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While we were in California, we bumped into lots of new and exciting experiences. Feeding giraffes by the ocean, listening to the Rocker score a new Rogue One trailer, and of course dining at some of the most innovative, delicious restaurants. But picking up the bill was even more  astonishing, because all along the Gold Coast the people voted to give themselves a “Living Wage,” so the bill could be shocking until you realize there is basically no tipping allowed.

Well, at some places tips were included in the bill, but the basic premise is that by 2020 the minimum wage will be $15 an hour, and supposedly one could live on that salary in LA County. Just look at this calculator, it shows two adults working would pull in $62,400 a year, however – “Note: Although the living wage model is a step above poverty, it doesn’t take into consideration extras such as entertainment, eating at restaurants, or being able to save and invest.”  http://www.latimes.com/visuals/graphics/la-me-g-california-new-minimum-wage-20160328-htmlstory.html

Never mind a family with kids who had to pay for childcare. Still it’s a start. Until now.

Mr T has appointed a fast food billionaire as the next Labor Secretary, Andrew Puzder is the CEO of CKE Restaurants. This California golden boy runs Carl’s Jr and Hardee’s and thinks the Living Wage thing is hogwash, in fact he’d like to see robots making his food! Oh but wait, he also wants to see bikini clad women eating his burgers, because well, who wouldn’t? What’s more American than that I ask you?

  • He has been critical of the Labor Department ruling to extend overtime pay to more than 4M workers
  • He accuses the Affordable Care Act of creating a “restaurant recession” since it has deprived citizens of their extra money for dining out…not making $7 an hour
  • His “record of fighting for workers” means he believes a higher minimum wage will kill the job market…

I guess having a robot put mayo and avocado on your burger doesn’t kill the market? I cannot wait to see what Elizabeth Warren has to say about Andy; oh wait, here ya go:

Throughout his entire career, Andrew Puzder has looked down on working people. At Hardees and Carl’s Jr., he got rich squeezing front-line workers on wages, overtime, and benefits, all while plotting to replace them with machines that are so much better than workers because they are “always polite” and “never take a vacation.” Appointing Puzder to run the federal agency responsible for protecting workers is a slap in the face for every hard working American family.

Wasn’t it Sandra Bullock who said, “Once a waitress, always a waitress?” Well I’ve been a waitress and it’s one of the hardest jobs on the planet. The Bride worked a snack stand at the beach as a teenager. The Rocker was a barista in high school. I’d wager a bet that most of you dear readers have worked for awhile in the service industry. That is, those of you who didn’t get a few Million handed to you on your 21st birthday. And I bet most of you think a Living Wage is self-explanatory.

After all, its opposite would be a Dying Wage. The kind of wage that shortens your life span, where food choices and health providers are limited to your station in life. The kind of life where obesity leads to chronic diseases, the kind that taxes our hearts, and any young person feeling suicidal in their low wage job could easily purchase a gun at the Walmart. You see where I’m going…

We now live in a country where our life expectancy has declined for the first time in 20 years. http://www.bbc.com/news/world-us-canada-38247385

We know about diabetes and heart disease factors, but what is causing the rise in infant deaths under the age of one? Parents are warned about suffocation concerns with babies sleeping in a family bed, but I’m afraid I agree with a doctor who states “…the rise (is due) to “social stressors”, such as financial pressures and addiction.

“The Centers for Disease Control and Prevention says the country is “in the midst of an opioid overdose epidemic”, with a record 28,000 people killed in 2014. No figures are yet available for 2015, though the 6.7% rise in deaths caused by “unintentional injuries” may be partly related.” How could you possibly care for a baby while addicted to pain killers?

Our ecosystem is so fragile, so intricately related: to billionaires running/ruining our government; to our life span shrinking; and to the beautiful giraffe grazing freely in Kenya. Like the canary in a coal mine, giraffes are now listed as “vulnerable” to extinction. Perhaps Mr T will invent a robot giraffe for our great grandchildren to feed at the zoo?

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When you see an obese child, what do you think? Do you immediately blame the parents, and/or poverty? There is no fresh produce to be found in their neighborhood, or maybe you think the parents are just lazy…What if we make school lunches more nutritious. Let’s get Jamie Oliver into every school cafeteria and teach those lunch ladies how to steam vegetables! Get a communal garden going outside the gym!

I find it fascinating that the GOP is all about getting government out of our way for free enterprise. They start yelling “fascist” whenever Mrs Obama wants to see kids get off the couch and move, or a school system tries to change what a school lunch may look like – don’t tell us parents what to do with our kids! Get government out of our lunch boxes!! We know what’s best for them, and if a parent wants to leave a gun lying around well…and then I picture a two year old yelling I WANT TO!!

Bob tells me he rarely mentions weight to one of his patients, after all he is not a family practitioner. But when he sees a severely obese child, he may say something to the parent in the ER. Because this is such a serious health risk, he risks that patient’s dismal satisfaction score. Not all doctors have the courage to tell a parent they are endangering their child’s health. Luckily, the rate of childhood obesity in this country is finally leveling off:

After a steady rise for many years, the number of calories American children take in each day is going down. Childhood obesity rates, though still too high, have now leveled off, and are starting to go down in some populations. The 5 billion school lunches served each year are more nutritious than they were a decade ago. Children are eating less processed food and drinking less sugar-sweetened beverages and full-fat milk.  http://www.cnn.com/2015/06/30/opinions/clinton-brown-healthy-kids/index.html

So yes, we can put juice in vending machines and model a healthier diet for our youngest children: by including them in food prep and offering fresh, real food; by sitting down to dinner as a family (an almost insurmountable task these days); by going to farmer’s markets or even helping them plant their own little tomato plant in a pot. I’ve mentioned my neighbor Kath the food blogger before. I love the way she has introduced real food to her toddler, he http://www.katheats.com/ways-motherhood-has-changed-me

Still, I think about how my Foster Mother Nell really didn’t cook, she would jokingly say she could open a can. Women in the 50s were sold that bill of goods – TV dinners on a tray, canned vegetables with marshmallows. Life was supposed to be “easy” for the 50s housefrau. They grew up watching their mothers actually grind meat on the dining room table, and wash clothes by churning them through a semi-automated washing machine, or maybe they were hauling clothes down to the creek? Why shouldn’t they get to vacuum in high heels!

And all I ever ate for lunch in high school was tuna sandwiches and potato chips, followed by a cheeseburger at White’s Drug Store immediately after school, with fries dipped in gravy… SO, canned food, semi-fast food, and I was never fat, in fact I made spaghetti for myself at night cause I thought I was too skinny! Those were the days, before babies, before menopause packed on the pounds.

We can all teach ourselves to prepare a healthier diet, we don’t need an RD to work up a meal plan. If there are no markets with fresh veggies in our neighborhood, we could plant some in pots. What we cannot and should not do for our kids is model complacency. What my generation had was the ability to walk to school, to go out on our bikes after school and not come home till twilight. We had the freedom to move, which this next generation may lack.

Kudos to the city planners and engineers who are redesigning parks and playgrounds all over the country. And bravo to the police who are walking beats and making neighborhoods safer and crime-free – not by stopping and frisking but by stopping and talking.

And maybe we could have a course at the police academy on nutrition?

Basil is ready for Pesto

Basil is ready for Pesto

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What do you do when you’re sick? Take to your bed and yell for “Mommy,” or ignore it and go about your business? Well when you’re married to an Emergency Physician, and you’ve given birth to another, your response to an illness pretty much doesn’t matter. After all, you are NOT dying, so it’s not a true emergency – like say, anaphylaxsis, septecemia, or a gun shot wound to the belly.

It’s only a virus. Antibiotics won’t help. In fact, my doctors rant about how other doctors overprescribe antibiotics, which is why we are in a drug-resistant pickle. You’ll be better in a few days. So you’d best go about your business; take Tylenol every four hours, force fluids and try to rest. Because as Daniel Tiger says, “Rest is Best.”

When I was young and caught a cold, Nell would rub my chest with Vick’s. Then she’d wrap some sort of gauze around me and tuck me into bed. In hindsight, she grew up when a small splinter could turn into an infection and kill you. Penicillin wasn’t invented until just before I was born. Growing up in the first half of the twentieth century meant you were isolated when you were sick, people took a cold seriously. As Adelaide would say in her Lament, a person can develop a cold, or La Grippe, La post-nasal drip…with the wheezes, and the sneezes, and the sinuses really a pip!
In other words,

Just from worrying whether the wedding is on or off,
A person can develop a cough.
You can feed her all day with the Vitamin A and the Bromo fizz,
But the medicine never get’s anywhere near where the trouble is.
If she’s getting a kind of a name for herself, and the name ain’t his,
A person can develop a cough.
Read more at http://www.songlyrics.com/actors-broadway/guys-and-dolls

But I digress. Back to the 50s, once an illness had passed, Nell would make me an eggnog. I know, sounds disgusting, but it was so good. Guess she didn’t know about salmonella in raw eggs? Oh and to keep me healthy, she would shove a teaspoon of cod liver oil into my mouth every morning, followed by a chaser of orange juice. It took me many years to like the taste of orange juice.

Still, this spring cold is a bad one, it starts off deceptively simple enough – a headache followed by a runny nose. You are lulled into thinking you’ll be fine by the third day. Then your larynx closes up and you can barely croak, a fever sets in and after awhile your eyes get all gucky. If you have children in preschool, or you have a spouse that is routinely seeing infectious disease every day they go to work, then it’s likely you’ll catch  it. In other words, “You can spray her wherever you figure the streptococci lurk,
You can give her a shot for whatever she’s got, but it just won’t work.” The cough will linger, you’ll want your Mommy, and someone to bring you chicken soup.

On my way home I listened to the TED Radio Hour “Believers and Doubters.” http://www.npr.org/2013/11/18/245949211/believers-and-doubters

And I thought about the time I nearly died from septicemia after a miscarriage. Lying in a hospital bed in the Berkshires, I prayed the rosary with my Polish room mate because she asked me if I would in broken English. I found her beads in her bag, and the words came back, they flowed through me like a salve. It was like being wrapped in a warm blanket and tucked into bed.    CLR in Bathrobe

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jack-russell
Well we didn’t have a three dog night. In fact, NY and NJ are feeling somewhat slighted by the blizzard, while the Blue Ridge simply got a dusting. Ms Bean was snuggled tight in her little cave; her bed is under a credenza next to my side of the bed. Her snoring is my night music. I’m still waiting to rescue a Corgi so we can be a two dog family once again. But before I tell you about my matchmaking skills with a male Jack Russell dog named Mona, let’s go over why owning and loving a dog is good for our health.

The American Heart Association actually issued a statement saying that pet ownership, particularly dogs, is associated with a lowered risk of cardiovascular disease, and it can also increase your chance for survival after having a heart attack! http://www.heart.org/HEARTORG/GettingHealthy/Owning-a-Pet-May-Protect-You-from-Heart-Disease_UCM_453586_Article.jsp

…there are a variety of reasons that may be at work that influence this relationship. It may be that healthier people are more likely to be pet owners or that people with dogs tend to exercise more. Pets also play a role in providing social support to their owners, which is an important factor in helping you stick with a new habit or adopting a new healthy behavior.

I used to walk my first Corgi Tootsie Roll two miles every day, until one day we were approaching Rumson Road and she wanted to turn around. Every day she was cutting our walk in half! I told the vet she must be getting Alzheimer’s, but he said she was smart. She was getting older and I would have to accommodate. So I just walked the same mile twice; once with Toots and her son Blaze, and twice with Blaze. I called this my “meditative walk,” and it helped me think and prepare my mind for writing.

Little did I know it was also helping my heart. But who would have thought that rescuing a dog could open your heart to love? And I don’t just mean the furry kind.

While our family was vacationing in FL last week we got together with Meredith, an old Med School friend of the Bride and Groom. It just so happens she is a practicing Ob-Gyn in Tampa. The Love Bug played with her sweet son in the pool for hours, while Meredith did her best to sell the doctor couple on the pleasures of practicing medicine in the Sunshine State. And then I just had to ask, “How’s Mona?”

You see I feel personally responsible for Meredith’s marriage! One day long ago BC (before children) in med school, Meredith told me she wanted a dog. I accompanied her to the Charlottesville Albemarle SPCA and we found a little male Jack Russell, who was full of energy and a kissing machine. It was love at first lick! I would grand dog sit him when she had to do an away rotation and he got on splendidly with my crew. Little did I know that within a few months Meredith met her future husband at a dog park with his Jack Russell, and the rest is herstory!

Dogs are not only good for your heart, they are great for your love life! And Mona is still alive and kicking.

the Maid of Honor, the Bride, the MOB, and Merdith

the Maid of Honor, the Bride, the MOB, and Merdith

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I remember when we moved back to NJ. The kids were little when we attended a new parents night. The elementary school principal spoke about all the wonderful things her school had to offer; while we parents were encouraged to think about outcomes. What did we hope their school would help instill in its students? She made a list on a blackboard; it was a long list. Parents were calling out things to put on the list – creativity, cooperation, academic achievement. This was a school, mind you, where awards for Being Quiet were displayed proudly on one wall. I called out, “What about compassion?”

Silence.

The Love Bug and the Bride are visiting us this week, and I just happened to read an article about teaching kindness.

It’s amazing the subjects that deserve research, how does one raise a successful child? How to raise a happy child! Finally it’s occurred to someone that children need to be taught NOT to always think of themselves first. I’ve noticed with the Bug, who will turn 2 next month, that altruism is there just waiting to be nourished. She noticed my wrapped hand and kissed it immediately. She shares her food willingly. She pets Ms Bean gently.

But I always thought you teach kindness by modeling it yourself. It’s not something you need a worksheet for, it doesn’t need to be drilled into your child. Today I offered the Bride a small gift of time to work out at our sports club. I played with the Bug, while Mama and baby-to-be raised their heart rates a bit. Since it was raining when we arrived, we didn’t swim, but we joined in with a group of children who were at day care and tennis camp. Suddenly a toddler ran into a wall, cutting his eyebrow.

The Bride arrived just in the nick of time, she got to work examining the boy, cleaning his superficial laceration and reassuring his mama that it didn’t need sutures. The Bug saw some of this medical operation, and I’m sure she registered this in her brain. We are the kind of people who help people.

Random acts of kindness might sound good in a curriculum, but I think it’s something we learn before Kindergarten, at our parents knees. Maybe if more of us practiced this concept, we’d be less inclined to wage war, or shoot down planes for instance. Maybe it’s as simple as that?

Bug rock climber

Bug rock climber

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Trumpets please. The cast came off and a splint went on, my dominant right hand that is. It seems that despite being told there is nothing one can do about a fractured pinky finger, the UVA Hand Clinic has me doing some serious physical therapy. I’m sure that my three week wait to actually see a doctor after the bounce house fall, planting in my garden and mailing 90th birthday party invitations, didn’t help my hand heal. But that’s just me; delay, deny and avoid doctors at all costs since I have so many at home. That’s my problem.

You might think that a doctor’s family has it made in the shade. But I’m here to tell you that’s not the case. It’s pretty well known that anyone involved in health care will be treated differently in a hospital. It’s kind of the opposite of selection bias – once the person treating you finds out you’re in the same field – nurse, doc, therapist or spouse of same, whatever – they may subtly change their strategy. The person treating you may not even realize they are doing this, but by being nicer, kinder and making exceptions to their rules and treating you differently, they are shortchanging you.

Let me find an example. When I came down with West Nile before moving to VA, after a week of unendurable headaches and fever, I finally got to an Opthalmologist who knew what he was doing. I was sent pronto to the nearest hospital’s MRI machine and ended up waiting in the hallway until one became available. I was in such pain and going blind that I hardly registered what Bob was saying to all those people who knew him so well, all I remember is everybody apologizing for me being in a hallway.

I really didn’t care about the hallway at that moment, I wanted the pain to stop.

They didn’t do a lumbar puncture (LP) because well I didn’t see the ER doctor on duty, and they didn’t have an available room, and besides I didn’t want an LP and nobody wanted to question my husband and his wife as to what they wanted in this emergent situation. I hope you’re getting my drift…

If I hadn’t been with Bob, if I’d have been anybody else, the eye doctor probably would have called an ambulance and I would have been whisked away toute suite to a hospital with a bed and an available MRI machine and an ER doc who would have punctured my spine alright, and I would have been admitted to the hospital. Instead I was sent home on steroids.

In the worst of circumstances the very best people in health care will try and make our (meaning everyone else in the health care field) lives easier – thereby putting us at greater risk.

This is why when I went to another state while pregnant with the Rocker for my “older mother” test – the one where they stick a needle in your pregnant belly to get some amniotic fluid – I told the receptionist that my husband was a contractor! Yes sir, I lied because A) this amniocentesis test was fairly new, and 2) I didn’t want anyone to know my husband was a doctor because I was unconsciously already aware of this selection bias.

I know I’m complaining in a sort of ‘poor privileged me’ way – first world problems. And I know this anecdotal bias has probably never been studied, but I’m not the first to notice it. Ask anyone you know in the health care field. Oh, and when my wonderful NP asked me at the UVA Hand Clinic to rate my pain on a scale of 1 to 10, I had to smile.

Because Bob has always said the day he hammered his thumb accidentally putting up a shelf was a BIG 10. He saw stars, he couldn’t speak, and finally when he could, all he could do was swear. When he walks into a room to see a patient and they are texting, he remembers his thumb and knows this is not a 10 on the pain scale. But pain is pretty subjective, your 7 may be my 3?

This is the first time in 2 weeks I’m using more fingers than two thumbs to write. And for that I am grateful. It’s good to start off your day listing two things you’re grateful for, soooo 1) Yay for 9 fingered typing

And B) I’m also happy my 6’3″ son and Ms Cait came to visit this past weekend. That baby who backed away in the womb from the needle in the ultrasound of my amniocentesis test, is going to turn 30 this summer! And his Grandmother Ada just turned 90! Bring on the fanfare!   IMG_0699

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I have a question I like to ask first time parents: “What’s the most surprising thing you’ve discovered about being a (father or mother)?” When I asked one young dad at a wedding recently, he was stumped for awhile, and admitted no one had ever asked him that question. So he literally asked me to wait while he thought about it; he took his time. His young son was just turning two and he was finishing an MD/PhD program. It was loud and crowded at this reception but eventually he turned to me and said, “His sense of humor!” He never thought he’d be having so much fun laughing at the world with his toddler!

I loved that answer. So we raised our champagne glasses to the new bride and groom, and to laughter!

Well yesterday, after all the amazing speakers and musicians and short films we saw at TEDx, one woman stood out, one woman surprised me. Don’t get me wrong, I had no idea a young man named Kluge, from a formidable Albemarle family, had decided to make dirty water sexy – like the many clean water initiatives throughout the developing world. He started a campaign called “Toilet Hackers” and is determined to make sanitation available to 2.5 billion people. Quite a worthy mission that would impact disease, economic growth and even education world-wide.

But the statistic that surprised me yesterday was 50,000. A beautiful young woman, Dawn Averitt Bridge, walked out on the stage and told us point blank that she had been diagnosed with HIV at the age of 19 in 1988. Normally, this would have been a death sentence, and her doctor told her parents NOT to talk about it or they would risk being ostracized. She managed to qualify for a very early retroviral study, and has devoted her life to fighting the stigma and the spread of this disease. Bridge only teared up when she recounted giving birth to her 2 HIV-free baby girls, and said that tears come every time she talks about that experience. This is her project: http://www.thewellproject.org

With dignity and grace, she urged us all to get tested for HIV, to include testing as a normal part of health screening. Because when we take the stigma out of the disease, when we treat it like any other chronic, blood-born virus, like Hepatitis for example, it loses its power. And the earlier the diagnosis, the better our chance for survival. This made so much sense to me – every year in America 50,000 new cases of HIV infections are reported. Bridge says this is unacceptable. People are taking more risks today, because they are young and think they are invincible, because they think HIV can be controlled now, like any other STD.

And in my opinion, because many states have banned clean needle exchanges for arcane religious reasons – and you know my opinion on mixing ideology with policy…on treating substance abuse as a crime and not a public health epidemic.   http://articles.latimes.com/2013/apr/29/science/la-sci-hiv-screening-20130430

We can distribute nets to halt the spread of malaria in Africa, we can introduce plumbing to the poor in India to stop the spread of dysentery, and in this country we can do one simple thing. We can urge our friends and family to get tested for HIV; and if you don’t want to visit a doctor, you can buy an over-the-counter test at a local pharmacy. Sometimes the most simple intervention, can be the most surprising of all.

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