Government Shutdown: A Personal Perspective

There are plenty of people writing about the government shutdown. I’m reading articles about how it’s affecting people in different ways and how it’s affecting all of us as a society. I’m reading about the President’s stance and the House Republican’s stance and how the prospects of the government opening up soon don’t look too good. And this evening I’m reading about a woman who, according to current news reports, died on Capitol Hill today after ramming her car (!!with a child inside!!) into a barrier. I have no idea if that’s connected to the shutdown or not. It’s just terrible, no matter what the story.

With all that, I wonder if it’s even worth writing about the shutdown in a personal way. And yet as I read the news it seems like there are still people who don’t get how big and real this is to so many of us. There are still people who are saying that this is okay. I don’t know if those people will read this. Probably not, right? But the shutdown is not okay with me. It’s real and it is making a big and personal impact.

I’m a federal employee. I’m one of the fortunate ones whose work was deemed essential, which means I’m still working this week and that I will eventually get paid for the work. The key word here is eventually; I won’t get paid until Congress passes a budget so that there is money to pay my salary. Like the all rest of the federal civilians I’ll be living off savings until then. I’m very blessed that I have some savings to do this, because not everyone does. I also count myself fortunate that at least I will get that money back again, unlike my mom, my brother-in-law, and several friends who are involuntarily sitting at home this week. They aren’t celebrating or having fun, they are worrying about how they will get the bills paid. They have no assurance that this loss of pay will be made up to them eventually. I’m worried about them.

Because the furlough is going on, I’m not allowed to take my earned vacation time from work right now. My work was deemed essential, remember? That means I have to be there, even though I had previously been approved for a few days vacation in a few weeks. So that trip in a few weeks to attend a good friend’s wedding, the trip I paid for months ago and have been looking forward to for those months? I may not be able to go at all. It depends on my director granting permission for me to be furloughed without pay for a couple days. It’s not a matter of obtaining coverage, because I’ve worked those issues out. It’s just a matter of policy. I know my friends will understand, but it’s not the kind of event you get a second chance to attend.

My daughter has been asking to go to the zoo. We live near Washington D.C. and the National Zoo is one of our favorite destinations. We also love the Natural History Museum which has dinosaur bones and a butterfly pavilion. Both of those are closed right now. Have you tried explaining to a three-year-old that the government is shut down and that’s why she can’t go to the zoo? And then that she can’t go to her favorite museum? It didn’t go over well.

At work I’ve seen several patients now who have been suicidal because of the financial stress of the furlough. These are hard working, middle class people who won’t be able to pay their mortgages until Congress gets its act together and passes a budget so they can go back to work. Even then they will be scrambling to catch up and make up for that missed pay. If the shutdown continues it becomes the kind of blow that can wreck a family financially. People do kill themselves in despair over financial problems. I can try to help but I know I can’t save everyone. Those lives aren't replaceable. You can't measure them in dollar amounts because they are of infinite worth. But if this keeps going on, some lives are going to be lost.

Some of those issues, particularly the ones that are just mine, are small, I know. I do count myself as someone who is very lucky. If you are in agreement with the shutdown, I guess you could read this and shrug. You could say “so what?” or “big deal!” or “you made your choices, live with them.” And I would say you’re right. My problems aren’t huge. I mention them because they are mine, and they are real, and I want you to understand that this isn’t a game or a story. This isn't some minor blip that will quickly be forgotten. 

You're right to say my choices are my own. I made a choice to serve my country, both as an active duty military member in the past and now as a federal employee. I made that choice with the expectation, which I think is reasonable, that my country would hold up its end of the bargain and continue to function. I think it’s not unreasonable for me to expect Congress, whose members are also paid to serve, to honor its own responsibilities by passing a budget.

I blame Congress for the shutdown. The passing of a budget to keep the country running should never, ever be a bargaining chip. It should never be a tool for a minority to terrorize the majority into giving them what they couldn’t win through elections and legislation and courts. It’s too important and too many lives are affected. Members of Congress, please be aware that you are hurting real people with your actions. As you posture and play games and insist that you be given your own way, you are damaging real lives. And if you can’t act with wisdom and compassion, you might consider acting with your own self-interest in mind. After all, even if you don’t care about me, I will remember you. And I vote. 

Dear Congress, Please Behave Like Responsible Adults

I’ve heard a lot of talk about the government needing to operate like a household. Usually when people say this they mean that the government should balance its budget and spend within its limits the way a well-run household does. I’m not going to argue for or against that position right now although I will point out that many well-run households borrow money for various reasons. I borrowed money as a young woman for my education; my husband and I a few months ago borrowed quite a lot of money to purchase our house. There are obvious differences between a government and a home, but let’s go with the metaphor right now. There is a major point about a well-run household that I think people making this variation of a budget argument are missing.

Imagine a household in which the husband and wife disagree about the spending. She thinks he spends too much money while he feels that what he is buying is important and necessary (food, clothes, health insurance, etc…). That sounds pretty familiar to most of us, I would imagine. Now, what should this husband and wife do? Sit down and work it out, right? They should work together to come up with a spending plan that they can both accept. In order to do this they will need to compromise. She will have to allow more spending than she is comfortable with, perhaps, while he may have to forgo some of his purchases. In a well-run household the husband and wife will behave like adults, set aside their egos, demonstrate teamwork and focus on the well-being of the entire household and not their individual desires.

Imagine if the wife said to the husband: I hate your spending so I’m going to stop paying all our bills. I’m going to freeze our bank accounts and default on our credit card payments and mortgage payments. I won’t work with you on a budget unless you agree to stop buying food and health insurance for our kids. I don’t care that we’ll be hungry and homeless and that our credit will be ruined and that if the kids get sick we won’t be able to afford medical care. You have to do things my way. I hate your spending so much I’ll wreck this family rather than let you continue. What would you think?

You’d think she was crazy. You’d think her priorities were misplaced. You’d think that the cost of wrecking her family and their financial stability was far too high a price to pay for getting her way. You would be completely right. Which is why our government is completely wrong. Failure to pass a budget is a failure to do the job for which our congress was elected. Hinging the passing of a budget or the raising of a debt ceiling to one issue that does not have majority support is childish, like a three year old having a temper tantrum in an effort to force her parents to let her have her own way.

We need responsible government right now, which means congressmen and congresswomen who will sit down and make compromises, keeping as their priority the well-being of the entire nation. We need less focus on re-election and scoring political points and issues of ego and who’s in charge and more focus on getting the business of government done. The business of government is to do the things that are too big for us to do as individuals. Yes, that takes taxes. I’ll pay mine gladly in order to have good roads, police and fire departments, an education for my daughter, support for scientific research, a strong military, fair enforcement of laws and standards on businesses, health care for those who can’t afford it (because honestly, we’re paying for it one way or another), funding for the arts, safe air travel, a stable and inspected food supply, the rule of law instead of the rule of might, and all the other things government does for us. Things that let me go about my life with my family feeling secure and confident. That’s what it means to live in a well-run nation. That’s the nation I want to live in.

I’m sending letters to my representatives and my senators this morning. I think our congress needs to be reminded to do the job we elected it to do. If you agree with me that government needs to be managed responsibly, I encourage you to do the same. If you don’t know who your congressperson is, you can find him or her on this website and even send an email through the site http://whoismyrepresentative.com/. Let’s remind our congress that government needs to be run by responsible adults.

Vaccination - Just Do It!

This isn't the post I woke up thinking I would write. I thought I would write about the changing seasons and enjoying end of summer/beginning of autumn with my family. I was planning to wax poetic about my daughter crunching through leaves and our last of summer cookout with corn on the cob and s'mores and the pleasure of open windows and no air-conditioning.

Instead I woke up and read this article from a friend's Facebook link: http://www.huffingtonpost.com/jj-keith/vaccines_b_3829948.html. So this morning I am writing about vaccination too, because I agree with what this writer said. Those of us (the majority) who are vaccinating our children do need to speak up and let other parents know that this is the safest, sanest thing to do as a parent. It's the best thing for your child, because the disease that vaccination prevents are potentially fatal: measles, influenza, polio, hepatitis B, diptheria, tetanus, h. flu which is a bacteria that causes meningitis can and do kill people, and children are more vulnerable. The idea that your child will be protected because other parents vaccinate (herd immunity) isn't working so well anymore, because so many people are making a choice not to have their children vaccinated, so don't count on that to protect your kids. When vaccinations rates drop then more people get sick with these diseases, which increases the chance that an unvaccinated child will be exposed. It also increases the risk of exposure to our neighbors who are cancer patients, organ transplant patients, and babies still receiving their initial vaccinations who are in even more danger if they are exposed to these diseases. This is a big deal to me, because I work in a hospital. These very ill people aren't an abstract concept - they are real people that I have met and cared for. They don't deserve to be put at risk.

Vaccinations are much, much safer than the alternative of getting the diseases in question. Most vaccines have side effects (like any medicine) but typically these are fever and soreness and will get better after a few days. The most severe potential side effect is an allergic reaction to the vaccine, which occurs less than one in 100,000 times someone is vaccinated. There is no link between vaccination and autism. The doctor who wrote the report that initially proposed that link falsified his data, intentionally, for the purpose of his own financial gain.  Autism is a terrible disorder which needs more research so that we can better understand both the cause and the treatment. The symptoms do tend to become more obvious around the age of one, which is when most children receive the MMR vaccine, but this is a correlation, not a causation. The symptoms of autism become more obvious around age one because it is around the age of one that children should be learning to speak and speech delay is a major symptom of autism. It's also because around age one children learn to walk, which means they can get around independently AND reach/carry/pull objects at the same time. The potential for behavioral problems dramatically increases because now a child is more capable of enacting behavior. But you can see symptoms of autism earlier than age one; the symptoms are just more subtle, like refusal of eye contact or lack of engagement with other people.

My daughter is vaccinated, and she's educated about vaccines. She understands that she gets shots which hurt "just a few seconds" in order to protect her from germs that could make her sick. I will make sure she gets all the vaccines she needs, for as long as I can control that decision. Because there is so much I can't protect her from in this world, but this is something I can do. I can take advantage of the incredible gift of science to keep her from getting some of the disease that take children away from their parents.

At the end of this week my husband, daughter and I will engage in another of our autumn rituals. This one isn't as fun as crunching leaves or cookouts, but it's much more important for our health. We'll go get our flu shots together, so that we can be protected for another season. I hope to see you at the doctor's office.

I Need to Sleep!

If I could change just one thing about myself, I think I would change my sleep patterns. The reason I would pick this is I believe if I could change my sleep patterns I would buy back enough time in the day to tackle all the other things I would like to work on for myself. In a book by one of my favorite fantasy writers the main character goes to a Chinese herbalist and receives a tea that lets her obtain 8 hours worth of rest in 4 hours sleeping time. As a bonus, it increased the amount of energy she needed so she could eat more. Now that’s my idea of a fantasy!

 I am one of those people who really, truly needs 8+ hours of sleep every night. I can get by for a few days on 7, but I start feeling it and getting headaches before a week is up. I can function for about one day on 6 but only if I have been getting enough sleep before that. On those nights when I get five or less I make it through the next day groggy, aching and irritable. I typically use weekends to catch up on sleep, or at least I did before becoming a parent. Honestly, I am still not sure how I made it through internship when I regularly worked for 30 hours or more in a row. Perhaps it worked out because I was younger then, or perhaps the anxiety of the situation kept me going. Ditto making it through the earliest weeks of parenthood; I think I was just so jazzed about having a baby that I was able to cope. It also helped that my daughter seems to have inherited my sleep needs and started sleeping through the night early on.

To add insult to injury, I am not a morning person. I never have been. I can remember being a young child and my mother waking me up by pulling me up to sitting and hugging me and rubbing my back for 10-15 minutes until she was sure that I would not fall asleep again. When I started using an alarm clock to wake myself up I started struggling with being a few minutes late to everything. All through high school, college, medical school and residency training I played games with my alarm clock to try to be on time. I’m the person who sets her clock 10-20 minutes fast, and I have to change it periodically so I don’t adapt too much. I’m the person who will hit snooze 10 times before I finally get out of bed. Yes, I’ve been told that isn’t good sleep, but it sure feels good to me to spend that extra time in dreamland. And even when I get up in plenty of time, I find myself distractible and unfocused enough for the first hour after waking up that I have trouble getting myself out the door on time.

This is a profound mismatch with my chosen career as a doctor, particularly a doctor who works in a hospital. I have learned that hospitals seem to be run by morning people, or at least it is morning people who are establishing the schedules. I would, if given my choice, prefer to work from 11am until 8pm or so and then stay up until midnight and sleep in until 9am. This is not at all compatible with the hours my hospital requires. I routinely have 8am meetings and so ideally I need to be at work by 7:45am at the latest.

All of this leads to pinch points in my life. Morning exercise doesn’t work for me. Actually, morning anything pretty much doesn’t work for me on a consistent basis – exercise, meditation, bible study and prayer… it all falls victim to my wish for more sleep. I keep my hair and makeup super simple and my work clothes border on casual. My daughter looked at me one morning and told me I was wearing play clothes and insisted I change my outfit. She’s three, mind you! I limit myself to items that are no-iron and easy to grab out of my closet and wear a white coat at work as a quasi-uniform. I dream sometimes of looking like one of my colleagues, who is always dressed very fashionably and professionally with perfect hair and makeup, but I’ve come to realize that it’s just not going to be. Most days, using all my tricks and keeping things simple, I make it to work just barely on time. Which I really dislike, because I don’t think it’s professional or a good example, but haven’t yet managed to change on a consistent basis. I’ve been fortunate that my willingness to work hard and stay late when needed have always made up for my lack of early arrivals, but it would be nice to be that person who arrives 30 minutes early and starts the day completely organized.

I feel this mismatch in my life especially strongly after a stretch like the past twelve days, when I have been on call and working every day and getting less sleep overall (and more stress). Thank heavens it is Friday today and tomorrow I can sleep in (well, three year old permitting, anyway) and take it easy in the morning. I’m telling you, I need to sleep!

Wanting Mindlessness

Mindfulness disciplines teach that the best way toward happiness is to be present with unhappiness in an open, accepting and curious way. For example, tonight when I’m feeling really worn out mindfulness suggests that I be open to this. That perhaps I could engage in a mindful body scan and notice what that tiredness feels like in different parts of my body, and what other feelings are associated with it, and then just quietly, calmly sit with them. The analogy is to sit with them the way a parent might sit with a child who has awoken from a nightmare; the feelings should be held tenderly and not pushed away. The goal of the practice is not to get rid of the feelings, although often this kind of gentle awareness does result in the feelings lessening and dissolving, but just to be present to and non-judgmental of our own experience.

This contrasts with our usual efforts to get rid of our negative feelings. Most of us, when feeling sad, fearful, angry or shamed, become alarmed on a biological as well as an emotional and cognitive level. We have modes that we activate to try to get rid of these unpleasant feelings, which are usually patterns of reaction that we have learned and practiced over and over again through our lives. Some of us try to think and analyze our feelings to death: “Why do I feel this way? What’s wrong with me? What’s wrong with my life? What do I need to change?” Some of us try to ignore those feelings completely, pushing them out of awareness which usually results in the feelings going down into the body, creating headaches, backaches, nausea, and a host of other physical symptoms. Some of us just try to escape our feelings, using whatever means best suits our personalities and experiences: food, drugs, gambling, sex, exercise, television, books, work are all common tools people use to stay away from those yucky feelings. Many of us (including me) use a combination of strategies to do battle with our feelings. Mindfulness feels counter-intuitive; who wants to bring awareness and attention to things that don’t feel good?

I came home from work tonight completely wiped out. It was a rough week last week, I was on call and worked over the weekend, and it’s shaping up to be a busy week this week as well. I'm grumpy, I'm achy and I'm tired. What really sounds good to me is to sit on the couch downstairs, put my feet up, grab some snacks, watch television shows with happy endings, knit and not think about anything. Essentially, what I want is the opposite of mindfulness. I want to be mindless for a while. I know from experience that it will only make me feel better for a short while, while I’m in front of the TV. Then later I will feel more tired and even less enthusiastic about the work week. Also, if I follow through with the snack part of the plan, I will feel bad about eating when I wasn’t actually hungry. I know from many past experiences that mindlessness doesn’t really work, but that’s still what my brain defaults to wanting.

So I’m trying a hybrid plan tonight. I did lay down and do a body scan for about 15 minutes, bringing my kind attention to different parts of my body and my emotions. I invited my daughter to practice with me, which I remind myself gives me many more opportunities for my attention to wander and come back to the practice at hand as well as giving my daughter and I more time together. However, I am going to go downstairs and watch TV and work on my current knitting project next. I am trying to finish a hat and mittens for my daughter before it gets cold. I could knit mindfully (there are books about this, actually) but I’ll be honest. Even after my mindfulness practice, I’m just ready for an escape. I guess that’s what it means when you’re in transition and learning something new. You try out the new things but you aren't quite ready yet to let go of the old. And I guess that's something I can be open to and accepting of as well - mindful even in my mindlessness! 

Full Moon Blues

I really believe that people (including, or maybe especially me) are crazier when the moon is full. I know it’s unscientific and an old wives tale but in my experience it bears out that my roughest workdays are full moon days. This week the full moon was on the 19^th, and the 18^th-20^th have been really, really challenging. It doesn’t help that I’m on call, so I’m not even getting away from it in the evening. I told my husband this evening that from now on I’m checking the phases of the moon before I sign up for call.

I say this in part because I’m feeling bad about an interaction I had at work earlier. It had been a very, very busy day with a number of frustrations and so when I got a call around 3pm that there was yet another patient in the emergency room and that the patient was not suicidal and not homicidal and only there because of a relationship problem and wanting some counseling I felt frustrated.

If you don’t already know, the ED is not the right place to go for counseling. If you are in crisis, if you are suicidal, if you are homicidal, if you or a loved one is hallucinating or delusional, then yes, please come to the ED. Please come right away and let us help you stay safe and get to the next step in care. But the ED is not a good place for counseling. It’s noisy, it’s busy, you’re likely to wait a long time, and you’ll be seen by someone who won’t be following up with you so you’re just going to have to tell your story all over again anyway later when you get referred to a counselor who will see you long-term. That said, if you show up to the ED in my hospital looking for counseling, you will get seen and the ED physician will page the on call behavioral health staff to come talk to you. Which is what happened this afternoon.

I got the call to the ED through another person and I went down to the ED to see the patient. I ran into the person who had paged us and I gave him a bit of a hard time, stating that while I was there to do the consult I wasn’t happy because it really wasn’t an emergency. He got really mad at me (I think maybe more mad then my comment called for, but I shouldn’t have said it) and then walked off. A few minutes later I approached him and apologized and said, “I’m sorry, I shouldn’t have given you a hard time.” He grunted something at me and wouldn’t look at me, so I have the impression he’s still mad. And I feel bad about that, because I try really hard to get along with people in my hospital and to be professional even when I’m under stress. And I feel bad because I know I will work with this person again in the future, and I need to have a decent working relationship with him. But like I said, it’s been a super rough couple days and I think I get affected by the full moon too.

I’m trying to think about this the way I would talk to a patient about it. I’m reminding myself that I’m not perfect and that I can’t expect myself to never have a bad day. I’m reminding myself that I did show up to see the patient and that I saw many other patients today and hopefully did some good. I’m reminding myself that I’ve had many good interactions with this person, and if he can’t cut me a little slack one time, especially after I apologize, then the problem and fault lies more with him than with me. (Although I’ve also had that experience – someone holding a long term grudge against me and treating me badly because of a negative interaction that followed many good ones – and it still feels terrible even though I know it is the other person’s problem and not mine.) I’m reminding myself that I’m just not in control of what another person thinks or feels; I can only be responsible for my own behavior.

I’ll be honest. It helps, some, but I still feel bad. So I think I’ll be more careful about avoiding call on weeks with a full moon.

Decorating Thank You Notes

I love being able to combine two activities into one. I end up feeling clever and efficient. Tonight my combination activity was having my three year old daughter decorate the thank you notes I wrote on her behalf. I felt particularly good about this activity because it combines two of my parenting goals: teaching my daughter to be respectful, considerate and grateful and engaging her in creative activities.

I am a person who writes thank you notes. I think they are important and I like receiving them myself, although I have been told they are old-fashioned. That’s okay. My mother always made me write thank you cards promptly when I was growing up. She explained that if someone took the time, money and trouble to send you a present you could take the time and trouble to write them a note saying thank you. I agree with that. So now I make an effort to write them both for myself and for my daughter, and when she is old enough to write I will make her write her own. I think gratitude and consideration for others are key disciplines for a good life and any opportunity to practice these skills is useful.

I also really enjoy doing crafts with my daughter. Even better, she enjoys doing them with me. It’s gotten to the point that she’ll say to me “Let’s do crafts, Mommy!” which warms my heart. We have gone on shopping expeditions to our local arts and crafts store to stock up on materials (mostly stickers, paint, stamps and paper) which we keep in our craft box so we are ready to get creative on a moment’s notice. I’ve always loved arts and crafts stores but restrained myself because I didn’t have a good use, storage space, practical reasons, etc… to buy craft materials. Plus I didn’t have anyone to shop with (my husband, like most men I think, not finding any appeal at all in an arts and crafts store), and half the fun of shopping is doing it with someone else. Now I have a great excuse (I’m nurturing my child’s creativity! And her fine motor skills!) and a craft store shopping partner. My three year old and I carry our baskets through the store together (okay, she drags hers) and pick out items for future projects and she tells me she wants to pay (which I need to record and play back for her when she is a teenager!) and I explain that she didn’t bring her money and she hands me her invisible pretend money and I say thank you. I’m sure we provide massive entertainment for everyone else, but we’re having fun so it’s okay.

“Crafts” is usually our special mother daughter activity on weeknights when my husband goes out with friends. A few weeks ago we made a special toy jar for some of her little plastic figurines by decorating an empty pretzel barrel with stickers, drawings and contact paper. We have a plastic pumpkin to decorate in October and we’ll carve real ones this year when it is closer to Halloween. And tonight our fun craft activity was writing thank you notes. We found some plain notes and I wrote them out for her, and then she decorated them. My husband did actually help us with this, which was good since paint, ink stamps, stickers and a three year old is a combination requiring more adult supervision than I could manage and still write out notes. It all turned out pretty well by my standards: we had fun together, the mess stayed in the kitchen, the notes are written, they are reasonably legible, and they all have some touch of personalization from my daughter.

I hope my daughter will be a person who write thank you notes to others. I hope that she has a life filled with people who bless her in many ways and I hope she recognizes and appreciates that fact. I hope she reaches out to others in kindness and consideration and makes an effort to let others know they matter to her. And I hope over time my daughter’s love for crafts will turn into a creative hobby. Fiber arts (quilting, crocheting, knitting, cross stitch) in particular seem to run in our family, but if she doesn’t inherit that I hope she finds something she loves. I want her to be in touch with a part of herself that is joyful and vital. I attended a seminar through a church once in which a friend demonstrated her craft and spoke about how her own artistry and creativity reflected something of G-D’s nature – how when we create we are participating in our own small way in G-D’s joy in making new things. As I guide my daughter in creating something beautiful with her life, I hope that she remembers decorating thank you notes.