Wednesday, September 16, 2009

The Worst Day

photo:  Aihibed MagaƱa

I'm going to tell you about one of my worst parenting moments:  the day, about a year ago, when I smacked my 5-yr old upside the head.  When I shared this story with Carrie Contey, Ph.D., who I consult now and then about all matters mom-related, she urged me to write about it.  She thought it might help other parents.

The first thing you need to know about me is that I endeavor to be a very, very conscious, and certainly non-violent, parent. (I almost wrote "hands on," no pun intended).  I read a ton, and probably have at least the equivalent of a Master's degree in child development.  I am very engaged with my kids, I spend a lot of time with them, I am tuned in, and I have worked hard, especially in the first three years of each of their lives, to meet the vast majority of their physical, mental, and emotional needs.  This is my job; I am a professional.  Other parents have commented on my exceptional patience.

I don't spank my kids, because, well, I think it sends a bad message.  I know it's a controversial topic, and to those who advocate corporal punishment, this post will seem silly.  My bottom line is that using violence teaches violence.  And if an adult hit another adult, it's called "assault," and you can go to jail for it.  So why not give kids some other tools for their tool boxes?  I do a lot of things to help my kids communicate and behave well, so that's normal for them.  When things get out of control, we do "time outs," but my kids aren't isolated in their room while they're upset.  The "time out" is really a time to calm down, not a place to experience intense emotions without any support.  I have also been known to send myself to "time out."  My basic approach to my kids' emotions is something like teaching them to drive.  When they're having feelings, I try to support them by putting words on the feelings and helping them, gradually of course, to learn to regulate them.  It's possible to learn to regulate your own emotions while also dealing with being afraid and confused by your parent being violent, but I think it's harder.

But there was that one afternoon about a year ago, not long after my son started Kindergarten.  I had a neighborhood party to get ready for, so I was probably rushing.  And rushing him.  We found ourselves in an escalating power struggle over homework, and I could tell that he was getting overloaded.  Suddenly, as I was leaning forward over his paper, he hit me in the face, knocking my glasses to the floor.  Before I even realized it, I smacked him right back.  And then I stopped, gasped, and well, I don't even remember all of what happened after that.  I vaguely recall a lot of intense upset, a "time out" for him, an apology from me, and a lot of attempts to get back on track.  He said some things about the "pressure" of being in school all day.  I said what I believe--that it's never ok for a grown-up to hit a child, no matter what.  The whole thing blew over, on the surface, in that I stopped talking about it to him.  But I was a wreck for about a week.  At the neighborhood party that evening and afterward, I felt really, really horrible.  Who was I now that I had struck my kid?  How would other people see me if they knew?  No one was more shocked than me to learn that, if you hit me in the face and knock off my glasses, I just might hit you back, even if you're less than half my size.  It was pure reaction--this was something I never would have consciously chosen as a parent.

But you know what?  I also felt relieved.  My son and I had been having these micro-skirmishes, pretty much ever since his little sister was born.  And when these things happened, I would act okay on the surface, saying and doing the "right" things.  If another adult observed me, I think he/she would say that I handled them well. But under the surface, I was becoming acquainted with the most intense rage I've experienced since, well, probably since I was a little kid.  My son's behavior and our conflicts were triggering a bunch of old stuff for me.  I don't think I ever really put a lot of stock in "the unconscious" until I began to be emotionally hijacked by the behavior of this little person I love so much.  My internal reactions were much bigger than what his part of it warranted.

So when I finally snapped and smacked him, I was relieved because I had finally done what I was so afraid I was going to do.  And then, I could not only forgive myself for it, but I also talked to some other trusted friends and they still thought I was a pretty awesome mom.  And my son?  Well, it was really not such a big thing from his side of things.  He did hit me first, after all, and he knows what it's like to lose control and then move on.

Being a mom of two kids been a long hard road, with many chances to learn about myself and to do something that feels like detonating internal land mines.  I want to give my kids the best of what my parents gave me, plus more, including all of the information we have now about how kids attach and develop.  I'm amazed at how well I've done, how much help is out there, and how many ways I've figured out to react differently.  I'm happy to report that I don't think I will do that again.

Tuesday, September 15, 2009

Poverty and Politics

When I was an undergraduate at The University of Texas, I took an unforgettable government class, from a professor named Henry Dietz, called "Poverty and Politics." 
According to Dr. Dietz, all poverty policy is created from one of two approaches:  structural or cultural.

If you believe that poverty is structural, you think that people are poor because, try as they might, the system is not accessible to them.  If you are a policy maker who believes poverty is structural, you might try to pass laws that do things like expand transportation services, improve schools, or make housing (or health care) more affordable. 

If you believe that poverty is cultural, you think that people are poor because, even though the system is accessible to them, their immediate social environment prevents them from taking advantage of opportunities.  If you are a policy maker who believes poverty is cultural, you might try to influence the culture, by providing opportunities for education and role modeling.  Or you might believe it's not government's place to do anything at all, since poor people need to change themselves.

Which one is "true"?  They both are!  It varies from individual to individual, which one has more impact--structure or culture--even within one poor family.  That's why people can say, "Look at so-and-so!  He rose up from nothing!"  And it probably varies over the course of one individual's lifetime. 

Legislation is, indeed, a blunt instrument, especially if we're talking about federal legislation in a country as large and diverse as the U.S.  People can say that "government doesn't fix X, Y, or Z," but that statement will inherently miss part(s) of the picture--either who needs fixing, or what might fix them.  It will also overlook the fact that, in our glorious representative democracy with term limits, "government," like the population, is a changing body.

And I would also add my own theory:  poverty is spiritual.  Interestingly, this kind of poverty afflicts all kinds of folks, and doesn't care how much money you have.  In this case, the politician might not be as effective as the minister--or even better yet, the present, active, and engaged parents and community, from square one.


Sunday, September 13, 2009

Death Panels

No one really wants to think or talk about rationing health care. No one wants to be the one who chooses which country gets hit by the tsunami, either. We call those decisions "acts of God," and we accept them as part of life, even if we don't understand or like them.

But what about in realms, like medicine, where humans get to play God (sometimes)?

In the heat of current debates about health care reform in America, former Alaska governor/vice presidential candidate Sarah Palin caught a lot of folks' attention by spreading the rumor that the House bill contained provisions for the creation of government-run "death panels." Aside from reminding everyone that a vote cast in fear counts as much as one based on reason, this news further galvanized conservatives who already opposed the plan.

Rationing is a fact of life in a world where resources are finite. We ration food, money, time, and lots of other things every day. In health care, rationing decisions are ideally made by the doctor and her patient, with a reasonable assessment of the likelihood of success for a given treatment. But you hear stories about families who prolong the patient's treatment, for lots of reasons, healthy or otherwise (Terri Schiavo comes to mind). And you hear stories about doctors who misjudge the prognosis, informing that someone has X months to live when, in fact, the patient goes on for years.

In a previous life, when I thought I wanted to be a doctor, I had interviews at several medical schools. In one of them, the interviewer posed an ethical dilemma about rationing. In the scenario he described, there were two patients with kidney failure and only one dialysis machine in the hospital. I was in charge: who would I allow to use it? The wife of the town's banker, or the town drunk? He wanted to know who I would choose, and why. What criteria would I use to decide who would get to live--would it be age? social status? financial ability to pay? gender? the fact that one or the other had a family at home? future productivity?  The interviewer grew increasingly frustrated with me because I kept coming up with answers like "fly in another dialysis machine." He then amended the scenario to include a blizzard! This went on and on, comically, because I refused to choose whose life was "more important" than the other's. (I got wait-listed at that school!)

Conservatives can act like rationing will happen with reform, as if it doesn't now. They can pretend that the current form of rationing--folks with money get to live, folks without don't--produces the best results, or the most truly American results. Really it's just the results that favor them, for now.

What if we had town hall meetings about who we value most and why? Or meetings to help us better accept the reality that health care dollars--which represent the time and training of medical professionals, plus supplies, overhead, the unpaid bills of the uninsured, the fraudulent payments to the dishonest, the payments on the MRI machine, the decades of pharmaceutical research, the bonuses of insurance company executives, and so much more--are limited? What if we talked about how life is unfair, but that we--as families, communities, and as a nation--can try to make it as fair as possible, and accept it, with love, respect, and dignity, when we can't? Maybe those meetings should be called "church," or "therapy." Whatever they're called, they're not happening, as far as I can tell.

Thursday, September 10, 2009

Pulling the Plug on Grandma

By now, if you're tuned into the debate in the U.S. about health care reform, you've heard the scary predictions about how the proposed changes will affect folks who already have insurance. Conservatives and Republicans believe that offering a "public option" will lead to the following undesirable consequences:

  • no private insurance company will be able to compete with the public system because the government will keep raising taxes to subsidize it. The private companies will go out of business.
  • corporations who now offer health insurance to their employees will stop offering that coverage, forcing people to move to the public system.
  • the public system will be, by definition because it is public, poorly run and will provide worse care.
  • the public system will not adequately reimburse doctors for their services. Doctors who earn a lot of money now will not be able to do so once a large number of people are covered by the public plan.
  • the best doctors will not be doctors anymore. the doctors who remain in the field, and the people who train in the future to become doctors, will not be "the best" doctors.
  • the new plan will not be adequately funded (or something?), so there will be rationing of health care. In other words, someone else--not your doctor, and not you--will be deciding whether you receive treatment for your condition. Most likely, I'm told, it will be a government bureaucrat who knows only spreadsheets and not you. And certainly not health care.
  • we will pass on an unmanageable financial burden to future generations with no benefit.
  • providing health care to all Americans will cause us to lose our national character in terms of excellence and global competitiveness.
I have so much to say about all of these assumptions. First of all, because it's just how I am, I wonder how we know these things are going to happen. Second, I enjoy pondering what these assumptions say about us and our beliefs about human motivation. What do we believe and trust when we imagine about why people become doctors or politicians or bean-counting bureaucrats? And third, why do we act like this is the end of the world? Like we can't go back and adjust and amend things later as all of these "catastrophes" materialize?

Have you ever kept track of your predictions about the future? I'm amazed at how consistently I'm wrong! If I'm reluctant about going on a trip, I end up having fun anyway. If I'm in a bad mood, something good happens that turns my mood around. All of my fears (especially the worst ones) are based on the past. Usually the reality of life turns out to be a little bit of what I was afraid of, plus good things, plus some stuff I never imagined. If I reflect too much on how little I know about what a choice will bring, I might never get out of bed. The good news is that I trust myself, my ability to deal, and the support I have around me. And I trust that I can always re-group and keep evolving.

My bottom line? Health care reform has to start somewhere. Honestly, I don't care where, as long as 1) it does start, 2) it does continue, and 3) it always puts the needs and health of consumers above those of the shareholders of publicly-traded companies.

Monday, September 07, 2009

One of the Best Things I've Ever Done

Yesterday, for some reason, I thought back to 2005, which was one of the hardest years ever for me. At that time, we were struggling after a cross-country move, we had a toddler for whom we couldn't find the right child care, I was sleep-deprived and overworked, on and on. Oh, and I had two miscarriages somewhere in there. All of that stress played itself out everywhere, but especially in my marriage.

I remembered relaying all of this to a confidant, and saying these words, which still kindof amaze me: "I would never forgive myself if I made any decision about my marriage right now, because we're just under too much stress. When things are better, when we're sitting on the beach sipping daquiris, I'll ask myself if I like the person I'm with."

I'm here to tell you that I am grateful (and I gotta say, more than a little impressed with myself) for that stunning stroke of maturity. Yesterday, when we were all home for Labor Day, relaxing, I thought about all the good that has come out of not letting a genuinely trying time bring out the worst. I still like my husband--or maybe I like him again--and together, we've not only weathered some tough times but given our kids the gift of having parents who work on their relationship. I'm also grateful for my husband, who is also committed and hardworking and didn't give up on me, either!

Oh Well, That Mug Was Too Much Pressure Anyway!

It sure did fit a lot of coffee, though! I will miss that part.

Thursday, September 03, 2009

All of the Poor People Should Just Die

I don't like it that participants in the current Medicare Part B program can get free flu vaccines. I just saw that, on a sign at the grocery store. I don't want to have my tax dollars going to people who don't work as hard as I do. Why should I have to pay for other peoples' bad choices? It's not my problem that people didn't work hard like I did, and like my family did. It's not my problem that they don't have health insurance like I do. I work for a good, solid corporation. We were a plum account for our insurance company. We work hard, so the insurance company negotiates discounted rates with our doctors and hospitals.

If poor people can't afford to pay for their own vaccine, then let them get the flu. But if their kids get the flu, they shouldn't send them to school. They should stay home with them. And if they have to miss work to take care of their kids, they can just lose their jobs. And if their employers have to scramble because their employees have to stay home instead of coming to work, they'll get over it. And if their landlords have to evict them, they will find someone else to move in. If the landlord has to foreclose on the property, someone else who works hard will buy it. Eventually, the housing market will recover.

America is a great country because you can see what you're made of. You can pull yourself up by your bootstraps. That's what I do. Pull myself up by my bootstraps and make good choices. I was once a sperm and an egg, and I made the good choice to get myself together, to grow, and to be born. Then, I made the good choice to grow up in a good home and go to good schools and live in a house with people who had health insurance.

I don't want to have to pay for health care for poor people because it's too expensive, and I work hard. I am in the top tax bracket, and folks like me are the ones who pay for these programs, not the vast majority of people who don't work hard and don't make good choices. If my taxes go up, I might not be able to pull myself up by my bootstraps. If small businesses have to pay for their employees' coverage, then there goes the fabric of this country, entrepreneurship. Let them scramble when their employees are sick, or when their own kids get the flu from those other kids whose parents don't have the good sense to keep them home from school.

Government can't do everything! All I want is to preserve the fabric of this country, what has made us the envy of the world. And that's the ability to make your destiny, if you work hard. I don't want to live in the former Soviet Union. It's a slippery slope. If you start paying for the health care of people who don't work hard, you're just a few steps away from communism, despite the fact that the former Soviet Union was not a representative democracy with term limits, and despite the fact that that country began with a violent overthrow of the czarist system. Still, it's a slippery slope.

Doctors work hard. And hospitals work hard. If poor people can't pay their bills, that's not the problem of doctors or hospitals. They should just refuse to treat them. And then, maybe the poor people will all either die or go away. Or maybe go to college to get a better job.

I don't want to have to pay for prisons, either. I'd rather save up my money for a 15 foot high fence with an alarm system around my house. I'd rather move to a part of town where there aren't any poor people. I agree that health care is a problem, but it's not my problem.

Wednesday, September 02, 2009

Is Giving Over-Rated?

I'm being serious! For the life of me, I don't understand why humans say "it is better to give than to receive."

Aren't they both important? If I don't receive, then how can someone else give? And when I do give, I don't find as big of a "gift" in giving to someone who isn't able to graciously receive my offering. I guess it's noble to give to someone who's indifferent or ungrateful--but is it better than graciously receiving from someone else?

Also, I think that giving too much can dilute the value of a gift. I'd rather have someone give me one rare but thoughtful gift than a whole bunch of tiny ceramic thingies I don't have space for (not to mention that my small kids demolish breakables). And I'd prefer if some folks would give to themselves sometimes, instead of dissipating their own energy by worrying so much about others. Why doesn't anyone talk about that?

The older I get, the more I think it's about being mindful of all of this stuff moving around than about which direction it's going. We give and receive all the time, with our presence, our energy, our attention and encouragement, our sincerity. Happiness in life depends on paying attention to that, and remembering that we're all connected and dependent on each other.