soul | the greasy pancake theory

Question: How do you get over someone or something that feels like it breaks you? (lover? job?)

An answer:

I find myself repeating this theory/advice over and over to other people, so I figured it deserves a place on the blog (plus I finally told Cha I was going to do it and she approved).

It's her theory and it's called The Greasy Pancake Theory.
Stay with me, because I promise it's good - like extra butter, extra syrup good.

The theory goes that when you end something BIG, like a relationship or a job, that has really defined a lot of your growth and experiences, you can't just rush into the next BIG thing - like another serious relationship or career. It's like when you wake up on a Sunday morning and decide to make a whole batch of pancakes. You get your big bowl of batter all ready, you turn on the stove, and you throw on a little bit of oil to grease the pan. Then you put batter in for one pancake which ends up soaking up more than half of the oil you put in making it pretty unappealing (or pretty appealing, depending on your pancake style), but as you push it around, it starts to spread the oil evenly around the pan, and when you finally take it out and flip the whole greasy, soggy thing onto a plate - or feed it to your dog - the pan is ready for all the other pancakes. The rest of the pancakes now have the potential to be perfectly unsticky and golden brown because the greasy pancake prepped the pan.

So now you may be wondering - what in my life is a greasy pancake?

It's that first, kinda dirty hook-up you have after ending a serious relationship, with someone who you're not interested in dating, but helps to (figuratively...) soak up the excess butter so when you do meet someone you're really into, you don't have all that extra grease and craziness left over from the last relationship.

Same thing with a job - it's that summer you spend waitress-ing instead of rushing into the next job that's just like your last job. This way you have some time to think about what you want, to reflect on what you had, so that when you start your new job you don't bring with you all the grease and routines from your last job and have a fresh new start.

But the most important part of the greasy pancake is that it's not permanent and does not have to be incorporated into your pattern - so embrace it in all its greasy, buttery goodness, but then keep making more...

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"there are hundreds of ways to kneel and kiss the ground"
-Rumi

Successful Psychopaths V. Criminals

After a crazy summer I've decided to restart the blog!

I went to a fascinating lecture this morning on treating personality disorders with cognitive therapy (CT). This spurred three questions:

Questions: What is a personality disorder? What is Cognitive Behavioral Therapy? How will knowledge of both these topics give us insight into ourselves and our own coping mechanisms?

Some version of an answer:

Personality Disorders:
A personality disorder is basically when a normal coping mechanism - such as being wary of dangerous situations, paying attention to details, or feeling able to accept help - extended to situations in which it becomes problematic or even dangerous. Some examples include paranoia, dependency, passive-aggressiveness, and obsessive-compulsive personality disorder (not OCD). The American Psychiatric Association (APA) defines a personality disorder as "an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it".

What's striking about these disorders is that they're so relateable because these behaviors are effective in certain contexts. For example, paranoia can make you safer if you're walking alone at night, obsessive-compulsiveness can be productive when you're packing for a long trip, dependency is positive when you're sick and need to accept care. However, they become a disorder when they're projected into other parts of one's life inappropriately - like getting paranoid at the grocery store or becoming so dependent on a partner that you can't let them out of your sight.

One study surveying executives and criminals in Great Britain (reference: Board, B.J. & Fritzon, Katarina, F. (2005). Disordered personalities at work. Psychology, Crime and Law, 11, 17-32) found that some personality disorders were actually more common among the executives than the criminals. They refer to this as the difference between successful and unsucessful psychopaths. Taken with the cultural component of the APA definition, it speaks to "the importance of social norms in our definition of functioning - and adds to the discussion of interpretation of illness in different cultures (The Sprit Catches You and You Fall Down -style: how epilepsy is a divine gift or a disease depending on which cultural lens).

Cognitive Therapy:
The more I learn about cognitive behavioral therapy or CBT (of which cognitive therapy is a specific type), the more I think everyone should be engaging in at least some of the strategies. One of the clinicians with whom I work says that the real goal of CBT is to train someone to be their own therapist - or more specifically, to ask themselves the "Why am I thinking this?" and "What are the factors affecting this decision/action/response" as it's occurring, instead of only at therapy appointments.

CBT is based on a theory of dividing thoughts into three categories:
Core Beliefs: general beliefs about yourself, the world, and other people (e.g. I am compentant)
Assumptions: the ways in which you apply this to the world around you (e.g. I will do a good job)
Automatic Thoughts: in response to specific situations (e.g. I will do a good job on this paper).

Judith Beck, PhD, the speaker, said that when people have negative core beliefs it's usually because they feel at least one of three things: incompentent/ineffective, worthless/unvaluable, or unloved. Addressing why someone feels these things is not the point of CBT, rather the aim is to revamp ones responses/actions so that they prove these core beliefs wrong.

The speaker's father, Aaron Beck, MD created the most commonly accepted psychological theory of depression which is that people who are depressed feel depressed because their thinking is biased towards negative interpretations. Therefore, all of his theory of CT is focused on adjusting these interpretations to make them 1) more accurate and 2) more positive by evaluating what core beliefs and assumptions are going into them.

I keep trying to challenge myself and my friends to think about the assumptions and core beliefs we're working with as we make all these challenging decisions about navigating through "real life" - are we worried about feeling unloved? are we making sure we're not avoiding because we're worried about feeling ineffective? do we know how valuable we are?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"yet the terrible truth was that the girl who broke your heart would always have more power than you liked" -charles baxter (I'm pretty sure), feast of love

stay hungry, stay foolish

Question: What's the best graduation speech you have heard or read?

The best answer was from a friend:

In a commencement speech at Stanford a few years ago, Steve Jobs gave a brilliant speech where he calls upon the graduating class to forge their own lives and not to live within the boundaries of other people's thinking (or what you think is other people's thinking). He reminds us to listen to our inner voice and intuition - or, as my mother would say, to your heart's longings, wherever they take you.

This seems to come up with each set of new graduates - as if we're shocked every year that we're creating a society were inner voices are drowned out, as shown in a recent NYT article on new graduates. It questions whether colleges have become simply a selection mechanism for Wall Street and other elite professions that do nothing to change the system. How do we inspire people to change the world? When Obama spoke at my alma mater (ooh, that feels weird to say) he called it a "poverty of ambition" - this lack of momentum towards service after college. I'm not sure it's that we aren't inspired - I think we're very inspired. We're just broke, and scared of forever being broke. Scared that we'll never really be adults because even things like gas and rice are out of our price range.

So I think the question then becomes: how do we, as a society, as a world community support world-changing? how can we encourage it?

stay tuned for ideas as I ask all the brilliant people around me...

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Stay hungry, stay foolish"
-Steve Jobs (advice to graduates, and everyone)

Rumors of the Death of Feminism

Question: Is feminism over?

the short answer is no. The long answer is more like a conversation (as perhaps all answers should be):

The headlines all over the place as Hilary dropped out questioned what this means for women, feminism - will the glass ceiling come crashing down again? While I admit I'm saddened that now the articles can say "when the next president...he..." I don't think it's by any means the end. Reading a NYT article by Kate Zernike a few weeks before Clinton ceded the nomination clarifying what the next woman who runs for president has to think about and the qualifications she must have. The one that caught my attention - besides the fact that Zernike doesn't think the next candidate exists - is that "She will be young enough to qualify as post-feminist (in the way Senator Barack Obama has come off as post-racial)"...

What does this post-feminist woman look like? Someone who would not vote for a woman?

So much about this primary has pitted young, "post-feminist" women against older women who perhaps think we're resting on their hard-fought battles for equality. I'm still not sure how to reconcile these different vantage points into a coherent philosophy, but I do think that feminism is ultimately about choice - about working to create a world in which choices are not limited by gender or sex. But to say that the choices that present themselves or that we have to make aren't influenced by gender or sex is naive. I've discussed the career/family balance with every one of my female friends, plus some random female acquaintances over the past year, and it's come up maybe once with any of my male friends. My ex-boyfriend's mother recommended to me that I look into freezing my eggs, since by the time I finish my residency I'll be almost 30, and then I'll probably want to actually be a doctor. And she has had a career her whole life, with two children, so I know it was out of concern for me trying to have both.

I hope the next female candidate for president is post-feminist, but not complacent or content with the factors that influence women's choices - or, like some of my good friends, actually - feel like "all this anger is for someone else's fight, because we don't feel limited" - but post-feminist in the way that Dhalia Lithwick describes in her recent article in Slate's Feminist Blog, XX: "It's true that far fewer of us have bumped our foreheads on a rigid glass ceiling. But we're not blind to sexism and we don't tolerate it any more than our moms did. We've worked very hard to broaden our definition of feminism to include women of different classes and races and we are proud that the men we date and marry have met us halfway on the little things. We don't think our choices are frivolous. We think they are complicated."

complicated, indeed.

i dare MYSELF to jump in

Question: What is the best advice you've received by accident?

I confess in this case, this answer came to me before the question, though I like hte idea of accidental advice. While relaxing by the pool yesterday (yes, somehow, in the middle of downtown this happened - and was glorious) I kept dozing in and out of sleep, which makes for some very interesting dream/thoughts. We were next to the children's end of the pool and there was this group of kids who were taunting each other to see who could be more brave in the water. So one kid said, "I dare Rose to jump in and spin around. twice." in a sort of smirky voice. Another said "I dare Michael to jump in the FIVE FEET." And then a slightly younger voice, in what sounded like both an attempt to push himself into inclusion in the game and give him the guts to actually play, said, "I dare myself to jump in!" and jumped.

It made me think about the ways in which we, especially in our 20s, dare ourselves to jump in all the time - a friend of mine just jumped into starting a non-profit in NYC after she had planned on moving to DC to work on capitol hill; other friends are jumping into relationships - or taking next steps of relationships that they never would have thought they would do in the near future. Even last night, just diving into a conversation with someone it may have taken much longer to talk to - because why not?

At some critical point, whatever research, planning, maneuvering goes into making decisions or connections - at some point you have to dare yourself to jump in.

and then I guess you have to just hope you hit water.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"It wasn't scheming or wickedness that made people unhappy, it was confusion and misunderstandings; above all it was the failure to grasp the simple truth that other people are as real as you" - Ian McEwan, Atonement

in praise of the man who asks questions

Question: What book have you read recently that has given you insight into the ways people interact with one another?

My answer: I recently read Free Food for Millionaires after seeing Min Jin Lee (the author) speak - and while it wasn't life changing, I found the novel to be absolutely compelling because it's a wonderfully written account of several very different people's voyage through "the odyssey years". When I heard her speak, she explained that it is a book about grace - or rather, the attempt to navigate these crazy years gracefully.

The part I find myself recounting to others is actually about a relatively minor character, an investment banker who is a super smooth, handsome, wealthy guy and quickly identified as the guy who sleeps with everyone (in a totally attractive way, obviously). What's fascinating is that it's not his looks or even his charm that makes him so good at seducing the world, but that he understands how important attention is to a woman. How little things, like watching a woman completely as she walks away, on the off-chance that she turns around and notices - make all the difference.

If I were to give one general seduction tip (and this has been confirmed by many) it would be this: ask lots of questions... and then actually pay attention to the answers.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Love is the irresistible desire to be irresistibly desired"
-Robert Frost

the sick elephant in the debate room

Question: Why is universal health care still in not being talked about in the health care reform debate?

The answer: the many people invested in our current system continuing who know how to lobby hard.

Recently there's been some movement to try to push towards it without getting too aggressive:

The Securities and Exchange Commission - in a somewhat surprise move - has decided to allow shareholders to vote on a proposal for universal health coverage. According to an article in the NYT this morning, the proposal "asks companies to adopt 'principles for comprehensive health care reform' like those devised by the Institute of Medicine".

The American Medical Association - a group that has in the past taken a perhaps surprisingly nonsupporting stance on the issue - has asked American medical schools to increase enrollment this year, in an effort to address the looming (and very real) possibility of not having enough physicians if everyone does gain access to health care. Dr. Joseph Martin, in a Boston Globe article this morning discusses that this is particularly true of primary care physicians. This has certainly been the case in Massachusetts as the state version of universal health care went into effect this year - with politicians and taxpayers alike upset about the state under-budgeting for the implementation of the reform.

The implementation of a universal health care plan will not be easy, it will not be cheap, and it will not be a seamless transition however slow we try to do it. But that begs the question: if we aren't willing to go through reforming health care, what band-aid "solution" are we settling for?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~``
A great quote from Dr. Ian Furst (an oral and maxofacial surgeon in Canada, who writes on: http://www.waittimes.blogspot.com) : "It’s all well and good to make the argument that paying for the small stuff will save us money on the big stuff. But there will be a period (20 years) where we have to pay for both. Are you prepared to make a 20 year gamble that it will pay off in the end? Is there an economist somewhere that has actually run the models to prove that it’s true? Also, the major burden on health care is not from lack of drugs but lifestyle choices and old age. In an ideal world I think that acute and chronic problems should be covered but I don’t want to give up my ability to have my cancer or heart attack treated. Unless everyone is willing to pay during the transition it’s not going to happen"

farmers markets, organic foods, % of paycheck, oh my!

It's that time again -when the farmers markets start to open up all over the nation with cheap, delicious fruits and veggies, bread and honey, and of course, wine and beer.

Question: What are your priorities? - local? healthy? cheap? organic?

1) organic food costs more, but might be better for you - how to maximize
NYT Strategic Spending Guide (what to buy organic)
Big Business, Organically

http://www.ewg.org/

2) how to eat local?
Local Harvest inc. family farms, local organic, etc
Food Routes: inc. how to Buy Local or other sustainable options that can be ordered online
The Food Project: local food in Massachusetts

(photo from: http://www.richardahouser.com/)

3) how to make it affordable
compare prices - some things will be cheaper in certain places (like tomatoes at any farmers market in the northeast throughout the whole summer) or worth the extra cost (milk, for example). I think ultimately, each person has to figure out what works for her/him. I'm definitely open to suggestions or stories for this answer.

~~~~~~~~~~~~~~~~~~
For more information, check out
The Omnivore's Dilemma - warning: you may never eat corn again.
Animal, Vegetable, Miracle - one family's experience with trying to eat locally for a whole year

The Role of the Poet

Because the quote doesn't really fit - in a separate post:

"The poet's role has changed over the centuries, the ages. The poets, the griots, used to be the keepers of the facts; they were the story tellers, and the stories were allegorically written truths: where we came from, how we migrated over this river, got with this tribe, became this nation, and tamed the mountains. It changed from that to being purely entertainment. And once it became purely entertainment, it lost something." -Malik Yusef in Word on the Street

Morning After Pill for HIV?

It may be possible - according to a recently published article on HIV in the NEJM about the success of post-exposure prophylaxis for HIV. This means that you a take a pill (or a regimen of pills) very soon after possible exposure to the virus and it actually prevents the virus from invading your healthy cells. It's approved by the FDA for this purpose, standard procedure if a health worker is exposed while handling blood infected with HIV/AIDS and even covered by many insurance plans. Sounds like it should be as standard a procedure as putting your arm in a cast quickly after it's broken - so what's the catch?

*It's only available in San Francisco.
*It costs over $1,000/month without insurance.
*The CDC is really not into it (thinking it may actually encourage more risky behavior) so there's no federal funding for it right now.

For more information see this article in Mother Jones.

the spiritual dimension of life

In honor of the recent death of Albert Hofmann, the chemist who discovered LSD (btw, he was 102 - even with all that tripping...), I've been thinking a lot about the spiritual dimension and what we go through in our search for "deeper meaning" - or as J. put it this weekend, the aesthetic truths (as opposed to the functional truths that we search for as scientists or journalists, etc)

From a NYT article on Neural Buddhists today discusses how science, especially neuroscience, is changing its view towards deeper meaning - "Over the past several years, the momentum has shifted away from hard-core materialism. The brain seems less like a cold machine. It does not operate like a computer. Instead, meaning, belief and consciousness seem to emerge mysteriously from idiosyncratic networks of neural firings. Those squishy things called emotions play a gigantic role in all forms of thinking. Love is vital to brain development.
...The mind seems to have the ability to transcend itself and merge with a larger presence that feels more real."

This concept of "feeling more real" is intriguing to me - because I think those are the moments we crave, perhaps not all the time, but most nights I feel like that's the search is for. But as R. pointed out - you can't actually search for it, or you'll miss it. The aesthetic truths can't be pursued - we just have to slowly figure them out as we go...

~~~~~~~~~~~~~~~
Even though he tripped on LSD a lot, Albert Hofman found spiritual transcendence in other parts of his life as well. His advice to would-be trippers? “Go to the meadow, go to the garden, go to the woods. Open your eyes!”
(what a perfect quote for the beginning of summer)

the value of a smile (hear this, new england)

I was running along the river this weekend. If you do as often as I do, you know that you end up seeing a lot of the same people and because on this particular river almost everyone runs a loop - even though you can run over 10 miles on each side without crossing or turning around, almost everyone runs some type of loop because 1) loops are more fun than out and backs because you see more even though it's all the same river and 2) bridges are neat.

but the loop means that instead of seeing Familiar People once, I usually see them twice. Which was nice on Saturday, because there was this Pretty Good-Looking Guy who had a nice stride (I always check out people's strides) and smiled all happy-like (unfortunately not flirtatious-like, but that could have been because I was a sweaty fool) at me - Twice. Which is a big deal because in the northeast, runners are not so friendly and a smile at a young, albeit sweaty, woman, is more rare than you'd think. So after I passed the Pretty Good-Looking Guy the second time, I'm smiling all happy-like. Ahead of me, walking the other direction listening to his old school Walkman is a slightly tattered Old Man. And because I'm feeling so happy, I smile briefly at the Old Man as I run by, thinking very little of it.

But a few strides later, I hear him yell back at me (yell in a kind, not aggressive, way) "thanks for the smile; that was very nice". I regret that I didn't turn, I just gave him a behind-my-head thumbs up and kept going the other way.

But it just goes to show that a smile goes a long way. Note to the northeast: It is okay to smile. It doesn't mean you're flirting or hitting on anyone. It just means it's a nice day and you're a nice person. Try it, please? For the Old Man.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"the eyes are the window to the soul"
-I forget who really said it, but I heard it from my 10th grade English teacher - who was FABULOUS.

dividing up your passions... productive?

a friend said to me the other day that your passions/interests can be invited into 3 major categories:

1) ideas/issues you like to read about/know about/be able to talk about - but not necessarily be involved in
2) ideas/issues you want to be involved with in some capacity; on weekends, as something with which you complement your main interests; you wouldn't necessarily claim to be an expert at these or have them define you, but you enjoy and are fascinated by them
3) ideas/issues that become your main interest, that you create a career around, that you spend most of your "purpose time" pursuing; that you have to because they fascinate you more than anything else - the things that make you feel fulfilled and accomplished.

I think for me 1) includes post-colonial/diaspora literature, new technology... and 2) includes environmental sustainability, wine, dance... and 3) medicine/health, gender equality, and inter-cultural understanding (in not always a so intellectual-sounding way...)

what are yours? and what helps you decide what to put in each category?

~~~~~~~~~~~~~~~
"You massage the Universe's spine when you twirl
through time leaving shadows on the Sun..."
-Saul Williams (from The Dead Emcee Scrolls...)

health 2.0 and medi-cal cuts

First, a shout out to California doctors. A group of CA doctors is suing the state of CA for making $1.3 million in Medi-Cal budget cuts (effective Jul 1) - stating that the rates do not give beneficiaries the same access to care - because it covers less than half the price of private insurance. Read more about it in this WSJ article.

Second, I keep thinking about discussing health 2.0 - or this new wave of debate about online medical records, because I think it's fascinating. But I just haven't had the time to find legitimate, semi-unbiased resources. Any ideas?

fogo demas (too much fire)

I just finished the brief wondrous life of oscar wao by junot diaz - pick it up from the library from the bookstore whatever. you have to read it. I haven't been so sucked to the core of a novel since I read the power of one (by bryce courtnay and probably my favorite book) for the first time, and that was all sorts of different. or maybe not, come to think of it. more on that later.

I always get crazy thoughts at the end of a great novel and because it's so difficult to share that kind of moment with another person who hasn't just emerged from the soul of that particular novel, many of these thoughts are lost. but I'm curious about these ones and I want to process them more - later. so I wanted to share them with you and let them simmer a bit before thinking through them more.

sometimes, maybe too often, I find myself envying the educated oppressed - I know that's not remotely a politically correct or perhaps even linguistically correct term, and even just writing it out makes me feel like an asshole, but I'm resting on the hope that you understand a bit of what I mean and won't hate me. It's not envy of their suffering or their un-freedoms (as Amartya Sen, the author of Development as Freedom, the other book I'm reading right now, would call them) - but for their anger. Anger that's directed, focused - at those who created the Diaspora, who benefited from slavery (I always wonder if this is my family and then I think it must be, and if it wasn't, it is now); anger at a loss of place, a confusion of identity, at a language that narrates the western world but still can't figure out the words to articulate their past and story to define them now (African-Americans, Black, Latinos, Hispanics, Caribbean-American, Bi-racial?)

In Brazil everyone would talk of having African heritage as having a fire in your soul (literally "fogo d'alma") - and they say it as the cause of all the trouble that Afro-Brazileiros get into in Brazil is because of this fire in their souls (the social forces that provoke it and the racial context of the country's role in creating it aside), but it's also seen as something to be proud of - because as much as its a source of trouble and temper, it's a source of anger and passion -- of a kind that us lame ass white people just cannot comprehend even if we do learn to speak la lingua.

and it was true - and is true - I'm mostly just in awe of such passion, but what's more striking is that when I think about it, I'm more in awe of the anger. because while I've felt passion - serious passion - for serious - I've only felt anything close to that kind of anger once, maybe twice and only for fleeting situations, just a taste of what anger at being wronged feels like.

and while I understand conceptually the unbreakable link between this anger and oppression, my desire to feel the former, to empathize to the point where I can feel the start of a burn - carries me too close to actually feeling like I could accept the latter with it.

Maybe that's part of why I want to be a doctor - or at least a fear of mine about why I want to be a doctor - because a physician is rarely an object of this anger, and is most logically aligned with the oppressed, to the point where she can actually feel the anger because of their oppression. which I know is at least partly problematic, but what I can't sort out is how much.

I'm exhausted and slowly coming back into the world I'm in instead of the world of Junot Diaz and going to try to slip off to sleep before I try to work through these thoughts too much more. But I'd love to hear any thoughts, on this or the book (when/if you read it) or both or neither.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
I don’t want words to sever me from reality.
I don’t want to need them. I want nothing
To reveal feeling but feeling – as in freedom,
Or the knowledge of peace in a realm beyond,
Or the sound of water poured in a bowl.
-Henri Cole

how to have a difficult conversation

(courtesy of my mother, who has lots of sources of her own)

Questions to ask yourself when you're considering having a difficult conversations:
1)What keeps me from having this conversation?
2) Where do I want to end up at the end of the conversation?
3) Is this the right time/right place

-Focus on the Positive. "I want to have this difficult conversation because I respect you and our relationship/friendship and I am afraid if I wait or don't have this conversation, resentments will build and harm our relationship"
-Beware of strong feelings. Confront them in yourself before you start the conversation with another person
-Ask for feedback from the other person as you go along - have a dialog not a lecture

Most "minefields" in conversations are because one person or both feels one or more of the following:
(1) I am not competent
(2) I am not a good person
(3) I am not loved
When you think someone is overreacting or taking something too personally - consider which of the minefields you're touching on with the current topic and either address it or drop it.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"relationships are so important - and a whole lot of work"
-the one and only comment I've ever appreciated from a therapist

in fast forward (or "running with feathers")

For the past month or more I've had the sensation that my life is in fast forward and I'm always running behind trying in vain to catch up.

A. put it best when she described it as running with an armful of feathers: Every time you reach to grab a feather that's falling out of the pile, even more fall out - so that it actually becomes impossible to hold onto everything.

mathematicians and mentors

Over cocktails the other night and again while walking along the river with a few friends, I'm struck by the power of brilliant women - and although I know and love many brilliant men, keep wondering why the vibe of a group of brilliant women is so different.

I think some of it has to do with how unique it is to be with a group of women when no one is being self-deprecating. I know that may be harsh, but we are socialized from a young age to be apologetic for our talents, maintaining the stability of a group because no one feels threatened (some of this I'm getting from The Female Brain but it resonates with my own experiences with group dynamics). But at the same time women know how to be so passive aggressively cruel, especially if they feel threatened. So any time I'm with a group of women who are unabashedly and unapologetically brilliant AND are intrigued in each other's different takes on an idea - it gets wild, with ideas and thoughts and questions all buzzing around the table as we order another round.

One woman at the table was expressing that it's such an important skill, particularly for a woman in a field of men, to know when to get her bullshit on (because according to her, men are much better trained at this) and front like you know slightly more than you actually do. It's true - the successful women I know do know how to "turn their bullshit on" - but, and perhaps this is actually more important, they know when to turn it off, too.

Another aspect that is unique to groups of brilliant women (versus a group of brilliant people that includes men) is that everyone asks more questions. And when everyone is brilliant and confident, the questions aren't clarifying an already known answer, but actually make everyone reach a little bit further into what they know to be true. Questions, my female friends and I have learned, can really make or break whether women feel like you're connecting with them or just talking at them. In our experiences, men don't really feel the same way. I wonder if this continues to be true as we all get less self-absorbed. I guess I probably have enough questions to go around.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"It's spring fever...you don't quite know what it is you DO want but it just fairly makes your heart ache you want it so"
- Mark Twain

copayments rise: bearing a double burden

The basic idea of health insurance is spreading the burden - this is why everyone (healthy and sick) pays into a pool of money when they are well and able to work so that when they are sidelined by an illness or caring for an ill loved one, they can have the resources they need to get better. According to my grandfather, it's a lot like in the old days, you'd pass a hat amongst all the Italian workmen to pay for the hospital (or funeral) expenses for someone who needed them - and by giving your contribution, you're also assuring that if you needed it, the hat would be passed for you.

A NYT article this morning reports that in a new system, called Tier 4, health insurance companies have decided that system could be EVEN MORE profitable for them - and have decided that for some drugs, mostly the ones for life-threatening and chronic diseases, including cancer - people should have to be really sick (hence the "life threatening or CANCER" part) AND pay more for medication. Under this system, people are charged for a percentage of the total actual cost of the medication. This is extremely expensive (eg. $13,500 for a 90-day supply of a medication to treat a type of cancer called CML) and because most of these meds are for long-term illnesses, people have to pay for a continuous supply.

Apparently this isn't a totally new idea, as this 2005 article from the WSJ discusses new ideas for plans using "reference pricing" and "coinsurance" that would charge the user a percentage based on the actual price of the medication. In the WSJ Health Blog, they quote Dan Mendelson of Avalere Health saying “This is an erosion of the traditional concept of insurance...those beneficiaries who bear the burden of illness are also bearing the burden of cost.”

It makes me wonder how all these companies who aren't concerned with health are running our healthcare system...yikes. Maybe it would be better to go back to passing a hat?

Re-Vamping Primary Care in the US?

there's been a huge amount of press lately (by this I mean at least the last five years) about how our medical system is set up so that it rewards expensive treatments with big machines and not preventative medicine, like lifestyle changes, screening techniques, and other early interventions to diseases and disorders that later become difficult if not impossible to cure (eg diabetes, breast cancer, heart disease, MIs). The US Medicare Advising Committee (Medpac) just released a brief discussing this problem - emphasizing that less medical graduates are going into primary care careers because their work in other fields is viewed as more important and rewarded accordingly. However, the action recommended for this critical problem is only: "The Commission should review and discuss draft recommendations".

And what about the recommendations by physicians in this article in the Journal of the American Medical Association a few weeks ago? They included emphasizing more collaboration by an entire health care team - including Nurse Practitioners and Case Workers. Whatever the recommendations the Commission comes up with, I hope they include both collaboration and a reward system that allows doctors to keep people healthy and focuses on screening, education, and early intervention.

And, American Medical Association, doesn't it also make sense to decrease the price of medical schools, so new doctors don't graduate in so much debt that it's impossible for them to ignore the financial incentives of specialty fields.

intentional happiness

Last night I went out with some friends I hadn't seen in a while and we talked a lot about the life/work balance that we're all trying to figure out. More proof that even though we're in our early twenties, we have so little energy (and time and money) right now for fun. Because unlike college, there's not unlimited, effortless fun in a three block radius at all times.

Because this is apparently happening to everyone, my three best friends and I have been compiling a list of "intentional happiness building" ie things that one can do to increase one's happiness right now at any time.

Here are a few gems:
(1) drink a glass (just one) of whiskey/wine/your preferred relaxation beverage of choice, while listening to the sexiest music you own (I'd recommend Billie Holiday) while painting your toenails and wearing bright colored underwear so as not to feel too overwhelmed with how sexy you are
(2) haul your hiney to the hardware store and buy some new materials. So many hot craft possibilities. For example, I adore chicken wire - perfect for push-pinning to the wall and hanging earrings, necklaces, etc.
(3) browse a used book store for an old classic novel to read. Not only will you feel kind of awesome for plopping down with folks like Tolstoy, you will remember that reading is an unparalleled way to explore another world and reflect on/distance yourself from your own experience.
(4) strut/Model walk. break it out anywhere, anytime - it's sometimes more fun in some fiiine heels, but a little more baller if you do it in sweats and running shoes. Extra points if you're walking down a crowded street.
(5) reach out to a friend crush. Do something active with them--hike, ice skate, bowl, contra dance, bike--somewhere you haven't been before
(6) create (and keep) standing dates, whether its for lunch every week, a TV show, drinks after work - something you CAN count on amidst all this instability and ephemeral-ness

~~~~~~~~~~~~~~~~~~~~~
"She is a friend of mind. She gather me, man. The pieces I am, she gather them and give them back to me in all the right order. It's good, you know, when you got a woman who is a friend of your mind."
~Toni Morrison, Beloved

directing traffic

Every day on my commute, I see this man in a blue hoodie who stands at the merge point of the highway and the other main road into the city and "directs traffic". For a while I thought that perhaps he was a cop or hired to do it, but it's become increasingly clear that it's just something he does. When the cars stop (there's a light up ahead) he asks the cars around him for money, in a sort of half-hearted-just-passing-the-time-before-I-can-direct-traffic-again sort of way.

I guess we all just want to feel like we have a purpose.

~~~~~~~~~~~~~~~~~~

"Francisco, what is the most depraved type of man?"
"The one with no purpose"
-Atlas Shrugged (don't get me started)

1 in 4 teenage girls has an STD?

The NYT published an article last week (the only week in so long I haven't read it, figures) on a CDC study of 838 teenage girls found that 1/4 of them had a current STD, what's more, 1/2 of all the African-American teenage girls who participated had a current STD. While I found some of the terminology problematic (infected girls, sex diseases, no real mention of teenage boys' roles in the problem, see a critique of its presentation in the Nation here), if this doesn't convince everyone that we are in dire need of a new approach to sex-education, I'm not sure what will! Clearly abstinence-only education is not the way to go, but other reports have shown that kids report knowledge of how to use condoms and the dangers of STDs, so there is still a critical piece missing between getting the information out there and kids actually feeling empowered and able to use it to make responsible decisions about sex.

On his NYT blog Will Okun talked about the need for more parental involvement in sexual education in reaction to the CDC report. His post was interesting (not sure if I agree) but I was more struck by a comment on it (by Lamont) on how our educational system can work most effectively: "It is my belief that a sound educational system resembles an equilateral triangle...with sides made up of parents, society/education system, and the students themselves. If one of the sides fails, the entire system fails. The issue is not to blame any particular side but to ensure that all sides work together to succeed."

I think this is true of any major issue (the three I would list especially are health, education, and jobs/labor) - that there needs to be the guidance role (teacher, doctor), the support role (parent, family), and the outcome factor (student, patient) working together to ensure the system succeeds. And sometimes I'm not sure that's even enough...

Charity vs. My Stock Portfolio?

While walking in the Tenderloin section of San Francisco to meet my friend for coffee after work, a few of us got to discussing giving money to the people who ask for it along Market St (if you're in SF, or on Boylston St, in Boston or any street that happens to have lots of people of mixed incomes traveling along it daily). Another friend of mine has a self-enforced rule that he gives some money to every seventh person who asks - he feels that this is the most objective way he can give money because it removes his own judgment of who the person is and what they'll do with the money.

But then our discussion extended to donating money to charities - ranging from buying a magazine from your neighbor's kid to fund after school programs to donating to The Global Fund yearly. One friend said the he simply felt that at this point, his money was more valuable in his own hands (in the form of paying for graduate school, stocks, etc) than it could be to a charity. He used Bill Gates as the ultimate example of how great wealth can have a shot at curing malaria in a way "a thousand small grassroots organizations never could".

I personally hold a lot of admiration for grassroots organizations as one of the few things that can break through a pretty difficult system to help peoples lives - and my experiences working with and for a variety of grassroots groups has more than confirmed this. But it's does appear that for the most part small organizations seem hold the seams together - helping people survive, and perhaps slightly improve, the right now - but that it does take a lot of money and a lot of organization to make big changes. We all need to find out which way is more conducive to our individual lifestyles (as they are or perhaps as we want them to be) - because the world needs both.

My current thinking is this: first pick your cause(s), then think about what you'd enjoy (and feel fulfilled) doing on a daily basis that is somehow working towards it/them. And check yourself every once in a while to make sure you haven't deviated from that too much.

If Ever

"She had to let herself drop down to the reality to enjoy him as he really was"
-Anna Karenina

__________________
(not now) If Ever
_________________
to get to the sweet core
where fear slips away
and warm kisses smother all doubt
the line between right and right now
seems blurry

you slide your hand down my spine
as I exhale warm air on your neck
there's no room between us
for uncertainty
no answers or thoughts or even questions

just your lips
my mouth
our taste

it's just -
and nothing like it should be.

Go Peel an Orange

It seems like every conversation I have lately focuses on the past or the future – and a general frustration with being unable to stay fully submerged in the moment…

I read somewhere that a technique for people who worry obsessively is "to peel an orange" when they feel themselves falling into a "worry cycle". The idea is that the sensation of digging your nails into the flesh of an orange combined with the immediate release of a citrusy scent plunges you into the moment – tuning all your attention into the source of those sensations

I wonder if this theory could be expanded to social interactions of 20 somethings. These are at their best exciting and fun, but at their worst are desperate or destructive. These actions include sexual encounters without intimacy and drinking too much too often - but also the not wanting to move away from a conversation that does grab us or the trying to recreate moments of spontaneous and unexpected connection, or even the wanting to try new and crazy things, in the hopes that something about it will grab us and pull us in.

Are these all just alternate versions of trying to sink our nails into something solid; will we do just about anything to be totally submerged in the now?

I'm beginning to think more often than not.

glorious morning muffins

Because I'm a morning person and it's been quite a glorious morning...

GLORIOUS MORNING MUFFINS

2 c. flour
2 tsp. soda
1/2 tsp. salt
1 c. cooking oil
1 1/2 c. shredded carrots
1 1/2 c. apples, peeled and shredded
3/4 c. coconut
1/2 c. raisins
1 1/4 c. sugar
2 tsp. cinnamon
3 eggs, beaten
1 tsp. vanilla
1/2 c. chopped pecans

Combine flour, sugar, soda, cinnamon, and salt in a mixing bowl. In another bowl, combine carrot, apple, coconut, raisins, and pecans. Stir in beaten eggs, oil and vanilla. Add this mixture to the dry ingredients, stirring until just moistened. Grease and flour muffin tins and spoon batter in. Bake in a preheated 375 degree oven for 18 to 20 minutes. Remove from pan and cool on rack.

(source: cooks.com and my friend's mother)

where in the world is all the time?

time to save the world,
where in the world is all the time
so many things I still don't know
so many times I've changed my mind

guess I was born to make mistakes
but I ain't scared to take the weight
so when I stumble off the path
I know my heart will guide me back

-Erykah Badu, Didn't Cha Know

Medicaid and Missiles

Congress is currently responding to the problems put forth with The Bush Administration’s 2009 budget (also see the Senate’s “real explanation of the 2009 budget”).

The budget (released Jan 2008) calls for a 30% increase in defense spending (but interestingly, no spending at all on Afghanistan or Iraq after 2010, and only partial funding until then) along with huge cuts in virtually every social service sector (education, clean water, transportation, even renewable energy sources!), with healthcare, specifically programs like Medicaid and Medicare, bearing the brunt of the burden.

Brilliant. Just when the country is in an economic slump – when people actually NEED social services – cut them. Because Medicaid has traditionally been funded by federal funds matched against States funds, these cuts shift much of the cost of healthcare to the State governments, which are even more short on cash. The Center for Budget Policy and Priorities gives the breakdown on how all federal funding of state programs was cut.

The proposed tax cuts would cut Medicaid spending by 17% over the course of 5 years, and would stop increasing funds to Medicare, even as the baby boomers have expanded the number of people qualifying for the program. The cuts reduce payments for school clinics, nursing homes, and teaching hospitals, virtually removing the minimal health safety net we have in place. Much of the Medicaid cuts would be to teaching hospitals, where the vast majority of people eligible for Medicaid receive care. The Greater New York Hospital Association calls it “the worst attack on hospitals, nursing homes, and home health services that New York’s health care community has ever seen from a United States president”.

Since 1965, Medicaid payments have been used to subsidize resident and intern training at teaching hospitals, which has always been justified as these are the clinicians providing much of the care for Medicaid recipients. Quoted by the NYT, Dennis G. Smith (the director of the federal Center for Medicaid and State Operations) says, “We believe that paying for graduate medical education is outside the scope of Medicaid’s role, which is to provide medical care to low-income people,”. It worries me that Mr. Smith (and our current Administration) cannot make the connection between providing medical care to low income people and paying the people who provide this care!

Congress has been fighting the whole way – and did manage to get the Children’s Health Insurance Act (SCHIP) reauthorized by the White House, albeit with some restrictions on income levels. Keep it up – I forget where I read this, but someone said that America prides itself on its government, not religion or culture or even our economic prowess, above all other qualities of a nation; that American politics is what defines us for the world.

Make us proud, Congress, make us proud.

****

See also: Senatory Clinton’s Statement about the budget and its effects on New York:
http://www.senate.gov/~clinton/news/statements/details.cfm?id=291885&&

"human being" as a verb ?

One of my dearest friends and I have a theory about the friends in one's life and the friends we miss (or don't) when they aren't around. This has come up in more than a few conversations in the past months as all us 20-somethings figure out with whom we connect and then how much of our limited time and energy we want to invest in creating a friendship/relationship with a particular person.

The theory has two parts, which go like this:

part 1: at any given time in one's life where one is somewhat stable (ie staying in a single place for at least a year) there are certain types of friends that one needs in order to be happy.

The specific types of friends that one needs are different for each person, but they are generally like "the friend I run with" "the friend I see bad chick flicks with" "the friend I call in a crisis" "the friend I go out dancing with" "the friend I talk about politics with" etc. And people tend to fill these roles, more or less, wherever they are, with the people around them. Not that each friend necessarily corresponds to only one role - in my experience friends tend to play several roles at once and often have changed the roles they play over the course of our friendships.

And this does not mean that these friendships are insignificant, on the contrary, these are the basis of most friendships -common interests and shared life experiences- and as each vital role is filled by a different person, that person alters all future expectations and standards for that role and by doing so changes the way in which one processes interactions and events from that point on. That's the stuff of personal growth.

part 2: Some of these friends only stay in our lives for a few weeks, a semester, or a year, some for many many more than that, and then there are the special few who although they also start as a specific role (or roles), through shared experiences and unique interactions, they alter their role into one that differs from anyone who occupied that space in our lives before them until they are the only ones capable of filling it. And this is when a relationship becomes one that goes beyond mutual experience and growth to a connection of souls.

****
"Ubuntu: a noun to speak about the essence of being human; umuntu ngumuntu ngabantu (a person is a person through (other) persons); you can't be human in isolation"
-Archbishop Desmond Tutu

"Human being is much more a verb than a noun"
-Rachel Naomi Remen (in Kitchen Table Wisdom)

Potential Plot Twist

I went out to dinner with a friend the other night and we talked about how she's become disillusioned with dating because she feels like when she meets someone, she already knows the steps they're going to go through, can see it all pan out, and end (much to her disappointment), because so far they've all ended. She explained it as "like watching a movie you've already seen a few times before - after a certain number of times, it's like, 'what's the point?'"

That's life. I told her. Plus all the parts you can't predict or don't expect. The interactions that change the course of your life forever - or for the evening - or at least make you consider a different way. And the reactions that surprise you, shock you, disappoint you even.

I guess I just feel the opposite - I see every interaction as a potential plot twist.

****
"Man is a romantic at heart and will always put aside dull, peddling reason for the excitement of an enigma...mystery, not logic, is what gives us hope and keeps us believing in a force greater than our own significance" - Bryce Courtnay in The Power of One (p.34)