SMOKE GETS IN MY EYES

A few years ago I went through a period of reading YA Dystopian novels:  The Hunger Games series, the Divergent series.  I loved them.  Great characters, stories, settings.  Now, though, I almost feel like I am in the midst of one of those novels and it's not nearly so much fun.

For one thing, it's hard to breathe.  Not just because the current president and his minions continue to take my breath away with their slash and burn march to an authoritarian state, but because there is so much smoke in the air my eyes burn, my throat feels raw, and my chest feels a bit heavy.  I realize I'm taking shallow breaths, trying not to take in too much particulate matter with what life-giving oxygen is also available.

This is the second summer of weeks of low-hanging smoke, blotting out what should be the Northwest's best weather -- bright blue skies, sunshine, breathtaking (in a good way) views of mountains and water.  Summer is so precious here, I am feeling cheated from days I look forward to all the rest of the year.

Again this year the western United States and Canada seems to be on fire.  Forest fires are everywhere and the smoke drifts into this area from as far away as Siberia!  Why so bad?  The short answer is that summers are hotter and drier, making forests even more vulnerable to fire (due to careless humans or Mother Nature).

Climate change is REAL.  There is no "I believe in or don't believe in" climate change.  It's not a belief statement.  It's a fact.  We've been warned of the harmful effects of our love affair with fossil fuels for decades.  It's all escalating now and the effects are being visited upon us with more frequent and devastating forest fires, more frequent and devastating hurricanes, tornados, and torrential rainfalls and floods.  It's all escalating now with ice caps and glaciers melting at an alarming rate, causing sea levels to rise.  People talk about warmer winters, less snow.

People get confused about the difference between "weather" and "climate".  Short-term changes in the atmosphere is 'weather' and yes, it can be super cold in the winter, or there can be a big snowstorm and still we would be in the throes of global warming because long-term changes over time is "climate".  Scientific studies prove that over time, and rapidly escalating, the earth's climate is warming.  That's not good for the living things that are currently living.  I suppose there might be adaptation over time, for awhile, but not in our lifetimes, nor our grandchildren's.  I wonder if one day humans will be living a Waterworld or Mad Max life?

We are living this week under an "Air Quality Alert", with the pollution currently at a level in my community listed as:

169

Unhealthy

We are to limit outdoor exposure, to stay in with doors and windows closed.  My granddaughter's childcare/preschool is not allowing the kids to play outside -- on a midsummer's day.  That makes me very sad.  We will continue to be impacted as the air quality worsens, as it's predicted to do by tonight through Wednesday.  Some people in Eastern Washington, where Very Unhealthy and Hazardous air quality warnings are stretching into many days, are looking into home air filtration systems and respirator type masks.  Parents are getting desperate to find indoor activities for their housebound kids.

We are on an unstoppable train right now, but we can slow it down and maybe even reverse this trend if we, as a collective human family, have the will to do so.  It feels lately like we don't, at least in the US where the current president was elected on an "anti-regulation" promise and went on to choose Cabinet Secretaries who are happily dismantling their agencies, including Energy and the EPA, and who also exited the US from the Paris Climate Accords, which strives to address global warming concerns.  We stand alone at this point in being outside the Accords' world family.

In Washington state we have a chance to be national leaders on addressing climate impacts on the local level by passing I-1631 which will levy a fee on the most egregious corporate polluters.  The money would go not into the State's general fund, but into a designated fund overseen by a non-partisan citizen's group of environmentalists, health care providers, business leaders, faith groups, and communities of color coalitions.  Over 100 organizational endorsers are on board.  Hundreds of volunteers, including Hub and I, are door belling and reaching out via email and social media to Get Out The Vote.  The opponents are throwing millions of dollars at an "anti-1631 campaign" with advertising and attack ads.  Still, we remain hopeful.


So, as I sit writing inside on this 80-degree day, looking out at the smoke obscuring my usual lovely summer views, I have to wonder if there are any super fashionable respirator masks on Amazon.  I would like a purple one.

At least, that's the (smoke-obscured) view from here...©

RATS IN THE MAZE OF MODERN MEDICINE

AAAARRRRRGGGGGHHHHH!  That's me screaming in frustration.

Backstory:  The local multi-specialty medical clinic here was, until a couple of years ago, physician-owned and operated, founded by a handful of doctors in 1924.  When my husband joined the clinic in 1982, there were 33 doctors (one female!)  He went through a round of interviews, two of which included me.  These were social events, but I was aware that we were being evaluated as to whether we'd be a good "fit".  For my part, I was asked if I was sure I wanted to move so far from my midwest home and family -- they didn't want the little wifey to get homesick and demand to move back home to Illinois.  I told them we were looking forward to our new life in Washington.  Assured that he wouldn't flake out and quit, Hub was hired.  The docs in those days committed their entire careers to the clinic.

The clinic has grown tremendously since those early days and now has 500 care providers and 2,000 staff members and dozens of satellite clinics in outlying communities.  My daughter-in-law manages one of them and got the position all on her own!  No nepotism!

In 2016 the Board made the controversial decision to "merge" (which was a sneaky way of saying "sell") to a larger corporate outfit.  Big payouts went to some shareholders, to the consternation of others (us), and many took their wad of cash and quit or retired; everyone was in a state of flux.  No  one knew what to expect of the new bosses.

Well, the new bosses got in over their heads, grew disillusioned with their purchase and now have sold the clinic again!  The new new corporate bosses will come on board within the next year.  So the place is still in a state of flux.  Doctors are bailing left and right because they are overworked and understaffed and the bean counters want them to work harder for longer hours.  Support staff, as well, never know what the new decree from on high will be.

And patients, like me, are being jerked around!  Let's just establish that I admit to being bitter about this whole debacle because of my constant loyalty to and belief in the excellence of this clinic and it's doctors for the 25+ years Hub worked there.  To see it struggle now and to find myself a victim of the transition and the business (not the quality of care) of medicine is aggravating.

I had an excellent primary care physician for a number of years.  I loved her.  We got along great. But she decided to close her practice in 2014 and work in a different medical model (which is really cool and how all medicine should be practiced!)  I went to another doctor the following year and that did not go well.  She treated me like a warm body passing through the exam room, focused primarily on that stupid Medicare questionnaire about whether I've fallen lately and do I eat enough vegetables, etc.  She ignored what was important to me, brushed off my questions, and didn't order any routine labs.  Nope!  Not going back.

So I looked for another doc and found a woman who was sort of great. She helped me through a number of issues and I had a good rapport with her.  Whew!  I was relieved to find a new doctor I could rely upon.  Nope.  She quit.

I was "assigned" a doctor at that point, a man.  I hadn't had a male doctor in decades, but I was a bit worn down and decided just to check him out.  I liked him.  He was friendly and funny and listened to me and we were on the same page about being partners in my care.  I was happy.  I saw him a couple of times....before he quit.

Before leaving he referred me to a woman in the department, an Advanced Registered Nurse Practitioner (ARNP), who are being utilized more and more to "extend physician access".  Basically you don't have a doc, you have a Nurse Practitioner, who are also skilled primary care providers.  Anyway, he said she would be a great fit for me.  She was interested in a holistic approach to health care and would be open to me pursuing my interest a healthy lifestyle rather than taking medications.  I made an appointment in May to see her in August for my first visit with her.

I got a call last week confirming my August 13 appointment.  Then I got a call on Monday telling me she had to reschedule my appointment.  I was annoyed, because my last three doctor visits have been rescheduled due to the doctor needing to change the appointment.  This was becoming a trend.  But oh well.  OK.  I called back to reschedule and the gal in the Resource Center (nowhere near the doctor's office, in a separate building 3 miles away!) told me my new provider was leaving the clinic in September which was why she was cancelling and rescheduling some appointments.

My initial response was to laugh maniacally, I'm sure startling the gal on the phone.  "You've got to be kidding me!" I said.  "I've had 4 primary care providers in 4 years and I haven't even seen this one yet!"  I felt myself becoming angry, then sad, then discounted....I started crying as I talked, then sobbing.  Geez,  I could just imagine this poor young woman putting Behavioral Health on speed dial as she tried to help me with this dilemma.

I quickly calmed down and told her I knew a doc I wanted to see at an outlying clinic 20 minutes from my home, which frustrated me because I live 3 minutes from the main campus but it appears there are NO doctors there!  Whatever.  She checked and then told me the doc I wanted was no longer accepting patients.  I burst into tears again, ranting that I could have gotten in to his practice had I not wasted my time waiting to see the ARNP who had the gall to freaking quit on me!  I assured her several times this was not aimed at her and I was sorry for my reaction and I thanked her for her help.  Still, I hung up without an appointment with anyone.  But just before our goodbye, the gal in the Resource Center whispered, "Bless you."  So I guess I scared her into thinking I was a helpless lunatic.

An hour later I got a voicemail from the clinic from a nurse in the ARNP's office telling me I should have my labs done prior to my appointment on 8/13.  WHAT????  I thought they just told me I had NO appointment!  I called back and after 13 minutes on hold finally talked to the Medical Assistant in the office who confirmed the ARNP is leaving the clinic but she would still see me once and that my appointment shouldn't have been cancelled after all.  NO!  Why would I establish care with a provider who has one foot and half her brain out the door, only to have to establish with another doctor in short order?  The MA agreed this made no sense.  She recommended a few other providers, but I hung up with no appointment.  I have research to do and a letter to write to the CEO and Board President of the clinic.

I'm grateful to be healthy, able to navigate this craziness to some degree, articulate enough and savvy enough to know what I want and have some idea how to get it, but still I feel ultimately at the mercy of a system that no longer treats patients with the respect and care we deserve.  I'm sick of being a "customer" and paid the lip service of being their "#1 Priority"when the reality is anything but.  I'm sad for the many, many people who don't have the confidence, the courage, or the inside info I have to advocate for themselves.  I'm sad for those truly ill, confused, and those with hearing issues who likely can't navigate the six automated options offered every time you call the freaking doctor with a simple question!

We come to health care providers in a vulnerable state.  Our very lives are at stake.  We share with them the most intimate details of our physical and emotional selves.  Being shoved around like rats in a maze, expected to adjust to a new system (devoid of friendly faces now that check-in is completely automated and no receptionist is in sight!), and then expected to accept any care provider who happens to have an opening at any given time  (and who barely look up from their computers and are loathe to see us unclothed or have to touch us) is disrespectful and dismissive.

I guess I'm old enough now to compare this experience to the "good old days" and I hate that stereotype of being stuck in the past.  I'm all for change and modernization and generally welcome it, but in some cases we got it right back then.

At least, that's the view from here...©

Photo Credit:  www.pixabay.com

https://www.nbcnews.com/business/business-news/doctor-out-why-physicians-are-leaving-their-practices-pursue-other-n900921?cid=sm_npd_nn_fb_ma

AWAKE

Well, I had a helluva weekend.

Sometimes you don't know if you've been asleep until you wake up.

I've been having this horrific nightmare that some misogynist, racist, self-serving, unqualified doofus named Donald Trump won the presidency.  Crazy, right?  In my dream he defeated probably the most qualified person ever to run for president, a woman no less, and then went on to choose a cabinet of deplorables who have proceeded to dismantle the very agencies they are overseeing!  Crazy, right?  He regularly lies to everyone, antagonizes allies, buddies up to dictators, and calls our free press the 'enemy of the people'.  Turned out the Russians actually helped him win by attacking our election system with disinformation and hacking into private email servers.  And he's under investigation for colluding with the enemy.  It's one of those nightmares that could be a movie!  Crazy, right?

In my dream I've been a Resistance fighter, nose to the grindstone doing all I can, with a small local group of compadres, and other Resisters nationwide, to stop our rapid descent into authoritarian rule.  People on the other side are outspoken, violent, and rude to say the least.  They believe everything this guy tells them and can't see what he does is at their expense.  I fight for them too.  I could go on and on about the daily horror show, but suffice to say, I've been immersed in disbelief, dismay, and acting upon an urgent call to action.  At times I feel like I'm drowning.  I flail around trying to keep my head above water.  Sometimes I float to the bottom into the darkness.

What I noticed in my dream was that while all of this was going on, I also tried to have a normal life. I socialized, I took trips, I paid bills, I exercised, I went on Weight Watchers, I loved my family, I read books, I crocheted, I cooked and cleaned and got the car washed, I grew some food in my garden and planted some flowers...you know....life.  But a pall was cast over it all.  I felt like every moment NOT dong activism was wasted time in some way.  Intellectually I know better, but that pall was there nonetheless.

Friday night Hub and I had tickets to see Jackson Browne, my all time favorite singer/songwriter/musician.  We've seen him probably 20 times since discovering his music in the 70's.  In many ways his music is the soundtrack of a big chunk of my life.  His lyrics are poetry; perfect whether ballad or rocker or call to action.  So Friday night at the concert I sang along to every word to every song and I was freaking AWAKE!  His music roused me and gave me joy and hope and peace.  I realized at the end of one song, guitars and drums and keyboards blasting with the crowd cheering that I had opened my mouth and screamed; literally screamed at the top of my lungs for about 30 seconds, my primal yell drowned in the wall of sound around me.  As I was doing it I became aware that it wasn't about the music anymore; it was about giving all of my pain and anger and angst and lonliness voice.  It was pure release.

On Saturday I attended a workshop with John Pavolovitz http://johnpavlovitz.com, a pastor, author, blogger, and Resistance hero.  He led us in an exploration of compassion burnout and how to avoid it.  He was kind, welcoming, affirming, articulate, and so funny!  I found myself in tears as he so astutely and eloquently acknowledged how very disorienting and difficult it has been to find our country in this place in time and how exhausting is the daily struggle to remain sane and engaged when all around us chaos swirls.  He "got" exactly how I've been feeling.  He gave voice to my sadness.  His acknowledgment was like a hug, a balm to my spirit.  I felt less alone.

Saturday night, however, was a different awakening.  I sat with a group of friends who meet monthly and we talked about the Pavlovitz workshop and that he gave the advice to be engaged in social media.  (And to also beware of its toxic nature if we get obsessed with it.)  Almost everyone in the circle talked about their aversion to Facebook and social media, finding little of interest there and/or succumbing to the black hole it can become.  Most said they were weaning themselves away, might look but never engage there,  and/or never enjoyed it anyway.

I was stunned.  I went from feeling affirmed by what Pavlovitz had said about finding community on social media, finding support and encouragement, and a source of information, to feeling downright embarrassed about my social media use.

I have spent considerable time using social media to share about my personal life, about political issues, sharing information and calls to action, and hoping to find support and yet here was a group of close friends saying they pretty much wanted to shut down their Facebook pages.  I realized in that moment, that AWAKE moment, that again, I'd been sleeping.  I had not seen that what I'd been doing was only appreciated by a relative handful of people.  Much of my support on social media, at least for political action, comes from strangers in the form of various groups who post there.   No wonder I've often felt I'm whistling into the wind, when my FB friends ignore me and only a few respond.

On Sunday, I went to a concert by the incomparable Jami Sieber www.jamisieber.com.  She played at my yoga teacher's beautiful home and art studio space.  Jami's electric cello is magical and her music transcendent.  It was the calm, meditative, centering finale I so needed after a weekend of turbulent awakening.

Something has shifted now.  I can feel it.  I have screamed in joy and release, cried with compassion for myself, cried again in embarrassment and realization of erroneous assumptions, and laid back in the healing melodies of beautiful song.  I am stronger and more balanced today.

I will never stop being outraged at what is happening to our country, but I can only do so much.  I will do all I can, but not to my own detriment, not to the point of darkness.  And I will stop trying to rally people around me who have little to no interest in being rallied.  I will find my allies and we will march forward with what must be done -- together, in community, with joy, laughter, and music as the soundtrack to Resistance.

At least, that's the view from here...©

Photo credit: www.pixabay.com