Letters, notices and advertisements pile up on my kitchen counter
Which electricity supplier should I use?
Is there a difference among them?
A notice of unclaimed funds arrives in my mailbox
Three phone calls placed, four completed forms submitted
Five months later, I receive a check for $2.50
Another notice arrives via email
The bank has closed an account due to minimal activity
I ignore it
Four months later, I need that account
Something to do with a trust
A visit to the bank is in my near future
The La-Z-Boy in the family room invites me
I take the novel I started
Settle into the comfy chair
And disappear into 1980 Atlanta.
(For those who are curious, the novel was Silver Sparrow by Tayari
Random thoughts and observations about relationships……
I’ve been thinking about how we know the people in our lives. And, I’m wondering: do we really know them?
Often our connections are circumstantial. School, work or our children’s activities may throw us together. Is that enough to sustain a relationship? Sometimes it is. And, how well do we get to know the person when we only interact in a certain context.
Years ago, when I was in college, I read an article in a magazine that explored friendship. I don’t remember the adjectives the author used to label the different types, but one of the ideas was that some friendships develop because of a shared experience and when that is over, so is the friendship. I think the article mentioned college friends as an example. I don’t know if that fits for me. One of the things that was true in college was that I had a lot of time to devote to those friendships. We spent hours talking and sharing insights, our histories. I share a bond with those women. As an adult, busy with work, family and the mess and responsibilities of everyday life, I don’t have the luxury of spending time in that way.
It is true, though, that some relationships don’t continue beyond the circumstances. Sometimes it could be because you move on and don’t see the person any more. Though these days with technology being what it is, that may not be a legitimate excuse. Other times it can be because the friendship isn’t that deep. If you take a class with someone and bond during it, the connection may not be strong enough to sustain it beyond that. You may try to extend the relationship, socialize beyond the classroom, and find that you just don’t have enough in common. As you get to know the person, you may find that you like them less!
It is a rare and wonderful thing when you peel back the layers of a person and find out that you like them even more.
I’ve also wondered, how many friendships can a person sustain? It takes energy to keep up. I think I may be unusual in the amount of alone time I need, to contemplate, to reflect.
And, what about family? We need to tend to those relationships, too.
With some people, you can be out of touch for months and then pick right up as if no time had passed at all.
And, then, there is the situation where you thought you knew someone and they surprise you – and not in a good way.
Sometimes I wish I didn’t think so much! Relationships, and my interior life, would be so much simpler.
Note: I wrote the following essay about two weeks after the election of Donald Trump. I didn’t post it to the blog at the time, I wasn’t sure that I wanted to take the blog into the political arena since it is such a divisive subject. But, I am continuing to experience anxiety related to Trump’s presidency – in fact, I was motivated to write a poem, which you’ll find at the end of this essay. So, I re-read what I wrote, and did some editing and decided to share it. I hope it offers food for thought.
I am struggling. I have moments where I imagine I have the energy to do the things I need to do – laundry, cooking, planning stuff, paying bills, writing, etc. And then when I actually need to move to do them, I feel like I am in mud. My spirit is in quicksand and sinking slowly. Has it reached bottom yet?
I know that I need to move beyond that, but I am so profoundly disappointed. I feel drained. I’m hoping that writing this, as writing often does for me, will be a form of expurgation. Maybe I will be able to leave it on the page. So here goes….
In the wake of Trump’s election, I have been thinking a great deal about the people who voted for him and what they might believe.
Here are some beliefs I can accept, even if I don’t agree with them:
That government is not able to provide solutions to societal problems.
The primacy of individual responsibility, rather than “it takes a village.”
Big government is inefficient and incompetent.
American businesses and workers need more protection in global markets.
Religious faith, if one is a believer, should guide personal behavior and choices
Less regulated (or unregulated) capitalism is the best economic system.
Favoring national security over personal privacy.
Here are some beliefs Icannotaccept:
That immigration policy or immigrants are the source (or even a major source) of America’s economic and/or societal woes.
That building a wall will solve any of America’s problems.
That people of color have too much power (or that white people have too little power) in this country.
That by sanctioning same-sex marriage, we are on a slippery slope that will allow bestiality or polygamy.
That government has a role to play in regulating reproductive rights (other than its role in approving drugs and licensing doctors, etc.)
That one individual’s religious faith can trump another person’s beliefs.
That Hillary Clinton belongs in jail.
That registering Muslims, or preventing immigration of Muslims, will reduce the threat of terrorism.
The above is partially in response to something my nephew wrote after the election. He wrote about how essential it is to be willing to talk with and listen to people with differing perspectives and not live in an echo chamber (not his words, mine). I see the danger in that. But, I also don’t think the ‘echo chamber’ is the root of the problem. I think that makes the problem far worse, but the divisions in our country, at their root, aren’t caused by the failure to listen to others. I think the division is about fundamental beliefs and, in some cases, willful ignorance.
No matter how much I talk to someone who thinks Hillary belongs in jail, they are simply not going to be able to convince me (and it is highly unlikely that I will change his/her mind). My mind is closed to that notion. Unless and until evidence of a crime is presented, and despite the extraordinary effort to do just that, it hasn’t happened.
Some beliefs may be born of ignorance, for example, climate change denial may be based on ignorance of the science. But to overcome ignorance, you must be willing to be educated and accept information (facts) that doesn’t conform to your mindset (if actual evidence of Hillary’s criminality surfaced, I would change my view). The willingness to be educated is different than being willing to exchange ideas with someone. Yes, I can learn something by listening to another perspective, but at some point we need to agree to a body of knowledge or a set of facts about our world. I see that failure as the root of the problem.
When we are receiving information, it seems to me, we look at it through the lens of our belief system. I don’t see things in black and white, I see many, many shades of gray (which is sometimes a pain in the ass), but it generally makes me open to considering alternative ideas. When I receive information, I ask myself a number of questions: where did the information come from? Is it observable? Is it consistent with other known facts? It’s like when I used to read journal articles in graduate school – what was the methodology? Can the findings be trusted? Do others do that when they receive information? And if they don’t, what do we do about that?
I see most things on a continuum; values, beliefs, philosophies. Here are some of the belief continuums I see:
People inherently good—————————————–People inherently evil
Music is so powerful in evoking emotions. During a recent visit, my Mom and Aunt Diane were recalling times when a piece of music brought tears to their eyes. Not tears of sadness, but tears inspired by the beauty of the sound. Aunt Diane recalled a time when she was driving home from work, on the FDR Drive, when she pulled her car over to listen without distraction. They were talking about classical music, identifying particular works of Bach and Beethoven that triggered the tears.
I have had occasions, especially with a live performance, where I have gotten shivers down my spine and my scalp prickled upon hearing something that touched my soul. Most often, for me, I’ve had that happen when voices harmonize and I feel uplifted. But even when I don’t have that physical reaction, I almost always have a response to music.
As a teenager and young adult music was central to my life. I think many people share that experience during that time of their life. Perhaps there are those for whom that isn’t true – my brother Mark comes to mind, but I think, not surprisingly, he may be the exception rather than the rule.
In high school, I have vivid memories of putting an album on my turntable, in my room the size of a closet, lying on my bed, and letting the music take me away. I didn’t do anything while I listened. Occasionally I may have read or done homework, but mostly I just listened…to Simon and Garfunkel, Seals and Crofts, Carole King, James Taylor. I put on my headphones, turned up the volume so that my head was filled with their voices, their melodies, their poetry.
The combination of the music and the lyrics in songs like Fire and Rain, The Boxer, Only Living Boy in New York, America validated my own feelings of alienation, loss and sadness. Sometimes it felt good to wallow around in my loneliness – I may have overdone that a bit as a teenager. But, the music could be hopeful or soothing, too. You’ve Got a Friend, Beautiful and Bridge Over Troubled Water reminded me that I did have connections, there was another way to look at the world.
Somewhere along the line I stopped doing that – just listening. Of course, life intrudes, especially when you work and have a family. But, I waste plenty of time – there could be time to do it. Concentrating fully on music, other than when I am in the car or at a concert, is just not something I consider doing anymore.
Music was a significant part of bonding with other people, too. We took it quite seriously. I remember going to my friend Cindy’s house (not the Cindy I played hooky with in elementary school, for those of you keeping track) to hang out. We weren’t long out of high school. She put on Turnstiles (Billy Joel) – a newly released album at the time. As she was setting it up on the turntable she turned to me and said, “Let’s not talk during it, ok?” I nodded in agreement. “And, I hope you don’t mind if I sing along to some of the songs, I really love James.” Cindy had already listened to the album many times over. It was still new to me. I was fine with her singing, she had a good voice. If we wanted to discuss a song, she paused the record so we could talk – we wouldn’t think of talking over it. This was one of many times that I bonded with someone over the shared experience of listening to an album.
At college, especially freshmen year, this shared ritual was an important part of establishing friendships. Merle introduced me to Jackson Browne and Dan Fogelberg. I remember sitting on her bed in her dorm room, we weren’t roommates yet, and she handed me the album Late for the Sky. “You have to listen to this,” she said. The evocative photograph on the cover, a solitary old car parked in front of a house as a day draws to a close with a still bright blue sky with fluffy white clouds, set the stage for the intense, searching songs that followed. We sat together and listened, cementing our friendship and a shared love of Jackson Browne. The same thing happened with Fogelberg’s Home Free. I heard the first notes of To the Morning and knew it was special to me. We eagerly awaited the release of their new albums, hoping one of us had the money to buy it.
Alison introduced me to Joni Mitchell. Aside from listening to Ladies of the Canyon, Alison played the guitar and we sang the songs. Again, a bond was formed that has withstood the test of time.
Music had another role in that time and place (the mid ‘70s). It was often used as a complement to getting high. I managed to make it through high school without trying pot. At times, I felt literally alone in that status. In college, I decided to relax my rules a bit and experiment (thank you, Merle, for getting me to loosen up!). One friend, Rob, fashioned himself as a kind of pied piper for those getting high for the first time. He liked introducing people to weed and I was one of his subjects. I went to his dorm room, where he had created an appropriately mellow environment with low lighting and wall hangings. He put on the Beatles’ Magical Mystery Tour and we rolled up. I admit it was kind of pleasant and relaxing. I remember walking back to my dorm in the dark and feeling like I was watching a movie where I could see the campus scenery as frames of film. Fortunately, it didn’t freak me out, I just took it all in. Although it was a positive introduction, I never fully embraced getting high. It was fine now and again, but not something I wanted to do regularly. I wonder if my feelings about pot relate to my failure to embrace the Grateful Dead, though that may be a ‘chicken or egg’ thing. Did I not like the Dead because I didn’t love getting high? Or, was it that I didn’t love getting high and therefore didn’t love the Dead? Either way, it wasn’t my scene.
Music was also an important part of my relationship with Gary. In our first year together we spent time listening to each other’s favorite albums. I had heard Bruce Springsteen before, but I didn’t fully appreciate his artistry until I listened to it with Gary. Our taste in music overlapped quite a bit, but Gary tended to like a grittier sound. I was drawn to prettier, more melodic songs. I remember playing James Taylor’s You Can Close Your Eyes for him, expecting him to be similarly moved. Gary said something disparaging about it. I’ve blocked out what he said – but he made fun of it. I nearly broke up with him right then and there! His dismissive attitude cut me to the quick. We had a real fight (maybe our first?). We had to learn to respect each other’s taste in music – this was serious business. Clearly, we figured it out or we wouldn’t be here almost 38 years later (34 married).
There is one thing that remains different about Gary and me and our attitude toward music. Gary is happy to listen only to music from before 1980 – unless it is Springsteen or Jackson Browne. He listens to their new music. If something that sounds remotely like rap comes on the radio, he immediately changes the station or turns it off. I, on the other hand, like to hear new things, new musicians. While I’m not particularly interested in Top 40 or hip-hop, I do like trying out new artists. I listen to an alternative radio station. I’m still drawn to singer-songwriters, but I’m open to hearing new people. I listen to my old favorites, too, but I’m curious about new stuff.
As I write this and reflect on what music has meant to me, I have made a decision: I want to devote more time to listening, without distraction. Maybe I’ll borrow a page from my teenage self: Put on a CD, lay on my bed and let the music envelop me.
After I retired I took a writing workshop that was an awesome experience. I have written before about how liberating that class was for me. One of the assignments we were given was to write a poem in response to another work of art – a poem, a painting, song lyrics – whatever inspired us. I wrote a poem in response to “Down to You,” by Joni Mitchell. For those who aren’t familiar with it, or if you don’t remember the lyrics, here they are:
Everything comes and goes
Marked by lovers and styles of clothes
Things that you held high
And told yourself were true
Lost or changing as the days come down to you
Down to you
You’re a kind person
You’re a cold person too
It’s down to you
You go down to the pick up station
Craving warmth and beauty
You settle for less than fascination
A few drinks later you’re not so choosy
When the closing lights strip off the shadows
On this strange new flesh you’ve found
Clutching the night to you like a fig leaf
To the blackness
And the blankets
To lay down an impression
And your loneliness
In the morning there are lovers in the street
They look so high
You brush against a stranger
And you both apologize
Old friends seem indifferent
You must have brought that on
Old bonds have broken down
Love is gone
Ooh, love is gone
Written on your spirit this sad song
Love is gone
Everything comes and goes
Pleasure moves on too early
And trouble leaves too slow
Just when you’re thinking
You’ve finally got it made
Bad news comes knocking
At your garden gate
Knocking for you
You’re a brute, you’re an angel
You can crawl, you can fly too
It’s down to you
It all comes down to you
Joni Mitchell from the album Court and Spark, 1974
I must have listened to that song, among many other Joni songs, hundreds of times during my college years. She was a mainstay of the soundtrack of that time in my life. This is the poem (or prose-poem) that I wrote after reflecting on that song:
It is a Binghamton kind of night.
The air so cold it hurts.
The sky is clear, pinpricks of light shine against the velvet blackness.
I am in exile.
My roommate’s boyfriend is visiting.
I will spend the weekend studiously avoiding my dorm room.
I am holding my pillow pressed against my chest, my knapsack on my back.
Waiting til 8:00 pm when I will meet a friend at her dorm room
where I will crash for the next two nights.
So, I wonder, where is the ‘pick up station’ that Joni sings about?
I have never found it.
Wouldn’t know how to work it, if I did.
She counts lovers like railroad cars.
I’ve had none.
But, I would like to lay down my loneliness.
I don’t think her way will work for me, though.
Can’t imagine picking up a stranger and feeling less alone.
Joni is right about one thing, though.
Pleasure moves on too early and trouble leaves too slow.
Driving home alone, I could barely concentrate on the road.
My eyes welled up.
Will I be a good mother? Can I do this?
what I suspected was confirmed.
This was planned, yet I was overwhelmed.
I took a deep breath,
focused on the road and the sky, made my way home.
Into our little brick house.
I rush to the phone to call Gary.
He is still on rounds at the VA.
I have him paged.
It takes many minutes, seemingly forever.
Wow! This is such great news!
When do you think you’ll be home?
The usual time.
You can’t get out early?
Linda, you know I can’t.
I sighed and exhaled, resigned to this reality.
Okay, we’ll talk later.
I was left to my thoughts.
Eight months crawl by.
I was not glowing with new life.
Queasy, tired, morning, noon and night.
Ear infection, bronchitis, heartburn
I didn’t enjoy sharing my body.
So many rules:
No caffeine, no alcohol, drink milk
I don’t like milk.
Vitamins the size of Pluto.
Alcohol was no loss, caffeine another story.
I’m responsible for this new life!
I don’t want to screw it up!
The due date kept changing.
First May 2, then May 11, finally May 16
That day comes and goes.
The longest gestation in history.
I am ready! Nature has its way, though.
May 20 Gary travels to Long Island to take part 4 of his medical boards.
My parents come up from Brooklyn to keep me company.
At 5 pm they leave me with friends and
head back home, Gary is on his way.
I feel some contractions: Braxton-Hicks or the real thing?
Gary gets home by 9pm.
My water sort of breaks after midnight.
We call the doctor.
He tells us to come to the hospital.
It is before dawn on Thursday morning.
We put the garbage cans by the curb before going to Albany Med.
27 hours, the last 7 hard labor,
an apt description.
First, no progress, then Pitocin – a brutal treatment.
Finally, I push!
Such a relief! My body is almost my own again.
4:39 am, Friday, May 22, I look at my baby.
Labor was hard on me, but she is perfectly formed.
She is part of me and yet, she might well be an alien.
We are one and we are separate.
I understand her; I feel her joy, her hunger, her frustration.
But I am clueless, she is a mystery.
I fall in love over those first few weeks.
Her wondrous eyes, sparking with light.
Her pink, smooth skin.
She emerges into herself.
Curious, demanding, loving.
30 years later and
it is all still true.
[Note: Gary’s remembrance of that same time]
September 12, 1986. I was on rounds when I heard my name over the VA hospital intercom for the first (and only) time in my life. The operator put me through. Linda tells me that we are going to be parents. You could have knocked me down with a feather. I was elated and scared and excited. She asked me if I could get home early that day. But the patients cannot wait. I work as fast and furiously as I can to get out early but 10PM is the best I can do. I remember not being able to concentrate during rounds that day which is the one and only time that ever happened.
That VA rotation was in many ways horrible. Perhaps it was also an experience in growing up. The VA is an underfunded, second rate health care system and, in my mind, a poor excuse to offer people who fought for our country and now are down on their luck. And, to be sure, if you are a veteran and have other health care available to you, you are not going to the VA. So these are the guys who things have not gone well for after they came back home.
I was an intern along with two others on that rotation. Claude Scialdone was another intern with me and he was amazing. I can’t remember who the third intern was but it was not someone who did all that much. Worse than that, our resident who was supposed to guide and support us was an empty suit (perhaps an empty white coat is the better medical term?). And the attending physician came by in the morning to round, as he was supposed to do, but did nothing else. So Claude and I were basically two guys just out of med school trying to keep 40 very sick veterans alive with basically no help.
It was frightening and it was exhausting. On a normal day, when I was not on call, I would get there before 7AM and get home anywhere from 8PM to midnight. When I was on call I wouldn’t get home at all.
One particular patient still sticks in my mind. He had been there since well before I started my 6 week rotation and he was often times confused, weak and kept running fevers. I worked him up for sources of infection again and again. I ordered chest x-rays to look for pneumonia, urine cultures and blood cultures but they repeatedly came back negative. I asked my resident about the guy – I told him I was certain we were missing something. There was something going on and we were failing to identify it. The patient was treading water at best and sooner or later we were going to lose him.
My resident responded by asking me if any of the cultures had grown anything and the answer was no. He then explained that this means he’s fine. He wasn’t fine. He wasn’t close to fine and I knew that in my marrow, but I was out of ideas and had no help.
At that time, the VA closely controlled the use of the newer, broad spectrum antibiotics. If you ordered any of them, you automatically got an infectious disease consult. Normally that might not seem like a problem, but in the Albany VA at that time, it meant you got Dr. Aldonna Baltsch on your floor. Dr. Baltsch was as feared as any doctor I have ever known. She was a phenomenal, dedicated, passionate physician but she was also a perfectionist with a temper. She would come in and yell at you for all the errors she determined you were making. I think she just wanted to make us better doctors but perhaps didn’t exactly know how to go about doing it. In any case, nobody ever wanted to see Dr. Baltsch around.
For that reason, nobody ever called for an infectious disease consult. And the interns and residents became experts at using combinations of older antibiotics to avoid the newer ones that came with a dreaded visit from Dr. Baltsch. But in this moment, I realized I feared the prospect of failing and losing this patient more than I feared Dr. Baltsch.
So I ordered a new wave, broad spectrum, expensive antibiotic when my resident wasn’t looking. I did so because I knew that, while it would bring the holy wrath of Dr. Baltsch, it would also bring her expertise. She came up and was really, really angry. It was as if Mount Vesuvius was going to erupt and the lava would scorch us all. However, as it turned out, her anger was entirely directed at my resident. She never even spoke to me – which was fine with me.
And she ordered exactly the same tests I had ordered. But this time, after they yet again came back negative, she ordered an LP (spinal tap). That came back negative too but she told the lab to hold onto the spinal fluid sample longer for viral cultures and they eventually came back positive for Varicella (the virus that causes Chicken Pox). Turned out he had Varicella encephalitis, an infection of his brain caused by that virus. This is still the only case of Varicella encephalitis I have ever seen.
He was placed on antiviral antibiotics. His fevers ceased after a few days and he finally started to get better. Dr. Baltsch called for a special meeting of everyone in the entire department of medicine basically to humiliate my resident. It looked like vultures picking at a carcass as the entire faculty went after the guy. I almost felt sorry for him.
That rotation eventually gave way to others, some nearly as hard and some not quite as tough.
But fall turned to winter and winter to spring and then I took my boards exam on Long Island. Knowing Linda was past her due date and could go into labor at any minute, I rushed through the exam. It was the only time in my life that I was the first person out of the room on such an exam. That night, Linda had spontaneous rupture of membranes (her water broke). We took out the garbage and drove reasonably calmly to Albany Medical Center where she gave birth after 27 long hours of labor.
She was an amazing trooper. No anesthesia. One single dose of one pain killer. Hour after hour. I spent much of the time with her but also left to do rounds and see patients during parts of the process. At the end, on May 22nd, Leah emerged, perfect, beautiful, alert and brilliant. A miracle in our lives who has been such a great joy ever since.
Leah was a force of nature. It is hard to explain how even in those earliest days she had a spirit and a liveliness and a curiosity. I felt like she saw and understood the world around her in ways that most babies could not and her smile melted my heart. Life had taken on new meaning and I fell in love with her.
Still I was torn. I could not devote less time to my patients than what I felt I needed to. And yet I wanted to be home; to be with Leah; to help Linda who was in some ways almost a single parent. She was exhausted and I was exhausted. And I could not do all I wished I could do. I could not do all Linda needed me to do.
Having already completed all of the hardest rotations in May of 1987, my last rotation of internship was scheduled to be an easy one in a community hospital very near our house. It was going to be perfect. I would be working a short walk from our house, the hours would be reasonable. A long, hard winter was about to give way to a beautiful spring and hours with Leah and Linda. It didn’t work out that way. On the day Leah was born, an intern quit the program and the department of medicine met to determine who should cover that intern’s rotation. They decided I should cover it. I was back in the VA hospital.