.

The fam (minus my dad who preferred to walk) in the Safari Cycle at Zoo Miami

The fam (minus my dad who preferred to walk) in the Safari Cycle at Zoo Miami

For my dad’s part, his knees give him trouble, but that didn’t stop him from taking 10-year old Theo to the park every day to play basketball. On one trip, he did “a funny move” and fell like a bug on his back and had some trouble getting up, but some “nice young men” playing in the adjoining court came over and helped him up. He told them he was eighty and “they couldn’t believe it!”; their disbelief made his day.

My dad and his bball buddy Theo (who was mad at my flash)

My dad and his bball buddy Theo (who was mad at my flash)

My folks have a lovely routine: a sunny breakfast; trips to the bookstore for the (multiple) newspapers they read; tandem crossword puzzle solving; going to the pool; and lastly, but most importantly, Publix. My mom has been to every Publix in a 30 mile radius, but her favorite is about 2 miles from their place. She loves the layout and ease. Going to Publix is an occasion. She is now what I call a “European” shopper, getting daily groceries rather than making a weekly trip. There was talk of going to Whole Foods while we visited, but my mom said “I know my limits. I can’t handle that store. I don’t know the layout. It is overwhelming. And let’s not even talk about the parking lot”. I thought that was kind of….”rigid”, but I let it go and off we went to Publix.

After the zoo, I arranged for a lovely dinner at a highly rated Miami restaurant. The scene was gorgeous with an incredible sunset to watch, an attentive server and delicious food.

View from the Miami dinner table

View from the Miami dinner table

My dad however, looked like he smelled something bad. My husband turned to me and said “Your dad is NOT having a good time”. I mentioned this to my mom later (who loved the whole thing) and she said “Dad is most comfortable at the places he knows…knows the people, knows the menu.” Again, my thought bubble said “Rigid?!”.

rigidBack home in Ann Arbor, I mentioned the dinner experience to a colleague also with parents in their 80’s who nodded knowingly: “When we go back home, there are only 2 restaurants we go to–the steak house and Applebee’s. Do I want to go to Applebees? No! But I would rather that than have to deal with my mom’s extreme discomfort at a place she doesn’t know”.

Then I was in the local Whole Foods the other day and got in a very short line with only 2 items. I was in a hurry, needing to get a birthday card for one of my staff and still get to clinic on time. The lady in front of me (about 85 by my guess), wanted a gift card. Seemed simple. Then the employee told her that the gift card itself would cost a dollar because they were donating it to a “good cause”. That triggered a lot of confusion and a 10 minute discussion (my thought bubble “it’s a frigging dollar!…ok, stop that, you are a geriatrician…yes, but I need to get to clinic!!”). Once that was finally resolved, it turned out the lady actually had a little cart full of items that had been hidden in front of her, unloaded. Without a word, she suddenly turned in my direction, practically threw my 2 items off the belt and started unloading hers. While her behavior seemed rude, I deduced that she was simply overwhelmed by the whole gift card debacle. I also changed lines at that point, because like I said, I had to get to clinic. When I left the store, she was still checking out.

I have been mentally trying to jive these personal experiences with my professional work with older adults. We constantly tell older adults to try new things: “Stave off dementia! Learn a new language! Play the clarinet! Take samba lessons!”. But if new things overwhelm and stress the person, could they be defeating the purpose? Stress and anxiety are also not helpful for your brain. Perhaps the message should be try new things in moderation, kind of like the old childhood song “Make new friends and keep the old…one is silver and the other gold”. Routines, like old friends, are comforting and good, and folding in a little, but not an overwhelming amount, of novelty is also good.

 

A lawnmower, an older woman, a Mexican immigrant and the police

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It sounds like the title of a bad joke.  But it’s a real story.

 

My husband and I were walking our dogs in our neighborhood the other day.  “Hey!” Jane* called.  “Do you live in this neighborhood?”  “Yes” my husband said.  Later, he told me that as he said this, he steeled himself for some complaint about our dogs.  My husband and I have 2 adopted shelter dogs, each has their own “special qualities”.  Veritable “bulls in a china shop”, and not welcome at the neighborhood dog party.

Anyway.  Jane approached.  “Ok.  Alejandro* has done jobs for you, right?”  Alejandro is a Mexican immigrant who does the occasional odd job for us and others in the neighborhood.  She continued,  “Alejandro has worked for me for years.  I trusted him.  But he took an old lawnmower from my garage!  Then, he took a vacuum cleaner from my daughter and got rid of it.  I called the police!”

My husband and I didn’t know what to say except that we trust Alejandro implicitly.  He is a wonderful man who has been alone in our house a number of times and has only shown us hard work and a kind disposition.  Jane appeared angry that we didn’t take her story more seriously.  “Don’t say I didn’t warn you!”.

As we walked away, my husband and I felt worried.  About Alejandro: with thoughts about how the police might handle a Mexican immigrant who speaks no English and is accused of “robbery” by an older white woman.  About Jane: Beyond that she speaks no Spanish, and so her communication with Alejandro is largely through hand motions and gestures with lots of room for error, what if this accusation was really a symptom of a failing memory?

But here’s the pleasant twist to the story.  I ran into Alejandro today and told him what Jane had said.  He got a wry smile on his face and said “Todo está bien” (all is fine).  He went on to explain that Jane DID call the police.  One of Jane’s adult children gave him a heads up and Alejandro went to Jane’s house with a friend who spoke English and explained his side of it to the officers (He had used the mower to mow a section of Jane’s lawn that his newer larger mower couldn’t reach. He had returned it.  He had thrown away the vacuum that wasn’t working at the request of one of Jane’s kids when he was cleaning out the garage).  Alejandro said the police were fair and listened to him.  He said that the police told him that Jane’s memory was faulty (in fact, one of her kids was living with her to help out) and that no charges would be filed.  The officers were also compassionate to Jane, treating her with respect despite the fact that they didn’t lend credence to her story.

And here’s the even more pleasant twist to the story.  After we got done talking, Alejandro told me he had just come from Jane’s house having done another odd job.  “Yo la perdono. No es su culpa. Ella está perdiendo su memoria.” (I forgive her. It’s not her fault.  She’s losing her memory).  I was caught off guard.  In these times of divisiveness, it is all too rare for people to forgive, to be tolerant and to love in spite of bad things that happen.

I am thankful for Alejandro and Jane’s story as it gives me hope.

*Name has been changed.