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Family and Friends/General interest/Lifestyle/Politicians/San Francisco/Sports

April 16, 2015

Sailing as Metaphor

Life. Play it safe – or risk everything? Avoid conflict or seize the day?

At the end of a long-anticipated visit from across the country, this writer’s family – west coast grandmother, east coast son and daughter-in-law, granddaughters 11 and 13 – was invited to go sailing on San Francisco Bay with a close friend who owns (and carefully operates) a 36-foot sailboat. After showing us around – it sleeps seven, with almost all the comforts of home – our captain delivered a safety lecture, explaining things like where the life jackets are, and the way the boom can swing quite suddenly and one is advised to stay out of its way. He went into some detail about what to do if he fell overboard: a safety device attached to the stern contains rope and flotation collar, so all that’s required is to keep circling until the man overboard can grab the line. He then issued life jackets to the girls and offered them (this boat has life jackets for about a dozen) to the grownups. I declined, knowing full well that I would last about five minutes max in the chilly waters of the Bay; go figure.

For the next several hours we had a glorious sail, under the Bay Bridge, around the back of Alcatraz, nearing Angel Island, swinging parallel to the Golden Gate and heading back to meander homeward along the city’s edge. Picnicking in the sunshine and taking advantage of spectacular photo ops. I had one scary moment on the turnaround; it’s been a long time since I last sailed. Almost home we were stopped by the bay patrol and told not to sail back below the bridge for 10 minutes or so. Once we were cleared they explained to boats waiting on either side that Vice President Biden had been driving across the bridge. All in all it was a glorious day. In looking back, though, it’s hard to miss the basic messages:

1) Let the kids explore the universe, but keep the life jackets on.

2) White caps and turbulence make things interesting, and are seldom fatal.

3) The vessel with more power is supposed to get out of the way.

4) You can circle around someone who’s sinking, but he has to grab the lifeline himself.

5) On the other hand, when the sinker is you, be grateful for those circling around.

6) When you think the world’s going to keel over, there is ballast that brings it back to steady.

7) Sometimes the vessel with more power claims the right-of-way. Chill.

8) Wear sunscreen, and bring extra layers.

9) Don’t miss the scenery while you’re looking at your camera phone.

10) Life’s a breeze.

California/caregiving/compassion and choices/Death and Dying/End-of-Life/Healthcare/Lifestyle/Medicine

March 9, 2015October 7, 2021

Dying in the Fix-It Society

by Fran Johns

Buddhist teacher/lecturer Frank Ostaseski spoke recently to the Bay Area Network of End-of-Life Care on the subject of compassion – something Ostaseski preaches, teaches and practices himself. Co-founder, in 1987, of the Zen Hospice Project, the first Buddhist hospice in the U.S., Ostaseski currently heads the Metta Institute, created to provide education and training on spirituality in dying.

Buddhism, Ostaseski said, holds that life is supported by two wings, compassion and wisdom, and neither is at its best without the other. His audience, made up of physicians, hospice workers and others involved with end-of-life care, was in interested agreement with the renowned speaker as he expanded on the theme. But this writer, also in agreement, found one side remark particularly pertinent to today’s end-of-life issues.

Ostaseski spoke of a severe heart attack he suffered not long ago, and of the wisdom gained from that experience. It was insight on critical illness “from the other side of the sheets.” During his hospitalization most visitors, even longtime friends with credentials in compassion, said the wrong things. “They were always saying, ‘It’ll be better tomorrow, Frank,’ when I wanted to talk about what was going on that very moment.” Additionally, Ostaseski found that nurses and doctors “interacted with monitors far more than with the patient.” What could well have been an end-of-life situation was, in short, lacking in compassion and wisdom both.

“Hospitals are fix-it places,” Ostaseski remarked.

We may have gotten fixated on being a fix-it society. Whatever the problem, a chemical or technological answer, in the fix-it society, is instantly sought. We fix brain injuries, once-fatal diseases, missing limbs, and more. But can we let someone who is terminally ill quietly die? Seldom. More often than not we keep trying to fix her with extended interventions, futile and expensive treatments or hospital stays that make dying a horror.

Ostaseski and others are working hard to help people find meaning in their final days, focusing on palliative care. Some, including this writer, are working hard to make medical aid in dying a legal option available across the U.S. ALL of us want a peaceful and compassionate death.

The_flame_of_wisdom — The flame of wisdom

The personal bottom line, yours and mine, is this: eventually we die. If the focus can be shifted away from constantly trying to extend our days, we can fix the final days that lead, one way or another, to the mysterious, inevitable, unpredictable, un-fixable but quite natural end. All it takes is a little compassion, and a lot of wisdom.

Health/Lifestyle

March 2, 2015

Walk, Text, Crash: the Orwellian future

by Fran Johns

The man coming toward me in the park, maybe 500 yards up the path, was walking a large, mixed-breed black-and-white dog. He (the man, that is) was bearded and graying, nattily dressed in black pants, a red plaid sports shirt and gray sweater.

Just ahead of me, walking in the same direction as I, was a younger man dressed in sweat pants and jacket and holding the end of a leash attached to a tan Labrador retriever.

Both men were totally absorbed in texting.

It was a slow-motion episode exquisitely orchestrated for a YouTube video, if only I had been quick enough with my cellphone; as it was, I could only watch, fascinated and wordless. They collided at full speed, one cellphone clattering onto the asphalt and one leash dropped. But there were no apparent casualties. The dogs, at least, had sense enough to have steered themselves safely onto the grass where they were sniffing each other with unconcerned abandon. I smiled politely and kept going.

The episode underlined the hazards of texting while walking, which can surely be as dangerous as texting while doing almost anything else. Almost: there are no available statistics on the adverse effects of texting while having sex, which seems popular in some demographics.

Not long ago, New York Times columnist Nick Bilton wrote a piece in which he shared a New Year’s resolution to quit texting while walking.

“The realization that I may have a problem (along with a lot of other people),” Bilton wrote, “hit me smack in the face, literally, a few weeks ago when I was strolling through Kennedy International Airport, avoiding obstacles with my peripheral vision as I clambered out a text message. Without any warning (as I couldn’t actually see), I was involved in a head-on collision with another man who was also texting while walking.”

Most walking-zombie texters do survive, as Bilton did, with only bruised egos or minimal damage, but that’s not always the case. An Ohio State University study links “distracted walking” to the dramatic increase in pedestrian injuries and deaths.

Equally dismal, for the future of the planet, is how texting while walking may alter human interaction, whether texters live or die with their devices. One report, an interview with Dietrich Jehle, professor of emergency medicine at the University of Buffalo, suggests an Orwellian solution to texting/walking hazards: a cellphone app that shows the landscape ahead, so that texters can text interminably, and see where they’re going without ever looking up.

Is there life beyond a 2 ½ x 5 inch screen?

Holidays/Lifestyle/Religion

February 16, 2015

Lunar New Year: Hedging One’s Bets

by Fran Johns

The Lunar New Year, Year of the Goat/Sheep/Ram, is at hand. In honor of the occasion my acupuncturist — this traditionalist writer is an absolute convert to acupuncture – offered a special gift, in the form of instructions about how to start the year in the most auspicious way.

A good start is halfway to success, according to an old Chinese proverb quoted atop the instruction sheet.

“Both the timing and direction of your initial exit from wherever you are on February 19^th, 2015 are of utmost importance,” reads the instruction sheet. We are admonished to make our initial exit between 5 AM and 7 AM, or between 11 AM and 1 PM. “To welcome good luck, walk in the South West direction. To invite divine help and wealth-spirit, walk in the West direction. Please do not have initial exit facing the South direction…”

Well, here’s the problem. The only exit from the building in which I live faces south. Walking in a southwest, direction, furthermore, will take me straight into the Post Street traffic, not a good way to start any year. I’m unlikely to get moving early enough to be headed out by 7 AM, and if I wait until 11 there will be meetings missed.

None of this is to disrespect the Lunar New Year.

Depending on which part of the Lunar-calendar-observant world you live in, festivals, rites and customs (such as the above) abound. My current favorite, passed along by a State Department friend newly arrived in Hanoi, is this one: “Vietnamese tradition,” she writes, “holds that, a week before the Lunar New Year, each person should release a live carp into the lake. The Kitchen God then rides the carp to Heaven, and reports to the King of Heaven about whether the people in that person’s family have been ‘naughty or nice.’ The King of Heaven either rewards or punishes the family, based on the Kitchen God’s yearly report.” The tradition strikes my diplomat-wife friend as “A little bit eastern, a little bit Christmas-y and a little bit smelly.” But definitely good for anyone fishing for carp – and unworried about pulling in one with a Kitchen God riding on its back.

Like the eastern mysteries of exit times and feng shui, western religions have plenty of their own.

Soon after studying the instructions about starting the Year of the Goat, I went to a Sunday morning Presbyterian church service about the transfiguration of Jesus. (Transfiguration comes right before Lent, if you’re following these lines of thought.) For serious-but-still-questioning Christians such as this writer, the transfiguration ranks right up there with the resurrection and the ascension. Disputed and discussed from every corner of Christendom (certainly including poor, avowedly neutral Wikipedia), these are central to the faith – and you want to believe, because the faith has such good, basic stuff about how to live in the world – but still. Most Christian beliefs require little more than loving justice, mercy and one’s fellow creatures and working to advance them all. But around holidays we do get pretty zany about Santa and the Easter Bunny; so stockings are hung and eggs are hidden — just in case.

Which brings the story back to personal behavior up to and on February 19. This sideline observer will pass on the carp thing, but my New Year’s Day plan is to exit the building sideways, facing west.

California/Campaigns/compassion and choices/Death and Dying/Dying Unafraid/End-of-Life/Healthcare/Law/Lifestyle/physicians/Politics & Causes/Religion/seniors

January 18, 2015October 7, 2021

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

by Fran Johns

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?

California/General interest/Lifestyle/San Francisco/seniors/Sports

January 13, 2015

When Fences Come Down

by Fran Johns

“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.

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.

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?

Abortion/courts/General interest/Health/Healthcare/Lifestyle/Medicine/Politics & Causes/Women

January 12, 2015

“Personhood” by any other name

by Fran Johns

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.

Education/General interest/Holidays/Lifestyle

January 3, 2015March 4, 2015

Your Life In Review

by Fran Johns

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.

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