Monday, June 9, 2014

Fine Dining the OG Way

Saturday night, 1900 hours, my companion and I arrive on the scene. No lines, no waiting. Very suspect.

Seated too promptly, placard-like menus are thrust upon us. These are easy-wipe off  tri-fold affairs, with scalloped tops, replete with  1) 2) 3) step instructions... could I have wandered into Friendly's/Sonic  in error? I  surreptitiously peer at adjacent diners through the dim lighting and Tuscan-inspired decor. Yes, in fact at every table within eyesight, diners wear  T-shirts with emblazoned statements: PATRIOTS. HARLEY DAVIDSON. UNH. A few  sport  their ballcaps at the table as well. Though a date night, I didn't get the memo and am apparently overdressed-not for the first time, I remind myself that this is Manchester, known affectionately across New Hampshire as 'Manch-Vegas',  and resolve to stand down.

Our tushes have barely grazed the leatherette booth when a pimply-faced youth ( 15?  21? who can tell anymore) is slinging a wine bottle at us, sotto vocce  with a Boston accent, 'Try a sample?'  Whether it is an sample or a glass that is being proffered is never clear, because I tread into deep waters by daring to ask about organic wines?  Nope.  Low sulfite? This one sends him running for help; back in a jiffy, he announces:
'They only carry those at liquor stores.'  My heart sinks a bit, in a combination generation-gap attitude-adjustment senior moment. However, since I chose the damn place, we soldier on.

Didn't I warn my companion as we approached  the  windowless edifice that  Olive Garden stole anything good they ever did from Macaroni Grill, as did Carrabas, and that I can't understand why we still have to put up with the likes of this, while the closest Macaroni Grill is in Portland, Maine. It's a pretty sorry state of affairs in the chain restaurant world. OG employees might second my opinion: in 2011 OG converted the bulk of its staff to part- time status, thereby deleting health care benefits. No wonder the only wine slinger they can manage to hire for up front looks and sounds as if he should be washing dishes in the back. Note to self:  text  18 year old son to apply here, he can wipe the floor with this kid, even given his zero experience waiting tables.  At least my son has manners and is easy on the eyes.

Pluckily brandishing my phone as supplemental lighting, I  discern that there is a round green symbol next to several unappetizing menu items.  I mistakenly assume that it being a green symbol, these are the healthy choices. However, since these items are also laden with extra breading, butter, and cheese, this does not seem accurate...wait, it appears the letters 'OG' are inside the green thingy. Original gangster? Really? Well, it is nominally Italian... maybe they are taking this  'ye olde worlde' thing a bit too far, coupling sagging sales with a Godfather twist... ah, it appears that these choices have been designed by the chef himself, after a trip back to the old country. Yah right. Is a patently hokey claim merely suspect, or  actually offensive? I go with the latter... though I  fear  (present company excepted) they have not underestimated their audience. According to Wikipedia (a fitting source for an establishment of this caliber)  there are over 721  OG's in the United States. I can't imagine why.

Wednesday, May 28, 2014

     A recent NYT column by Perri Klass speaks posthumously about her aging mother, managing to avoid  knee-jerk, pithy conclusions. A semester has flown by since I wrote here last, a blur too-filled by seven graduate classes, in the seemingly farcical pursuit of  a distant, perhaps mythic, psychiatric nurse practitioner license. My most memorable clinical rotation took me into the homes, more aptly termed  the 'rooms',  and often simply the bedrooms of older adults, meeting them solo, as a nurse experiencing the provider role for the first time.

     The semester prior, I'd lost an argument that has since haunted me. One of my professors, a therapist by training, had skirmished with me over whether people suffering from a terminal painful disease have a right to call it quits. This spring's clinical brought the discussion into sharper focus, as most of the older adults I evaluated (and I use that term loosely, as I often groped blindly about) were suffering from some combination of illness, dementia, and 'depression'. During that argument, I'd taken the seemingly callous position of advocating for those who simply want to put an end to their litany of misery and loss. I'd argued that it was a rational choice, because we, the younger, the healthy, unassailed by death and infirmity, have simply no idea how much these people have borne, or will have to bear, and that in such a context, suicide is a rational, if not a kind, choice.

    My posited stance was heresy, a tough sell to an audience of psych-nurse-practitioner wanna-bees, ready to pounce on any opportunity to write scripts for anti-depressants, never mind the portentous professor. Splutteringly: did  I fail to understand my ethical obligations, my duty as a provider? How could I be so irresponsible, when these people were obviously suffering from profound depression! Not for me to know what was in their hearts and minds, simply my duty to rescue.... Setting aside the pretense of righteous indignation, my argument was reduced to bearing witness: the reality that many of these folks were living what had to be anyone's worst nightmare, squared.

     Death of a spouse, any remaining friends, loss of adult children, blindness, Parkinsons, dementia and Alzheimers, loss of mobility, incontinence. The continual degrading of any sense of dignity as increasingly more banal tasks, such as showering or taking a pill, become offloaded to a rotating cast of backstage minions. The 'ethical obligation' to effectively compel anyone to endure such a life would seem to convert my healer role to something akin to an overseer.

      I'm a big-picture person; a scant five years ago when I completed nursing school, the curriculum still required a course in Nursing Theory, a class that many protested and derided. Wherever they happened to complete that course, it's obvious that the utility of it has been lost on most nurses, as it is often mistakenly cited to me as the first example of why nurses don't need a bachelor's degree to enter the profession. I was fortunate enough to encounter a Nursing Theory professor who asked us to consider what we believed the task of nursing consists of, what is nursing about, what makes it different from the role of a physician, for example? From  there, we were asked to take our beliefs and find the closest nursing theorist who matched them; I chose Sociologist Anselm Strauss' theory of the Trajectory of an Illness. Briefly: just as our lives have an arc, so do death and illness; as caregivers, we must consider the biography of our patients, their life experience, in crafting a plan of care with them. Or, as one of my feminist classmates better schooled me, 'nothing about me without me'   as a manifesto in providing care. It's an honor and a privilege to nurse people in their most vulnerable time of life, never more so than when facing terminal illness, the ebbing of all one's sensory faculties, and the crushing loss of companionship of anyone we ever held dear.

     That day in class, I failed to persuade my therapist professor (or my classmates)  that buoyed as we are by denial, good health, and relative youth, we simply cannot conceive the perspective of the aging, debilitated older adult. But we can feel it; when we enter their homes, their little rooms in frighteningly expensive oh so carefully crafted assisted living spaces, where the sum total of a life has been reduced to a few framed photographs, an afghan-wrapped single bed, and an armchair, all in view of the kitchen sink, the microwave, and the water closet. I was working in what was considered one of the best facilities in the state, where such fine accoutrements and recreational facilities came at a frightening price. As one resident in her nineties confided to me quite simply: 'I had no idea I'd live this long. I don't know if the money will hold out.' Compared to the ravages of assisted living on one's income, a nursing home doesn't look like such a bad end, after all. The choice: gamble on spending just a few final years in somewhat illusory cushioned comfort, with a modicum of privacy; or  suck it up and deal with a roommate in a nursing home, leaving one's heirs a decent nest egg. Cartoonist Roz Chast boldly gave voice to such thoughts in her recent graphic novel, Can't We Talk About Something More Pleasant?  as interviewed by Terry Gross on NPR's Fresh Air.

     Is it ugly or merely realistic to talk about the economic calculations of care? Trained as a clinical nurse leader, one who quantifies the dimensions of the micro-system, I can't help but contemplate this, along with the knowledge  that very few in our society are privileged enough to even begin to make such choices.

Monday, January 6, 2014

Did you like Philomena?

As good as the film Philomena was,  the screenwriters took license with the original details; if you want the real story, read the book, originally titled the Lost Child of Philomena Lee. The entire plot (loosely based a true story) hinges on whether the birthmother/adopted son are able to find/connect with each other.

In this case, the connection between birthmother and son was able to be established fairly easily for a few reasons:

1) The adoption was international, so there was an accessible visa record for the baby, which furnished the parents' names
2) The adoptee became well known, and had financial wherewithal, so he was easy to trace
3)The adoptee was male, so he never changed his name (after infancy/the adoption, when it originally was changed by his US parents)

Most adoptees (such as my brothers) have no such assistance. Although they have registered, they are unable to locate their birth parents or find information about their genetic and historical heritage. Most developed countries (including Great Britain) have open records for adoptees once they reach age 18; the US lags behind. Even slaves had access to their birth records...

If you start on this page and read through, it explains the situation for US adoptees and birth records:

Since the story of Philomena did have a US component,  I thought the filmmakers missed a chance to note (in the black and white follow-up statements at the end) the continuing inequities for adoptees that exist in this country.

Thursday, November 1, 2012

text of speech given on Sunday

There are things I don’t believe I do well, and don’t like to do (funny how those go hand in hand) and giving a speech is one of them. I’m grateful ….that this talk is limited to three minutes. It’s a measure of how much I love this church that I am up here speaking to you;Kevin and I feel that we receive so much more from Grace Church than we give. We give when we are asked, and ongoing, in whatever ways we can think of. It’s one of those principles of life that hopefully one discovers early on- the more you give of yourself, the more involved you are, the greater benefit you receive . This idea of giving is intrinsically linked to gratitude. Giving of oneself makes one more aware, more grateful for blessings. The more involved one is at Grace, the more blessed one feels, the more grateful. It’s a paradox, but that’s how it seems to work.

To me, gratitude is essentially an awareness.

Spiritual thinkers through the ages have posited that what we put our mind on grows, or becomes our reality. I can’t help but be reminded of those I work with as a mental health nurse…daily I meet folks who cannot stop thinking of ways to kill themselves, and sometimes they take action. In order to make an assessment, I have these odd conversations with folks in which we dispassionately discuss how they planned to jump off a bridge, take pills, or run their car into a bridge abutment. Taken out of context, anywhere else such sentences would appear as totally incongruous or even blasphemy…and yet they are spoken on the path to healing, or they wouldn’t be spoken at all, just suppressed. One has to acknowledge the present awareness in order to begin to think of living again.

On the gratitude scale, a person whose mind is constantly occupied by suicide cannot be simultaneously counting their blessings. As with many types of mental illness, a person’s equilibrium can be compromised because certain thoughts,certain emotions, predominate and become the entire awareness to the exclusion of others. It can become a negative habit of mind; the converse is also true, that maintaining a practice of gratitude is a habit of mind as well.

It’s possible that maintaining a mental stance of gratitude may even be self-protective, as it demonstrates awareness. Certainly, when we thank God in prayers, we are in this stance. Apparently the early American pilgrims built seven times more graves than they did houses, yet despite their losses, the enduring tradition they have bequeathed us is a day of Thanksgiving – fast approaching, I might add. Nor is it an accident that many of the words associated with gratitude speak to holy origins – words like benediction, invocation, blessing, and grace , to name a few.

We can demonstrate our practice of gratitude by giving, praying, doing good works, acknowledging, and maintaining awareness. I will close with these words from the poet Edwin Arlington Robinson:

'There are two kinds of gratitude: The sudden kind we feel for what we take; the larger kind we feel for what we give.'

Sunday, October 14, 2012

Evidence that I May Have Become an Old Fart

1)  I  email harangues to academic libraries who remove book jackets from all their books, arguing that it reduces visual appeal, promotes the use of e-books, deters browsing, and will put librarians out of work.

2)  I cannot abide the use of spandex in my long sleeve shirts, jeans or pants- nay, in any garment. Within an hour of wear my knees/elbows seem convinced they are undergoing selective waterboarding.

3) Recently attended the movie Pitch Perfect with our two female exchange students, along with a row of college girls seated behind us. At various moments, the actors would break into song. I knew not one of the words of any of the songs, but those around me enthusiastically sang everything, indicating these were major hits.

4) "Modern" cut pants liberally expose my middle-age spread. When one bends over, the 'coin slot' is revealed in all its glory.

5) I always pay the parking meter.

6) I vote in primary elections.

7) I tell my kids that when I was growing up, we didn't have malls, video recorders, cable TV, Old Navy, cell phones, or computers, let alone "social media". We played entire sides of  LPs and read the album covers, rode bikes and made brownies. The idea of always reaching people instantly was off the table. When you ran out of gas, you waited patiently for a good Samaritan. They can't conceive of this existence.

8) When I see women out shopping wearing kiddie-print flannel pajamas, I am horrified and think of them as slobs who can't bother to get dressed.

9) I just started texting in the past year.

10) My mother thought that only gypsies had pierced ears, thus when I finally got them, it was considered risque. Now they won't stay open so I can no longer wear the damn earrings anyway.

11)If I don't hit the hairdresser every three weeks, I sport a 1/2 inch silver skunk stripe as my part.

12) The sight of  men with tattoos is abhorrent to me, let alone women.

13) I  yearn for the days when major music artists actually had bands, and everyone knew how to play at least one instrument well. Today, that is a rarity.

14) I can't be bothered to download music online, and thus still buy CDs, which I find inadequate in fidelity compared to the sound of LPs.

15) I still read books.

16) I drive a 2004 Buick Century.

Tuesday, September 4, 2012

The Adventure Begins

So this is the year we take on two 17 year old female foreign exchange students from different countries, and I start  the second nursing job in  six months. September brandishes the starting gate; and truth be told, am I not just superimposing a waning bandage over a persistent case of empty nest syndrome? Mind you, the sixteen year-old is only in eleventh grade and  already I muffle rising panic.  The twenty-four year old is gone, the twenty-one year old rows away his senior year of college whilst polishing off  Arabic and eyeing Egypt with fervor... them's horses  are out 'o the bahn.

My year perrenials (a new verb I just coined) in September, even before I was an educator. For someone who attended no less than seven institutions of higher learning on her way to earning three degrees, the school calendar is hard-wired in. We won't count the half-finished technical writing masters at University of North Texas or the paralegal certificate, those educational u-turns... nay, verily  I proclaim with a straight face that every single learning experience continues to be utilized and applied to this very day.

As far as the premature case of empty nest, it may well be the result of  attempting to adopt a total of seven older children over six years and retaining just one. Have the other six been adopted by anyone? No, but  most would have if  the state Department of Children Youth and Families would just listen to their parents in the trenches. The photo above was taken three  kids ago. Do you think in the old days, when many offspring died, that parents marked the passage of time by using the deaths of their children? Instead of fall or spring or a number, that time would be known as "when Sandy left us" .... losing a child in a failed adoption is nearly as traumatizing as the death of a child. It has a way of stopping you in your tracks, putting life on hold.  This year alone, we'd  already lost two kids, following one last year...the most recent two I can't bear to talk about just yet.

They are not the reason we won't attempt to adopt again; that honor lies with the last, the final state social services caseworker who repeatedly lied and back-stabbed us over the course of 15 months. Lest you think I have it in for this class of person, I will say that my previous experiences with such workers had in fact been uniformly positive. Alas, this misguided woman was backed by her organization all the way to the very top. I was personally told by the head of the organization that the children would be taken away if I didn't toe the nonsensical party line,  and then, as they had repeatedly, the organization contradicted itself. They made up new rules that applied only to our family, and subsequently refused to honor those selfsame rules when the shoe was on the other foot. The subject defies sensibility; there's a book in it somewhere. Invariably, in my life when it's time  to move on and I still think this is something I need to be doing, it requires a whopping dose of something really nasty to turn me off. Finally I heeded the message, though I can't keep the kids out of my life just yet.

On a lighter note: our newfound international student exchange organization is dubiously blessed with an acronym that had to be penned by a non-English speaker. In all sincerity - phonetically, it is pronounced "Assy". Kevin and I run around the house making "assy" jokes and mimicking fake "assy" commercials, replete with butt shots, such as " Assy come home" which poses a nice double entendre on the international student side of things.  The poor girls haven't arrived yet, but when they do, it will be our special pleasure  to begin teaching them English slang.

Wednesday, February 1, 2012

According to a 2011 report by the Evan B. Donaldson foundation,   ,

fewer older youth are  being adopted from foster care than at any time in the last ten years.

"Adoption of older youth, as well as subsidized guardianship (discussed later in this paper), are important ways to create such relationships for youth at risk of aging out of care. Each legally formalizes a relationship with an important adult or adults, removes the youth from direct involvement in the child welfare system, and typically continues state financial support, access to medical care through Medicaid, and ongoing services through the subsidy."

Numerous studies have shown that children who age out of foster care or emancipate will face high rates of homelessness (up to 49%) drug and alcohol addiction, and incarceration. Due to their lack of supports and previous emotional challenges, young adults who leave foster care without a family will disproportionately drain resources and end up costing 'the system'  or the state far more than children who have been adopted.

The Donaldson report highlights state efforts  such as "You Gotta Believe"  a New York based agency targeted solely to recruiting adoptive parents for older youth. How difficult would it be to form a similar agency for the five New England states, whose goal was to prevent ANY youth leaving care without a family?  Organizations such as Adopt Us Kids ostensibly serve the same purpose, but if my experience is any guide, they serve largely as a front. Over the course of two years I submitted more than ten homestudy packets  to social workers listed on that site for specific children  as 'requesting homestudy' . I heard back ONCE from one Ohio  social worker who said  the child pictured  was not yet available...and never heard from him again. From the rest I never heard anything, though the same children I inquired about (multi-racial sibling groups) continue to be pictured as available for adoption on the site YEAR AFTER YEAR (and today).  I had more luck using a state site  through Maine social services when I submitted requests, and also through the Maine Heart Gallery site which has since been eliminated ; in that instance I heard from workers by phone,and was even invited to two Maine 'adoption parties', but again that effort was not productive. If I, as an educated, motivated, trained foster parent with homestudy in hand, knocking hard on the door, cannot get through what reality faces other potential adoptive parents, who may not even be licensed foster parents yet?

My point is that states are not doing enough to get older children adopted, and in fact have made few changes to the way they operate social services  to specifically meet the needs of older children at risk of aging out. Programs such as You Gotta Believe  are an excellent response to this need; the question is, why is this organization such an isolated phenomenon?