Health care on my mind

So, now that the health care debate is in the hands of the US senate, I have been thinking a lot about health care. Again. I think about it a lot, just because I seem to always be paying doctor bills.

And I don't even mind that. We have really good health insurance, and I am grateful for that every day.

But what I do mind is that I don't believe I feel the "care" in health care very much. And that is something that I really miss about the "evil" socialized medicine that I had in the Great White North.

When we moved to British Columbia, one of the first things I did was get pregnant with Patrick. Not really planned--but glad to be living someplace where an unplanned pregnancy wouldn't present a huge financial burden. I asked around about finding a doctor, and ended up with a Dr. Harris, who was fine. But the really great thing was that he went on a camping trip a few weeks before Patrick was born, so I ended up with his colleague, Dr. Oswin. First time I had a female doctor and I LOVED it. Having a baby with a female helping you, especially a female who is a mother? Awesome. I switched to Dr. Oswin and loved her. When we moved from Burnaby to Port Coquitlam, I was determined to drive in to Burnaby to the doctor...but traffic in greater Vancouver? Pretty horrible. So I looked at the clinic closer to home and found Dr. Ewert.

Dr. Ewert was fabulous! She was young and cute and funny, and she cared. If I went in with one sick child, she would ask about the other kids. She knew their names; she didn't have to look them up on a chart. When our oldest daughter Kelli went through her truly terrible experiences, Dr. Ewert was always caring and concerned about Kelli, about me, about the effects of the situation on everyone in our family. Dr. Ewert had a baby one year and would pick my brain for mothering tips. When I ended up having another baby, five years after Patrick, I picked her brain for doctoring tips, and Dr. Ewert was simply wonderful as Josie's first doctor. I loved her, and was so sad to move to Alberta and away from her.

But in Alberta we had fabulous doctors, too. Dr. Spackman, Dr. Jensen and Dr. Weiss were all top-notch, caring people. I was excited when Dr. Weiss's wife, Dr. Weiss, finished medical school so I could have a female doctor again.

One day, we were at a swim club picnic. Nancy was playing with Josie, holding her by both hands and letting her walk up Nancy's legs, and then back-flipping her so that she would land on her feet. We all played that game with Josie often, because she loved it. Josie was about three, so Nancy would have been about twelve. Well, one time, Josie didn't walk up Nancy's legs as high as usual, and when she flipped, her head was too low, and ended up crashing into a rock. Josie was bleeding (profusely, as head wounds do) and she and Nancy were crying. They came to me for help.

Did we rush Josie to the hospital? We did not. Dr. Jensen, whose kids were also swim club members, stepped forward with his big smile and gentle bedside (or picnicside) manner, cleaned Josie's head, and then said to all the kids who were gathered around to watch in his impromptu operating theatre: "Now, I am going to use her hair to sew up this wound. If we were at the hospital, I would do stitches, but since we are here, I am just going to tie her hair in knots and that will hold the wound together." And he carefully would take a hair from each side of the wound and tie it in a tight knot with a hair from the other side. A few minutes and quite a few knots later, she was all "sewn" up. He was laughing and smiling at her, and she was as calm as could be as he tied her head together.

Of course, we did go into his office for a follow-up apointment, but she was fine, and the knots held, and her head healed, and she and Dr. Jensen were really good buddies after their shared experience.

Josie never liked to take medicine. Even when she was a baby, she would purse her lips to avoid having to take it, and if some did manage to get into her mouth, she would spit it out as quickly as possible. Once, when she was about five, she had a terrible ear infection. She was getting worse and worse, and I really needed her to take the medicine, but she just would not do it. So I talked to Dr. Weiss about it. She asked me to make an appointment and bring Josie in. She sat Josie down and said, "Josie, you need to take this medicine. I know that you hate medicine, but you have to take this whether you like it or not. Now, I am going to tell your mom to give it to you twice a day, and if you don't take it, she is going to call me. And if she calls me and tells me that you won't take it, I am going to put you in the hospital, and then we will make you take the medicine there. If you won't open your mouth, we will give you needles, but you are going to take this medicine." And when we got home, Josie took her medicine--she didn't want to go to the hospital.

Can you even imagine a US doctor doing that? Hospitals are way too expensive here to admit a child who won't take her medicine! And it was not an empty threat either; Dr. Weiss meant every word. She wanted Josie to get well, and she would have admitted Josie just to get that medicine inside her.

Soon after we moved to the US, Patrick began to have some physical problems. We took him to the doctor, who sent us to the urologist, and Patrick was slated for surgery. He was twelve or thirteen, and had the surgery in early June, soon after school was out. He got to recuperate instead of playing and camping and hiking and all that kind of summer stuff. But he didn't get better. Soon we were back at the urologist's office and scheduling a second surgery, which he had as soon as school was out in December, so that he got to use up his Christmas break recuperating, too. It was while we were at the December surgery that the doctor told me that the first surgery doesn't work in about 40% of cases! And they know this! But...insurance companies (at least ours) insist that the first surgery be done. It is more invasive but less costly. The second surgery works in about 99% of cases, is less invasive, but is more costly. So, if the first surgery doesn't work, then they will authorize payment for the second one. Which means they pay for two surgeries in 40% of the cases? How dumb is that? I am wondering if they have ever really done the math on that one...

And I am pretty sure that if we were in Canada, they would just do what works, because hello? Why not? And oh yes, they might even care about the child who has to undergo two surgeries within six months, when one would have done the trick.

This experience makes me think back to my pregnancies--I get diabetic in pregnancy. I didn't pass the first glucose test with David in 1983 in California; they weren't doing the glucose tests yet in Alberta when Nancy came along in 1985, but I am pretty sure I wouldn't have passed; when Patrick was born in British Columbia in 1989, I didn't pass the first glucose test, or the second one. It is pretty miserable to be a pregnant diabetic when you have four other kids with busy schedules and you have to go to umpteen billion different doctors and nutritionists, etc. So when I was pregnant with Josie in 1994, Dr. Ewert and I decided that we would just act as if I had already failed the first glucose test. So from the get-go I was on a special diet and exercise routine, with the goal of passing the second test. And our plan worked, so I was not officially diabetic for Josie! Yeah! Much simpler for me, much simpler for Dr. Ewert. Ultimately less expensive for the medical system. But, surely you can see that if we were in the US, we wouldn't have had that option. Because it isn't the doctor who gets to decide, is it? It is the insurance company. And you can bet they wouldn't pay for the second test unless I had failed the first one. They wouldn't care about my track record of failing that particular test...so even if my doctor cared, the insurance company wouldn't.

When my mom was dying of liver cancer in Canada, her health care providers really cared about her. Her doctor was very up front about what was happening with her. He came over to her house while I was there and had a heart-to-heart meeting with my mom, my sister, my two cousins (Mary and Helen) and I. He talked about her options--honestly stated that nothing was ultimately going to work. That he would do whatever Mom wanted, but that chemotherapy and radiation therapy were going to add a misery of their own. And while using them might extend her lifetime by a few months or even a year, that the extra time would most likely be full of pain and misery. He told her quite honestly and compassionately that she was actually pretty lucky, because she knew how she was going to die (of liver cancer) and that, as deaths go, it is a pretty good one. He let her set the standard of care she wanted, made sure we all understood, answered all our questions.

That was not his only house call. She didn't ever have to leave the house to go to the doctor or the hospital in the last months of her life, unless she wanted to. She had nurses in several times a week to take care of things that were hard for my sister Colleen and brother Bruce, who were her primary caregivers, and home-help attendents to spell them off and keep her company. They brought in a hospital bed and put it in her living room when going back and forth from her bedroom to the recliner she sat in most of the time got to be too difficult. And that was where she died: in a hospital bed in her own living room. Very peacefully.

A couple of years later, my neighbor here got liver cancer. I knew it was a death sentence, because Dr. Steed had explained this illness to us very, very thoroughly. I am not really great at visiting the sick, but I finally got up my courage to go and see the neighbor. I had really appreciated all the neighbors who came to see my mom, though, and I wanted to do the same for him.

Of course, my mom's neighbors all knew that she was dying. They totally knew the score, and so they knew how to treat her. They knew that every day they went to visit might be their last opportunity. We could talk pretty openly about mom's future to her, because there was no pretending. We knew.

So, my neighbor...blew me away! I could see that he was dying, but the talk was all about him getting well. About the treatments that had been tried, the treatments that were planned. I was shocked. But how could I say what I was thinking, which was "Hello!! This is an incurable cancer!! You are going to die. The things they are going to do to you will make you miserable, and will suck you dry financially, and then you will still be just as dead at the end of them!" Since we were all pretending that he was going to get well, it was hard to know what to say. And easy for me not to go back because everytime I thought about him, I was just shocked at the lack of open, honest health care! And the acceptance of health money-sucking invasion!

Well, he lived for about a year, instead of the five months that mom had between diagnosis and death. But what a year of financial and emotional drainage on the family. Death is hard, but lengthening the process does not make it any easier on anyone, the victim or the family.

But I shouldn't have been surprised...my husband goes to a lot of health care providers. I remember we were at one appointment together, with a therapist who was supposed to be helping with the emotional and relationship trauma caused by his physical difficulties. I don't remember exactly what she said, the exact words, but basically what she meant was that she didn't really care about us or what happened to us, she just cared if the bill got paid. Our bills were being paid, no problem there--so that wasn't why she said whatever she said. I just remember us looking at each other, and the look said, "This is our last appointment here." Because she didn't care; we knew that. And what is health care without the care? It isn't worth much, that is what I think.

Dilemma

On Thursday afternoon, I picked Josie up from school. She was wearing a gray hoodie with a front pocket, and I noticed that the front pocket looked strange. She opened the door to the back seat of the car, put her backpack on the seat, took her hoodie off and put it on the back seat, and took her Ipod from the pocket. "Oh," I commented, "I was wondering why your pocket looked a funny shape. It was your Ipod."

Josie LOVES her Ipod. It is her most prized possession. She has very eclectic taste in music, and has sound bites from all over the world on the Ipod. She loves film scores, and has many of them on her Ipod. She also has movies, most notably movies in Arabic and other foreign languages. The contents of her Ipod would not be of interest to every teenager, but they are Josie's treasures.

We came home; Josie came in the house, and as is her habit, placed her Ipod and sunglasses on the table. I made myself a late lunch; Josie made herself an after-school snack. And I left and went back to work. Just as I was leaving, one of Josie's friends was arriving.

After working for another couple of hours and then going to French choir, I met up with Patrick, and we drove home. I didn't even look at the table; Josie had a different friend over, and she left soon after Patrick and I got home. Since Bruce was working late, we just had grilled cheese sandwiches and sat at the counter.

Patrick was excited because he had a date that he was looking forward to; he went and cleaned out the car a bit, and then left on his date. Josie had a morningside, so she went to bed early. She had to be up at four AM.

In the morning, I heard Josie up and about, heard the honk, and she left with the friend who picked her up. When I got up myself at about 6:30, I noticed that she had left every light on! I went around turning lights off, and Patrick and I were ready and out the door by 7:15 am.

A couple of hours later, I got a text from Josie. (She can text my e-mail from her phone) and she said "I couldn't find my Ipod this morning. I looked everywhere." (Ahh! I thought--that explains all the lights on!--she was looking everywhere!) So I messaged back, "We know you took it home, so it must be there somewhere. Don't worry."

She came up to campus after school because we had a two-hour gamelan rehearsal. Josie and I are both playing the gangsas for Hujan-mas, and our parts are really difficult. I play polos, which is difficult and Josie plays sangsi, which is uber-difficult. But we had a good rehearsal, Josie only being mildly distracted and worried about her Ipod.

We had an hour and a half between rehearsal and our concert. We came home to find the Ipod. I thought it would be easy. Because I remembered our conversation about the Ipod from Thursday, I KNEW she had taken it home. Patrick and Garion were here when Josie and I got home; we all did some Ipod hunting. Josie and I spent almost the entire time looking for it. It was nowhere in our house. I even looked in the fridge and both freezers (what if she was getting something to eat and put her Ipod in the fridge?) and in all the drawers of all the bathrooms. (We have four of them.)

Josie has a testimony of prayer--she had already been praying for help to find her Ipod all day. She was frustrated because she had looked everywhere and not found it, and she didn't feel prompted to look anywhere else. So we prayed together about it. When we finished the prayer, I said, "Do you think one of your friends might have taken it?" And immediately the name of one of the friends who had been in our house that day popped into her head.

Not wanting to be accusative, she texted both of the girls who had been over and just asked innocuously about had they seen her Ipod...one answered; the other one didn't. I guess you can figure out which one didn't answer...

When Josie and I went to the concert, we were both pretty distracted. We knew the Ipod was last seen in our house; we both were fairly certain if not positive that her friend had "borrowed" it. And that made us sad and upset, and we both played Hujan-mas the very worst we have ever played it. Hopefully no one could tell, since thankfully we have three other people who play exactly what we play.

But it kind of took the joy out of our concertizing. Now--what to do? That is the dilemma. Josie, as I said, loves her Ipod; she uses it every day. (Except for yesterday, and now today...). She is willing to forgive (although she will be much less trusting of this girl than she formerly was) and she just wants her Ipod back. What would you do?

Why am I so weird?

There is a Halloween play, the name of it escapes me, that has a scene in which a very strange character sings a song that asks, "Why am I so weird?"--a question that I often have to ask myself. Indeed, why am I? So weird?

I guess I am usually weird for no apparent reason, but when I get into those moments on the borderline of awake and asleep, the weirdness gets right out of control.

Once, when David and Nancy were in high school, they had a group of friends over for a soiree. (Well, they did that more than once, but I only behaved quite so weirdly the one time.) I was really tired, so I went to bed, just planning to lie down and rest while they partied on. After some time, I thought I heard the doorbell ring, and Nancy went to the door. Whoever was on the other side of the door started to sound menacing, and then he grabbed her and started pulling her out the door, and she was screaming for help. So I quickly jumped out of bed and raced down the hall to go rescue her. Wouldn't you do the same?

Except...when I got to the door, Nancy and David were laughing and talking with their friends, who were just leaving. I think that Matt Thomas was the only person who saw my look of half-crazed grim determination before I realized that I must have been having a very vivid but totally false dream and beetled back to my room, snickering at my own incredible stupidity. I think he even asked the kids, very appropriately, "Is your mom always so weird?"

Well, last night I had another episode of loony-bin weirdness. Patrick had gone to a late movie with Garion. I was worried about him getting home because he doesn't get enough sleep anyway, and he had a big project at school today. As I usually do, I left the back porch light on, and went to bed. I never sleep well if all the people in the house aren't in bed and the lights aren't all off, but if I fall asleep, and then wake up and the house is all dark, I just go happily back to sleep, because I know that everyone is in the house and in bed.

I woke up, and it was still light. I looked at the time, tried to go back to sleep, but just kept waking up. I was worried about Patrick, so I felt my way (I am blind as well as weird) to the phone, and called his cell phone. He didn't answer, which worried me, but I left a message, "Patrick, it is just me calling to remind you that you need to get some sleep!" Satisfied, I laid back down. And waited for him to come home. Which he didn't do.

So I eventually got up to see if the car was gone. He had left with Garion, but he was going to a girl's house after the movie to borrow a wig (don't ask) so maybe he was just talking to her and lost track of time? So if the car was gone, I would at least know where he was. So I got up, and opened the back door, and the car was there. Wait--the door to "cat prison" is closed--it was open when I went to bed...that means that someone put the cats in cat prison...and then I looked on the table and there was a white curly wig.

So...that means that Patrick was at home, in bed, all those hours that I lay awake worrying! He was just really tired, came in and forgot to turn off the light after diligently taking care of the cats. So why didn't I just check his room instead of calling him?

I'll tell you why...so that in the morning, he could say, "Mom, why did you call me at 12:30?" when he had been in bed and asleep since eleven! He didn't say "Why are you so weird?" but I am pretty sure that he thought it!

We are Family!

(My brother Bruce, Elizabeth and I: Nov. 14, 2009)

Last night my niece Elizabeth and her university choirs and orchestras premiered a new sacred work, sort of like a modern oratorio, at the Tabernacle in Salt Lake. The music was wonderful, but what I want to blog about is family, because that is even more wonderful.

Specifically, I want to talk about how fabulous it is that my brother has married three wonderful women, and that somehow we have been blessed to be able to "keep" them all.

When my brother and his first wife, Marie Christine, got divorced--that was really hard. We, as a family, did not really know how to deal with divorce, and frankly, we didn't know anyone who did. Divorces break up families, after all, and from my observation, it looked like they were always messy and left a lot of hard feelings. I was amazed that my brother had been so civil with his ex-wife, sharing a lawyer, and going his way in peace without much fighting. But I didn't know what to do about Marie, who had been like a sister to me--so I did nothing. Since she was in France, and I was in Canada or the US, it was very easy to do nothing. And I just let her drift out of my life...but I missed her. There was a sadness in my heart when I would look at pictures of her, because I loved her.
(Marie, Colleen, me and Arlene in 1971)

When Bruce married Judy, I was happy to have another new sister. Judy was a lot of fun, and easy to talk to. Our family welcomed her and her three daughters with open arms. But. some years later, after the births of Elizabeth and Andrew, their little family unit passed through hard times, and it got to the point where a divorce was imminent. I remember saying to my brother that I was fine with him getting a divorce, but I didn't want to have to give up Judy. I had already given up one sister-in-law, and I didn't want to give up another one. I wanted her to still feel like family, because I loved her. (Family picture with Judy beside me and Nancy, in the middle, 1985)

My mom set a very good example for me in "keeping" Judy. A couple of years after Bruce and Judy's divorce, my aunt Lillis died. We were all at her funeral--I think this memorable moment happened at the grave site. Mom was standing with Judy, and someone she knew came up to talk to her. She introduced Judy to the person by putting her arm around Judy and saying, "This is Judy. She used to be my daughter-in-law, but now she's my daughter." That touched my heart.

Judy's marriage to Wally brought a whole bunch of new people to love into my heart. Wally is awesome and amazing, and just perfect for Judy. I am so glad they found each other. His six children are fabulous people. I am closer to some of them than to others, but I love them all, and the spouses and children of the girls. It didn't take my children long to be able to call Wally "Uncle Wally" and feel it in their hearts, because he has always been so interested in them, and always made them feel welcome around him.

Sometime after Judy married Wally, I was blessed to "find" Marie again! I am so happy for her that she has Philippe and is so content with him, and happy that my children, at least the younger three, are getting to know her. Patrick is the only one who has actually met her in person, but thanks to the fabulous technology that we have the use of, they can "talk" to her through blogs and Facebook and e-mail, and have enjoyed getting to know and love her as I do. Nancy has met the "cousin" that Marie brings to our family, JC; I can't wait to meet him someday, too!

My brother shocked me when he married Sara. Seems like I hardly knew he was dating her when he was married to her. But I am so glad he did. He is so happy with Sara, who has a warm and compassionate heart. Sara is another sister for me to love, another aunt for my children to love. And Sara's six children are just a whole bunch more nieces/nephews for me to love, and cousins for my children to love! (With a few spouses and next generation as well!) Sara's daughter Jessica is one of Josie's favorite first cousins--even though technically they are not cousins at all!

What does this have to do with last night and Elizabeth's performance? Judy had four tickets to the concert, and had offered one to me. The extra ticket, she gave to Bruce, so he could go and be there for Elizabeth. Bruce invited Judy and Wally and I (and Andrew, who didn't want to go to a concert but did want to see his dad) to a dinner that he and Sara were putting on for some of their family and friends. Isn't that fabulous, that they are divorced, yet so generous with each other? I think it is!

When we got to the dinner, Bruce hugged Andrew, greeting him as "Andrew, my son." And then me "Myrna, my sister." And then "Judy, my friend." And then "Wally, my friend's wife." Much laughter-- "I mean, my friend's husband, and my friend too." And I felt such a feeling of love for my brother and his big heart. And such gratitude for the civility that he and Judy always show to each other.

Inside at the dinner, it was so fun to meet and greet my "nephew' Eli and his wife Sadie, and to hold baby Lukas (who is huge! and heavy!) and to see my beatiful "niece" Rachel's cute pregnant belly, and all Sara's sisters and her mom and her fun family, and to talk with all these people I love who I wouldn't even know if my brother hadn't married Sara.I love this family picture, taken at Elizabeth's wedding two years ago...there are lots of people missing, but isn't it cool how it is a mix of Conrads and Graves and Powells and Breitensteins? I think it is way cool!

At Elizabeth's wedding dance, I overheard my niece Mindy (a Graves step-daughter) say to Jessica (a Powell step-daughter) "Isn't Bruce a great step-dad?" And they talked together about how they loved my brother, and how he had blessed their lives. And I thought to myself that if Bruce hadn't gone through his first divorce, nor his second divorce, much as I didn't like either at the time, those two girls would never have been having that conversation, because they wouldn't have even known each other. And I wouldn't know them either! Hard to imagine my life without them in it!

So, actually, I guess I have to thank my brother for his divorces, because he has blessed me with three sisters to love, and directly (2) or indirectly (16!) more nieces and nephews to love!
I am so grateful that pictures like this one are possible, because my brother and my various sisters-in-law are so wonderfully civilized! We are a very lucky family.

Guy magnet

Where did this girl come from? She is nothing like her mother! Her best friends have often been of the male persuasion, and as she gets older, that isn't changing. (Her mother, as I recall, was afraid of boys.)

So, Saturday about 4 pm a male person came over to "study languages" with her. A couple of hours later, no sign of him leaving, so I asked if he wanted to stay and eat with us. He most emphatically did want to. After dinner, she was going to a girl friend's house to watch a movie--he went too. She came home at 12:30. He left a whole bunch of books and stuff at our house, since he is planning to come again on Tuesday.

Sunday, we are walking home from choir practice at 5 pm. We see a male person leaving our house, walking toward us. Different male. He stops and asks her to come over to his house for hamburgers--okay with me; her brother is already at this particular house. So she joins a whole bunch of boys and her brother for that get-together. She is the only female. Same boy walks her home and comes in and stays until about 9:30 pm.

Monday, she joins that boy and yet another boy to hang out at the other boy's house after school. (This "another" boy would be one who once told her brother David that she is "hot"). When we get home from work, she and the boy from Sunday are on our computer using Facebook. Now that boy is watching a movie with her dad while she is playing with her cats.

Tuesday--it will be the turn of the boy from Saturday for more "language study."

Sixteen is still five months away!