A Quiet Thirty-nine

2020 has been a year of cancelled, or muted, celebrations. I know many people who have had to postpone or cancel special events, vacations, and weddings due to COVID-19.  People asked me if I was going to be "doing anything special" for my birthday this year and of course the answer was "nope."  I'm not a big birthday-celebrator in normal years, so today's quiet day suited me just fine!

I asked the kids to "sleep in" for me so, even though they were up shortly after 6 a.m., they stayed in their room until 6:45! Unfortunately, because I had fallen asleep early reading last night (under the new weighted blanked that Kelvin got me!), I was awake and up at 5 a.m., but definitely had some quiet time to myself to exercise and read, which was a nice start to the Saturday. 

This past week in school, Iver learned how to make "pop-up" cards, and he sure made me a great one!

My siblings-in-law know me so well.  Kenn and Lisa sent me Obama's new 700-page memoir, A Promised Land in hardback (Theresa independently gifted me an ebook version, too, which was funny!) and Katherine sent me Untamed. I read so many books, but hardly ever buy them, so their thoughtfulness in gift choice felt so indulgent! 

My friend Karen had texted me this earlier in the week which is so true.

I FaceTimed with my parents, and enjoyed a lazy day at home, doing art with Iver, reading, and watching tennis.

It was a lovely sunny fall day and later afternoon, we took a short drive to the Clam Beach Overlook and walked along the Hammond trail.

He's into crazy faces.

We saw some seals poking their heads through the inlet water, which was a treat!

We watched a lovely Humboldt sunset over the Pacific, and then picked up some local Mexican take-out from Fiesta Cantina and enjoyed dinner (which I didn't have to cook-- yay!) at home.  

It was a quiet, but pleasant, day and just my preferred low-key style.  Thank you to everyone who reached out to wish me birthday love! I'm hoping that in late 2021, and for the big 4-0 (when I will officially be "old,") COVID will be behind us and perhaps we can take a nice vacation to celebrate!  Until then, I'll enjoy the simple things, lots of cozy time at home with a book and a warm blanket, and our tight little family. 

Moped kids

A couple of weeks ago, the boys got to hop on a (stationary) moped of a friend of ours.  I realized I'd forgotten to post the pictures.

They sure got some cute and gleeful pictures "pretending" to ride!

And here are some side-by-sides with another pair of siblings (Kelvin's brother Kenn and sister Theresa)!

With rainy weather picking up, we haven't been able to do much biking anymore, but were lucky to get these cute snapshots. Moped sibs 4-eva!

Slapped in the face, and still going to work for you

This Atlantic article  published last week explained well what so many healthcare workers are feeling these days. I am, admittedly, not on the "front lines" fighting COVID in our ERs, inpatient units, or ICUs like many people I know. Our outpatients are screened and tested for COVID at a drive-through testing site rather than in our regular family medicine clinics.  We haven't yet had a COVID+ mom on our inpatient labor unit, but the threat and reality is that we will, soon, when those cumbersome N95 and face-shields we've been wearing for eight months already will be critical barriers to preserve our own health. Thankfully, local cases have been low to date, as people in our area have taken the disease appropriately seriously, but as cases rise nationally (and internationally) again, we are all bracing for our own surge, which could be devastating in a low-resource rural setting. With never enough clinical providers, our remote community will be stretched very thin if any of us doctors or nurses are placed on quarantine due to a positive contact or active infection. It's not a question of if, but when, we will all be personally affected.

I won't spend time or energy here trying to "convince" people who don't already understand the reality of COVID-19 and its severity about epidemiology, public health, science, and truth (I’d guess that almost all readers of this blog are on our side, although it seems, based on the recent election results, that 47% or more of people who give a damn in this country are not living in reality anyway and are likely, sadly, unpersuadable). While I've seen some people make a valiant effort on social media to "educate" those in denial or who feel that the alarm about this virus is political, changing human behavior and true "conversion" of people's minds is exceedingly difficult as I've learned in my own medical practice (and personal efforts) over the years! 

All of us all humans and Americans are tired of COVID-19. We all want to live normal, social lives. We all feel weighed down by the burden of background COVID all day long. We all hate wearing masks. We are all grieving not seeing family, or friends, or getting to travel, or having our kids be able to participate in activities out of the home. I am particularly sick of and exhausted by screen-based "home" schooling as a second job, and devastated by this lost year for so many kids as in this country, as here, bars are prioritized over children’s education (which apparently is nonessential). I am so over all of the virtual meetings, workplace electronic communication, and Zoom.  It’s been a very long year, and we’re still not past the worst of it. 

However, healthcare workers, who already face moral injury on a daily basis because of how our nation's fractured health care system works and the huge administrative burdens on healers just trying to help, are especially tired.  We need a break, but even those of us who are not inpatient-based feel guilty taking any days off--because hypertension, and infections, and diabetes/its complications, and many other life-threatening conditions that can steal life, don't stop because of COVID, and it's even harder to keep people healthy who don't come in (or who can't figure out the virtual care) or delay care due to fear and other barriers of access. People are sicker, mentally and physically, than ever, and it takes its toll on those of us trying to keep those people well. We healthcare workers feel slapped in the face when we see photos of family reunions, mask-less social gatherings, and travel, because we are just barely getting by in our regular workdays (while not losing our minds and “missing” things) just trying to keep people alive (and as a female primary care doc, I personally struggle with burnout even in non-COVID times!). A huge part of my job is to provide education and screening to prevent disease, and to keep people out of the hospital and from needing critical care. We feel often that our best efforts and personal sacrifices are in vain, but we still show up daily to take care of people, many of of whom don't seem to care much about or take ownership of their health outcomes, much less those of their fellow community members.

We doctors have been through a lot of years of school and have done a lot of reading. We know a thing or two about supporting life, and health. We urge you to postpone this year's holiday gatherings and avoid nonessential travel this winter. Listen to the experts (in the new administration). Wear your masks. Stay home as much as possible. If not for your neighbors, do it so that you might still have a doctor or nurse there healthy enough to be there for you when you get sick. Listen to the alarms so that we healers won't have all been pushed to the brink, thrown our gloved hands up, and walked away from a field and people that have taken advantage of our compassion and stolen our last shreds of empathy. 

Sincerely,

A very tired healthcare worker

A historic (great) day for America!

 Weeping may endure for a night, but joy comes in the morning. - Psalm 30:5.

Yesterday was a good day in this country (the highlight of 2020, I'd argue). I wonder if, years in the future, we will remember where we were and what we were doing when we heard the decisive results of this pivotal 2020 election. 

I heard the news (that Joe Biden was projected by all major news outlets to win Pennsylvania and clinch the presidency with its twenty electoral college votes) on Saturday morning (November 7th, 2020), after I had been up all night with a laboring mother who, at 8:27 a.m., delivered her first baby. The mood in the room was already incredibly joyful.  As it often is with birth, the pains of labor (particularly ones overnight) sometimes seem interminable... until that baby cries for the first time.  To see women and their families welcome new life from their bodies to their arms, and to know that the long journey and all of the struggle was worth it, is one of the most beautiful things to witness in the world (I obviously truly love this part of what I do!).

The charge nurse who helped with the newborn care reported that, while the birth was happening, the election was called. It was basically over (even though votes are still trickling in, they are unlikely to shift the outcome in any meaningful way). The relief, and joy, from that news only added to the spirits of the already jubilant room. Even after 24, 48 or more hours of labor, most women after delivering their baby experience a "birth high," due to a combination of endorphins, adrenaline and oxytocin, the "hormone of love."  I had an "election high" (and birth high) the whole rest of the day (and weekend).  The suffering, and what seemed like a long night amidst the longest week ever (and during the longest-seeming year ever), was worth the reward at the end, as it so often is after a grueling labor.

The week of the election held a lot of up-and-down emotions for me, and for so many others in my friend and family circle and the majority of people in this nation. It was hard to dare to hope, lest we be disappointed (again). It was hard to sleep. There was a lot of anxiety, fear, resurfaced trauma, and breath-holding. There was so much prayer. When I heard the results, it was like a 100-pound weight was lifted off my shoulders and my heart was unburdened. I could breathe again (in a year that brought us the famous words from the murdered George Floyd). So much emotional energy and mental hard-drive space has been freed up (some people have likened the feeling to escaping an abusive relationship and I heard another grandfather compare the national sentiment to that which accompanied defeating the Nazis at the end of World War 2 [and they actually surrendered!]). Yes, Joe Biden thankfully defeated Donald Trump and it's nice to see a decent, faithful man realize a lifelong dream and triumph over an authoritarian narcissist and sociopath at a critical moment in this history of the country he loves and that he has served for decades (in what turned out to a be nail-bitingly close race for several days). However, it wasn't until later in the day that I truly began to be able to appreciate the history-making that was this election and its implications and I was so moved by the words and pictures I saw.

Look at this striking picture.

In the nearly two hundred and fifty years since our country was founded, we have never had a woman, nor a person of color (or someone who was both!), elected to the vice presidency.

Like there was after Obama's election in 2008 (about which I joyfully blogged), there was widespread rejoicing, nationally and internationally, including in India (from where Kamala's mother immigrated to the U.S. as a young woman, as did my own mother). We have a truly stunning human being, a child of immigrants (and a Californian!) as our future vice president.

CNN's Van Jones had a particularly moving statement about the election results, where he was choking up talking about what this day represented for so many, especially in a year where the Black Lives Matter movement gained a lot of support. I still am haunted by his words following the 2016 result, when he explained the election of Trump as a “white-lash” to the election of Barack Obama. 

Later in the evening when the birth center calmed down, I was able to listen to both Biden's and Harris' acceptance speeches.  Kamala's, in particular, was (not surprisingly) incredible. She honored her late mother and spoke powerful words that had me in tears.

"And to the woman most responsible for my presence here today — my mother, Shyamala Gopalan Harris, who is always in our hearts.

When she came here from India at the age of 19, maybe she didn’t quite imagine this moment.

But she believed so deeply in an America where a moment like this is possible.

So, I’m thinking about her and about the generations of women — Black Women, Asian, White, Latina, and Native American women throughout our nation’s history who have paved the way for this moment tonight.

Women who fought and sacrificed so much for equality, liberty, and justice for all, including the Black women, who are too often overlooked, but so often prove that they are the backbone of our democracy.

All the women who worked to secure and protect the right to vote for over a century: 100 years ago with the 19th Amendment, 55 years ago with the Voting Rights Act, and now, in 2020, with a new generation of women in our country who cast their ballots and continued the fight for their fundamental right to vote and be heard.

Tonight, I reflect on their struggle, their determination and the strength of their vision — to see what can be unburdened by what has been — I stand on their shoulders.

And what a testament it is to Joe’s character that he had the audacity to break one of the most substantial barriers that exists in our country and select a woman as his vice president.

But while I may be the first woman in this office, I won’t be the last.

Because every little girl watching tonight sees that this is a country of possibilities.

And to the children of our country, regardless of your gender, our country has sent you a clear message: Dream with ambition, lead with conviction, and see yourself in a way that others might not see you, simply because they’ve never seen it before.

And we will applaud you every step of the way."

Representation matters. How incredible it is for all the black and brown little girls, and boys, in this country to see their faces and their skin tones (and their centuries of struggle) about to be reflected in the highest (well, second-highest, for now) office in the land. I know that Joe Biden will fill his administration and cabinet with a group of people who look like the diverse America we are.

Also being a biracial, brown half-South Indian woman (and once a child) myself, seeing pictures like these gave me all the feels. 

Stacey Abrams, another incredible woman of color and the person who should be Georgia's current governor, also changed the entire race and should be honored (I'm currently reading her book, Our Time is Now). When all the votes are in, a southern state that has not voted collectively for a Democratic president since 1992 may flip blue this year, thanks to her efforts in registering over 800,000 new voters in her home state and protecting the votes especially of people of color, whose voices are so often silenced (but were certainly heard loudly this year). The numbers have been there, but the investment and belief have not (until now). Thank you, Stacey, for being a patriot, a hero, and an inspiration for so many. (If you feel so moved, you can contribute to her organization to fight voter suppression as well as to critical Georgia January senate runoff races here). And, to black and brown women and people everywhere, who showed up in big numbers this year to save our fragile democracy, we owe and celebrate you.  The country was careening towards a ditch, and you took the wheel and swerved back to the road.

In her concession speech in 2016, I remember Hillary Clinton quoting Galatians 6:9 "Let us not become weary in doing good, for at the proper time we will reap a harvest if we do not give up." I give a special thank you to her and for so many other amazing women (even in defeat), who have paved the way for this moment.  We haven't had a female president--yet (and, at the moment, we also don't have a former president willing to concede). But right now, it feels palpably possible that it could happen in the near future (my lifetime?) even though it wasn’t meant to be in 2016. I am a believer that good things come to those who wait and keep the faith (and women are forced to be good at waiting). What a sweet day it will one day be. 

Listening to calming and positive messages of unity, possibility, and the future (and in full sentences which are also appropriate for kids’ ears!) has been so uplifting. This country is still incredibly divided (a horrifying more than 70 million people voted to re-elect our president and are disappointed their candidate didn’t win), and there's so much hard work yet to be done. We will always be fighting an uphill battle in the anti-democratic Senate, gerrymandered state districts, and the courts against a party that has the demographic trend working against it and thus has to cheat the system (or claim election fraud) to maintain power. However, this year, democracy was on the ballot, and it survived; the good soul of this country prevailed. It feels so redemptive to have the popular vote finally result in majoritarian rule as so often (especially in my voting career, starting with disastrous Bush v. Gore) it hasn't, in what turned out to be the election with the highest turnout in our country’s history (amidst the worst global pandemic in a century, nonetheless!). I am confident that President-elect Biden will serve and strive to be a president for all Americans, building bridges and fighting for even those who did everything in their power to keep him out of office and who baselessly maligned his character. 

What is clear is that acts of citizenship are required daily, not just only every two or four years at the ballot box. We all need to stay engaged, keep showing up, and we should never forget the dramatic difference between how disenfranchised we felt after the election in 2016 and how we felt today. Let’s never be complacent or secure in our privilege regardless of who is leading us or which candidate seems the “most electable.” I’m ready to put in the hard work. 

Nevertheless, I want to pause to appreciate and recognize this moment of joy, and to welcome back an emotion that is so wonderful to feel again-- hope. 

On this day, I am proud of our country. 

God Bless America.

Longing for "before" (and the longest election ever)

I sometimes think that I will remember my adult life and purpose to be divided into "before" and "after" the 2016 election, even though this year's election season is even more disconcerting (but I had far different, ahem, lower expectations this time around and wisely vowed never to trust a poll again).  Like many people and patriots who "thought" they understood the values of this country (having lived in several different states and countries) and fought hard to honor them (and, admittedly, relaxed a bit and were complacent from the Obama years), I was shocked into the reality that includes the dark and hidden corners of this nation and, as a result, my degree of political engagement and alarm have been changed, likely forever. One day, I hope to understand the deeper meaning of God's plan in allowing this wicked man's election to our national leadership; however, I am currently feeling that it may have been a personal wake-up call do do more active work for good and justice, while learning how to walk in faith amidst the depths of despair.

At this point (2 p.m. PST) on Thursday, we still don't know for sure if Joe Biden (who holds a large popular vote lead and has surpassed the highest vote count for any presidential candidate in our country's history, and is ahead in several states with mail-in ballots still being counted) will triumph, or if (either by actual vote tallies, or vote suppression, allegations of "fraud" and legal challenges, the messed-up anti-democratic electoral college or a coup) Trump either somehow pulls out the race or refuses to leave office despite losing. I've been trying to avoid reading the news and being on social media until all the votes are counted (as, yes, ALL VOTES MATTER!) and "it's all over," as this degree of anxiety about an outcome not in our control is not healthy.  This is a nation of people holding its breath, and no one knows what will come after.  I personally fear armed and MAGA hat-wearing militias in the streets and the end of peace and democracy in this country. It's not a rosy future, no matter the outcome. I so wish I could go back to before. (Of note, if Republican state legislatures had permitted mail-in ballot-counting before election day, the current picture would be clearer!).

Even if Biden ekes out this victory, as it appears (thankfully) that he will (although we'll see if the judicial and legal system works as it should), none of us should feel particularly secure or happy. There will be considerable relief in many parts of this country and for many people for the lifting of the heavy burden of the immediate fascist threat of Trump out of office; however, we will still have fear-- he's still a one-term president who could run again, and it's going to take a lot of time to undo his damage. The majority of us will allow ourselves some moments of celebration, before we get back to work. We are bracing ourselves for what will probably be a whole lot of civil unrest in red areas. 

What remains is a deeply divided, sick country (full of the scourge of Trumpism and home-grown terrorism on one side) in which, despite more than 230,000 lives lost to a disease the president mismanaged, his lies, his racism, his immorality, and his failure to lead or serve our nation's people, more than 65 million people thought it would be reasonable again to elect him as a leader. The fact that an election with this candidate and these stakes is this close should show us all that we have lost (and how far we've fallen), as a country.  I wonder how a "normal" Republican or conservative candidate would fare in such an environment-- will this be the new normal for their party from now on?  How how do our spirits and souls endure the stress of divisive elections and seasons like these every few years going forward? (Can't we just go back to before?)

There was a time, before,

when I thought that most people were "generally good,"

and that we Americans wanted the same things-- 
safe homes, high-quality education for our children,

strong families, 

economic security,

access to health care, fewer abortions,

clean air and clean water, a sustainable planet,

and equality for all,

despite differing opinions on how to get there.

There was a time, before, 

when I believed that we could "agree to disagree"-- that we could still relate,

that we had more in common than divided us,

that, even though we lived our lives in different places,

and learned different things along the way,

and had different worldviews and experiences,

and that we may have voted for different candidates in the past, 

that we could still appreciate one another's values and hearts, 

talk politics without feeling dismissed or betrayed,

that we could come together, work together, compromise, for good,

and that growth and change were possible. 

Before, the aisle didn't seem that wide. 

Now it's a gaping chasm.

There was a time, before, 

when I believed that we were a nation--and people-- 

who would eschew racism in our borders, houses of worship, and homes, 

protect the marginalized,

welcome strangers,

follow the rules,

speak up for fairness and justice,

where everyone was entitled to a voice (and a vote),

and where we were truly "all created equal." 

There was a time, before, 

when I believed that most Christians were authentic,

that they believed in love like that radical love of Jesus, 

that they obeyed the commandments,

that they also loved their neighbors--

not in words alone, 

but in their actions, and deeds, and what they stood for,

where they would act to serve the "least of these" and help the poor,

rather than lining the pockets of the rich,

that they would be truly pro-life and not just pro-birth,

opening their arms to strangers rather than locking them in cages and building a wall.

Instead, many have stayed silent, neutral, complicit, 

tolerating evil and following false prophets,

clutching their Bible in one hand

and a gun in the other,

voting as they do because they've been conditioned to believe that "the other side also seems bad,”

and because to speak out would be socially costly

(even though it was for Jesus, too, but was all for eternal gain).

There was a time, before, 

when Americans trusted science, and doctors,

expertise and facts, 

that they believed in objective truth,

institutions and norms,

read actual books,

and got most of their news from reputable places (not FOX [faux] or Facebook).

There was a time, before, 

when we all agreed that our leaders should serve as moral examples for our children,

that they were held to a high standard, 

and that they were expected to model kindness, empathy, humility, decency, and grace.

I miss the "before."

We are all so looking forward to "after" the election, and "after" Coronavirus.

I desperately want to see my family, friends, and connect with patients outside of screens.

I miss the library, the playgrounds, shared spaces,

seeing kids play with their peers without masks and smiling without mine. 

I miss holidays, vacations, travel, breaks, "regular life."

I'm truly tired of all of the disruption, fear, misinformation,

the imposed distance and barriers. 

I so badly want to be post-Trump, too.

We are all eager to be past this dark chapter of our lives,

all wondering when it will finally be over.

However, I'd much prefer to go back to "before."

I want to be like Eve before the fruit was eaten,

when there was innocence, naivete, and joy,

before I saw the destruction that evil--allied with power-- 

could unleash on our country, our spirits, our relationships, and the world.

I don't recognize this country anymore-- some of us are mere states away, but galaxies apart.

I don't know how this country heals when the pain and divisions run so deeply.

I hope that we could come together again, but I just don't see the path.

Is there a time when, not truly believing deep down that the hearts and minds of your fellow citizens can be changed for good, 

that you surrender and walk away,

even when most people are doing the right thing?

When do you stop fighting for and believing in your homeland?

In that time, before, I was proud to be an American, 

and now I'm just shocked and ashamed.

This is not a country that I believe is healthy or should be an example for any other place on earth.

As a doctor, my diagnosis is that the United States has an incurable illness (and a reasonable thing to do may be to amputate a leg or two to save the body).

Nevertheless, I will pray for this country, for the president, whoever he(/she) is.

I will root for democracy, unity, and pray for fair decisions and elections. 

I will continue to always speak for justice.

I will have conversations that may be uncomfortable (while, with hope, respectful) and try to nudge people towards the righteous path, together.

I will try to stay strong in my faith in our Creator and His plan, despite my anxiety about this and so many outcomes which can seem so depressing.

I will dare to hope when things seem hopeless.

I will do my best to love and forgive those who have done so much harm even when they do not feel remorseful; while the Lord is the ultimate judge of their hearts, I certainly have strong opinions (and recognize that this task is very, very hard for me, especially right now).

However, it is nearly impossible to forget what I have learned about the character of so many of my "neighbors," and how sad that has made me feel.

I will continue to put one foot in front of the other, serve patients and God, be kind to those I meet, and try to raise my children to do the same.

I will push for progress, so that all of the efforts for good will not have been in vain; 

however, I still long for the "before."