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Sunday, August 25, 2013

Sadie, Princess of Mercy

Ms. Sadie, Princess of Mercy
I'm not sure how it happened, exactly.

It started, I think, when the daughter of one of my patients got a new little puppy. A Havanese named 'Thelma' (her 'sister' was named 'Louise').  'Thelma' looked so much like our Ms. CoCo Chanel when she was a pup that it broke my heart.

Ms. CoCo died February 22 of this year. She was feisty and opinionated and so damn smart it was scary. She was definitely the "Alpha Dog" in our pack. Mr. Lenny and Mr. Theo knew her as "She Who Must Be Obeyed". She was known in the neighborhood as "The Harbor Mistress" because she would bark at all the boats that went by.

Ms. CoCo Chanel
 She will never be replaced, but she left such a Very Big Hole in our lives that we knew we one day would have to fill.

And then, the Obamas got 'Sunny', their new Portuguese Water Dog, so "Bo" would not be alone. This, after Mr. Obama 'promised' that his reelection did not mean another dog in the White House.

I smirked.  Ha! Don't ever make promises you don't know you can keep. Especially about dogs!

I think things began to crystallize when I met Thelma and began to hear of her breeders, two men who live not far from us. The whole town knows about them. They are the "go to guys" for Havanese puppies.

Everyone still talks about the day Condoleza Rice came to town to pick up her pup. The  secret service guys in the black limos that lined the streets made it even more exciting than the day Barbara Walters came to pick up her pups.

Mr. Theo, the Great
So, next mistake: I came home and told Ms. Conroy about Thelma.

Within seconds, she had the web page up and was "Ooo-ing" and "Ahh-ing" so loudly, Lenny and Theo came over to see if she was alright.

The next thing I know, I'm being shown pictures of dogs that have been "retired". These breeders only allow their dogs to have three litters of puppies and then they are "retired from duty". With full honors. But, at a mere fraction of the cost.

Mr. Lenny Bruce Brisco
And then, there she was. Right there on Ms. Conroy's laptop screen. Ms. Sadie. She's three years old - well, she will be on August 29th - and had only had two litters of puppies but did not do so well with motherhood. The guys decided that she should enter early retirement.

Well, there was nothing to be done but to go see her.  Which we did. The very next night. It was decided. Especially since Ms. CoCo would have been eight years old on August 30th. The proximity of the birthdays was too serendipitous for us not to be intrigued. 

Oh Lord, but is she sweet! A little timid but that's pretty normal for a first meet.  Even so, I was a bit concerned how she'd fare with Lenny and Theo - both of whom are rough and tumble kinda guys.

And, after all, they had been without Ms. CoCo's influence for six months. I thought they'd be a bit intimidating to Ms. Sadie, such a pretty, gentile lady.

The guys suggested we bring her home for the weekend and see how she - and they, and we - adjust.

And that, as they say, was that.

She does fine with the boys and they with her. We are having some 'bathroom issues'. No, it's not what you think. It's that she won't go. Anywhere. She went 12 hours without peeing the first day.

We finally figured out that there are three problems (1) She's only ever peed on concrete (2) She's never peed while being out on a leash and (3) Nothing here or outside smells like her.

So, when she did finally pee, we blotted some up on a paper towel and put some on the grass and on the deck. She's peeing just fine now, but she prefers the deck. Without a leash. Thank you very much.

We gave her her very first 'Denta bone'  chewie last night. Oh, my, my, my, but didn't she enjoy that!

I knew she was fine when she had a bout of "puppy crazies" with Theo this morning. Back and forth and forth and back they ran, from one bedroom across the house to the other bedroom. She took the lead but Theo followed close behind, while Lenny..... well..... Lenny just watched in his usual bewilderment. Poor baby.  He takes the short bus to school, don't you know.

Sadie is eating well. Sleeps all night, glued to my side. Bonding well with us both. And, she hasn't barked. Not once. Oh, she's whined a bit when either of us leaves, but not a bark out of her.

I suspect that's because Theo does enough barking for all three. Poodle! Such a mouth on that one!

Sadie - as those of us who once lived in the Northeast Corridor know - is a Yiddish baby name meaning "Princess". It's also a nickname in Mexico for Mercedes, meaning 'Mercy'.

Ms. Sadie, Princess of Mercy, on her throne
So, her full name is "Sadie, Princess of Mercy".

She rules with quiet authority from her throne, which she picked out about 12 hours after her arrival at Castle Llangollen.

We suspect there's an iron paw hidden in that soft, furry glove, which she has yet to reveal.  All it will take is one time for Mr. Theo to cross the line with her and he will be put in his place.

Of this, we are quite certain.

We will have to have her spayed and she needs one last inoculation, but we didn't pay any more for her  that we did to rescue any of our other pups.

We have started to take her for long walks on her leash around the neighborhood. She's very curious - about everything but especially about the water and boats - and she's very friendly and gets along well with others - human as well as other creatures.

Her fur was sheered after her puppies were whelped and then given to another dog to nurse (see also: didn't do well with motherhood), so she doesn't look much like a Havanese right now. But, she will. She will. Her coat is shiny and healthy. And, we've got this 'black and white' thing going here, in case you hadn't noticed.

We are just thrilled with the newest member of our family.  She's wonderful and we love her so much already. How did we ever live without her?

I'm not sure how, exactly, that this all came to be. 

Then again, that's the way of the miracle of relationships, isn't it?

Saturday, August 24, 2013

ACA: Affordable Care Angst.

The  Patient Protection and Affordable Care Act  (aka "The Affordable Care Act" - ACA - and "Obamacare") was passed into law on March 23, 2010.

Ever since, the howling from the Right has not lessened one decibel.  The Republican majority in the House has attempted to repeal it no less than 40 times.

On June 28, 2012, the Supreme Court upheld the constitutionality of most of the ACA in the case National Federation of Independent Business v. Sebelius. However, the Court held that states cannot be forced to participate in the ACA's Medicaid expansion under penalty of losing their current Medicaid funding.

Since the ruling, the law and its implementation have continued to face challenges in Congress, in federal courts, and from some (guess which ones?) state governments.

Why? Beats the heck out of me.  Except, of course, it was passed under the leadership of the first Black President in our history. Wait! No! That couldn't have anything to do with it right? Right!
A full list of the provisions of the ACA are lengthy, but here are the central important points:  
It aims to increase the quality and affordability of health insurance, lower the uninsured rate by expanding public and private insurance coverage, and reduce the costs of health care for individuals and the government.

It provides a number of mechanisms—including mandates, subsidies, and insurance exchanges—to increase coverage and affordability.

The law also requires insurance companies to cover all applicants within new minimum standards and offer the same rate regardless of pre-existing conditions or sex.

Additional reforms aim to reduce costs and improve healthcare outcomes by shifting the system towards quality over quantity through increased competition, regulation, and incentives to streamline the delivery of health care.

The Congressional Budget Office projected that the ACA will lower both future deficits and Medicare spending.
All that being said, the ACA is one small but critically important step in leveling the playing field for access to affordable health care for every citizen in the United States. We need more revisions and changes and reform. Many more.
A personal example:

A few years ago, I developed an allergic rash. I didn't know it at the time but it was the fault of my pharmacist who dispensed the wrong form of a medication. I went to see a doctor locally. After the exam, she ordered a full battery of blood work. When I saw the order, I went right back into her office and questioned it. She was stunned - I mean, in addition to the fact that she had already spent the requisite 15 minutes with me - and said, "Why are you concerned? Your insurance will pay for it."

I was stunned by her response. "Yes," I said, "but do you really need to know my cholesterol level to determine the cause of my rash?" She admitted she didn't, along with several other blood panels. But, because this was the first time she had seen me, it was "allowed". Working together, we eliminated all but the ones she really needed, which turned out to be a few simple tests.

After that episode, I never went back to her.

Most consumers of health care still labor under the illusion that doctors are demigods. They are not. They are human. I'm reminded of what one of my physicians once said to me, "Remember, 50% of all doctors graduated in the lower half of their class."

Oh, and turns out that the lab the doctor used charged more than the "usual and customary" fees my insurance would allow and I ended up being charged to pay out of pocket to cover the balance. I contested it. After 3 months, the lab dropped the charges.
Oh, and turns out that my pharmacy had dispensed this other form of medication because -  guess what? - they made more money on it.

Medicare is a highly successful government program, saving hundreds of millions of dollars by containing the greed that has infected our health care system and the insurance industry. I can tell you from professional experience as a Hospice chaplain that Medicare is a model of effective compassionate care combined with business efficiency.

Unfortunately, doctors are often seduced by greed, supporting unnecessary lab, X-Ray and "Big Pharma" which feeds the system. Our political process is, more often than not, a reflection of that greed. Some politicians vote not to serve "we the people" but those who line their pockets with money that will get them re-elected.
Misrepresentations? Oh, yes. They abound. There are no "death panels". That has always been a heinous, fear-mongering lie.

It hurts business? People are losing their jobs? Corporations are laying off people or reducing the hours their employees work not because they can't afford health insurance, but because it cuts into their profit margin.

See also: greed.
Jesus said, "The poor will always be with you." I suspect he said that because he knew something about the human condition and the inclination we have toward greed.

The Affordable Care Act is complicated and complex because the health care and insurance industry have intentionally been made complicated and complex. The ACA is one small but critically important step in unraveling the tangled mess and changing a system that is in desperate need of revision.

I think we had best get used to it. Christians ought to support changes in laws and policies that insure best practices of medicine and businesses so that all of God's children have access to affordable health care.

I think that's the "conservative" Christian thing to do because it "conserves" as well as preserves the respect and dignity of every human being.
One last note: I'm curious to know if sermons about the Affordable Care Act in particular and health care in general are being preached in The Episcopal Church. Some of us preach on racism and sexism and domestic violence  and, God knows, homosexuality but I've yet to hear a sermon address this issue. Especially now that it is hitting closer to home.
Has the House of Bishops Theology Committee written a statement that outlines the scriptural and/or theological thinking about affordable health care? You know, something that might help stimulate some theological thinking in the pulpits and pews on this critically important issue? Anybody had an article written in HuffPo or done an OpEd piece or written a Letter to the Editor?

If you have heard a sermon about this or know where I can read it online, please let me know. I'm not holding my breath, but I'd love to hear from you.

I think church leaders ought to start making some noise about the Affordable Care Act.

Why? Because Jesus said, "The poor will always be with you."

He also said, "Whatever you do for the least of these, you do for me."

That's one theological cure for the Affordable Care Angst.

Saturday, August 17, 2013

My mother, myself.

Thérèse of Lisieux

My mother and I, as with her own mother, had a complicated relationship.

I suppose most mothers and daughters do, at least on some level. Books have been written about the dynamic. Any way you look at it, your relationship with your mother is complex. At any given moment, it can be as joyful as it can be difficult.

My relationship with my mother was no different.

I think that's because, as much as I did not want to be like her, the truth is that there are parts of me that are very much like my mother.

My temper, for one. My tendency to sarcastic humor, for another.  My love of cooking and baking are some of the good things I share with my mother. And, my grandmother.

My mother wasn't a big church-goer. My grandmother went to Mass every day, and I went with her. My mother loved Jesus and often sang hymns around the house, but she had a real distaste for and suspicion of the institutional church. Hmm.... remind you of anyone?

My mother loved to write. My grandmother could only write in Portuguese and then, only at about a fifth or sixth grade level. My mother wrote letters to EVERYONE. Distant relatives. Old friends. Her siblings. Her children. The week before she died, I got an eight page letter from her, filled with chatty information about this or that. "The Epistles of Lydia," we called them when they came in the mailbox. She never complained about the extra postage.

She once entered a writing contest on the radio (long before we had a television set in the house, we listened to EVERYTHING on the radio). She won second place - $25 whole dollars - which absolutely delighted her, and us. She joyfully spent on some clothing for her four children and a new dress for herself.

My mother did not like either of my two spouses. The first was an addict - like her husband and her father and most of her brothers. Her instincts were good on that one. The second is a woman, which my mother simply could not get her head wrapped around.

I have always been super cautious around the people our children were "serious" about. Not because they were bad people. I just couldn't imagine anyone being good enough for any of our children. Turns out, they were very wise. I couldn't have chosen better life partners for them myself. 

My mother also had a great devotion to Thérèse of Lisieux which, I confess, I will never really understand. My mother was Very Proud of being Portuguese and didn't much care for the few French immigrants in our neighborhood. Why she chose a saint of French heritage, I'll never know.

She told us lots of stories about the four years my father was away, fighting in WWII on the Pacific Front. She would say that she would pray her rosary in front of a statue of "Therese of the Little Flower," offering a fresh flower from of my grandmother's garden, and pray for my father's safety.

At this point in the storytelling, my father would say that, so many times while he was in "the jungles of the Philippines, the bullets would be whizzing by and not one hit me. It was . . . it was . . . a miracle," he'd say. "It was . . . . . . ."

Then, he'd look at my mother and they'd both smile and say together, "St. Therese." 

As we got older, we'd love to join them. We'd all shout together, "St. Therese!!"

When we got a home of our own, the first thing on my mother's wish list was a shrine to St. Therese in the yard. My father dutifully made a shrine out of cement, painted it aqua, framed a 'grotto' in wood and slid in a piece of thick plastic to shield the statue from the elements. The plastic could also be lifted so that my mother could change the silk roses periodically, when they faded. 

St. Therese of Llangollen
After my father died, she sold that house, moved in with one of my siblings, gave a lot of her stuff away, and put some stuff in storage, including the statue of St. Therese.  A few years later, when her own health started to fail, she started to give some of her "stuff" to particular people.

Once, a few months before her own death, when I visited her in the hospital, she reminded me that she had not left any money to me in her will. I had disappointed her, she said, and my "lifestyle" had "hurt a lot of people". 

This, after I had traveled 5 hours from NJ to MA to visit with her. She was like that. 

Like I said, our relationship was complicated.

But, she wanted to know if there was anything of hers that I wanted. At first, I thought it was a set up. One of my mother's classics. Whatever I said I wanted, she'd say was already promised to someone. The old pull-the-rug-out-from-under-you emotional trick so common to those who are spouses of those who have an addiction. It mirrors what they experience, living with an addict. I've come to believe that it's one way to communicate what they are experiencing internally - to make you feel what they are feeling because they can't express it with words.

As we talked, however, I realized that she was sincere. Maybe she was feeling a bit guilty about cutting me out of her will? Not that I wanted her money. Or, cared, anymore. She was entitled to her anger and if this made her feel better, to "punish" me through disinheritance, so be it. 

She kept pressuring me, gently. It was uncharacteristically gentle for her. She must really not be feeling well, I thought. 

"Surely, there's something of mine you um....... remember me?"

Ah, now, this was different. This wasn't so much about a gift as about a memory.

Suddenly, I knew.

"St. Therese," I said.  

"What?" she said, startled and trying to take in my answer.

"I'd like the statue of St. Therese. I'm sure no one else wants it."

My mother smiled. I think my response really pleased her - so much so, that she had to gather her thoughts before she put them into words. "Do you promise to take care of her?" she asked. "You know how much she means to me."

"Of course I will. You know no one else wants her."

"Good," she said, and then, "Done." 

I knew, as soon as she said it, that it would never happen. It would, I was certain, be the next red hot item wanted by one of my siblings. And, indeed, it was.

My mother died five years ago, on July 29, 2008. I was at the Lambeth Conference in England at the time. It wasn't easy - and, one of my siblings didn't make the scheduling any easier - but I was able to get home just in time for her funeral. 

And, no, I still don't have my mother's statue of St. Therese. Oh, I was given a little planter of St. Therese that my sibling insists is the one my mother intended for me. 

It is not. The one I was given was one of the planters my mother had in her hospital room. I remember it well. It's not designed for outdoors. And, it's too small.

It really bothered me for a while. From time to time, it would make me angry. It wasn't about the statue. How dumb is that to get angry about a statue?

Here's the thing:  I had made a promise. To my mother. A few months before she died. 

It was the promise I made that couldn't keep. I hated to admit it, but it really hurt.

And then, I realized I had more control of the situation than I realized. 

On the fifth anniversary of my mother's death, I bought my very own statue of St. Therese. That's a picture of her above, on a cement block for now, in between and among the boxwood rose bushes.  

She'll soon have her own pedestal.  God knows, she deserves one.

I also took out the St. Therese planter I was given, put one of my plants in it, and set it in my kitchen near the window. She and the plant seem very happy there.  She certainly didn't deserve to be wrapped in bubble wrap in an envelope and stuck in my closet. 

My family's dysfunction is not her fault.

Taking care of her and buying my own statue for my own yard is one way to keep as much as I am able of the promise I made to my mother. 

My mother always taught me, "Never make a promise you know you can't keep".

I am my mother's daughter. 

And you know, finally, after all these years, I'm okay with that. 

It must be the miraculous work of St. Therese.  

Or, maybe I'm finally becoming an adult.