Mulling and Meandering

It was beautiful outside this morning, which made it a no-brainer to go for a long walk.  The birds were singing their little hearts out, squirrels were frolicking, flowers bursting out all over in waves of color and fragrance.   The breeze was still cool, swirling around the dew-drenched greenery of garden and thicket, but the air was lush and moist enough to suggest definite sultriness to come.   The sweetest perfume of all was from the heavy banks of lilacs standing in the places where old houses used to be:

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I walked along my regular running route, which takes me past Antioch College, through quiet neighborhoods with a wide mix of architectural styles, out into farmland, back in along the rails-to-trails bike path along the edge of a nature preserve, and up through the heart of downtown.   It’s deeply familiar territory, but there’s always something new to see, particularly at walking pace.  Like these proud papas defending their territory:

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Passing through the “suburbs,” it looked as if another kind of avian skullduggery was afoot.  The “You’ve Been Flocked” yard sign made me giggle for a good 100 yards.

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Long (45-60 minutes or more) walks are a wonderful centering technique for me.  They re-establish me in my body and environment, pulling me out of my own head where my thoughts too easily become self-referential and obsessive.  It’s a great time to practice focused observation and attention to my surroundings, and also a fine opportunity for thinking things over without getting stalled or stuck in a rut.  There’s a palpable harmony about traveling on foot at a comfortable pace; the long deep breaths and warm muscles create a physical comfort and relaxed alertness conducive to mellow thinking.    There are unique satisfactions about walking a familiar route, too.  It allows me to appreciate the slow, incremental changes—foliage, angles of shadow and sunlight, abandoned buildings aging, trees blossoming or fruiting—as well as the smaller, more specific alterations—home or garden improvements,   birds and animals, passers-by, unusual cars or dogs or costumes.  Being of a philosophic turn, I like to observe the inner conversation that accompanies the myriad of sights and sounds and smells.  This conversation is like a waking dream, images and words and ideas flowing unfettered, sometimes in rational lines of premise to conclusion, sometimes in lilting, unbidden notion-sculptures of unexpected beauty.  As I was in the midst of one of these reveries along the bike path this morning, I paused to admire this splendid Yellow Springs landmark, whose whimsical practicality (or possibly the other way around) captured exactly my interior state of mind.

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A little further along, coming into downtown for the final stretch, it looked as if this little tree was blossoming beyond its wildest dreams.

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What a splendid thought for someone to have and then to execute, adding new loveliness to an already lovely thing, gilding the proverbial lily to yield two delights instead of one.  I scanned the early morning foot traffic of coffee-seekers and schoolchildren to see if I could see in any of them the germ of the spirit that had devised that pretty scheme.

The final few blocks of my route are through the central part of the village where every house is different from its neighbors and the styles range from curvy Art Deco stucco to low-country southern cottages wrapped in verandah.   These are houses where I know the inhabitants and their children, remember which ones have endured death  and which have welcomed new babies.  This is where my home begins, the haven where I am known and accepted for myself alone.

The red cottage on the corner has been thoughtfully restored by a woman whose eye for design is matched by her extraordinary green thumb .  She likes old-fashioned flowers and my favorites are blooming now, forget-me-nots.

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Because, after all, isn’t that really the point?

May Day and Medicaid Expansion

Last night I went to see one of my favorite musicians, Billy Bragg, in a splendidly rabble-rousing musical plea for social justice and political equality. Today is International Workers Day, celebrating the achievements of millions of working people who struggled and continue to struggle to equalize the balance of power in the workplace (balance requires equal weights on each side of the fulcrum, after all).  What better time to think about healthcare in this country?

During the week I work for a nonprofit Medicaid HMO, supervising a case management team working directly with the poorest and sickest of Medicaid recipients to help them manage their healthcare.  We provide education, transportation and social service referrals, and facilitate improved provider access and authorization processing.   We collaborate with providers to promote free flow of information between patient and doctor, and between doctors.  Our goal is to empower people to be mindful and effective in managing their healthcare, improving their quality of life and reducing costs by minimizing waste.  And it works, driving costs down by a minimum of 10% for each target population in the last year (I speak for my program alone, since I am ignorant of others).  It’s single-payer healthcare, driven by a monthly per-capita fee that must be stretched to cover all medical expenses for the aggregate.    Expenses increase along with the acuity of patient needs, so the most sensible way to manage costs is to figure out interventions to reduce acuity (prevention, early detection, timely access, chronic disease management, effective discharge planning, etc.), and then to implement those interventions in the most efficient manner possible.  Everybody wins.  And the beauty of doing it in a single-payer system is that interventions can be implemented across the board, touching all members of the targeted populations, and protected by provider agreements and state contracts.

Is it always pretty? No.  But it’s a hell of a lot prettier than what’s available to the uninsured working poor.   Aside from federally-funded clinics (FQHCs) or charitable agencies, there is nowhere that an uninsured person working a minimum-wage job can afford to pay for a primary doctor’s visit, let alone any lab work or medications.   Expansion of Medicaid, one of the possibilities made available to states by Obamacare, would allow these hardworking, responsible adults to maintain their lives when assaulted by illness.   Under the current system, a competent, able-bodied worker may be lost to the workforce by something as simple as inability to pay for antibiotics for a case of strep throat which can, if left untreated, have deadly complications.  Business coalitions that advocate for employers of low-wage staff (janitorial, grocery, etc.) are clamoring for Medicaid expansion so that their employees can remain productive, saving the enormous costs of onboarding new employees.  Another step toward a single-payer system?  Sure, but how does that hurt the people with private insurance?  Until the single-payer model comes into direct competition with the existing private insurance structure, there is no real conflict, right?  Everyone wins if the poor are receiving basic primary healthcare in a cost-controlled managed-care environment instead of receiving preventable, high-cost treatment at the cost of the population as a whole. 

Some of us whose lives are deeply entwined with this issue think the benefit to our society if everyone embraced single-payer healthcare would far outweigh the inconveniences.  But that’s a discussion for another day.

Comfort Food

Today, though productive and cheerful, felt very long by the end of it. Went to bed at 1 a.m. the night before and woke at 4:48, just before the alarm. Dressed for the gym and left the house at 6:05, drove 30 minutes to the office fitness center.  Put in 60 minutes of walk-running on the treadmill, showered, changed into work clothes and worked a full day including a lunch with my boss that was pretty healthy, but not exactly relaxing. Had to detour on the way home to avoid construction, then stopped at the store for ant traps. coffee filters, trash bags and tea. Arrived home, let the dog out, changed into soft comfy clothes, and warmed up the flavorful, nutritious meal I had been looking forward to all day-leftover braised kale with onions and a bowl of black bean and sweet potato stew.

I posted the soup recipe a couple days ago, check it out if you want something outrageously healthy, flavorful and easy to make.  I used a slow cooker, it works brilliantly on the stovetop too.

The kale preparation is too simple even to be called a recipe: saute half an onion in a tablespoon or two of olive oil until translucent, add a bunch of fresh kale (or collard or mustard or other greens) that has been washed, tough stems stripped away and roughly chopped. Add two teaspoons each of cider vinegar and brown sugar, a couple healthy pinches of salt, plenty of your favorite hot sauce, a muscular grind of black pepper and stir to combine. Add up to a cup of water to the pan, depending on how much pot liquor you want in the end, cover the pot tightly and cook at a slow simmer for 45-60 minutes. The result? Tender, deeply flavorful greens with a luxuriously silky mouthfeel and a spicy, tangy brightness of flavor.  Ham or bacon? By all means. Garlic and white wine instead of vinegar and sugar? Yum. You get the idea.

The beauty of both these dishes is that they keep beautifully. I made the soup 3 days ago, the kale day before yesterday when I had time to chop and assemble ingredients. The flavors had a chance to mellow and marry, the textures to nestle together without losing their identity. I knew they’d be delicious. A couple minutes each in the microwave and they’re filling the room with savory, inviting fragrance. The anxiety of the day falls away, and a wave of relaxation lifts my spoon happily to my waiting lips.

This is what food is supposed to be: made at leisure to be eaten by weary, hungry folk, full of nutrients that feed the body, flavors to soothe the soul, texture and color to delight the eye. Making food like this for myself, by myself, is still a new joy, but one I hope never to take for granted. I love to feed other people, but there is a special satisfaction in being my own benefactor, in nurturing myself. This has been a very long day, but the end of it is full of peace and promise.

Nursing in the Cave (no pictures)

A 12-hour hospital shift can be an infinitely fertile experience for a student of humanity.

Take the alcoholic patient who ends up in the hospital after 2 hours in rehab because her liver is failing. Her shame and fear fill the room like a cold wind, her jaundiced eyes plead for understanding as her shrunken arms and swollen belly announce the years of self-destruction that she has yet fully to acknowledge. Alone with her nurse, she swings between heartbreaking bravado and unnerving stillness. When family members come to visit she lapses into tears, or shouting, or melodramatic embraces. This is a soul in chaos, body and mind at war, paralyzed between exhausted denial and intolerable hope. No one can fix this; it’s an existential struggle in which the outcome depends not on strength or intelligence but on whether the suffering creature in the trap will find the door in time, providing that it ever becomes clear where creature ends and trap begins

Medically the patient is stable; she’ll go back to rehab today. The nurse is only waiting for confirmation that her bed is still available. The phone rings, and the plan changes; the rehab facility can’t accept the patient back into their program until she is re-assessed by their nurse as a viable candidate, and their nurse won’t be available until tomorrow to perform the assessment. The doctor postpones the discharge, and the patient is informed that she’ll have to spend another night in the hospital before beginning her program.

This change of plan is too much for her. She’s already dressed, has called her family to pick her up, can’t bear the thought of another minute where she is. She springs to her feet, weeps, curses the hospital, the rehab staff and the moment of weakness in which she reached out for help. She threatens to leave and go to a bar. Her diatribe ricochets from how the rehab facility has betrayed her to how the hospital is trying to dissuade her from recovery. Her emotional pain is so real and so immediate that her body responds as if it were physical: grimacing, rocking back and forth, punching at the air.

This is where it really helps if the nurse has read Plato and can conjure up the mental picture of men cowering from shadows on the wall of a cave. Or the Bible, where Jesus himself believed that his own Father, the Almighty, had forsaken him. Or Shakespeare, where Lear is driven mad by his own despair and self-loathing. Because this patient, on this day, in this hour, is all of these, the paradigm of a person trapped by who she is, a tragic hero.

It is to that tragic hero that the nurse reaches out her hands. It is to the infinite sorrow that accompanies our capacity for joy, the darkness which swallows some of us up despite every advantage, every natural gift, every opportunity for happiness. And when the nurse reaches out in that spirit, when she is present to and humbled and awed by the magnitude of what stands before her, the patient reaches back and the connection is made.

Then the emotional spiral decelerates and the way to peace re-opens. The nurse can hold a hand, offer a tissue, speak the words of courage and empowerment that we are trained to speak. It doesn’t always work. There are abysses of misery that are too deep for any mind to encompass. But it worked today.

On Knitting

 

When I was 30 or so, my grandmother, who taught me to knit when I was little, entered a nursing home. To celebrate her, I re-taught myself to knit and made her a shawl which she wore or kept nearby until she died and it came back to me. Here it is:

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Since then, I’ve kept knitting through good times and bad, finding essential order and elegance in each slow transformation of colored string into fabric with its own form and character. I read books about knitting, like these:

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I cruise the Internet for patterns, like this one (remember my daughter’s shawl? Here’s the pattern chart for it:

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And how it looks so far:)

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and I talk about knitting with other knitters every chance I get.

It’s the perfect hobby for a mathematically-minded introvert who gets cold easily.

I don’t think of myself as artistic at all. I can’t even draw a recognizable stick figure, some days. I am much more of an observer than a creator, “a terrific audience,” as my father would say, and that suits me fine. But something about knitting brings out the creative spark, and that’s where I get a glimpse of what being an artist might be about, as the new thing takes shape first in my mind and then in my hands.  Take the “Smitten,” the hand warmer for unabashed lovers, here both plain and modeled by myself and my spiffy new husband:

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Knitting is a slow art, at least for me. It takes time to understand how the pattern “works,” why a particular arrangement of stitches or shaping technique affects the project as it does. Knitting is all about geometry and ratios and such, and nothing beats the “Eureka!” moments when the math comes together and it all makes sense. Life doesn’t have nearly enough of those, I find, so I hold tight to them when I’m knitting.

Knitting, like any handwork, I suppose, allows the mind to be active and alert without getting sucked too far into itself. I tend to worry unnecessarily about things I can’t control, and knitting helps me avoid that spiral–unlike, say, lying in bed where my mind can race to panic with no checks or balances. With needles in hand, I can only pay so much attention to my thoughts and emotions, I have to step back and let them ebb and flow without engaging. It’s my version of Zen and other meditation practices that focus on detaching from the inner landscape and simply observing without judgment. The result is often a feeling of emotional calm and balance, with occasional deepening of awareness or insight. Knitting allows me to sidestep the shrill, accusatory voice in my head that says traditional meditation is “wasted time,” because it’s not productive. At the end of knitting there is something beautiful, useful and likely to give great pleasure to the recipient. This one is being saved for my future granddaughter(s), by their future Mommy, who wore it until she finally got too big:

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Knitting has no end. There will never be time to knit every project that catches my eye, or to learn every technique, or to track down every gorgeous yarn. There will always be better, faster, more creative knitters than I am, and always new things to learn from them. As long as I can physically hold the needles, there will be intellectual stimulation galore and the satisfaction of making something lovely out of sticks and string. At the same time, I’m connected by infinite miles of cosmic yarn to all the knitters before me, men and women who kept themselves and their families warm in winter, brightly decorated in poverty, and alive to art and beauty through the mastery of the craft.

I taught my teenaged daughter to knit and she is now accomplished enough only to need me as an occasional consultant on her projects. She, in turn, taught a dear friend from Japan to knit, and now serves as her knitting mentor, overturning language and cultural barriers to establish that connection over their shared craft. My grandmother would be very, very proud.

Slow-Cooked Black Bean/Sweet Potato Stew

I went off my normal vegan routine for a week and went to Annapolis to get married.  Oh, did I feast!  Softshell crabs, curried chicken salad, perfectly rare roast lamb, decadent deli sandwiches, crab and Provolone omelets and something called Crab Eggs Benedict, which looked like this but tasted even better.

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The final hurrah of the trip was a second visit to the Café Normandie (that served the lamb), where we split a grilled artichoke stuffed with—you guessed it—crab, and I had sea bass for the first time, served over sautéed spinach with toasted pine nuts.  Like this:

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So then I drove from Annapolis back to Ohio and it was time to get back into the groove of real food, the kind that sounds good, tastes good and best of all makes me feel  good.  Eased into it with a plate of roasted cabbage, a banana and a whole-wheat tortilla for lunch.  And while I ate it, I was smelling this, my newest experiment into comfort food:

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Slow-Cooked Black Bean and Sweet Potato Stew (feeds 8-ish, depending on starvation levels and if there are any teenagers in the house)

Soak 3 cups of dry black beans overnight (I have super-hard water so I boil them for 2 minutes before soaking overnight and add a generous pinch of baking soda to the soaking water).

In the morning, drain beans and pop them into the slow cooker.  Add two large sweet potatoes, chopped into half-bite-size chunks or so, and two onions chopped a bit smaller than that.  Add a lot of chopped garlic.  I put in around a quarter-cup, but I cheat and use the kind that comes in a jar.  Any garlic is better than none, so chop until just before it stops being fun if you’re chopping by hand.  Festoon the pile with a tablespoon or even more of each of these:  chili powder, smoked paprika, cumin and Italian seasoning.  I put in about 2 teaspoons of Vietnamese chile-garlic sauce for heat, but you can use hot sauce, cayenne or red pepper flakes, whatever floats your boat. Add 1 ½ teaspoons of salt and some black pepper to taste.  You can always salt it more after it’s cooked for a while.  Cover with enough water to allow all the ingredients to move freely, and cook on Low for 8-10 hours.  If you start late, cook it on High until it starts to boil and then turn it back.  At which point it will look much like this:

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Italian seasoning, you say? In a dish overflowing with Southwestern sensibilities?  The ingredients in my enormous but cheap plastic container are oregano, thyme, marjoram, rosemary and sage.  What I really wanted was oregano (but I was out), so I substitututed this and it was yummy.  And the heresy only gets worse.  After the beans are fully tender, add a cup of drinkable red wine and a can of Ro-tel  or other canned tomatoes with chiles.  The theory behind adding acidic ingredients last is that it helps the beans soften in the hard water.  Chemically-minded readers will immediately associate this with the pinch of baking soda added during soaking.  Bingo!

This soup benefits from an occasional stir during cooking, if you happen to be home; the stirring helps some of the sweet potato chunks fall apart and thicken the soup.  But it really does just fine left to its own devices.  A well-placed couple of strokes with a potato masher (possibly an immersion blender although I’ve never tested it) will have the same effect.  Like this:

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Make sure to taste for salt before serving, and if you’ve left out tomatoes or wine, consider a splash of vinegar or lime juice to brighten the flavors. This soup, like all its beany relatives, will improve in flavor for several days after making it, so make sure to get maximum mileage out of the leftovers!

Welcome to Far and Wee

Life just keeps getting more interesting. And to me, that means it’s getting better. Sure, it may all collapse under its own weight one of these days, but that’s part of the deal; nothing lasts forever nor, in my opinion, should it.

I’m at least halfway through my life now, and it has been quite a ride so far. Four marriages, two beautiful children, homes across the country, friends as far as the eye can see. Never a dull moment, for sure. But that’s what keeps it interesting. And interesting, my friends, is the name of the game.

Take this blog. It’s named after a poem about Spring, by e.e. cummings, that goes like this:

in Just-
spring      when the world is mud-
Iuscious the little
lame balloonman

whistles far      and      wee

and eddieandbill come
running from marbles and
piracies and it’s
spring

when the world is puddle-wonderful

the queer
old balloonman whistles
far and wee
and bettyandisbel come dancing

from hop-scotch and jump-rope and

it’s
Spring
and

the

goat-footed

balloonMan           whistles
far
and
wee

–Chansons Innocentes: 1 (1920)

As a little child hearing that poem read aloud every Spring, I learned that life is playful and musical and mysterious and maybe just a little crazy. And it stuck. So this blog is my whistle in Spring, in honor of balloonmen everywhere, and most especially the one who read me that poem so many times.

Pictures? Sure. Here’s me getting married the last and final time, only a few days ago.

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And here’s the shawl I’m knitting for my daughter who heads off to college in September, and the sweater I made for my 15-year old son who’s off at boarding school.

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And the soup and bread that are my staff of life.

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And here are Uther the dog (welcoming you with a sock) and Alcibiades the cat.

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That pretty much sums it up. Except for the being a nurse and a bit of a radical leftist and a Quaker and a big believer in community and eating plants and being content with what is.

I hope you come back and see me, and I hope I have something interesting to offer you every time you do. Please comment freely; you may be the one to open my eyes to something I never realized before!