Arguing With the Doctor – A plea for end-of-life choice

Dandelion

Does the doctor always know best? And in the case of one’s own precious life and death, is it wise to argue the point?

“No One Here Gets Out Alive” – a quote from Jim Morrison – led the title of a lively (pun intended) debate about aid in dying held recently at San Francisco’s Exploratorium. Part of a series on the intersection of science and politics, the event’s full title was “No One Here Gets Out Alive”: The Science, Politics and Law of Death and Dying. The program sought to address a few issues not easily covered in two hours – but still – including (reprinted verbatim):

Is there a constitutional right to “physician-assisted suicide”? What about a “dignified death” – and what is a dignified death? Should terminally ill patients facing mental incapacitation or unbearable pain have access to fatal ingestion – also known as physician aid in dying? Or would that jeopardize our society’s progress toward more compassionate, comfort-based care?

Participants included John M. Luce, Emeritus Professor of Clinical Medicine and Anesthesia at the University of California San Francisco; Laura Petrillo, MD, a Hospice and Palliative Medicine fellow at UCSF; and program host David L. Faigman, Professor of Law at UC Hastings College of the Law and Director of the UCSF/UC Hastings Consortium on Law, Science and Health Policy.

The program kicked off with a discussion of the science of death itself – defining death being more and more problematic these days. Think Nancy Cruzan, kept alive through a feeding tube in a “Persistent Vegetative State” for nearly a decade until her family managed to convince the State of Missouri that she would never have wanted to be “kept alive.” Or Terri Schiavo, whose PVS ordeal lasted even longer. More recent is the tragic story of 13-year-old Jahi McMath, declared brain-dead by multiple physicians more than a year ago but whose body is still existing somewhere, connected to machines that keep her heart beating.

Those cases are just a few of the markers on the path toward today’s critically important death with dignity movement. This writer’s involvement in the cause began with work as a hospice volunteer in the 1980s, a member of an HIV support group in the ’90s and a volunteer with Compassion & Choices (and its predecessor organization Compassion in Dying) since the late 1990s. C&C is currently leading the fight to make aid in dying legal throughout the U.S., having won significant battles – five states now protect that right for terminally ill, mentally competent adults – with others underway in many areas.

And that issue – should medical aid in dying be legalized in California (and elsewhere) – was the heart of the two-hour program. Of the two physicians, Luce was eloquently in favor, and Petrillo was adamantly opposed. In this writer’s admittedly biased view, Luce’s lifetime of experience as a distinguished physician and professor rather embarrassingly outweighed Petrillo’s credentials, but it is possible to see her emerging-palliative-care-physician status as basis for her absolute certainty that everyone on the planet can experience graceful, pain-free death if only he or she has access to palliative care.

I am less certain. Thus my argument.

In the Q&A period, I posed this question to Petrillo: “If you were my doctor, which is unlikely, and I were dying, which is increasingly likely (I’m 81, for heaven’s sake,) and I have expressly, repeatedly made clear that I do not wish to linger – why should you have the right to insist that I linger?”

Petrillo dodged the question. “I would ask what is causing your pain,” she said. “I would try to determine if you are depressed, and talk about how we can alleviate your pain and possible depression…”

After several abortive attempts to get a response to my question, and figuring the audience had not paid good money to listen to me rant, I gave up. But here are the arguments I had for Dr. Petrillo, questions I wish the minority of physicians who do still oppose aid in dying would answer:

Why should you have the right to insist that I linger, when I am dying?

How can you presume to understand my pain better than I? And why should I have to describe it if I don’t choose to do so?

When I have watched dying people with the very best care and pain control suffer in ways I would not choose to suffer, how can you insist on my going that route?

Why should your conviction about the efficacy of your medical field trump my autonomy?

Dr. Petrillo said she is not religious, so this question would be addressed to others: Why should your religion overrule my religion? Or dictate to me?

It’s my only precious life, after all. Why should I be denied control of its precious end?

 

 

 

When Fences Come Down

Fence.Mtn Lake

“Something there is that doesn’t love a wall,” wrote Robert Frost, and I think he was onto a larger truth. Of course, Frost – in his “Mending Wall” – was talking about rocks and neighbors, and the poem leaves us with ambivalence about the goodness of fences.

Fences and walls may, at times, make good neighbors – but the big ones tend to be symbols of enmity (think Berlin, Israel, Arizona…) and we just want them down.

A few months ago a high, dark fence went up around lovely Mountain Lake, in the San Francisco park that is one of my favorite spots on the planet. It’s a city park, but the lake (fortunately for us all) is part of the Presidio National Park and has been undergoing an extraordinary restoration for the past few years. It may not yet be back to the purity that made its water just fine for Spanish settlers (and probably the Ohlone and Coast Miwok indigenous people before them) to drink, but years of accumulated glunk, trash and sludge have been hauled away and the lake’s return to life has been a rare joy to watch.

The problem? Although the waters began to clear and native greenery emerged, a proliferation of non-native fish were quashing any hope of bringing back the fish who once belonged. We’re not talking just a couple of ordinary intruders. It was possible to stand on the beach near the murky water’s edge and watch goldfish the size of ahi tuna swimming casually back and forth. With native fish and turtles long displaced by casually dumped household pets, the lake was overrun with carp, bullfrogs – somebody reported a sturgeon – and who knows what else. This writer remembers the brief residence of an alligator, who famously evaded a gator hunter imported from Florida but was eventually removed to the local zoo.

Presidio Trust personnel tried snagging, netting and every known removal method before conceding that the only solution would be to poison the lake. They chose plant-based Rotenone, which kills everything with gills (and happily not much without) and disappears within three days. Thus the fence went up – presumably it was still not a good idea for gill-free people to be wandering near the water. Almost the moment the solution was poured into the four-acre lake, the alien fish died. They were scooped up by the thousands to be studied by ecologists (who reluctantly went along with the project) to determine their origin and soon composted as a final act of goodness. But the fence, for assorted reasons, did not come down.

Sign.Mtn Lake

And over the long weeks that followed it was as if the park itself was inhabited by an alien being. Children still played on the adjacent swings and slides, dog walkers still tossed tennis balls, this writer still exercised on the bars of the fitness trail – but the now-sparkling lake was hidden behind its foreboding shield. Even when the gulls could be heard returning beyond the black screen, and actually seen if you peered through the mesh, the park felt bifurcated and somehow forlorn. Thanksgiving came and went, Christmas was less merry, the New Year not yet happy.

A few days ago, the fence came down. Mountain Lake, the shimmering heart of Mountain Lake Park reappeared, putting on a show of new life. A few familiar ducks may never have left; now they have been joined by coots and grebes and a spiffy ruddy duck who is apparently courting two slightly less flashy lady ruddy ducks. Western pond turtles, chorus frogs and native fish will begin to return in the spring.

Lake.Mtn Lake

The metaphors are abundant: fences come down, sunlight spreads from reflected waters, varied creatures happily coexist, romance blooms.

 

Where is Robert Frost when we need him?

 

 

 

 

“Personhood” by any other name

Personhood

A recent report by the Guttmacher Institute took a new look at an old game being played – anew – by anti-abortion, anti-women forces. It is called the Personhood Game. If anti-women forces win, a fertilized egg becomes accepted as a person. Which means that every fertilized egg is accorded rights above those of the woman in whose body it is housed – fine for eggs, but pretty dismal for women.

Not a lot of rational people, including rational people who vote, think it makes sense for eggs to be deemed persons. This was made clear last year by the failure of such bills in several state legislatures. Not to be dismayed, players of the Personhood Game have simply switched their energies to fighting contraception. The more contraception bans succeed, the stronger the eventual case for declaring fertilized eggs sacrosanct. Why? Because contraception bans are based on religious doctrines that hold such a view. Though keeping their distance on personhood politics for now, anti-abortion groups including Americans United for Life, the Heritage Foundation, Susan B. Anthony List and the U.S. Conference of Catholic Bishops are among those working hard and widely to ban access to contraception.

Is there a disconnect here? Since effective contraception lessens the number of unwanted pregnancies, and thus the number of abortions? Well, yes. But the people playing the Personhood Game simply have their eye on the prize: Fertilized egg wins, woman loses.

Writer/blogger Joanne Valentine Simson, who is credentialed in both science and poetry, has posted a number of thoughtful and informative essays on contraception. Simson points out three critical factors seldom considered in all the arguments for and against contraception: women’s physical wellbeing, women’s social wellbeing, and overall environmental impact. “These are larger issues about long-term human survival,” Simson writes, “(than) the false debate about whether a cell (or cluster of cells with 46 chromosomes) is a human being.” To conflate contraception with abortion simply bypasses every one of them.

But the Personhood Game players are as adept at bypassing reality as they are at steering the debate.

“The influential organizations behind this anticontraception agenda,” writes Joerg Dreweke in a recent, comprehensive Guttmacher policy review, “have compartmentalized the debate, which allows them to pick and choose when contraception should be viewed as abortion and when it should not. They are essentially able to pursue a “personhood” argument in areas where doing so is politically feasible, but at the same time feign moderation by keeping the full-fledged, politically toxic “personhood” agenda at arm’s length. This deception is part of a deliberate, long-term strategy to limit women’s access not only to safe and legal abortion, but to common methods of contraception as well.”

If this seems devious, and underhanded – well, it is. But it’s the way the game is being played.

For women – who are both pawns and victims – it is a dangerous game.

Your Life In Review

A New York City subway train holds 1,200 people. This blog was viewed about 5,800 times in 2014. If it were a NYC subway train, it would take about 5 trips to carry that many people.

The good people of WordPress opened their Year-End Review with those words – below this worldscape with bursting fireworks – and what blogger could resist? They went on to report that my busiest day was February 24, that one of the most-viewed was a piece on Eleanor Roosevelt from 2013 (Mrs. Roosevelt has nothing if not staying power) and most viewers were from the U.S. “with Brazil and Canada not far behind.” Come on, Brazil? The country of my birth comes through.

The cold, hard truth is that there are plenty of blogs that are viewed 5,800 times a day, of course, but you’ve gotta love the subway train analogy.

The sheer amount of data collected on our life’s work, and our lives, can still give one pause. WordPress is entitled. Without the nifty platform, easy-to-use format, multiple tools and automatic archive this writer would be virtually wordless. (Or restricted to Huffington Post, which attracted way more than 5,800 viewers to essentially these same words, but there’s a lot to be said for freedom of the WordPress.)

But what about Facebook’s now ubiquitous Year-In-Review? Who could resist at least scrolling through her life of the past year (and I hereby admit to posting the thing.) What boggled my mind was the uncanny way Facebook picked almost the exact photos I would have chosen. How did they know? Spooky.

Books have been written – and at least one film made – about The Examined Life, although I seriously doubt the Facebook algorithm-coders have read them. It has to do with trying to make sense of things, figuring out what’s important, sorting the good from the bad. Elevating the good from its place within the ordinary. Occasionally – though the idea was always for one to do it oneself – these Year In Review things may help with such a task.

But any way you look at it, our lives are undoubtedly being examined.

Farewell, 2014, and Happy New Year each and every one.

 

Saying Goodbye, and Hello to 2015

sunrise

My friend M has died, just shy of the old year’s end and significantly decreasing the joy of the new. But her dying was full of life lessons about saying goodbye, being grateful and trying to ring in a better planet for the days ahead. And thus she leaves a gracious greeting for 2015.

M was a believer in good causes, and she put her substantial time and energies to work for them all. We became friends over our mutual love of writing but we bonded over our mutual commitment to end-of-life choice. Once you concede that you won’t live forever, a reality most prefer to ignore, it is possible to live both gently and joyfully even in tough times. Both of us spent long years encouraging anyone who would listen to confront mortality, make choices, and make personal decisions known to all. It’s called living fully, even into dying.

So M, after conceding her own days on the planet were dwindling, sat down over a cup of soup I’d brought her not long ago and we went about the business of saying goodbye. I told her why I thought she was such a wonder, and she told me all the things I’d be happy to have said for my own eulogy. OK, we had an extravagant mutual admiration society. But the life lesson is that telling others about their own gifts and good qualities (however hard it might occasionally be to uncover them) is something anyone can do, any time; the planet would be immeasurably better if more of us did it more often.

M was supportive of my activism for reproductive justice, having done more than a little of that herself in years past, but once she expressed reservations about how much time I was investing in that cause. “It’s time for young people, young women, to take that on,” she said. Well, yes. Another 2015 greeting for that demographic: reproductive rights are disappearing at an alarming rate. Unless more of us of whatever gender or age pitch in, women – particularly women without money or power – will soon be back in the pre-Roe dark ages, with no control over their own bodies. Which could make for a very unhappy new year for uncounted thousands of women.

The daughter of a rabbi, M was aggressively non-religious. We didn’t waste a lot of time on the subject, though she applauded the idea of my Presbyterian church working to break cycles of poverty. But once, after some sort of “What Would Jesus Do?”-type remark I made she said, “Oh, you and Anne Lamott.” I am personally fine with being lumped in with my funny, gifted friend Lamott, but this was not meant as a compliment. It did lead to a brief, lively discussion about faith and practice. And wouldn’t 2015 be a happy new year if fewer wars were fought in the name of Allah (or Whomever) and more focus were put on the peace, justice and love for fellow creatures that is the basic message of every religion around.

Rest in peace Maya Angelou, Robin Williams, James Brady, Pete Seeger – and all those other good souls we lost in 2014. Most especially, M.

And Happy New Year to us all.

Abortion rights, women’s rights: A major victory

Lady justice

The government has finally been ushered out of the exam room.

In a definitive step protecting women and their very private decision-making, the U.S. Circuit Court of Appeals for the Fourth District on December 22 permanently blocked a 2011 North Carolina law that created huge physical and emotional trauma for women seeking abortions. Not to mention trampling on doctor-patient relationships and the rights of physicians themselves to have rational conversations with their patients.

Those fighting the extremely punitive law included the American Civil Liberties Union, the ACLU of North Carolina Legal Foundation, the Center for Reproductive Rights, Planned Parenthood and others

The law required providers to show an ultrasound and describe what’s on the screen. That is certainly right and proper if patient and provider so choose. But suppose the woman chooses otherwise? The law allowed her to close her eyes and cover her ears, but said the provider still had to go through this narration, regardless of circumstances. Suppose this pregnancy was the result of rape or incest, or there were serious health risks or fetal anomalies — the woman still had to cover her eyes and ears, perhaps singing “La, la, la, la…” to drown out the narrative. Is there any conceivable way in which any of this makes sense?

Fortunately, the Fourth District Court of Appeals thought not.

What has been so appalling about the evolution of this law and the political fight to keep it in effect is the total absence of empathy or concern for women. The same is true for literally hundreds of other state laws still on the books that are designed to shame or coerce women out of having abortions. Public outcry is raised about “protecting the fetus,” often by politicians and others whose concern for that fetus ends as soon as it becomes an unwanted child. With these laws, sanity, good medical practice and women’s rights go out the window. And who loses? The woman. Particularly if she is poor, or disempowered and thus can’t travel to somewhere safe and free from harrassment.

None of us, whatever our politics, want to see women’s lives made worse. None of us really want to see children brought into the world to suffer, other children forced to bear babies who are the result of personal tragedy, or families plunged into chaos and despair. Most of us credit women with having perfectly good brains and don’t want to see them denied use of their brains or control of their bodies. But these are the results of punitive abortion restrictions. At least this one punitive law is now gone, a holiday gift to us all.

Thank you, U.S. Circuit Court of Appeals for the Fourth District.

 

Good news, bad news for an old week

landscapeThe holiday-week news in review was a doozy. Good news (to most of us) about Cuban-American relations and climate change, bad news for Sony and internet security. Plus the relentlessly ongoing bad stuff: ebola killing off entire families in Africa, terrorists killing children in Pakistan, crazies killing innocents, and a total absence of politicians able to do much besides calling other politicians names.

It was all up for discussion during a recent “Week to Week” political roundtable discussion at the Commonwealth Club in San Francisco. Panelists included San Francisco Chronicle political reporter Joe Garofoli and columnist C.W. Nevius, and writer/attorney Melissa Griffin Caen, along with moderator John Zipperer, Vice President of Media & Entertainment for the Commonwealth Club. Despite the unfunny bad news, the group had a seriously good time dishing about Uber executive Emil Michael – and why not? Set aside the fact that his company sought to make good news (Everybody wants rides! Raise Rates!) of the hostage tragedy in Sydney, Australia, Michael first endeared himself to the fourth estate by launching a campaign to investigate unfriendly journalists. Then came the news about his suit against his landlord for sending a stranger repairman into the apartment to fix something Michael himself had complained of. Throw in Michael’s claim of being buddies with the police chief (quickly denied by the police chief,) the condo cost ($9,500 per month) and its reported amenities such as hot tub and private garden, and it’s altogether too much for any political roundtable to resist.

But the evening opened with good news. Salesforce founder/CEO Marc Benioff, the panelists say, is making news with his 1/1/1 integrated philanthropic model. One of the founding principles of Salesforce, the idea is to give 1 percent of profits, I percent of equity and 1 percent of employee hours to charity. For months, Benioff has been working to bring other tech firms into the plan, and it’s working. Often at odds with their new San Francisco community, tech firms and their employees are increasingly giving their time, talents and money back to help the less fortunate. And who knows? The bad will generated by the likes of uber-rich Uber folks could be outweighed by the goodwill of 1/1/1 programs.

Closer to home, or at least to the heart of this non-techie writer, my friend Tara Culp-Ressler over at ThinkProgress.org posted a similar good news/bad news piece about the year of reproductive justice: “Six victories for reproductive freedom you may not have realized happened this year.” At the end of a year crammed full of legislative assaults on women, with newly-empowered anti-abortion lawmakers vowing to take us back to the dark ages – here is good news worth noting.

And all tiny tidings of joy are welcome.

Andrew Young on peace, justice, and assorted other issues

andrew young

Andrew Young wants you not to worry. Despite humankind’s failure to solve the problems of poverty, racism and inequality, and the smaller issues that cause us to despair, Young tells his listeners that a benevolent creator has everything under control. He offers this assurance in the biblical words of his grandmother …. “Don’t be anxious about tomorrow… Consider the lilies of the field; they toil not…” and after a few more verses that roll easily off his tongue he adds with a beatific smile, “You don’t have to be a believer to know that sounds good.”

Young was in San Francisco recently, drumming up support for world peace, justice, compassion and his Andrew Young Foundation. In an informal – “You don’t mind if I just sit in this comfortable chair instead of standing at the podium?” – talk at the Commonwealth Club, his remarks ranged from theories on how to make the world work to why prisons don’t.

Just a few of those random thoughts include the following:

Re dealing with the bad and the angry: “Don’t get mad, get smart.”

Re getting smart – one of the first things Young did after being elected Mayor of Atlanta in 1981 was to increase the percentages of blacks and women in the police department, in order to insure that it reflected the population of the city. A story about how well that worked in one instance delighted his 2014 audience:

Anticipating two or three thousand people for a Ray Charles concert in Piedmont Park, the city sent a contingent of a dozen police officers to look after the crowd – but the crowd turned out to be over 100,000. “Ray Charles said he wasn’t going out there,” Young recalled. “He said, ‘I’m blind, but I can see there’s people pushing against the stage and I ain’t going out there.’ And we had a dozen police officers to handle 100,000 people.” Enter one of the police contingent, “a tiny little woman named Sadie.” Sadie mounted the stage, blew her whistle, got the crowd’s attention and told them they were going to play a game. “You all know about Simon Says? Well, this is Sadie Says.” When she blew her whistle, she explained, everybody on the front row was to turn around and face the opposite direction. When she blew it again, everybody on the next row was to turn around… and so on. By the time Sadie finished blowing her whistle, the entire crowd was facing away from the stage. “Now,” she said, “everybody take ten steps forward.” The crowd surge was ended, the concert went on as planned.

FullSizeRender (2)Re prisons: “You go to prison for taking money from an ATM; you come out knowing how to take the ATM.”

Re global peace and prosperity: There are “ways to make the world work,” Young believes. Because food and jobs are two of the keys, his foundation is pushing programs to make protein from duckweed in the south. Small farmers could be back in business, the hungry could be fed.

Young is almost as enthusiastically pro-duckweed as he is anti-Halliburton. “We don’t need to be fighting ISIS,” he says; “that’s Halliburton’s war. You want to go after people for not paying taxes? Go after Halliburton.” And as to those wars, “One of the things we should know by now is that there is no military solution.”

How can we find lasting solutions to issues like poverty and war? Young says, “I don’t know how to do it – but our kids will know how to do it. I was in a restaurant where a two-year-old had his iPad out and said, ‘Mom! They don’t have wi-fi here!’ — but a few minutes later he said, ‘That’s okay Mom, I fixed it.’” Young urges audiences of all ages to work for peace and justice, acknowledging both the enormity of the tasks and the potential for success. And in the end, he says, “We just have to believe we’ve done the best we could.” You don’t have to be an Andrew Young believer to know that sounds good.

Sacramento Mayor Kevin Johnson, host of the recent event, asked Young which of his titles he preferred: Mayor, Congressman, husband, father, CEO, Ambassador…? The reply came with another quick smile.

“Andy.”

Immigration Then and Now: Three families, three stories

PRELUDE: A contemporary story -

Maluki had what she thought was a minor infection in her chest. She took a couple of pain relief tablets. She is undocumented and uninsured. She had no access to a community clinic where she might have seen a doctor with no questions asked; no one in her suburban family had heard that such things exist. Within a few weeks Maluki was doubled over with pain and was rushed by a neighbor to an emergency room at a major public hospital two hours away.

Two surgeries later the 38-year-old mother of three will be out of work for a very long time. Her husband, partly disabled, works irregular hours when he can, leaving the family dependent on what money the teenaged children – all U.S. citizens – can bring in. The children still hope somehow to finish high school and attend college.

What’s wrong with this picture?

Almost everything, if you asked the five California experts on a recent Commonwealth Club panel in San Francisco. “Undocumented and Uninsured” brought together two heads of clinics where treatment is available to all and two others with unique insight and perspectives. Moderated by Daniel Weintraub, Editor in Chief and Project Director, California Health Report, the panel included John Gressman, President and CEO, San Francisco Community Clinic Consortium and Scott Hauge, President of CAL Insurance & Associates Inc and Co-Founder and Vice Chairman, Clinic by the Bay; Laurel Lucia, Associate Policy Specialist, UC Berkeley Center for Labor Research and Education; and Jirayut New Latthivongskorn, Co-Founder of Pre-Health Dreamers. They were looking at how the Affordable Care Act will impact immigrants unable to get health insurance, and what the healthcare future might hold for them.

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There are, by one estimate, 11.7 million undocumented immigrants in the U.S. Some have health coverage through their jobs, and a few have private coverage; but the vast majority of these are uninsured. The resulting costs, in human terms such as the case above, are inestimable; the costs in dollars are also significant. “If we get the patient into basic care for colds and flu,” said Gressman, “we save thousands in hospital care.” In California, care is widely available through publicly funded community clinics as well as nonprofits – the problem is in getting the word out and building trust. “We look at how to get the patient to care,” Hauge said, “not at anyone’s immigration status.”

While Gressman, Hauge and Lucia each brought extensive understanding of both the policy and the real-world details affecting healthcare needs of undocumented immigrants, it is the personal stories of Lucia and Latthivongskorn that illuminate the remarkable richness of our immigrant nation.

Nearly a century before she was invited to bring her expert knowledge to a Commonwealth Club panel, Laurel Lucia’s great-grandfather was a frequent speaker at the Commonwealth Club himself. Felipe N. Puente was memorialized in the Club’s Journal upon his death in January, 1951. He was, his obituary reads, “by far the most important personal tie between Northern Californians and the Republic of Mexico for nearly a quarter of a century.

“Commencing as a colorful revolutionary Mexican leader in 1917 (as Jefe de Transportacion for the late Revolutionary General Francisco Villa), he had for 25 years been a resident of San Francisco, with five children in our public schools, and the long-time Manager of the Mexican National Railways, San Francisco division, in the Monadnock Building.

“Although a railroadman by profession, his expert and sagacious advice was freely at the service of American travelers by sea, highway or air, and a letter from ‘el Puente de San Francisco’ (the San Francisco Bridge) as he was affectionately known clear down to the border of Guatemala, opened all doors in Mexico.” Great-grandfather Puente’s expertise reached beyond transportation to government affairs. In a Commonwealth Club speech broadcast over KYA Radio in 1942 he spoke of the importance of Mexican-American cooperation in the war efforts, citing cargo lanes and Mexican ores that were critical to the U.S. and quoting President Avila Camacho as saying, “Mexican soldiers are willing to shed their blood anywhere in the world where they may be needed.” His Journal obituary began and ended, “Adios, Amigo Felipe N.Puente!”

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Lucia missed out on knowing her notable ancestor, “but I was quite close to his daughter, my grandmother.” She had not, she says, ever made any connection between his immigrant status and her current work – as a Policy Analyst for the UC Berkeley Labor Center – which partly seeks to strengthen the safety net for those more recently arriving on our shores.

 

Laurel Lucia with Moderator Weintraub

As for the other young person on the “Undocumented and Uninsured” panel, Jiryat New Latthivongskorn (hereafter identified by his familiar name, New) confesses to having been a little startled to hear himself constantly referred to during the evening as “the first undocumented student to be admitted to UCSF (the University of California San Francisco) Medical School.” But that is, in fact, part of his current resume, and a not insignificant achievement.

There were 7,453 applicants to UCSF Medical School for New’s class, out of which pool 490 were interviewed and 149 were accepted. The overall grade point average was 3.77.

New Latthivongskorn came to this country with his parents when he was 9 years old. His parents worked in Thai restaurants every night until 11:00. But whenever he tried to help, he said in an interview on KQED Radio last May, “the answer never changed. ‘Don’t worry, and do your job.’ My job was to get an education.” So far, he appears to have done his job quite well. New never considered the idea of being a doctor until one scary incident during his junior year in high school when his mother fell gravely ill and had to be taken to the emergency room. The family had, until that time, relied on a medicine cabinet full of remedies for colds and pain and a few old antibiotics from Thailand. But in the ER, when his mother couldn’t understand the doctors and they couldn’t understand her, New realized his job might be more than just a translator.

There are those, including a few who commented on the KQED program, who argue that anyone who is in this country illegally should simply be sent back to wherever he or she came from and until then should receive no benefits – and certainly no healthcare. That may, however, be an overly simplistic – not to mention cruel and unusual – answer to a very complex issue.

“Immigrants don’t come here,” New told the Commonwealth Club audience, “for free healthcare. They come here to escape danger or terrible conditions; they come here to work.” In short, to create a better life for themselves and their families, and ultimately to give back to the communities of their new world. That was definitely true for immigrant Puente a century ago, and is demonstrated by the hard-working parents of doctor-to-be New.

Other than the Native Americans who pre-date most of us, it would be hard to find many U.S. citizens whose ancestors didn’t have similar stories.

 

 

On being grateful – for rain & waterfronts

bridge in rain

(This essay also appears on Huffington Post)

“It’s not happiness that makes you grateful,” goes one of my favorite recent quotes (thanks, Joann Lee;) “it’s being grateful that makes you happy.”

Here’s to gratitude.

For one thing, it has been raining in San Francisco. That strange wet stuff that falls occasionally from the sky – but we haven’t seen in a very long time. A planned Commonwealth Club Waterfront Walk tour, which I had earlier volunteered to help host, was advertised “Rain or Shine;” and as it happened there was both. The rain dampened all streets but no spirits, and the beauty of the waterfront literally shone.

There is something mystic about a waterfront on a dark day: an ethereal quiet hanging just below the clouds, the call of a gull who could be from another world, the scent of newness.

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The waterfront in sunshine is brilliant and exciting; in rain it invites your imagination – and appreciation.

As with waterfronts everywhere, San Francisco’s is steeped in history: sailors and conquerors, longshoremen and adventurers. There is public art, and private beauty. Waterfront Walk guide extraordinaire Rick Evans covers a remarkable range of them in two hours:

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The rise and – literal – fall of Rincon Hill, once one of San Francisco’s famous seven, which overlooked the Bay until the city unwisely bulldozed a street through it in the 19th century and the sandy hill collapsed upon itself. (Earthquake and fire finished the job.) Today Rincon Hill is rising again, as gleaming steel towers. The buildings that survived earthquake and fire are other centerpieces of the walk, plus the monumental artwork on the waterfront that was a trade-off for Gap tycoon Don Fisher’s corporate headquarters building when it went up – insurance of unobstructed, breathtaking views.

Some of the beauty of many waterfronts, physical and informational, is manmade, as is true of this piece of San Francisco Bay. But every waterfront has its story, and its soul.

Rain or shine. A cause for exquisite gratitude.

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