curlysalamander's blog

Happiness is not a place

Today at lunch with a friend I heard myself say, "Happiness is not a place that you get to, it's a practice."  And I so often fail to hear the wise words that sometimes drop from my lips, I decided that blogging about the practice of happiness might actually help me remember it.  What is the happiness practice, you may ask?  Pretty simple, really, -- it boils down to forgiveness and gratitude.  They did some pretty elaborate social science research on this and found out what the churches and songs have been telling us for years -- money doesn't make you happy.  Win the lottery and you might feel a bit better for a few weeks.  Surprisingly enough, even health -- poor health or recovery from poor health doesn't make much of a difference in the happiness set point, which is whatever is your normal amount of happy.  The only things that seem to change the set point are a regular practice of gratitude and some strenuous forgiveness.    

Since tomorrow is the U.S. Thanksgiving,  it's an excellent time to let the gratitude begin.  Here's just some of the things I'm grateful for:

My new daughter in law and the happiness in my son's eyes when he looks at her.

My good health and the fact that I actually can and do swim a kilometer every week. My shoulder recovery is complete and it makes such a difference.

Mr. Salamander who just keeps getting better, it seems to me. (Oh yeah, that's the other thing that can make you happier.  A stable relationship.)

Life in the damp dark Pacific Northwest.  Call me crazy, but I love this season.

Knitting and spinning, which have been gentle outlets for my obsessive tendencies. 

Yoga.

Spiritual teachers, both embodied and written, who have helped me remember what's important.

All the things that scare me, from my own aging and death to that of those I love, to thoughts of large scale calamity.  So many things can go wrong, will indeed go wrong; we are so fragile, "so lightly here" as Leonard Cohen sings.   The real and imagined dangers, if I can live with these thoughts, remind me to come back to the present and to treasure every precious moment.

Happy Thanksgiving, everyone.

 

I'm a Mother-in-Law!

ceremony 2

We've just returned from Dabysan and Carrienation's wedding and our follow-up trip to New York City and I could not be  a happier new mother-in-law. The wedding itself was perfection, thanks to their meticulous planning and generous attention to the sweet details that made everyone feel special.  More importantly, I'm just so happy that these two found each other.  They seem so compatible in so many ways.  I love her, love her family and just generally loved every moment of the experience.  My mom, who is in her eighties, was enthralled and I was also thrilled that my cousin Rosanne and her husband Ralph made it down from New England for the event.

Here are a few pictures:

I like this one because it shows the detail of her beautiful sash, and David's happy face.

carrie 2

This was taken just before the wedding.  I just love this picture of Carrie.  As you can see, she is radiant. 

I was asked to do a reading they selected from the Bhagavad Gita. Those who have been following my wardrobe drama will note that a) I did not break my leg on the high heels, contrary to Mr. Salamander's prediction and b) the sweater I knit for the occasion and the dress Lynn planned and Monique made for the occasion were worth all the effort.  It takes a village to dress me up, it seems.  It was also a great excuse to lose 15 pounds.

Reading 2

And then we took off to New York, where Mr. Salamander grew up.  I just love that big spectacle of a city, and he gave me a great tour of all the fun little kid parts. 

sorting hat

I tried on the Sorting Hat from Harry Potter at FAO Schwartz.

Where I also needed to play the big piano.  And then we communed with Alice and her friends in Central Park.

in central park 2

big piano 2

Being (or becoming) Lovable

Back when I was a young thing, still in college, a marginally older friend and I had a conversation about aging.  I was reflecting that I didn't want to grow old and unloved, and his response was, "the only way you can ensure that you will be loved when you're old is to become extremely lovable."  Which makes perfect sense in one way and is also a nonsensical passive construction.   Love is in the eye of the beholder after all -- not something we do to or for ourselves.  But, looking a little more deeply, maybe the important question is this: do we actually find ourselves lovable?

The Dalai Llama is said to have wept when he was told that Westerners have a very difficult time with what is considered to be the easy first step of the loving kindness meditation that is core to the Buddhist tradition --i.e., extending good will to oneself.  It basically goes like this:  "May I be happy, may I be free of fear and suffering, may I live at ease."  Traditionally one starts with oneself and then practices to extend the kindness all the way out to include strangers and even enemies.  Westerners often have to start elsewhere -- often with a beloved pet or a child because they find it so difficult to simply regard themselves as worthy and lovable.  The Christian admonition to love others as we love ourselves also assumes that we already know how to love ourselves.  These ancient traditions express the basic truth that love is an expanding spiral -- the more we practice it, with ourselves at the core, the bigger it gets, wrapping us up in the goodness.

But the reverse is also true.  People who believe themselves to be unlovable stay stuck in the expanding cycle of blame.  The wrongness spirals outward to include everyone. Feeling that one person after another has betrayed them masks the even worse knowledge that they have betrayed themselves at the most fundamental level.  It is so intolerable to think that we have brought suffering upon ourselves through some fundamental flaw or inadequacy of our own that our only relief is to find someone else to be wrong.  

The following poem says it better, and makes me laugh:

                                                                 Why Just Ask the Donkey

By Hafiz

Why

Just ask the donkey in me

To speak to the donkey in you.

When I have so many other beautiful animals

And brilliant colored birds inside

That are all longing to say something wonderful

And exciting to your heart?

Let's open all the locked doors upon our eyes

That keep us from knowing the Intelligence

That begets love

And a more lively and satisfying conversation

With the Friend.

Let's turn loose our golden falcons

So that they can meet in the sky

Where our spirits belong--

Necking like two

Hot kids.

Let's hold hands and get drunk near the sun

And sing sweet songs to God

Until He joins us with a few notes

From His own sublime lute and drum.

If you have a better idea

Of how to pass a lonely night

After your glands may have performed

All their little magic

Then speak up sweethearts, speak up,

For Hafiz and all the world will listen.

Why just bring your donkey to me

Asking for stale hay

And a boring conference with the idiot

In regards to this precious matter--

Such a precious matter as love.

When I have so many other divine animals

And brilliant colored birds inside

That are all longing

To so sweetly

Greet

You!

 

You Just Never Know

I inherited a tendency from my mother to scan for the worst possible outcomes and prepare accordingly.  This risk- averse tendency keeps me flossing and getting check ups, and probably has prevented me from being either very rich or very poor.  I'm the ant in the grasshopper and ant fable -- trying hard to get ready for winter, not singing the summer away.  (Those of you who know me well will point to some rather large leaps of faith I have taken with my life, quite grasshopper like, but let's not let the disconfirming evidence distract us from the narrative at hand.)

Ant

Anyway, my father is rather more the model grasshopper.  He really does live in the moment -- definitely not in a state of high preparedness.  He's had his highs and some pretty dramatic lows, but seems to keep ending up on his feet in improbable ways.  Recently they found a suspicious mass in his lung and all but assured him it was cancer.  Today he went in for the biopsy and poof, no more mass in his lung.  The doctors compared the xrays and couldn't believe what was before their eyes.  I'm sure there's a lesson in there somewhere for us anxious ants.

green grasshopper

Over the Bounding Main

Mr Salamander and I just returned from a week of sailing around the Gulf Islands on a 40-foot sailing vessel we rented with another couple, Monike and Paul.  Although we didn't venture very far, we did discover some wonderful little communities in the various marinas and bays we sailed into.  My favorite was Genoa Bay, a sheltered little spot north of Cowichan Bay, with charming houseboats and some really fabulous art.  

Genoa Bay Houseboat

There was another bay where we spent the night with a bakery boat that had hot cinnamon buns for us first thing in the morning.  We got to the Saturday market on Salt Spring Island, which is quite brimming with bounty from the garden and clever, hand-crafted pieces.  It was really magical discovering new places and travelling by wind power.  

I also really enjoyed the sailing itself.  When I was nine years old my parents got me my own sailboat.  Before I could get it, there were many hoops to jump through -- sailing lessons, swimming lessons and general good behavior.  It was definitely the best thing I remember about my childhood.

Monike and I also managed to get quite a lot of knitting done.  We made nice warm hats that came in quite handy in the chilly moments.

Mr. Salamander seemed to enjoy having a very large toy to play with and especially the part where there was a stiff breeze and the boat heeled over.

Mr Salamander Heeling

That having been said, it was almost sinfully wonderful to return to the land of gushing showers, comfy beds, full size kitchens and flushing toilets.  You don't miss these things until they aren't available, I think.  I can't quite imagine how people adapt to living at sea for weeks and even months at a time.  And I'm quite aware that we were on a rather fancy boat.

The Porcupine Dance

I've been thinking a lot lately about how we define our social distance with other people in our lives.  That barrel-of- laughs philosopher Schopenhauer described the "hedgehog dilemma."  When hedgehogs get cold and lonely they cling to each other for support.  But when they get too close they prick each other and move further away.  Being a somewhat misanthropic guy, Schopenhauer concluded that it's preferable to be a person who generates a lot of his/her own internal warmth so as to be in a position to generate fewer pricks from others.  

Porcupine[1]

Many people scoff at social networking and blogging as activities for people who have no real friends.  I disagree.  I think that it's healthy to maintain friends and acquaintences at different orbits in your life.  In fact, in one of his many books (it may have been The Tipping Point, but I'm too lazy to find the exact reference), Malcolm Gladwell points out that our richest source of opportunities for new and different experiences, for work advancement, and even for finding  true love, comes from the orbit of people we think of as tangential --less intimate friends and acquaintences.  We already know the same things and people as our close friends and family, the theory goes -- we need to cultivate this outer layer of friendliness to have access to a rich diversity of life's possibilities.  Easy for extroverts to say, perhaps.  But it seems that social networking technology makes it easy for even introverts to reach out at touch people, while sitting at home in their pajamas.  Having met Mr. Salamander via on-line dating, I'm pretty happy to let my fingers do the walking, although I certainly like the face-to-face interaction as well.

Trouble arises when people want to be in an intimate orbit with you and you would prefer them to hang out on one of the outer rings of Saturn.  You like them, maybe even a lot, but for various reasons need a bit of distance.  Or the opposite -- you think you need more from someone than they are willing to give.  Getting skillful at this porcupine dance is a lifelong process, and there are no simple answers.  But maybe social networking can help fill in the missing spaces and help us maintain our social ozone layer.

Blood Blackberry Pie

Blackberry-32032

Blackberry picking is blood sport.  They grow in dense and snaky brambles that have a creepy way of grabbing your clothes and hanging on.  They are covered with thorns and 

BlackberryPie

bees.  They are also a non-native plant here in Canada and much despised for their way of overtaking huge tracts of land. Removal is quite difficult and has been known to make grown men cry.

That having been said, they do make a tasty pie.  Dabysan's favorite, in fact.  So every year, whether he is near or far, I don gloves, long sleeves and pants, and prepare to do battle.  

Daby, this pie's for you!

Death With Dignity vs. Futile Care

Even living in Canada, with its quite sensible health care system, is not protecting me from episodes of sputtering rage regarding the insane debate about health reform going on south of the border.  The latest flap about "euthanasia" is so horribly misinformed I want to cry.  I have been a hospice worker for nearly 10 years, both in the U.S. and in Canada.  In the U.S. hospice is a federally funded program that encourages terminally ill people to maximize the quality of life of their last months of earth.  They are supported to be at home and free of pain.  There is spiritual and psychological support for the dying person and the patient.  

The alternative to hospice can be pretty ugly.  There's still some financial incentive in the Medicare system to perform expensive and invasive "procedures" on people who are close to death.  These procedures rarely add more than a couple of months of "life," often at the expense of the patient's comfort and sanity.  As anyone who has been in a hospital can attest, it's not the warm fuzzy setting you imagine for yourself as you bid goodbye to those you love.  

Hospice has waged a long, quiet campaign with doctors and with the public for "death with dignity."  People who have experienced hospice care are blown away with gratitude that they are treated so well.  People who die in hospitals hooked up to tubes and ventilators don't have similar support.  Families' last image of their loved ones is often incredible pain and suffering.  

Eliminating Medicare's financial incentive to do everything possible at the end of life would  save a great deal of money.  Something like 80 percent of all health care dollars are deemed to be for "futile" care -- i.e. care in the last months of life.  Wouldn't that money be better spent on curing someone with a real chance at life?

I understand that many people are reluctant to even think about death.  I understand from experience the gut wrenching panic that goes on right at the edge of consciousness when you contemplate your own or your loved ones' demise.  But I can also say from experience that familiarizing yourself with these alternatives, and making an informed choice by way of a living will helps to manage that panicky feeling.  I find that when I am active with hospice, my overall anxiety level goes way down.  The dying process has been compared to the birth process, and can be quite a beautiful time in a person's experience.  It's always a privilege to be part of that.

Healthcare Part 2: Why Socialized Medicine is a Good Idea

When I used to give talks, I would sometimes lead with the observation that as a healthcare writer and consultant I've learned very little about health and a lot about economics.  The best way to understand how the economics of healthcare differ from the economics of other goods and services is to read Robert Kuttner Everything for Sale: The Virtues and Limits of Markets.  He makes a persuasive case that while capitalism is an excellent mechanism 

for keeping the price low and the quality high for most goods and services, it simply doesn't do the trick for everything.  The blurb from Publishers weekly sums up his case with regard to healthcare:

Everything for Sale: The Virtues and Limits of Markets

Robert Kuttner

Overreliance on market mechanisms is ruining the health care system, contends Kuttner, a contributing columnist to Business Week, because of enormous hidden costs engendered by opportunism, fragmentation, underinvestment in public health and prevention, and inefficient use of home care and nursing care. In a humane society, whole realms of activity necessarily depart from pure market principles because market norms drive out nonmarket norms, i.e. civility, commitment to the public good, personal economic security and liberty. 

I knew (and respected) the theory, but in moving to Canada I've had the opportunity to live the reality of socialized medicine.  Canada has perhaps the most socialized of all healthcare systems since there are no alternatives at all to the public system.  Your money simply will not buy you more health care in Canada.  I also had the opportunity to consult within the Vancouver regional health care system, so I got to see a bit of it from the inside.  

Let me first say that no system devised by humans is without fault. No health care system will give everyone everything in the optimal time and quantity.  That having been said, the Canadian system is quite impressive.  One thing you notice right away is that the investment in public health and primary care is enormous.  Everyone knows that dollars spent on prevention are the most effective of health care dollars.  The primary care access is simply unbelievable.  There are free walk-in clinics everywhere, and plenty of private primary care physicians (at least in this city -- probably not in all parts of Canada).  My own personal physician spends over an hour with me annually, and employs a level of testing and referral that I am reasonably certain would not be covered in most HMO settings. The breast imaging center is state-of-the-art -- the technology is a big step up from the one I was going to in Port Angeles Washington before I was eligible Canadian coverage.

Primary care physicians here are in private practice (although they are paid by the government).  Specialists are largely employed by the healthcare system.  My subjective impression is that they are not as cranky as U.S. physicians, and definitely not as harassed with regard to paperwork, malpractice insurance and limits on their decision-making.

Like the U.S., Canada also does its fair share of spending on "futile" care, (something like 80 percent of health care dollars are spent in the last 6 months of life).  But, as a volunteer hospice worker I do see many patients who have been helped to understand that major invasive surgery for cancer that has already spread is probably not in their overall best interest.  

Where Canada does fall short is in the waiting lists for elective surgery -- particularly orthopedic surgery.  Although they have made some progress in shortening the queue and managing it openly and fairly, it could be years before you get that hip or knee fixed.  The reasons for these delays are complex, but one of the reasons is staffing.  There just aren't enough orthopedists who are willing to stay in Canada when they can make a fortune south of the border.  Orthopedics is big money in the U.S. and the demand is virtually unlimited.  

There's more to say, but in a nutshell, by and large Canadians love their healthcare system. I read somewhere that British Colombia males are the longest lived on the planet.  Premiums are very low for everyone and zero for those in need. Standards of care are high, even if waiting rooms are shabby.   Public health is taken seriously and is not the orphan child it is in the U.S.  I have more confidence in Canada's ability to manage an epidemic than I do in that of the U.S.  And, the icing on the cake, the costs are dramatically lower:  In 2006, per-capita spending for health care in the U.S. was US$6,714; in Canada, US$3,678.^[5] The U.S. spent 15.3% of GDP on health care in that year; Canada spent 10.0%. 

Healthcare Part 1: The Toxic Legacy of Ronald Reagan

Reading the debate about health care reform in the U.S. makes me really feel my years.  I was a health care reporter under both the Carter and Reagan administrations, and after moving to California in 1986, spent the ensuing 20 years as a consultant to various health care organizations.  So I hereby offer a bit of history and perspective:

It's simply disgusting how much damage Ronald Reagan managed to accomplish in his quest to enrich the rich and disenfranchise the poor and middle class though deregulation.  We see it in the current banking meltdown, but his policies were equally pernicious and invisible with regard to health care.  There was at the time a cabal of healthcare economists stumping around the halls of D.C.,  whose mantra was that healthcare was in a state of "market failure" and that the solution would be to make it more competitive by incentivizing the development of HMOs.  These health plans would theoretically compete with each other to bring prices down.  Up until that point, nearly everyone -- at least everyone with a job -- was covered under state-regulated Blue Cross and Blue Shield organizations.  These huge  bureaucracies were admittedly inept at containing costs, but they did one thing splendidly, and that was to spread out those costs over the entire population, so that the healthy premiums supported those who had the misfortune to be ill.  

Anyway, within a few short years, HMOs and the various health plans merged aggressively, thereby re-creating a new and much more dangerous type of market failure.  They did not re-institute a broad population basis on which to spread out the risk. Instead, deregulation allowed  these new corporations to cherry-pick their members to avoid insuring the sick. Corporate speak for the money spent on actual care for the ill was termed a "medical loss"  (as opposed to shareholder gain). In California alone the number of health plans went from more than twenty to fewer than eight in less than two years. Nearly all hospitals found their way into larger systems so that they could more effectively negotiate with the new behemoths. Billions of dollars of capital were stripped out of the system, never to be seen again. Physicians, duped into believing they were running the show, supported their Republican golf buddies, who sold them far far down the river.  Most of them still have no idea what happened, but, except for the most stratospherically paid specialists, I can tell you they are not loving life under the feudal chiefs of the corporate monopoly.  

In my next post I will describe how, both personally and professionally, I learned to love the socialized health care system in Canada. Sorry, dear readers (however few you may be). I really need to get this stuff off my chest.  And then we can return to our regularly scheduled program of fibre, books, and vacation.